1.Establishment of Local Diagnostic Reference Levels for Pediatric Neck CT at Nine University Hospitals in South Korea
Jisun HWANG ; Hee Mang YOON ; Jae-Yeon HWANG ; Young Hun CHOI ; Yun Young LEE ; So Mi LEE ; Young Jin RYU ; Sun Kyoung YOU ; Ji Eun PARK ; Seok Kee LEE
Korean Journal of Radiology 2025;26(1):65-74
Objective:
To establish local diagnostic reference levels (DRLs) for pediatric neck CT based on age, weight, and water-equivalent diameter (WED) across multiple university hospitals in South Korea.
Materials and Methods:
This retrospective study analyzed pediatric neck CT examinations from nine university hospitals, involving patients aged 0–18 years. Data were categorized by age, weight, and WED, and radiation dose metrics, including volume CT dose index (CTDIvol) and dose length product, were recorded. Data retrieval and analysis were conducted using a commercially available dose-management system (Radimetrics, Bayer Healthcare). Local DRLs were established following the International Commission on Radiological Protection guidelines, using the 75th percentile as the reference value.
Results:
A total of 1159 CT examinations were analyzed, including 169 scans from Institution 1, 132 from Institution 2, 126 from Institution 3, 129 from Institution 4, 128 from Institution 5, 105 from Institution 6, 162 from Institution 7, 127 from Institution 8, and 81 from Institution 9. Radiation dose metrics increased with age, weight, and WED, showing significant variability both within and across institutions. For patients weighing less than 10 kg, the DRL for CTDIvol was 5.2 mGy. In the 10–19 kg group, the DRL was 5.8 mGy; in the 20–39 kg group, 7.6 mGy; in the 40–59 kg group, 11.0 mGy; and for patients weighing 60 kg or more, 16.2 mGy. DRLs for CTDIvol by age groups were as follows: 5.3 mGy for infants under 1 year, 5.7 mGy for children aged 1–4 years, 7.6 mGy for ages 5–9 years, 11.2 mGy for ages 10–14 years, and 15.6 mGy for patients 15 years or older.
Conclusion
Local DRLs for pediatric neck CT were established based on age, weight, and WED across nine university hospitals in South Korea.
2.Development of the Korean Version of the Meaning in Life Scale for Cancer Patients
Namgu KANG ; Hae-Yeon YUN ; Young Ae KIM ; Hye Yoon PARK ; Jong-Heun KIM ; Sun Mi KIM ; Eun-Seung YU
Psychiatry Investigation 2025;22(3):258-266
Objective:
This study aims to understand the structure of meaning in life among patients with cancer through the validation of the Meaning in Life Scale among Korean patients (K-MiLS) with cancer.
Methods:
From August 2021 to November 2022, participants were recruited from multiple sites in South Korea. Participants completed related questionnaires, including the MiLS, on the web or mobile. Test-retest reliability was assessed between 2 and 4 weeks after the initial assessment. Exploratory and confirmatory factor analyses and Pearson’s correlations were used to evaluate the reliability and validity of the MiLS. A multiple regression analysis was conducted to examine the sociodemographic and disease-related variables correlated with the MiLS. Regarding concurrent validity, a hierarchical regression analysis was performed.
Results:
The results (n=345) indicated that the K-MiLS has a four-factor structure: Harmony and Peace; Life Perspective, Purpose, and Goals; Confusion and Lessened Meaning; and Benefits of Spirituality. Regarding convergent and discriminant validity, K-MiLS was negatively correlated with Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Fear of Cancer Recurrence Inventory while showing a significantly positive correlation with the Posttraumatic Growth Inventory, Self-Compassion Scale, Functional Assessment of Cancer Therapy-General, and Functional Social Support Questionnaire. Hierarchical regression analysis revealed that the demographic variable influencing MiLS was religious affiliation.
Conclusion
The K-MiLS had a multidimensional four-factor structure similar to that of the original version. It is also a reliable and valid measure for assessing cancer survivors’ meaning in life after a cancer diagnosis.
3.Establishment of Local Diagnostic Reference Levels for Pediatric Neck CT at Nine University Hospitals in South Korea
Jisun HWANG ; Hee Mang YOON ; Jae-Yeon HWANG ; Young Hun CHOI ; Yun Young LEE ; So Mi LEE ; Young Jin RYU ; Sun Kyoung YOU ; Ji Eun PARK ; Seok Kee LEE
Korean Journal of Radiology 2025;26(1):65-74
Objective:
To establish local diagnostic reference levels (DRLs) for pediatric neck CT based on age, weight, and water-equivalent diameter (WED) across multiple university hospitals in South Korea.
Materials and Methods:
This retrospective study analyzed pediatric neck CT examinations from nine university hospitals, involving patients aged 0–18 years. Data were categorized by age, weight, and WED, and radiation dose metrics, including volume CT dose index (CTDIvol) and dose length product, were recorded. Data retrieval and analysis were conducted using a commercially available dose-management system (Radimetrics, Bayer Healthcare). Local DRLs were established following the International Commission on Radiological Protection guidelines, using the 75th percentile as the reference value.
Results:
A total of 1159 CT examinations were analyzed, including 169 scans from Institution 1, 132 from Institution 2, 126 from Institution 3, 129 from Institution 4, 128 from Institution 5, 105 from Institution 6, 162 from Institution 7, 127 from Institution 8, and 81 from Institution 9. Radiation dose metrics increased with age, weight, and WED, showing significant variability both within and across institutions. For patients weighing less than 10 kg, the DRL for CTDIvol was 5.2 mGy. In the 10–19 kg group, the DRL was 5.8 mGy; in the 20–39 kg group, 7.6 mGy; in the 40–59 kg group, 11.0 mGy; and for patients weighing 60 kg or more, 16.2 mGy. DRLs for CTDIvol by age groups were as follows: 5.3 mGy for infants under 1 year, 5.7 mGy for children aged 1–4 years, 7.6 mGy for ages 5–9 years, 11.2 mGy for ages 10–14 years, and 15.6 mGy for patients 15 years or older.
Conclusion
Local DRLs for pediatric neck CT were established based on age, weight, and WED across nine university hospitals in South Korea.
4.Development of the Korean Version of the Meaning in Life Scale for Cancer Patients
Namgu KANG ; Hae-Yeon YUN ; Young Ae KIM ; Hye Yoon PARK ; Jong-Heun KIM ; Sun Mi KIM ; Eun-Seung YU
Psychiatry Investigation 2025;22(3):258-266
Objective:
This study aims to understand the structure of meaning in life among patients with cancer through the validation of the Meaning in Life Scale among Korean patients (K-MiLS) with cancer.
Methods:
From August 2021 to November 2022, participants were recruited from multiple sites in South Korea. Participants completed related questionnaires, including the MiLS, on the web or mobile. Test-retest reliability was assessed between 2 and 4 weeks after the initial assessment. Exploratory and confirmatory factor analyses and Pearson’s correlations were used to evaluate the reliability and validity of the MiLS. A multiple regression analysis was conducted to examine the sociodemographic and disease-related variables correlated with the MiLS. Regarding concurrent validity, a hierarchical regression analysis was performed.
Results:
The results (n=345) indicated that the K-MiLS has a four-factor structure: Harmony and Peace; Life Perspective, Purpose, and Goals; Confusion and Lessened Meaning; and Benefits of Spirituality. Regarding convergent and discriminant validity, K-MiLS was negatively correlated with Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Fear of Cancer Recurrence Inventory while showing a significantly positive correlation with the Posttraumatic Growth Inventory, Self-Compassion Scale, Functional Assessment of Cancer Therapy-General, and Functional Social Support Questionnaire. Hierarchical regression analysis revealed that the demographic variable influencing MiLS was religious affiliation.
Conclusion
The K-MiLS had a multidimensional four-factor structure similar to that of the original version. It is also a reliable and valid measure for assessing cancer survivors’ meaning in life after a cancer diagnosis.
5.Establishment of Local Diagnostic Reference Levels for Pediatric Neck CT at Nine University Hospitals in South Korea
Jisun HWANG ; Hee Mang YOON ; Jae-Yeon HWANG ; Young Hun CHOI ; Yun Young LEE ; So Mi LEE ; Young Jin RYU ; Sun Kyoung YOU ; Ji Eun PARK ; Seok Kee LEE
Korean Journal of Radiology 2025;26(1):65-74
Objective:
To establish local diagnostic reference levels (DRLs) for pediatric neck CT based on age, weight, and water-equivalent diameter (WED) across multiple university hospitals in South Korea.
Materials and Methods:
This retrospective study analyzed pediatric neck CT examinations from nine university hospitals, involving patients aged 0–18 years. Data were categorized by age, weight, and WED, and radiation dose metrics, including volume CT dose index (CTDIvol) and dose length product, were recorded. Data retrieval and analysis were conducted using a commercially available dose-management system (Radimetrics, Bayer Healthcare). Local DRLs were established following the International Commission on Radiological Protection guidelines, using the 75th percentile as the reference value.
Results:
A total of 1159 CT examinations were analyzed, including 169 scans from Institution 1, 132 from Institution 2, 126 from Institution 3, 129 from Institution 4, 128 from Institution 5, 105 from Institution 6, 162 from Institution 7, 127 from Institution 8, and 81 from Institution 9. Radiation dose metrics increased with age, weight, and WED, showing significant variability both within and across institutions. For patients weighing less than 10 kg, the DRL for CTDIvol was 5.2 mGy. In the 10–19 kg group, the DRL was 5.8 mGy; in the 20–39 kg group, 7.6 mGy; in the 40–59 kg group, 11.0 mGy; and for patients weighing 60 kg or more, 16.2 mGy. DRLs for CTDIvol by age groups were as follows: 5.3 mGy for infants under 1 year, 5.7 mGy for children aged 1–4 years, 7.6 mGy for ages 5–9 years, 11.2 mGy for ages 10–14 years, and 15.6 mGy for patients 15 years or older.
Conclusion
Local DRLs for pediatric neck CT were established based on age, weight, and WED across nine university hospitals in South Korea.
6.Development of the Korean Version of the Meaning in Life Scale for Cancer Patients
Namgu KANG ; Hae-Yeon YUN ; Young Ae KIM ; Hye Yoon PARK ; Jong-Heun KIM ; Sun Mi KIM ; Eun-Seung YU
Psychiatry Investigation 2025;22(3):258-266
Objective:
This study aims to understand the structure of meaning in life among patients with cancer through the validation of the Meaning in Life Scale among Korean patients (K-MiLS) with cancer.
Methods:
From August 2021 to November 2022, participants were recruited from multiple sites in South Korea. Participants completed related questionnaires, including the MiLS, on the web or mobile. Test-retest reliability was assessed between 2 and 4 weeks after the initial assessment. Exploratory and confirmatory factor analyses and Pearson’s correlations were used to evaluate the reliability and validity of the MiLS. A multiple regression analysis was conducted to examine the sociodemographic and disease-related variables correlated with the MiLS. Regarding concurrent validity, a hierarchical regression analysis was performed.
Results:
The results (n=345) indicated that the K-MiLS has a four-factor structure: Harmony and Peace; Life Perspective, Purpose, and Goals; Confusion and Lessened Meaning; and Benefits of Spirituality. Regarding convergent and discriminant validity, K-MiLS was negatively correlated with Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Fear of Cancer Recurrence Inventory while showing a significantly positive correlation with the Posttraumatic Growth Inventory, Self-Compassion Scale, Functional Assessment of Cancer Therapy-General, and Functional Social Support Questionnaire. Hierarchical regression analysis revealed that the demographic variable influencing MiLS was religious affiliation.
Conclusion
The K-MiLS had a multidimensional four-factor structure similar to that of the original version. It is also a reliable and valid measure for assessing cancer survivors’ meaning in life after a cancer diagnosis.
7.Effects of Clinical Nurses' Ethical Climate and Ethical Nursing Competence on Moral Distress
Journal of Korean Academy of Nursing Administration 2025;31(1):25-35
Purpose:
This study aimed to identify the effects of clinical nurses' ethical climate and ethical nursing competence on moral distress.
Methods:
The participants were clinical nurses who provided direct nursing care; nurses with more than one year of work experience in general hospitals were targeted. The data were collected between January 3 and 19, 2024, and analyzed using t-test, analysis of variance, Games-Howell test, Pearson correlation coefficient, and multiple regression.
Results:
Moral distress was significantly and negatively correlated with ethical climate and ethical nursing competence. Factors affecting the moral distress of clinical nurses included having a position of charge nurse or higher, total clinical experience of more than 20 years, turnover intention from current job due to ethical issues, hospital sub factors of the ethical climate, and ethical behavior sub factors of ethical nursing competence, showing 27.0% explanatory power.
Conclusion
Establishing a positive ethical climate and improving ethical nursing competence providing opportunities for nurses to raise and solve ethical issues will contribute to resolving nurses' ethical conflicts and reducing moral distress.
8.Connective tissue disease is associated with the risk of posterior reversible encephalopathy syndrome following lung transplantation in Korea
Tae Jung KIM ; Hyun Joo LEE ; Samina PARK ; Sang-Bae KO ; Soo-Hyun PARK ; Seung Hwan YOON ; Kwon Joong NA ; In Kyu PARK ; Chang Hyun KANG ; Young Tae KIM ; Sun Mi CHOI ; Jimyung PARK ; Joong-Yub KIM ; Hong Yeul LEE
Acute and Critical Care 2025;40(1):79-86
Background:
Posterior reversible encephalopathy syndrome (PRES) is a rare complication of lung transplantation with poorly understood risk factors and clinical characteristics. This study aimed to examine the occurrence, risk factors, and clinical data of patients who developed PRES following lung transplantation.
Methods:
A retrospective analysis was conducted on 147 patients who underwent lung transplantation between February 2013 and December 2023. The patients were diagnosed with PRES based on the clinical symptoms and radiological findings. We compared the baseline characteristics and clinical information, including primary lung diseases and immunosuppressive therapy related to lung transplantation operations, between the PRES and non-PRES groups.
Results:
PRES manifested in 7.5% (n=11) of the patients who underwent lung transplantation, with a median onset of 15 days after operation. Seizures were identified as the predominant clinical manifestation (81.8%, n=9) in the group diagnosed with PRES. All patients diagnosed with PRES recovered fully. Patients with PRES were significantly associated with connective tissue disease-associated interstitial lung disease (45.5% vs. 18.4%, P=0.019, odds ratio=9.808; 95% CI, 1.064–90.386; P=0.044). Nonetheless, no significant variance was observed in the type of immunotherapy, such as the use of calcineurin inhibitors, blood pressure, or acute renal failure subsequent to lung transplantation.
Conclusions
PRES typically manifests shortly after lung transplantation, with seizures being the predominant initial symptom. The presence of preexisting connective tissue disease as the primary lung disease represents a significant risk factor for PRES following lung transplantation.
9.Effects of Clinical Nurses' Ethical Climate and Ethical Nursing Competence on Moral Distress
Journal of Korean Academy of Nursing Administration 2025;31(1):25-35
Purpose:
This study aimed to identify the effects of clinical nurses' ethical climate and ethical nursing competence on moral distress.
Methods:
The participants were clinical nurses who provided direct nursing care; nurses with more than one year of work experience in general hospitals were targeted. The data were collected between January 3 and 19, 2024, and analyzed using t-test, analysis of variance, Games-Howell test, Pearson correlation coefficient, and multiple regression.
Results:
Moral distress was significantly and negatively correlated with ethical climate and ethical nursing competence. Factors affecting the moral distress of clinical nurses included having a position of charge nurse or higher, total clinical experience of more than 20 years, turnover intention from current job due to ethical issues, hospital sub factors of the ethical climate, and ethical behavior sub factors of ethical nursing competence, showing 27.0% explanatory power.
Conclusion
Establishing a positive ethical climate and improving ethical nursing competence providing opportunities for nurses to raise and solve ethical issues will contribute to resolving nurses' ethical conflicts and reducing moral distress.
10.Effects of Clinical Nurses' Ethical Climate and Ethical Nursing Competence on Moral Distress
Journal of Korean Academy of Nursing Administration 2025;31(1):25-35
Purpose:
This study aimed to identify the effects of clinical nurses' ethical climate and ethical nursing competence on moral distress.
Methods:
The participants were clinical nurses who provided direct nursing care; nurses with more than one year of work experience in general hospitals were targeted. The data were collected between January 3 and 19, 2024, and analyzed using t-test, analysis of variance, Games-Howell test, Pearson correlation coefficient, and multiple regression.
Results:
Moral distress was significantly and negatively correlated with ethical climate and ethical nursing competence. Factors affecting the moral distress of clinical nurses included having a position of charge nurse or higher, total clinical experience of more than 20 years, turnover intention from current job due to ethical issues, hospital sub factors of the ethical climate, and ethical behavior sub factors of ethical nursing competence, showing 27.0% explanatory power.
Conclusion
Establishing a positive ethical climate and improving ethical nursing competence providing opportunities for nurses to raise and solve ethical issues will contribute to resolving nurses' ethical conflicts and reducing moral distress.

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