• Clinical and Experimental Pediatrics
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• v.50 no.5
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• pp.462-468
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• 2007

Purpose : The purpose of this study was to analyze the changes of the late potential of Signal- averaged electrocardiography (SAECG) and Electrocardiography (ECG) parameters during follow up of those who had taken surgical repair of Tetralogy of Fallot (TOF). Methods : Nine patients who had taken surgical repair of TOF since 1985 checked SAECG and standard 12 leads ECG twice in 1999 and 2005 in Kyungpook national university hospital. We evaluated changes of QRS duration, QT interval and JT interval, QRS dispersion, QT dispersion and JT dispersion of standard 12 leads ECG and Filtered QRS (f-QRS), High frequency low amplitude potential (HFLA), Root mean square in terminal 40 ms (RMS) and Mean voltage in terminal 40 ms (MV) of SAECG between in 1999 and 2005. Results : There were significant decrease of JT dispersion ($101.11{\pm}50.11$ vs $71.11{\pm}22.61ms$, P< 0.05) and significant increase of HFLA ($24.67{\pm}13.19$ vs $32.89{\pm}14.21ms$, P<0.05). But there were no significant changes in other parameters. Conclusion : In repaired TOF patients, we evaluated ECG and SAECG to detect possible late complications such as tricuspid regurgitation, right ventricular enlargement, ventricualar arrythmia and sudden death. And there were significant changes of ECG and SAECG in some parameters (JT dispersion, HFLA). But to see the relationships between the changes of these parameters and the long term prognosis, we need to check more patients and longer follow-up.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.54-60
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• 2010

Purpose: Nuclear medicine manufacturers provide various softwares which shorten imaging time using their own image processing techniques such as UlatraSPECT, ASTONISH, Flash3D, Evolution, and nSPEED. Seoul National University Hospital has introduced softwares from Siemens and Philips, but it was still hard to understand algorithm difference between those two softwares. Thus, the purpose of this study was to figure out the difference of two softwares in planar images and research the possibility of application to images produced with high energy isotopes. Materials and Methods: First, a phantom study was performed to understand the difference of softwares in static studies. Various amounts of count were acquired and the images were analyzed quantitatively after application of PIXON, Siemens and ASTONISH, Philips, respectively. Then, we applied them to some applicable static studies and searched for merits and demerits. And also, they have been applied to images produced with high energy isotopes. Finally, A blind test was conducted by nuclear medicine doctors except phantom images. Results: There was nearly no difference between pre and post processing image with PIXON for FWHM test using capillary source whereas ASTONISH was improved. But, both of standard deviation(SD) and variance were decreased for PIXON while ASTONISH was highly increased. And in background variability comparison test using IEC phantom, PIXON has been decreased over all while ASTONISH has shown to be somewhat increased. Contrast ratio in each spheres has also been increased for both methods. For image scale, window width has been increased for 4~5 times after processing with PIXON while ASTONISH showed nearly no difference. After phantom test analysis, ASTONISH seemed to be applicable for some studies which needs quantitative analysis or high contrast, and PIXON seemed to be applicable for insufficient counts studies or long time studies. Conclusion: Quantitative values used for usual analysis were generally improved after application of the two softwares, however it seems that it's hard to maintain the consistency for all of nuclear medicine studies because result images can not be the same due to the difference of algorithm characteristic rather than the difference of gamma cameras. And also, it's hard to expect high image quality with the time shortening method such as whole body scan. But it will be possible to apply to static studies considering the algorithm characteristic or we can expect a change of image quality through application to high energy isotope images.

• Journal of the Korean Society of Radiology
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• v.14 no.5
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• pp.603-612
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• 2020

This study has a purpose to look into the effect of the relationship between the Tube current (mA) and SOD(Source to Object Distance), which is a parameter of lower limb angiography examination, and the dilution rate of the contrast medium concentration (300, 320, 350) on the image. To that end, using 3 mm vessel model water phantom, a vessel model custom made in the size of peripheral vessel diameter, this study measured relationships between change of parameters, such as tube current (mA), SOD and varying concentrations (300, 320, 350) of contrast medium dilution into SNR and CNR values while analyzing the coefficients of variance(cv<10). The software used to measure SNR and CNR values was Image J 1.50i from NIH (National Institutes of Health, USA). MPV (mean pixel value) and SD (standard deviation) were used after verifying numerically the image signal for region of interest (ROI) and background on phantom from the DICOM (digital imaging and communications in medicine) 3.0 file transmitted to PACS. As to contrast medium dilution by the change of tube current, when 146 mA and 102 mA were compared, For both SNR and CNR, the coefficient of variation value was less than 10 until the section of CM: N/S dilution (100% ~ 30% : 70%) but CM: N/S dilution rate (20%: 80% ~ 10% : 90%) the coefficient of variation was 10 or more. As to contrast medium dilution by concentration for SOD change, when SOD's (32.5 cm and 22.5 cm) were compared,For both SNR and CNR, the coefficient of variation value was less than 10 until the section of CM: N/S dilution (100% ~ 30% : 70%) but CM: N/S dilution rate (20%: 80% ~ 10% : 90%) the coefficient of variation was 10 or more. As to contrast medium dilution by concentration for SOD change, when SOD's (32.5 cm and 12.5 cm) were compared,For both SNR and CNR, the coefficient of variation value was less than 10 until the section of CM: N/S dilution (100% ~ 30% : 70%) but CM: N/S dilution rate (20%: 80% ~ 10% : 90%) the coefficient of variation was 10 or more. As a result, set a low tube current value in other tests or procedures including peripheral angiography of the lower extremities in the intervention, and make the table as close as possible to the image receiver, and adjust the contrast agent concentration (300) to CM: N/S dilution (30%: 70%). ) Is suggested as the most efficient way to obtain images with an appropriate concentration while simultaneously reducing the burden on the kidney and the burden on exposure.

• Journal of agricultural medicine and community health
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• v.31 no.1
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• pp.35-46
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• 2006

Objectives: In recently. the management and protection on individual information in patient's medical & nursing records have been very important, and that need a guideline. The purpose of this study was to investigate the status of using the patient's nursing records of nursing students in clinical practice, to find and discuss the patient's informed consent, and status of education and management concerned to patient's nursing records. Methods: This study used a mailing survey. data collected from September 24th to October 31th in 2002. The subject were 333 professors who are major in adult nursing, pediatric nursing, psychological nursing of 111 university of nursing department and nursing college. And then we received the survey mail from 103 professors that respondent rate was 30.9%. Results: The characteristics of study subjects showed 49.0% of university. 51.0% of college of nursing. 50.0% of the subjects practiced point the patient by oral approval in clinical practice. But when the decision of the patient was very difficult, 21.6% of the subjects take to informed consent from his or her families. During the clinical practice, 49.0% of the subjects were explain to patient about clinical practice and contents of the nursing student, only 7.8% of the subjects were explain to patient with nursing records. 52.0% of the subjects were took out records from the hospital, only 17.6% of the subjects had standard of the patient's informed consent and standard of handling practice records. 17.6%-92.2% of the subjects that educate and manage concern to patient's nursing records.

• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.757-762
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• 2006

Purpose : Pneumonia is one of the most common infections in children who visit emergency departments(ED), but standard clinical guidelines for children with pneumonia in Korea have not been studied. This study was performed to collect and evaluate a data-base of children with pneumonia for establishing clinical guidelines in ED. Methods : This study reviewed 304 children who were diagnosed and treated for pneumonia in the ED at one tertiary hospital between January 2003 and December 2003 retrospectively by reviewing the charts and analyzing the clinical characteristics, laboratory findings, and radiologic findings between an admission group and a discharge group. Results : The 2 year-5 year age group was the top of age distribution and the peak incidence of monthly distribution was December. Two hundred forty seven(81.3 percent) children were hospitalized(admission group), and the mean length of hospitalization was $7.24{\pm}3.24$ days. The most common indications of admission were fever, tachypnea and an age of less than three months. There was statistical differences in the outpatient department follow-up between the two groups(85.8 percent in admission group vs 35.1 percent in discharge group). Conclusion : More prospective studies are needed to establish clinical standard guidelines for children with pneumonia. This will be helpful in ED management and will aid the prevention of pneumonia.

• Progress in Medical Physics
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• v.26 no.1
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• pp.28-35
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• 2015

In this study, we investigated the effects of an iterative reconstruction algorithm and an automatic exposure control (AEC) technique on image quality and radiation dose through phantom experiments with coronary computed tomography (CT) angiography protocols. We scanned the AAPM CT performance phantom using 320 multi-detector-row CT. At the tube voltages of 80, 100, and 120 kVp, the scanning was repeated with two settings of the AEC technique, i.e., with the target standard deviations (SD) values of 33 (the higher tube current) and 44 (the lower tube current). The scanned projection data were reconstructed also in two ways, with the filtered back projection (FBP) and with the iterative reconstruction technique (AIDR-3D). The image quality was evaluated quantitatively with the noise standard deviation, modulation transfer function, and the contrast to noise ratio (CNR). More specifically, we analyzed the influences of selection of a tube voltage and a reconstruction algorithm on tube current modulation and consequently on radiation dose. Reduction of image noise by the iterative reconstruction algorithm compared with the FBP was revealed eminently, especially with the lower tube current protocols, i.e., it was decreased by 46% and 38%, when the AEC was established with the lower dose (the target SD=44) and the higher dose (the target SD=33), respectively. As a side effect of iterative reconstruction, the spatial resolution was decreased by a degree that could not mar the remarkable gains in terms of noise reduction. Consequently, if coronary CT angiogprahy is scanned and reconstructed using both the automatic exposure control and iterative reconstruction techniques, it is anticipated that, in comparison with a conventional acquisition method, image noise can be reduced significantly with slight decrease in spatial resolution, implying clinical advantages of radiation dose reduction, still being faithful to the ALARA principle.

• Progress in Medical Physics
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• v.21 no.2
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• pp.137-144
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• 2010

The purpose of this study was to evaluate the usefulness of reducing of craniofacial radiation dose using automatic exposure control (AEC) technique in the 64 multi-detector computed tomography (MDCT). We used SOMATOM Definition 64 multi-detector CT, and head of whole body phantom (KUPBU-50, Kyoto Kagaku CO. Ltd). The protocol were helical scan method with 120 kVp, 1 sec of rotation time, 5 mm of slice thickness and increment, 250 mm of FOV, $512{\times}512$ of matrix size, $64{\times}0.625\;mm$ of collimation, and 1 of pitch. The evaluation of dose reducing effect was compared the fixed tube current of 350 with AEC technique. The image quality was measured the noise using standard deviation of CT number. The range of craniofacial bone was to mentum end from calvaria apex, which devided three regions: calvaria~superciliary ridge (1 segment), superciliary ridge~acanthion (2 segment), and acanthion~mentum (3 segment). In the fixed tube current technique, CTDIvol was 57.7 mGy, DLP was $640.2\;mGy{\cdot}cm$ in the all regions. The AEC technique was showed that 1 segment were 30.7 mGy of CTDIvol, 340.7 $mGy{\cdot}cm$ of DLP, 2 segment were 46.5 mGy of CTDIvol, $515.0\;mGy{\cdot}cm$ of DLP, and 3 segment were 30.3 mGy of CTDIvol, $337.0\;mGy{\cdot}cm$ of DLP. The standard deviation of CT number was 2.622 with the fixed tube current technique and 3.023 with the AEC technique in the 1 segment, was 3.118 with the fixed tube current technique and 3.379 with the AEC technique in the 2 segment, was 2.670 with the fixed tube current technique and 3.186 with the AEC technique in the 3 segment. The craniofacial radiation dose using AEC Technique in the 64 MDCT was evaluated the usefulness of reducing for the eye, the parotid and thyroid with high radiation sensitivity particularly.

• Journal of Oriental Neuropsychiatry
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• v.21 no.4
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• pp.21-39
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• 2010

Objectives : This study was to investigate the characteristics of the heart rate variability(HRV), types of insomnia and accompanying symptoms of 175 insomnia patients. Methods : For this study we carried out HRV, Inbody of 175 patients with insomnia who have come to Dongeui oriental hospital of Dongeui university from the period of Janaury 2008 to September 2010. We studied the association of the insomnia patients' age and gender with HRV, accompanying symptoms and the types of insomnia. The information of the accompanying symptoms and types of insomnia was based on each patients' progress note. Results : l. There was no significant differences in the characteristics of HRV between male and female. 2. The most frequent symptom shown among the insmonia patents' was headache(41.14%). 3. Comparing the symptoms between the gender, female patients had more dry mouth, alternative periodic chill and fever, and hot flush symptoms than the male patients. 4. Comparing the symptoms between the age groups(divided in two), the lower age group (20~59) had more dizziness and constipation symptoms than the higher age group (over 60). 5. Comparing the types of insomma between the age group, the higher age group (over 60) had more termination insomnia. 6. The types of insomnia of the entire insomnia patients were onset insomnia (73.1%), maintenance insomnia(20.6%), termination insomma(l7.1 %), shallow sleep (52.6%), listed by order of frequency. 7. The patients who takes hypnotics had more anorexia symptoms than the patients who doesn't take hypnotics. 8. There was no visible differences of the average fractal portrait between male and female. The age group of 20~30yrs. had the highest average fractal portrait, and the age group of 30~59yrs. the second highest, and the age group over 60yrs. the lowest. 9. The average of the regulation reserves of the autonomic nervous system(B2) - was lower than the regulation level of the ANS at the present (Bl). 10. When compared the priority of the function of the ANS, it showed that the proportion of HF($38.61{\pm}29.19%$)was the most, and than VLF($30.65{\pm}23.36%$), LF($20.04{\pm}19.13%$) the least. 11. The average of the compensation level of the central nervous system at present(Cl) - was lower than the compensation reserves of the CNS(C2). 12. The average of the control reserves of the cerebrum(D2) - was lower than the control level of the cerebrum at the present (Dl). 13. There was no visible differences between different sexes and ages in pulse rate. 14. The abdomen fat ratio above the line of the insomnia patients was 77.97% in male and 93.1% in female. Both sexes showed that insomnia patients had more abdomen fat that the standard, and female patients had more abd. fat than male patients. Conclusions : This study shows that the HRV of insomnia patients had no significant differences between gender. Fractal portrait, HF, LF and VLF of the insomnia patients are in inverse proportion to the age. The study of the Body Component Analysis showed that female had more abdomen fat than male, and both gender showed more abdomen fat than the standard. When looked into the accompanying symptoms of the insomnia patients, the symptoms show differences according to gender, age and hypnotics taking, as shown as below. In the entire patients, Headache was the most accompanying symptom. Female had more dry mouth, alternative periodic chill and fever, and hot flush symptoms than male. Higher age groups had more dizziness and constipation as accompanying symptoms than lower age groups. Patients who takes hypnotics had more anorexia than those who dont.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.47-55
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• 1984

To study the risk factors associated with maternal HBsAg carrier and the effects of maternal HBs antigenemia on the neonatal health, sera of 729 pergnant women admitted to the Keimyung University Hospital for delivery during the period of February 1-May 30. 1982 were tested for HBsAg by RPHA method and for anti-HBs by PHA method. Among them 43 women (5.9%) had HBsAg and 246 women (33.7%) had anti-HBs giving an infection rate of 39.6%. The interview data for 43 HBsAg positive mothers and randomly selected 210 HBsAg negative mothers showed a statistically significant association between acupuncture history and HBsAg positive rate (p<0.005) which suggest that acupuncture might have contributed significantly to the propagation of viral hepatitis in Korea. The living standard of HBsAg positive mothers was generally lower than that of HBsAg negative mothers which supports the hypothesis that environmental factors are associated with viral hepatitis B infection. None of the 43 neonates born to HBsAg positive mothers had HBsAg in their cord blood. Three months after birth, 35 out of 43 infants were retested and only one infant became HBsAg positive. At six months of age, 32 out of 35 infants were retested and none of them were HBsAg positive except the same infant who was positive at three months. Among 20 control infants of HBsAg negative mothers, all of them were HBsAg negative at three and six months follow-up. These findings are not consistent with the supposition that perinatal infection is a main route of viral hepatitis B transmission in south-east Asia including Korea. HBsAg positive mothers had significantly higher rate of premature delivery (27.9%) than HBsAg negative mothers (11.7%) (p<0.05). Also, the low birthweight incidence rate was higher among HBsAg positive mothers (23.3%) than negative mothers (14.1%) but this was not statistically significant (P=0.16). The premature rupture of membrane was more frequent among HBsAg positive mothers (25.5%) than negative mothers (11.1%) (p<0.05). There were no significant differences in the stillbirth rate and incidence of congenital anomalies between HBsAg positive and negative groups. It was not clarified in this study due to small sample size whether higher incidence of premature delivery and premature rupture of membranes among HBsAg positive mothers was due to HBs antigenemia per so or their lower living standard than HBsAg negative mothers.

• Journal of radiological science and technology
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• v.27 no.4
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• pp.55-60
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• 2004

The purpose of this study was to examine both patient exposure dose during mammography and the utility status of mammograpy equipments. The data of this study were collected through questionnaire survey for 278 medical facilities registered at Korean Hospital Association and finally 161 medical facilities's data were analyzed. According to data analysis, medical facilities of 14.9% used the average glandular dose of less than 0.5 mGy, $0.51{\sim}1.0\;mGy$ 8.6%, $1.01{\sim}1.5\;mGy$ 14.9%, $1.51{\sim}2.0\;mGy$ 11.1%, $2.01{\sim}2.5\;mGy$ 9.8%, $2.51{\sim}3.0\;mGy$ 33.3%, and 7.4% more than 3.01 mGy. It was found that medical facilities of 92.6% used less than 3 mGy, showing that this figure is similar to the limit value of 3 mGy recommended by Korea Food & Drug Administration(KFDA). Recently, international organizations such as ICRP associated with radiation protection suggests that less than 3 mGy of average mammary gland dose be used during mammography in case of using Mo target+Mo filter, film/screen system and craniocaudal projection with the breast pressed to 4.2 cm. The standard dose is being strictly observed and that of the limits is going down to 2 mGy or 1.5 mGy. The major results of this study indicate that interests and a counterplan to reduce patient dose during mammography should be considered. Based on this study, the authors of this study will continue to measure exposure dose to set a new standard for patient exposure dose during mammography.