• The Korean Journal of Emergency Medical Services
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• v.15 no.1
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• pp.47-63
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• 2011

Purpose : This research is to examine the work and job satisfaction of paramedics in the emergency room of university hospitals. This research is done to provide basic data needed for establishing work realms of paramedics in hospitals and to enhance their degree of satisfaction. Methods : Research questionnaire survey was conducted on 141 paramedics working in the emergency room of 32 university hospitals from August 24, 2010 to September 30, 2010 through direct visits and telephone interviews or email to explain the purpose of this research and assurance of confidentiality of responses on the questionnaires. As the tool for the degree of job satisfaction, 'The Index of Work Satisfaction' developed by Slavitt, et al(1978) and revised and supplemented by Soon-shim Kim and Hye-ran Kwon(2002) was used. The collected data were analyzed by evaluating frequency, percentage, mean, standard deviation, t-test and ANOVA, Cronbach's $\alpha$ by using SPSS WIN 18.0 program. Results : 1. Investigating the work and role of paramedics in the emergency room of university hospitals, electrocardiogram(EKG) was found to be highest with $\alpha$ was widely used with the rate of patient evaluation and test area. In the medical treatment for patients area, cardiopulmonary resuscitation(CPR) with 95%(134 persons) and ventilation assistance through ambu bagging(BVM) with 95%(134 persons) were found to be high. $\alpha$ were performed. In the role within the hospital and other areas, a member of CPR team in the hospital accounted for 78%(110 persons). 2. In the measurements of the job satisfaction of paramedics working at university hospitals, the total mean score was 2.91. The mean score in each question area indicated: section on job 3.48, autonomy 3.05, interaction 3.01, organizational demand 2.85, working conditions 2.67, salaries 2.40. This result obviously demonstrates the work of paramedics itself was most satisfied but the salaries were most dissatisfied. 3. In the measurements of the job satisfaction of paramedics working at university hospitals, job satisfaction based on the general characteristics showed significant difference in age (F=6.547, p=.002), gender (F=4.436, p=.000) marital status (F=-3.270, p= .001), religion (F=2.041, p= .043), motive for application (F=3.603, p= .015), and salary (F=6.658, p= .000). 대학병원 응급실 내 1급 응급구조사의 업무와 직무만족도 The Journal of the Korean Society of Emergency Medical Technology Vol. 15 (1) 63 4. In the measurements of the job satisfaction of paramedics working at university hospitals, job satisfaction based on the working environmental characteristics showed significant difference in total number of paramedics (F=3.779, p= .012), form of employment (F=5.601, p= .001), existence or non-existence of intention to change jobs (F=-4.037, p= .000). Conclusion : The work of paramedics in the emergency room of university hospitals consists of lots of treatment processes after specialized diagnosis and performance of professionally subdivided works. However, current legislation does not reflect such circumstances to which paramedics are exposed; thus, it should be considered for further revision and modification. The degree of job satisfaction of paramedics in the emergency room of university hospitals was high but low in salaries and working conditions were the weak points. The measures to enhance their degree of job satisfaction should be taken though improvement of labor conditions such as consideration of the rate of increase in salaries, compensation for overtime work, providing rest areas, improvement of current employment system, and conversion of temporary employees into regular employees.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.3 no.2
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• pp.299-316
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• 1996

This study is the descriptive survey to provide basic data for nursing intervention to pain management of cancer patients by finding more effective way to manage pain with recognize pain level and pain characteristics. To achieve the purpose of this study, the subjects of this study are 110 male or female gastro intestinal tract patients who are older than twenty, are hospitalized in Pusan University Hospital from 1995. 5. 28 to 1995. 9. 25 and have had medical treatment. The modified pain assessment of cancer patients of Cornne, H. Rosermary, M. was used as the tool of study with 16 questionaries. The pain score consists of sensory intensity score and distress score. The data was analyzed by the SPSS statistical program number, percentage, mean, standard deviation, t-test, One Way Anova and Duncan's Multiple Range Test were utilized for analysis. The results were summarized as follows : 1. In population-sociological characteristics : in the age-range of subject, the sixties are most as 32.7% and the subjects after the forties are 89.5%, in sex of subjects, male patients are 66.4% and female 33.6%, in the number of family, the subjects who has 4 or above families are 70% and the subjects who live with their spouse, sons and daughters are 54.5% 2. In the disease characteristics : stomach cancer patients were most as 39.1%. And the most of patient who had never been operated before. In time of pain, the most of subjects were intermittent. In the type of pain, the most of subjects were 'dully pain' as 31.8%. Metastatic subjects were 30.0%. In the origin of pain, nervous pressure was 50.8%. The number of complication was 46 and most of complication are obstruction as 6%. 3. In the pain level, 91subjects complained pain. And mean pain score was $287.1{\pm}116.1$ The mean pain score of female subjects was higher than that of male subjects. 4. In the pain characteristics, the pain began usually at meal time as 40.7%. The duration of pain was mostly from 1 month to 3 months as 57.1%. The appetite was mainly concerned with the pain as 31.8%. The etiology of pain was usually tumor as 69.3%. The meaning of pain was incurable disease as 14.5%, anxiety, death and suffering. 5. The 56(61%) of 91subjects were treated with Analgesic pain management. The kinds of Analgesic is usually valentac as 46.4%. The medication was usually intramuscle as 66.1% at whenever necessary, Response of Analgesic after Medication was usually 'moderate release'. The side effects of medication were nausea as 26.8%. The average amount of morphine dosage hospitalized to cancer patients with pain was 80mg in a day and metastatic cancer patients with pain was 101.9mg in a day. 6. In the relation between the disease characteristics and pain level, there is a significant statistical difference : whether subjects had been operated or not : (t=2.88, p=0.005), time of pain is(t=3.34, p=0.005), stage of metastatic(F=9.323, P=0.0002), and type of pain(F=4.013, p=0.0008). In the pain level of diagnosis, Colon cancer was $353.3{\pm}81.7$(F=2.34, p=0.049), the origin of pain, nerve pressure $316.3{\pm}98.5$(F=2.44, P=0.045), In the complication, ascites and obstruction $324.9{\pm}96.8$(T=2.60, P=0.04).

• The Journal of Korean Medicine
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• v.26 no.2 s.62
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• pp.95-104
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• 2005

Objectives: This was a double blinded, randomized, placebo-controlled clinical study for evaluation of safety and effective dose finding of Cardiotonic Pills$^{(R)}$ in patients with chest pain and discomfort. Cardiotonic Pills$^{(R)}$ are composed of Salviae Miltiorrhizae Radix (丹蔘), Notoginseng Radix (三七根) and Borneolum (龍腦). Major effects of Salviae Miltiorrhizae Radix and Notoginseng Radix are vasodilatation, sedation and analgesic action. Borneolum has an antibacterial effect, and can stimulate the central nervous system. All of these substances are oriental herbs that have been used for a long time in east Asia. Cardiotonic Pills fi received Investigational New Drug (IND) approval from the Food and Drug Administration (FDA) in the USA and 40 million people in the world take this pill. We performed a phase IV clinical study to confirm its efficacy and safety in patients who have probable cardiogenic or psychogenic chest pain or chest stifling. Methods: This study was planned for a multi-center clinical trial including four university hospitals of oriental medicine in Korea. This was the first time to evaluate the 'planning treatment according to diagnosis (辨證施治)' of chest pain or chest discomfort according to oriental medical guidelines. The patients who were included in this trial were adult volunteers from 20 to 70 years old who had chest pain or chest discomfort more than twice during a recent month, and we received written consent to participate in this study from all of them. After administration of Cardiotonic Pills$^{(R)}$ for 8 weeks, number of occurrences, duration, appearance and degree of chest pain or chest discomfort was observed and degree of symptoms (severity of illness, global improvement) were measured using a patient's global assessment composite scale. Results: In the patient's global assessment scale, the severity of illness of the Cardiotonic Pills$^{(R)}$ group (n=25) was 14/25=0.56 but of the placebo group (n=25) was 7/25=0.28 (p-value=0.0449). This result indicates Cardiotonic Pills$^{(R)}$have a positive effect on the symptoms of chest pain and discomfort. However, the global improvement of the Cardiotonic Pills$^{(R)}$group was 23/25=0.92, and of the placebo group was 22/25=0.88 (p-value=0.6374). The total symptom score of the Cardiotonic Pills$^{(R)}$ group was $1.68\pm20.06$, and of the placebo group was $16.76\pm72.l4$(p-value=0.2285). The number of symptom events of the Cardiotonic Pills$^{(R)}$ group was $72\pm29.78$, and of the placebo group (n=25) was $10.80\pm38.42$ (p­value=0.3660). We could not find any effects on the other factors examined besides the severity of illness, beyond the difference of standard deviations. Conclusions: Cardiotonic Pills$^{(R)}$ significantly reduced chest pain and chest discomfort in patients. Therefore, we expect that Cardiotonic Pills$^{(R)}$ will be helpful for patients with chest pain and chest discomfort not only caused by heart disease but also by other diseases.

• Tuberculosis and Respiratory Diseases
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• v.54 no.3
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• pp.330-337
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• 2003

Background : Low spirometric forced vital capacity(FVC) in conjunction with a normal or high ratio of the forced expiratory volume at 1 second to the forced vital capacity($FEV_1$/FVC%) has traditionally been classified as a restrictive abnormality. However, the gold-standard diagnosis of a restrictive pulmonary impairment requires a measurement of the total lung capacity (TLC). This study was performed to determine the predictive value of spirometric measurements of the FVC for diagnosing a restrictive pulmonary abnormality. Methods : Test results from 1,371 adult patients who undertook both spirometry and lung volume measurements on the same visit from January 1999 to December 2000 were enrolled in this study. The test values for the FVC, the TLC that was below 80% of predicted value, and a $FEV_1$/FVC% that was below 70%, were classified as being abnormal. Results : Of the 1,371 patients, 353 patients had a reduced a FVC. Of these patients, 186 patients had a reduced TLC. Therefore, the positive predictive value was 52.7%. Of the 196 patients with a normal $FEV_1$/FVC% and a reduced FVC, 148(75.5%) patients had a lower TLC. Thirty eight (24.2%) patients out of 157 patients with a low $FEV_1$/FVC% and a low FVC showed a restrictive defect. Conclusion : Spirometry is useful to rule out a restrictive pulmonary abnormality, but a restrictive pattern on the spirometry dose not mean there is a true restrictive disease. For the patients with a low FVC, TLC measurements are essential for diagnosing a restrictive pulmonary impairment.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.4 no.1
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• pp.147-162
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• 1997

This study was attempted to provide the basic data for nursing intervention to improve the psychosociological adaptation of patients receiving chemotherapy for breast cancer by examining relationship between anxiety and hopelessness that they are experiencing and family support, in order to help them successfully cope with various psychological problems. This study was carried out with 93 breast cancer patients who are receiving chemotherapy in the injection treatment room of K University Hospital located in the downtown of Taegu after having underwent mastectomy in the hospital between December 1995 and August 1996. This study used the systematized questionnaires which contain 7 questions about general characteristics, Spielberger's trait anxiety & state anxiety scale, the tool that WON(1987) modified the hopelessness scale which was developed by Beck et al.(1967) and the family support tool made by TAE(1985). By using the SPSS/PC program, this study obtained the real number and percentage for the general characteristics of the subjects, and mean and standard variation for the degrees of trait anxiety, state anxiety, hopelessness and family support. The correlation between each variables was identified on the basis of the Pearson Correlation, and the degrees of trait anxiety, state anxiety, hopelessness and family support in the general characteristics of the subjects were analyzed by using the t-test, ANOVA, and Duncan test. The results of this study were summarized as follows. In the general characteristics of the subjects, most of each group were 51 years old or more and the middle class in income, had educational background under elementary school, no job, Buddhism in religion and spouse, and were receiving chemotherapy using MTX and 5FU. It was shown that the degree of the subjects' trait anxiety is, on an average, 50. 29, state anxiety 49. 68, hopelessness 51. 46 and family support 34. 28. Both trait anxiety and hopelessness showed normal correlation ; the higher the degree of trait anxiety is, the higher the degree of hopelessness is, while trait anxiety and family support showed reverse correlation ; the higher the degree of trait anxiety, the lower the degree of family support that the subjects perceive is. State anxiety and hopelessness also showed normal correlation ; the higher the degree of state anxiety is, the higher the degree of hopelessness is. Family support and hopelessness showed reverse correlation ; the higher the degree of family support is, the lower the degree of hopelessness that the subjects perceive is. And family support and state anxiety showed reverse correlation but there was a statistically significant difference. The degree of trait anxiety in the general characteristics of the subjects showed a significant difference by age, job and religion, the degree of state anxiety a signigicant difference by job and religion, the degree of hopelessness a signigicant difference by age, educational background and existence or not of spouse. In conclusion, the breast cancer patients receiving chemotherapy perceive anxiety and hopelessness due to several causes such as diagnosis itself or side effects of chemotherapy, so that it is required not only to develop specific nursing interventions including family support to alleviate anxiety and hopelessness but also to apply such interventions to clinical practice.

• Tuberculosis and Respiratory Diseases
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• v.63 no.4
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• pp.353-361
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• 2007

Background: Malignancies are a common and important causes of exudative pleural effusions. Several tumor markers have been studied because the pleural fluid cytology and pleural biopsy specimens do not provide a diagnosis in a high percentage of malignant effusions. In an attempt to overcome this limitation, procalcitonin and C-reactive protein (CRP) in pleural effusions and serum, which are known to be inflammation markers, were measured to determine if they can differentiate an exudate from trasndate as well as the diverse causes of exudative pleural effusion. Methods: 178 consecutive patients with pleural effusion (malignant 57, tuberculous 51, parapneumonic 31, empyema 5, miscellaneous benign 7, transudative 27)were studied prospectively. The standard parameters of pleural effusion and measured serum and pleural procalcitonin were examined using in immunoluminometric assay. The level of CRP in serum and pleural fluid was determined by turbidimetric immunoassay. Results: The pleural procalcitonin levels in the exudate were significantly higher than those in the transudate, $0.81{\pm}3.09ng/mL$ and $0.12{\pm}0.12ng/mL$, respectively (p=0.007). The pleural CRP levels were significantly higher in the exudate than the transudate, $2.83{\pm}3.31mg/dL$ and $0.74{\pm}0.67mg/dL$, respectively (p<0.001). The pleural procalcitonin levels in the benign effusion were significantly higher than those in the malignant effusion, $1.15{\pm}3.82ng/mL$ and $0.25{\pm}0.92ng/mL$, respectively (p=0.032). The pleural CRP levels were significantly higher in the benign effusion than in the malignant effusion, $3.68{\pm}3.78mg/dL$ and $1.42{\pm}1.54mg/dL$, respectively (p<0.001). The pleural procalcitonin levels in the non-tuberculous effusion were significantly higher than those in the tuberculous effusion, $1.16{\pm}3.75ng/mL$ and $0.13{\pm}0.37ng/mL$, respectively (p=0.008). Conclusion: Measuring the level of procalcitonin and CRP in the pleural fluid is helpful for differentiating between transudates and exudates. In addition, it is useful for differentiating between benign and malignant pleural effusions.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.6 no.3
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• pp.414-433
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• 1999

The purpose of this study is to identify the needs which are perceived by one of the familiy members who have head injury parients by traffic accidents in the intensive care units. Subjects were 70 families members of head injury patients admitted to 2 general hospitals NICU located Pusan city, 1 general hospital NICU located Ulsan city from December 1. 1998 to February 28. 1999. For this study, 70 family members were interviewed with aid of a Likert scale which was developed by researcher for this study. For development of the survey instrument, literature review and open questionnaire technique with family members and the nurses working in NICU. The 50needs-items were classified into 7 groups according to the homogeneity of the items with the support of literature review. For the content validity, the instrument was reviewed by 1 nursing professor and the internal reliability of this instrument was Cronbach alpha=0.94 which is highly accepted. Data was analyzed by a SPSS computer program. Data analysis included frequency. percentage, mean, standard variance and t-test or ANOVA. The results were as followings : 1. The general characteristics of head injury patients shows that the male was 74.3%, the female was 25.7% and age distribution shows that the fifty-fifty nine years was 30%, the highest. Of religion the buddhism was the most, The diagnosis distribution shows that epidural hematoma was 32.9% and subdural hematoma was 24.3%. The mentalility distribution shows that semicoma was 31.4% and stupor was 31.4%. Hemiplegia was 42.9% 2. The general charaterisrics of the family needs of head injury patients shows that thirty-thirty nine years was 31.4%, the highest. sex distribution shows that the male was 20%, the female was 80%. Of religion the buddism was the most. 3. The family needs of head injury patients was $3.03{\pm}0.42$, needs for the information of a patient's condition was $3.65{\pm}0.48$, the highest. And needs for the information of care and treatment was $3.48{\pm}0.48$, needs to be supplied with comfortable facilities for family was $3.04{\pm}0.66$, needs to be participate in a patient's care was $2.90{\pm}0.55$, needs to be informed about the available resources was $2.83{\pm}0.59$, needs to be supported emotionally for family was $2.79{\pm}0.55$, needs for religious assistance was $2.51{\pm}0.85$. 4. Examining the family needs of head injury patients according to patient's characteristics, mentality, plegia degree and operation were shown be variables to make an effect on the needs for the head injury patients family. At all, according to severity of head. injury, the family needs of head injury patients was high. 5. Examining the family needs of head injury patients according to their general characteristics, we could know that religion, job. income were shown to be variables to make an effect on the family needs. Through the examination it can be seen that the characteristics of head injury patients and the family needs of head injury patients. In conclusion, the family needs of head injury patients was almost same the family needs of ICU patients. Therefore we must involve the family's care of head injury patients and we must provide exact and repeated explanation, education and support the family of head injury patients. As this study was resulted in selecting the families admitted to NICU of some general hospital, we couldn't stretch the result in our favor. Therefore, continuous studies are suggested.

• Clinical and Experimental Pediatrics
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• v.50 no.10
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• pp.965-969
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• 2007

Purpose : Measurement of antistreptolysin O (ASO) is often necessary to confirm a clinical diagnosis of recent streptococcal infection, especially in patients suspected of rheumatic fever and acute glomerulonephritis. Standard normal ranges for ASO should be established locally for each age group. We analyzed ASO to determine the upper limit of normal (ULN) ASO in children in the Gyeonggi-Incheon area. Methods : ASO in normal individual concentrations were measured quantitatively by nephelometry on sera from 753 children (Male : 381, Female : 372). ULN were determined by separating the upper 20% from the lower 80% of the group (80 percentile). Results : The mean ASO concentration calculated in a total cases was $149.9{\pm}7.2IU/mL$. The ASO concentration in neonates was $83.4{\pm}10.7IU/mL$, and lowest in the 1 year of age group, $26.7{\pm}6.6IU/mL$, and increased to $318.0{\pm}33.2IU/mL$ gradually in the 9 years of age group. Thereafter, ASO concentration decreased. The ULN for neonates was 122 IU/mL, for 0-3 years, 40 IU/mL; for 4-6 years, 113 IU/ mL; for 7-9 years, 489 IU/mL; for 10-19 years, 433 IU/mL; for 20-29 years, 122 IU/mL. Conclusion : The age-specific ULN for children in the Gyeonggi-Incheon area were determined. The distribution of ASO concentration according to age groups was different from previous reports. These results should be of clinical value to physicians to interprete the ASO results of their patients.

• Investigative Magnetic Resonance Imaging
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• v.8 no.1
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• pp.24-31
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• 2004

Purpose : To know the differences of proton MR spectroscopic features between recurrent rectal cancer and fibrosis in post-operative period, and to evaluate the possibility to discriminate recurrent rectal cancer from post-operative fibrosis by analysis of proton MR spectra. Materials and Methods : We evaluated the proton MR spectra from 25 soft tissue masses in perirectal area that developed in post-operative period after operation for the resection of rectal cancer. Our series included 11 cases of recurrent rectal cancer and 14 of fibrotic mass. All cases of recurrent rectal cancer and post-operative fibrosis were confirmed by biopsy. We evaluated the spectra with an attention to the differences of pattern of the curves between recurrent rectal cancer and post-operative fibrosis. The ratio of peak area of all peaks at 1.6-4.1ppm to lipid (0.9-1.6ppm) [P (1.6-4.1ppm/P (0.9-1.6ppm)] was calculated in recurrent rectal cancer and post-operative fibrosis groups, and compared the results between these groups. We also evaluated the sensitivity and specificity for discriminating recurrent rectal cancer from post-operative fibrosis by analysis of $^1H-MRS$. Results : Proton MR spectra of post-operative fibrosis showed significantly diminished amount of lipids compared with that of recurrent rectal cancer. The ratio of P (1.6-4.1ppm)/P (0.9-1.6ppm) in post-operative fibrosis was much higher than that of recurrent rectal cancer with statistical significance (p < .05) due to decreased peak area of lipids. Mean (standard deviations of P (1.6-4.1ppm)/P (0.9-1.6ppm) in post-operative fibrosis and recurrent rectal cancer group were $2.71{\pm}1.48\;and\;0.29{\pm}0.11$, respectively. With a cut-off value of 0.6 for discriminating recurrent rectal cancer from post-operative fibrosis, both the sensitivity and specificity were $100\%$ (11/11, and 14/14). Conclusion : Recurrent rectal cancer and post-operative fibrosis can be distinguished from each other by analysis of proton MR spectroscopic features, and $^1H-MRS$ can be a new method for differential diagnosis between recurrent rectal cancer and post-operative fibrosis.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.6
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• pp.456-463
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• 2008

Purpose: We evaluated the incidence and malignant risk of focal breast lesions incidentally detected by $^{18}F-FDG$ PET/CT. Various PET/CT findings of the breast lesions were also analyzed to improve the differentiation between benign from malignant focal breast lesions. Materials & Methods: The subjects were 3,768 consecutive $^{18}F-FDG$ PET/CT exams performed in adult females without a history of breast cancer. A focal breast lesion was defined as a focal $^{18}F-FDG$ uptake or a focal nodular lesion on CT image irrespective of $^{18}F-FDG$ uptake in the breasts. The maximum SUV and CT pattern of focal breast lesions were evaluated, and were compared with final diagnosis. Results: The incidence of focal breast lesions on PET/CT in adult female subjects was 1.4% (58 lesions in 53 subjects). In finally confirmed 53 lesions of 48 subjects, 11 lesions of 8 subjects (20.8%) were proven to be malignant. When the PET/CT patterns suggesting benignancy (maximum attenuation value>75 HU or <30HU; standard deviation of mean attenuation > 20) were added as diagnostic criteria of PET/CT to differentiate benign from malignant breast lesions along with maximum SUV, the area under ROC curve of PET/CT was significantly increased compared with maximum SUV alone ($0.680{\pm}0.093$ vs. $0.786{\pm}0.076$, p<0.05). Conclusion: The malignant risk of focal breast lesions incidentally found on $^{18}F-FDG$ PET/CT is not low, deserving further diagnostic confirmation. Image interpretation considering both $^{18}F-FDG$ uptake and PET/CT pattern may be helpful to improve the differentiation from malignant and benign focal breast lesion.