• Science of Emotion and Sensibility
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• v.9 no.2
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• pp.111-118
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• 2006

The purpose of the study is to examine the effects of the positive menial stress, eustress, on autonomic nervous system(ANS) and human health. For this, we analyzed heart rate variability(HRV) parameters, the most promising markers of ANS function to assess the changes of emotional and physiological states of human body. We measured HRV Signal of World Cup group(281 male subjects: $29.8{\pm}5.6yr$., 187 female subjects: $29.0{\pm}5.4yr$.) in two stadiums at least an hour before the game during '2002 FIFA World Cup Korea/Japan' event. We also measured control group's(331 male subjects: $30.9{\pm}4.7 yr$., 344 female subjects: $30.2{\pm}5.2 yr$.) in the health promotion centers in two university hospitals at least a month before and after the world cup event period. Considering physiological differences between males and females, the data analysis was applied to 'male group' and 'female group' separately. As a result, some tendency was observed that is different from what we have known as the stress reaction. In general, all parameter values except that of mean heart rate tend to decrease under stressed condition. However, under eustressed condition, both heart rate and standard deviation of the Normal to Normal intervals(SDNN) were higher then those of normal condition(p<0.05). Especially, in case of female group, contrary to distressed condition, every frequency-domain powers showed tile higher value(p<0.05, p<0.001). Considering that decrease of HRV indicates the loss of one's health, the increase of SDNN and frequency parameters means that homeostasis control mechanism of ANS is functioning positively. Accordingly, induction of eustress from international sports event may affect positively to the people's health.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.4
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• pp.2691-2703
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• 2015

This research aims to provide basic materials for assisting DNR patient cares by understanding ICU nurses' awareness and ethical attitude regarding DNR. A total of 154 results were analyzed which were collected from Aug. 1st to Sep. 5th in 2014 by surveying nurses working in ICU (from 1 advanced general hospital in G metropolitan city and other general hospitals of more than 700 beds in Cheolla provinces). (1) For the decision attitudes of DNR, there were both consent and objection. Consent for the patient's opinion of rejecting further treatment and life extension despite of bad prognosis. And objection for no conducting DNR in the case of the patient's wish, treatment requested by the guardian, and CPR for the patient who has no chance. (2) Objection for artificial respirator and other treatment requested by the patient's family and the entrance of guardians into ICU. Consent for the passive use of artificial respirator by the doctor and the decrease of basic care to stabilize patients physically and mentally. No specific opinion for treatment not following aseptic techniques. Objection for frequent reports to primary care physician requested by the family. (3) Acknowledging less interest by the doctor, while supporting the health care team in the case of the guardian's complaint, objection for the DNR decision mede by the primary care physician. Objection for the DNR decision by the guideline. Objection or neutrality for straightforward explanation to the patient of bad prognosis. Objection for straightforward explanation of the patient's status (even near to death) to the patient him/herself or the guardian. In conclusion, the subject of DNR is the patient and the patient's opinion should be fully reflected. The conflict arising from the scope of medical practice and decision processes should be minimized. The standard and guideline for DNR decision is required for the ethical decision making for the patient along with agreements based on full explanations.

• Journal of Hospice and Palliative Care
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• v.7 no.2
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• pp.153-168
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• 2004

Purpose: The purpose of tile study was to identify types of care needs of hospice patients and those from the family caregivers' perspective and to compare these two groups in reporting patients' care needs through Q-methodology. Methods: Twenty three Q-statements concerning care needs were selected through in-depth interviews of hospice patients. Data were collected from 20 hospice patients as well as 20 family caregivers respectively by sorting 23 Q-statements into 9 points standard. Data analysis was performed by using PC QUANL program. Results: Principal component analysis identified four types of care needs of the hospice patients. Overall, the accuracy of family caregiver reports was 48% in all types of care needs. Type 1 was named 'physical care needs type' for those whose greatest need was physical care to be free of pain and comfortable. The accuracy in Type 1 was 62.5%. Type 2 was named 'emotional care needs type' for those who would like to share love and intimacy with their family members. The accuracy in Type 2 was 20%. Type 3 was named 'spiritual care needs type' for those who would like to receive forgiveness from their God and prayers and visitation of clergy. The accuracy in Type 3 was 60%. Type 4 was named 'social care needs type' for those who would like to complete their ongoing work and to give service to others. The accuracy in Type 4 was 50%. Conclusion: There was a great difference between hospice patients and the family caregivers in reporting patients' care needs. Thus, hospice nurses need to educate family caregivers to more accurately assess patients' care needs.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.2
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• pp.152-161
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• 2007

This study was conducted to patients visited oral maxillo-facial surgery, KNUH and the purpose of the study was to assess skeletal and dento-alveolar stability after surgical-orthodontic correction treated by skeletal Class III malocclusion patients with open bite versus non-open bite. This retrospective study was based on the examination of 40 patient, 19 males and 21 females, with a mean age 22.3 years. The patients were divided into two groups based on open bite and non-open bite skeletal Class III malocclusion patients. The cephalometric records of 40 skeletal Class III malocclusion patients (open bite: n = 18, non-open bite: n = 22) were examined at different time point, i.e. before surgery(T1), immediately after surgery(T2), one year after surgery(T3). Bilateral sagittal split ramus osteotomy was performed in 40 patients. Rigid internal fixation was standard method used in all patient. Through analysis and evaluation of the cephalometric records, we were able to achieve following results of post-surgical stability and relapse. 1. There was no significant statistical differences between open bite and non-open bite with skeletal Class III malocclusion patients in maxillary occlusal plane angle of pre-operative stage(p>0.05). 2. Mean vertical relapses of skeletal Class III malocclusion patients with open bite were $0.02{\pm}1.43mm$ at B point and $0.42{\pm}1.56mm$ at Pogonion point. In skeletal Class III malocclusion patients with non-open bite, $0.12{\pm}1.55mm$ at B point and $0.08{\pm}1.57mm$ at Pogonion point. There was no significant statistical differences between open bite and non-open bite with skeletal Class III malocclusion patients in vertical relapse(p>0.05). 3. Mean horizontal relapses of skeletal Class III malocclusion patients with open bite were $1.22{\pm}2.21mm$ at B point and $0.74{\pm}2.25mm$ at Pogonion point. In skeletal Class III malocclusion patients with non-open bite, $0.92{\pm}1.81mm$ at B point and $0.83{\pm}2.11mm$ at Pogonion point. There was no significant statistical differences between open bite and non-open bite with skeletal Class III malocclusion patients in horizontal relapse(p>0.05). 4. There were no significant statistical differences between open bite and non-open bite with skeletal Class III malocclusion patients in post-surgical mandibular stability(p>0.05). and we believe this is due to minimized mandibular condylar positional change using mandibular condylar positioning system and also rigid fixation using miniplate 5. Although there was no significant relapse tendency observed at chin points, according to the Pearson correlation analysis, the mandibular relapse was influenced by the amount of vertical and horizontal movement of mandibular set-back(p=0.05, r>0.304).

• Radiation Oncology Journal
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• v.22 no.1
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• pp.1-10
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• 2004

Locally advanced (Stage III) non-small cell lung cancer (NSCLC) accounts for approximately one third of all cases of NSCLC. Few patients with locally advanced NSCLC present with disease amenable to curative surgical resection. Historically, these patients were treated with primary thoracic radiation therapy (RT) and had poor long term survival rates, due to both progression of local disease and development on distant metastases. Over the last two decades, the use of multidisciplinary approach has improved the outcome for patients with locally advanced NSCLC. Combined chemoradiotherapy is the most favored approach for treatment of locally advanced unresectable NSCLC. There are two basic treatment protocols for administering combined chemotherapy and radiation, sequential versus concurrent. The rationale for using chemotherapy is to eliminate subclinical metastatic disease while improving local control. Sequential use of chemotherapy followed by radiotherapy has improved median and long term survival compared to radiation therapy alone. This approach appears to decrease the risk of distant metastases,, but local failure rates remain the same as radiation alone. Concurrent chemoradiotherapy has been studied extensively. The potential advantages of this approach may include sensitization of tumor cells to radiation by the administration of chemotherapy, and reduced overall treatment time compared to sequential therapy; which is known to be important for improving local control in radiation biology. This approach Improves survival primarily as a result of improved local control. However, it doesn't seem to decrease the risk of distant metastases probably because concurrent chemoradiation requires dose reductions in chemotherapy due to increased risks of acute morbidity such as acute esophageal toxicity. Although multidisciplinary therapy has led to improved survival rates compared to radiation therapy alone and has become the new standard of care, the optimal therapy of locally advanced NSCLC continues to evolve. The current issues in the multidisciplinary management of locally advanced NSCLC will be reviewed in this report.

• Radiation Oncology Journal
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• v.26 no.4
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• pp.257-262
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• 2008

Purpose: Oral mucositis induced by radiotherapy to the head and neck area, is a common acute complication and is considered as the most severe symptom for cancer patients in the early stages of treatment. This study was proposed to establish the oral mucositis mouse model induced by a single dose of radiation for the facility of testing therapeutic candidates which can be used for the oral mucositis treatments. Materials and Methods: Fifty-five BALB/c mice were divided into four groups: control, 16 Gy, 18 Gy, and 20 Gy. Oral mucositis was induced by a single dose of radiation to the head and neck using 6 MV x-Ray from linear accelerator. After irradiation, body weight and physical abnormalities were checked daily. Tongue tissues from all groups were taken on days 1, 2, 3, 5, 7, 9, and 14, respectively and H&E staining was conducted to examine morphological changes. Results: Body weight dramatically decreased after day 5 in all irradiated mice. In the 16 Gy treatment group, body weight was recovered on day 14. The histology data showed that the thickness of the epithelial cell layer was decreased by the accumulated time after radiation treatment, up to day 9. Severe ulceration was revealed on day 9. Conclusion: A single dose of 16 Gy is sufficient dose to induce oral mucositis in Balb/C mice. Significant changes were observed in the Balb/C mice on days 7 and 9 after radiation. It is suggested that this mouse model might be a useful standard tool for studying oral mucositis induced by radiation.

• Journal of Gastric Cancer
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• v.7 no.1
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• pp.1-8
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• 2007

Purpose: There has been increased the number of early gastric cancer and laparoscopy-assisted gastrectomy (LAG), due to early detection through mass screening program. We started the LAG in April 2004 and performed 119 cases of gastric cancer in 2005, so we report a surgical outcome compared with that of open gastrectomy (OG). Materials and Methods: 119 patients underwent LAG in 2005, and for open group, 126 patiens of early gastric cancer were selected sequentially from January 2005 to March 2005. We compared clinicopathologic characteristics, postoperative courses and complications between two groups. Results: There was no significant difference between age, a length of hospital stay, distal resection margin and a number of retrived lymph nodes. The operation time was longer in LAG group (239.2 vs 123.3 mins, P<0.001) and a diet progression was faster in LAG group (first flatus: 3.05 vs 3.70 days, SOW: 2.86 vs 3.22 days, liquid diet: 3.87 vs 4.19 days, soft diet: 4.84 vs 5.26 days, P<0.001). But there was no difference statistically in postoperative discharge date (7.73 vs 8.25 days, P=0.229). The additional requirement of analgesic injection was less frequent in LAG group (2.97 vs 4.92 times, P<0.001). The harvested lymph nodes were similar in both groups (23.9 vs 23.1, P=0.563). A complication rate was lower in LAG group (4.9% vs 9.5%), but there was no statistical significance (P=0.179). There was no mortality in both groups and no conversion to open gastrectomy in the LAG group. Conclusion: LAG can be performed safely and accepted in view of curative procedure in treatment of early gastric cancer. But we need the follow up of long-term period to evaluate the survival rate and recurrence, and a prospective randomized controlled study should be done to establish that LAG will be a standard operation for early gastric cancer.

• Progress in Medical Physics
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• v.17 no.1
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• pp.24-31
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• 2006

Automated analysis software was developed to measure the magnitude of the intrafractional and interfractional errors during breast radiation treatments. Error analysis results are important for determining suitable planning target volumes (PTV) prior to Implementing breast-conserving 3-D conformal radiation treatment (CRT). The electrical portal imaging device (EPID) used for this study was a Portal Vision LC250 liquid-filled ionization detector (fast frame-averaging mode, 1.4 frames per second, 256X256 pixels). Twelve patients were imaged for a minimum of 7 treatment days. During each treatment day, an average of 8 to 9 images per field were acquired (dose rate of 400 MU/minute). We developed automated image analysis software to quantitatively analyze 2,931 images (encompassing 720 measurements). Standard deviations ($\sigma$) of intrafractional (breathing motion) and intefractional (setup uncertainty) errors were calculated. The PTV margin to include the clinical target volume (CTV) with 95% confidence level was calculated as $2\;(1.96\;{\sigma})$. To compensate for intra-fractional error (mainly due to breathing motion) the required PTV margin ranged from 2 mm to 4 mm. However, PTV margins compensating for intefractional error ranged from 7 mm to 31 mm. The total average error observed for 12 patients was 17 mm. The intefractional setup error ranged from 2 to 15 times larger than intrafractional errors associated with breathing motion. Prior to 3-D conformal radiation treatment or IMRT breast treatment, the magnitude of setup errors must be measured and properly incorporated into the PTV. To reduce large PTVs for breast IMRT or 3-D CRT, an image-guided system would be extremely valuable, if not required. EPID systems should incorporate automated analysis software as described in this report to process and take advantage of the large numbers of EPID images available for error analysis which will help Individual clinics arrive at an appropriate PTV for their practice. Such systems can also provide valuable patient monitoring information with minimal effort.

• Progress in Medical Physics
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• v.23 no.2
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• pp.114-122
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• 2012

For the determination of absorbed dose to water from a linear accelerator photon beams, it needs a exposure calibration factor $N_x$ or air kerma calibration factor $N_k$ of air ionization chamber. We used the exposure calibration factor $N_x$ to find the absorbed dose calibration factors of water in a reference source through the TG-21 and TRS-277 protocol. TG-21 used for determine the absorbed dose in accuracy, but it required complex calculations including the chamber dependent factors. The authors obtained the absorbed dose calibration factor $N_{dw}{^{Co-60}}$ for reduce the complex calculations with unknown $N_{dw}$ only with $N_x$ or $N_k$ calibration factor in a TM31010 (S/N 1055, 1057) ionization chambers. The results showed the uncertainty of calculated $N_{dw}$ of IC-15 which was known the $N_x$ and $N_{dw}$ is within -0.6% in TG-21, but 1.0% in TRS-277. and TM31010 was compared the $N_{dw}$ of SSDL to that of PSDL as shown the 0.4%, -2.8% uncertainty, respectively. The authors experimented with good agreement the calculated $N_{dw}$ is reliable for cross check the discrepancy of the calibration factor with unknown that of TM31010 and IC-15 chamber.

• Journal of Korean Academy of Nursing
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• v.8 no.1
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• pp.152-162
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• 1978

The desire to maintain health is increasing, consequently the role of nursing which has as one chief aim the solving of man′s basic problems is more and more important. Today, in spite of a growing concern about the nursing activities which nurses provide for individual human having specific needs, clinically in fact, it is questionable that individual′s expectation of nursing activities agrees with nurse′s performance of nursing activities. In this study the importance and agreement of the importance of the nursing activities during the hospitalized puerperal period as viewed by women in the puerperal period and by nurses caring for them, were assessed. The present study was undertaken in an attempt to furnish the basic data for expediting the progress of research activities in this area and further to be helpful in planning maternity nursing practice. The study population defined and selected was nurses (13) caring for women in the puerperal period and doing duty on obstetric & gynecologic ward at Y. hospital, and the women in puerperal period (39) as sum of 3 women selected by each nurse during the period of May 13th-June 4th 1976. The study data was collected by the direct interview method based on the questionnaire which the investigator made out. The study result was analyzed by percentage, t - test. The findings can be summarized as follows: 1. General characteristics of nurses doing duty on puerperal ward: a. Nurses′average age was 24.8 years old. b. 84.6% had educational background of 4 years of college. c. 69.2% had a religion. d. 53.8% were married. e. 53.8% had clinical experience of 1 year -3 years. f, 61.5% did duty on puerperal ward during 1 year -3 years. g. 46.2% desired to do duty on obstetric ? gynecologic ward. 2. General characteristics of the women who were studied during their puerperal period: a. Women′s average age was 26.4 years old. b. 79.5% had educational background above high school. c. 56.4% had a religion. d. 84.6% had living standard above medium. e. 89.7% had no occupation. f, 53,8% had previous hospitalization experience. g. 56.4% had previous delivery experience. 3. Examining the importance of 39 nursing activities during puerperal period selected by investigator, studied group of women considered that the most important nursing activity was "Record precisely about condition, medical treatment and nursing activity results etc". Nurses considered that the most important nursing activity was "Notice whether having pain and care for that". Both groups considered that the least important nursing activity was "Talk with her about topics such as news, hobbies, other interests". 4. Examining the importance of nursing activities in 4 specific categories, studied group of women considered that the most important nursing activity in physical nursing category was "Be sure of safety measure to prevent accidents, injuries", and nurses considered that the most important nursing activity was "Make her sleep and rest sufficiently". Studied group of women considered that the most important nursing activity in psychological category was "Explain about medical treatment and nursing activity ahead of time so she knows what to expect" , and nurses considered that the most important nursing activity was "Explain about puerperal period so she understands". Studied group of women considered that the most important nursing activity in relation to medical care was "Record precisely about condition, medical treatment and nursing activity results etc.", and nurses considered that the most important nursing activity was "Observing, cleaning and protecting the perineum" Studied group of women considered that the most important nursing activity in nursing category in preparation for discharge was "Instruct about personnel hygiene during puerperal period", and nurses considered that the most important nursing activity was "Instruct self-care to protect the perineum". 5. The analysis of this study showed a significant amount of disagreement computed by subtracting the nurse′s score from the patient′s score. Studied group of women put greater importance on physical nursing category, psychological nursing category, nursing in relation to medical care, than the nurses. These results were statistically significant at 0.01 level.