• Quality Improvement in Health Care
• /
• v.2 no.1
• /
• pp.68-84
• /
• 1995

Background: Guideline for practice is useful because it can be the standard for assessment and way to improve quality. We need to take account of expert opinion and consensus as well as scientific evidences to develope practice guideline because it should be practical. Delphi method has been developed to gather opinions from experts fairly. This study was designed to develop practice guideline and apply it to practices as a method to improve quality in primary medical care. Methods: Hypertension(in adults over 18 years old) was selected as a target problem. Self questionnaires about management of hypertensive patients were developed by a researcher with advice of 11 experts. The questionnaires were designed to response as a 5 pont scale. The results of previous questionary were given to respondents in second and third questionnaires. If needed, the questionnaires were changed on the previous responses. The items with medium greater than or equal to 4 point in 1st and 2nd responses were accepted in guideline. The items with medium lesser than or equal to 3 point were questioned again about whether they can be excluded or not. The criteria for assessment was made with reference to guideline and applied to 85 hypertensive patients of 9 family practitioners. At 3 months after practice guideline had been given to family practitioners, performance of same practitioners was assessed with 36 new hypertensive patients. Results: 23 professors in family medicine, 22 family practitioners and 6 cardiologists, responded among 50, 50, 15 respectively. Practice guideline with 33 items was developed as a result of 3 times questionaires. The difference of responses between professors in family medicine, family practitioners and cardiologists was not significant. Performance of practice was improved in diagnosis, history taking about 6 fields, laboratory examination and decision making about time of pharmaceutical prescription. It was not improved in physical examination, life style modification, method of pharmaceutical prescription, choice of initial antihypertensives and history taking about duration of disease and diet habit. It was decreased in history taking about psychosocial factors. The assessment scores were low in history taking, physical examination and life style modification before and after use of practice guideline. Conclusion: Practice guideline for hypertension could be developed by Delphi method. Performance of practice improved partially after use of guideline.

• Journal of the Korean Society of Radiology
• /
• v.84 no.6
• /
• pp.1324-1336
• /
• 2023

Purpose This study aimed to compare the diagnostic performance of cardiac CT and transthoracic echocardiogram (TTE) depending on the degree of valvular calcification and bicuspid aortic valve (BAV) subtype. Materials and Methods This retrospective study included 266 consecutive patients (106 with BAV and 160 with tricuspid aortic valve) who underwent cardiac CT and TTE before aortic valve replacement. Cardiac CT was used to evaluate the morphology of the aortic valve, and a calcium scoring scan was used to quantify valve calcium. The aortic valves were classified into fused and two-sinus types. The diagnostic accuracy of cardiac CT and TTE was calculated using a reference standard for intraoperative inspection. Results CT demonstrated significantly higher sensitivity, negative predictive value, and accuracy than TTE in detecting BAV (p < 0.001, p < 0.001, and p = 0.003, respectively). The TTE sensitivity tended to decrease as valvular calcification increased. The error rate of TTE for CT was 10.9% for the twosinus type of BAV and 28.3% for the fused type (p = 0.044). Conclusion Cardiac CT had a higher diagnostic performance in detecting BAV than TTE and may help diagnose BAV, particularly in patients with severe valvular calcification.

• Journal of Radiation Protection and Research
• /
• v.33 no.4
• /
• pp.167-172
• /
• 2008

Recently a high-quality voxel model of a Korean adult male was constructed at Hanyang University by using very high resolution serially-sectioned anatomical images of a cadaver, which was provided by the Korean Institute of Science and Technology Information (KISTI). Most existing voxel phantoms are developed based on an individual in the supine posture. This study converted the HDRK-Man voxel model into surface model and adjusted the flattened back of the HDRK-Man to a normal shape in the upright posture using 3D graphic softwares such as $3D-DOCTOR^{TM}$, $Rapidform^{(R)}$2006, $Rhinoceros^{(R)}$4.0, $MAYA^{(R)}$8.5. The effective doses of adjusted model were compared with those of unadjusted model for some standard irradiation geometries (i.e., AP, PA, LLAT, RLAT). In general, the differences were not very large and, among those, the largest difference was found for the PA radiation geometry, as expected. These methodologies can be used for the development of various deformed posture models of HDRK-Man in the later stage of this project.

• Journal of Nutrition and Health
• /
• v.57 no.2
• /
• pp.244-260
• /
• 2024

Purpose: With the 2021 revision of dietary guidelines in Korean emphasizing environmentally sustainable dietary practices, this study attempted to develop an evaluation tool to comprehensively evaluate the degree of practice and compliance with food and nutrient intake, dietary habits, and dietary culture guidelines based on the revised dietary guidelines. Methods: The candidate evaluation items were collected by reviewing 934 literature reviews on domestic and foreign dietary evaluations. Fifty-nine candidate items were derived by selecting the items corresponding to dietary guidelines. The content validity ratio (CVR) cutoff point evaluation was conducted with 11 experts to delete 11 items that did not meet the CVR standard. Fifty-five pilot survey candidate items were selected through revision and additional process according to expert opinion. Seventy final candidate items were selected by adding 15 questions for validity verification and reference. A pilot survey was conducted online and offline on 332 adults aged 19-64 in Seoul and the metropolitan area, and exploratory factor analysis was used to verify the construct validity of the evaluation items. Through exploratory factor analysis, the Kaiser-Meyer-Olkin, Bartlett's sphericity test, variance explained, and Cronbach's alpha criteria were confirmed in each process. Results: Exploratory factor analyses derived three criteria: food and nutrient intakes (11 items), eating behaviors (9 items), and dietary culture (14 items), consisting of 34 evaluation items. Conclusion: The present scale was validated and can be used for comprehensive evaluations of the dietary guidelines for Korean adults in a simple way.

• Food Science and Preservation
• /
• v.30 no.1
• /
• pp.109-121
• /
• 2023

This study was conducted to evaluate vitamin D intake of Koreans in a total diet study (TDS) and to determine the effect of irradiation on vitamin D synthesis in mushrooms. For analysis, sample were saponified and extracted with hexane, and vitamin D was quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Based on the validation results, the recovery of the National Institute of Standards and Technology (NIST) standard reference sample (SRM) 1849a was 96.7% and the z-score of -1.6 was obtained by the Food Analysis Performance Assessment Scheme (FAPAS) proficiency test (PT) 21115. Vitamin D₂ was not detected in any samples, and the highest level of vitamin D₃ was detected in mackerel and anchovies ranging from 24.2 to 120.2 ㎍/kg. The mean daily intake of vitamin D was 0.99 ㎍/day, as estimated from the vitamin D contents of the analyzed foods and their corresponding intake. The adequate intake (AI) of vitamin D based on the Dietary reference intakes for Koreans provided by the Ministry of Health and Welfare is 5-15 ㎍/day for Koreans aged 6 to 75 years. Compared with this AI, vitamin D intake of Koreans estimated in this study was inadequate. For that, the increased vitamin D content in ultraviolet (UV)/sun light irradiated mushrooms warrants further research to increase vitamin D intake of Koreans through diet.

• Journal of Korean Society of Coastal and Ocean Engineers
• /
• v.19 no.4
• /
• pp.329-335
• /
• 2007

The eye measurement to observe the sea surface condition and estimate the wave height has been used in the open sea or the ship. The experts in the eye estimation can measure the wave height very accurately. The Beaufort wind scale is most widely used as a standard index of the eye measurement. However, more definite reference data such as the representative images by each wave heights must be necessary because the appearances and explanations in the Beaufort wind scale are not enough to understand the sea surface condition far the researcher and the public. The modern field data acquisition technique has been developed to measure wave heights, ocean weather data and even images of the sea surface in real-time. In this study, the wireless field image transmitting system for wave heights and images is installed in the real-time ocean measurement system of Chodo light tower near Sokcho city in South Korea. The wave heights and surface images acquired from the real time system in the field are compared with explanations of the Beaufort wind scale. The wave heights and images measured with the precision ultrasonic wave sensor and the scientific sea surface image transmitting system should be helpful to obtain more precise and definite information than the data from the Beaufort wind scale.

• Journal of Nutrition and Health
• /
• v.47 no.4
• /
• pp.268-276
• /
• 2014

Purpose: The aim of this study is to estimate total sugar intake and identify major food sources of total sugar intake in the diet of the Korean population. Methods: Dietary intake data of 33,745 subjects aged one year and over from the KNHANES 2008-2011 were used in the analysis. Information on dietary intake was obtained by one day 24-hour recall method in KNHANES. A database for total sugar content of foods reported in the KNHANES was established using Release 25 of the U.S. Department of Agriculture National Nutrient Database for Standard Reference, a total sugar database from the Ministry of Food and Drug Safety, and information from nutrition labeling of processed foods. With this database, total sugar intake of each subject was estimated from dietary intake data using SAS. Results: Mean total sugar intake of Koreans was 61.4 g/person/day, corresponding to 12.8% of total daily energy intake. More than half of this amount (35.0 g/day, 7.1% of daily energy intake) was from processed foods. The top five processed food sources of total sugar intake for Koreans were granulated sugar, carbonated beverages, coffee, breads, and fruit and vegetable drinks. Compared to other age groups, total sugar intake of adolescents and young adults was much higher (12 to 18 yrs, 69.6 g/day and 19 to 29 yrs, 68.4 g/day) with higher beverage intake that beverage-driven sugar amounted up to 25% of total sugar intake. Conclusion: This study revealed that more elaborated and customized measures are needed for control of sugar intake of different subpopulation groups, even though current total sugar intake of Koreans was within the range (10-20% of daily energy intake) recommended by Dietary Reference Intakes for Koreans. In addition, development of a more reliable database on total sugar and added sugar content of foods commonly consumed by Koreans is warranted.

• Analytical Science and Technology
• /
• v.16 no.5
• /
• pp.391-398
• /
• 2003

Basic research for the determination of boron content in biological sample has been carried out using the PGAA facility of the 24MW research reactor(HANARO). For investigation of characteristics for the measurement condition, neutron flux and its homogeneity were measured at irradiating geometry. The size of thermal neutron beam collimated from beam guide is $2{\times}2cm^2$ at the sample position. The neutron flux measured was the range of $1.0{\sim}6.5{\times}10^7n{\cdot}cm^{-2}{\cdot}s^{-1}$, and flux distribution from center within the radius of 4.5 mm and 9.0 mm was $5.77{\pm}0.71{\times}10^7n{\cdot}cm^{-2}{\cdot}s^{-1}$ and $4.68{\pm}1.64{\times}10^7n{\cdot}cm^{-2}{\cdot}s^{-1}$, respectively. Accordingly, sample size is adjusted within 10 mm for a homogeneous irradiation of high quality. Measurement system is designed to reduce the background source by Compton scattering and to improve the analytical sensitivity. To investigate the energy calibration and Compton suppression effect of gamma-ray counting system, the background conditions on both of Compton and single-mode were measured using NaCl standard. On the other hand, degree of spectral interference for sodium 472 keV peak as a matrix effect in the sample is established for an accurate boron analysis, and then boron content in three certified reference materials (NIST SRM 1570a, 1547, 1573a) was measured by using two modes and the results were compared with each other.

• Land and Housing Review
• /
• v.4 no.4
• /
• pp.383-393
• /
• 2013

The trends of green growth and eco-friendliness came to be the core development indicator for the sustainable global environment. Korean government reflected these trends in the main flows of the national development index, and suggested diverse directions for green construction technologies and high quality construction environment through Third master plan for construction environment. However, the efforts to follow these trends during the construction process as a step for production phrase are not being considered enough yet. In this study, we identified the basic environmental management factors in order to enhance the eco-friendliness of public housing construction sites, and suggested the reasonable conducting parties and process for those respective factors. The results of this study are expected to be the valuable reference in defining the required activities and participants' responsibilities, and improving the work process for systematic on-site environmental management. In applying those results, the discussion should be followed on the executing party of each unit activity and the responsibility assignment for each process. At the same time, the legislation and standard related to environment need to be essentially amended. In the future, the method of evaluating the environmental management activities, and the technical solution to environmental problems are to be reviewed as a further research for successful environmental management.

• Journal of dental hygiene science
• /
• v.15 no.1
• /
• pp.54-59
• /
• 2015

The present study investigated the influences of various abutment teeth shapes (maxillary right canine, pre-molar, molar) on the marginal adaptation of computer aided design/computer aided manufacturing-fabricated zirconia core. In vitro adaptation of zirconia cores manufactured by three different abutments were evaluated. Thirty zirconia cores were made per each models and the adaptation was evaluated through a silicone replica technique. The measurement of the adaptation was carried out using digital microscope. The mean and standard deviation of each reference point were analyzed using the one-way (ANOVA) and Tukey's honestly significant difference tests (${\alpha}=0.05$). The overall marginal fits of the zirconia cores were as follows: canine: $47.59{\mu}m$, pre-molar: $43.74{\mu}m$, molar: $40.36{\mu}m$. They were no statistically significant differences between groups for adaptation (p>0.05). This confirmed that the type of abutment teeth used does not determine the precision of fit of zirconia core.