• 한국노년학
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• v.41 no.2
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• pp.197-215
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• 2021

This study aims to evaluate Person Centered Care practice and characteristics of care services in Korean long-term care facilities using Dementia Care Mapping as a tool. DCM, systematic observational evaluation tool for measuring dementia patients' QOL, was transformed into self-report rating scale. The process of transforming DCM into a scale of 34 items involves operationalization of DCM concepts and it's adaptation into Korean long-term care practices. Review by research team of Bradford university was added to maintain DCM concept and meaning in this scale. The scale with Cronbach alpha of .88 was surveyed on 343 care workers. Survey result shows PCC value practiced by them is 3.77(of 5 likert scale) and values on each categories of PCC reveal the characteristics of care in Korean facilities; attachment(4.02), comfort(3.95), inclusion(3.89), identity(3.67) and occupation(3.41). Dementia care in Korean facilities focuses on recipients'safety, comfort but lacks individualistic care and the meaningful and fulfilling occupation for patients. Looking at the organizational and individual factors influencing DCM values, the small facilities showed higher PCC values and there are no significant difference in PCC values between public and private facilities. Managers and care workers with career of 1~2 years showed higher PCC values compared to other career ranks and lengthes. This study suggests care practice should be centered on personhood of patients in long-term care facilities, for which introduction of unit care and education of PCC for service providers including support personnel are needed. DCM and Korean DCM scale developed in this study are suggested for the PCC-based assessment on care quality.

• Journal of the Korean Orthopaedic Association
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• v.55 no.4
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• pp.324-330
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• 2020

Purpose: Korean studies on the prevalence of a tarsal coalition are quite rare, and there are very few reports on the prevalence of multiple tarsal coalitions among adults in the foreign literature. Therefore, this study examined the characteristics and prevalence of tarsal coalition in the Korean population based on imaging tests. Materials and Methods: The prevalence of tarsal coalition and its anatomical location and histological classification were reviewed retrospectively among 4,711 patients (4,454 males and 257 females) with an ankle sprain or ankle fracture who underwent foot and ankle computed tomography and magnetic resonance imaging between March 2009 and February 2019 at the authors' institution. Results: Over a period of 10 years, 78 patients (1.7%) had a tarsal coalition, among whom 53 patients (67.9%) had an isolated tarsal coalition and 25 patients (32.1%) had multiple tarsal coalitions. Regarding the anatomical location, a talocalcaneal coalition was the most common type in both isolated (31 patients, 37 cases [62.7%]) and multiple (22 patients, 23 cases [45.1%]) tarsal coalitions. In the isolated coalition group, the second-most common type was calcaneonavicular coalition (10 patients, 16.9%), followed by naviculocuneiform (nine patients, 15.3%) and cuboidonavicular coalitions (three patients, 5.1%). In the multiple coalition group, the second-most common coalition type was calcaneonavicular coalition (14 patients, 14 cases [27.5%]), followed by talonavicular coalition (six patients, six cases [11.8%]). From a total of 60 cases of talocalcaneal coalition, 24 cases (40.0%) were in the posterior facet, 18 cases (30.0%) in the middle facet, and four cases (6.7%) in the anterior facet. Regarding the histological classification, cartilaginous coalition was the most common in both single (32 patients, 35 cases [59.3%]) and multiple (20 patients, 37 cases [72.5%]) coalition groups. Conclusion: The present study found that talocalcaneal coalition was the most common type of tarsal coalition. In contrast to previous reports that a talocalcaneal coalition generally occurs in the middle facet, it was usually observed in the posterior facet in the present study. In addition, although multiple tarsal coalitions have been reported to be quite rare, this study confirmed that they are not rare and can occur in a range of patterns.

• Journal of the Korean Society of Radiology
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• v.83 no.5
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• pp.1059-1070
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• 2022

Purpose To compare the sensitivity of tumor detection and inter-observer agreement between acquired diffusion-weighted imaging (aDWI) b2000 and computed DWI (cDWI) b2000 in patients with prostate cancer (PCa). Materials and Methods Eighty-eight patients diagnosed with PCa by radical prostatectomy and having undergone pre-operative 3 Tesla-MRI, including DWI (b, 0, 100, 1000, 2000 s/mm²), were included in the study. cDWI b2000 was obtained from aDWI b0, b100, and b1000. Two independent reviewers performed a review of the aDWI b2000 and cDWI b2000 images in random order at 4-week intervals. A region of interest was drawn for the largest tumor on each dataset, and a Prostate Imaging-Reporting and Data System (PI-RADS) score based on PI-RADS v2.1 was recorded. Histologic topographic maps served as the reference standard. Results The study population's Gleason scores were 6 (n = 16), 7 (n = 53), 8 (n = 9), and 9 (n = 10). According to the reviewers, the sensitivities of cDWI b2000 and aDWI b2000 showed no significant differences (for reviewer 1, both 94% [83/88]; for reviewer 2, both 90% [79/88]; p = 1.000, respectively). The kappa values of cDWI b2000 and aDWI b2000 for the PI-RADS score were 0.422 (95% confidence interval [CI], 0.240-0.603) and 0.495 (95% CI, 0.308-0.683), respectively. Conclusion cDWI b2000 showed comparable sensitivity with aDWI b2000, in addition to sustained moderate inter-observer agreement, in the detection of PCa.

• Journal of the Korean Society of Radiology
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• v.81 no.2
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• pp.395-408
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• 2020

Purpose To evaluate the value of clinicopathologic factors and imaging features of primary breast cancer in predicting early recurrence after the primary treatment. Materials and Methods We enrolled 480 patients who had been followed-up after breast-conserving surgery and adjuvant therapy from January 2010 to December 2014 at our hospital. Early recurrence was defined as recurrence within 3 years after completion of primary treatment, and univariate and multivariate logistic regression analyses were performed to determine the clinicopathologic and imaging predictive factors of early recurrence. Results In the univariate analysis, among the clinicopathologic factors, advanced stage (p = 0.021), high histologic grade (p < 0.001), estrogen receptor negative (p = 0.002), high Ki-67 proliferation index (p = 0.017), and triple-negative breast cancer (p = 0.019), and among the imaging features, multifocality (p < 0.001), vessels in the rim on Doppler ultrasonography (US) (p = 0.012), and rim enhancement (p < 0.001) on magnetic resonance imaging of the breast were significantly associated with early recurrence. In the multivariate analysis, advanced stage [odds ratio (OR) = 3.47; 95% confidence interval (CI) 1.12-10.73; p = 0.031] and vessels in the rim on Doppler US (OR = 3.32; 95% CI 1.38-8.02; p = 0.008) were the independent predictive factors of early recurrence. Conclusion Vascular findings in the rim of the primary breast cancer on Doppler US before treatment is a radiologic independent predictive factor of early recurrence after the primary treatment.

• Journal of the Korean Society of Radiology
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• v.84 no.2
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• pp.427-440
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• 2023

Purpose This study aimed to investigate the correlation between the fat signal fraction (FF) of the fat-dominant bone tissue of the knee joint, measured using the MRI Dixon method (DIXON) technique, and bone mineral density (BMD). Materials and Methods Among the patients who underwent knee DIXON imaging at our institute, we retrospectively analyzed 93 patients who also underwent dual energy X-ray absorptiometry within 1 year. The FFs of the distal femur metaphyseal (Fm) and proximal tibia metaphyseal (Tm) were calculated from the DIXON images, and the correlation between FF and BMD was analyzed. Patients were grouped based on BMD of lumbar spine (L), femoral neck (FN), and common femur (FT) respectively, and the Kruskal-Wallis H test was performed for FF. Results We identified a significant negative correlation between TmFF and FN-BMD in the entire patient group (r = -0.26, p < 0.05). In female patients, TmFF showed a negative correlation with FN-BMD, FT-BMD, and L-BMD (r = -0.38, 0.28 and -0.27, p < 0.05). In male patients, FmFF was negatively correlated with only FN-BMD and FT-BMD (r = -0.58 and -0.42, p < 0.05). There was a significant difference in the TmFF between female patients grouped by BMD (p < 0.05). In male patients, there was a significant difference in FmFF (p < 0.05). Conclusion Overall, we found that FF and BMD around the knee joints showed a negative correlation. This suggests the potential of FF measurement using DIXON for BMD screening.

• Sleep Medicine and Psychophysiology
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• v.17 no.1
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• pp.41-49
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• 2010

Unlike the case of adult obstructive sleep apnea syndrome (OSAS), there was no consistent finding on the changes of sleep architecture in childhood OSAS. Further understanding of the sleep electroencephalogram (EEG) should be needed. Non-linear analysis of EEG is particularly useful in giving us a new perspective and in understanding the brain system. The objective of the current study is to compare the sleep architecture and the scaling exponent (${\alpha}$) from detrended fluctuation analysis (DFA) on sleep EEG between OSAS and normal children. Fifteen normal children (8 boys/7 girls, 6.0${\pm}4.3$2.2 years old) and twelve OSAS children (10 boys/2 girls, 6.4${\pm}4.3$3.4 years old) were studied with polysomnography (PSG). Sleep-related variables and OSAS severity indices were obtained. Scaling exponent of DFA were calculated from the EEG channels (C3/A2, C4/A1, O1/A2, and O2/A1), and compared between normal and OSAS children. No difference in sleep architecture was found between OSAS and normal controls except stage 1 sleep (%) and REM sleep latency (min). Stage 1 sleep (%) was significantly higher and REM latency was longer in OSAS group (9.3${\pm}4.3$4.3%, 181.5${\pm}4.3$59.9 min) than in controls (5.6${\pm}4.3$2.8%, 133.5${\pm}4.3$42.0 min). Scaling exponent (${\alpha}$) showed that sleep EEG of OSAS children also followed the 'longrange temporal correlation' characteristics. Value of ${\alpha}$ increased as sleep stages increased from stage 1 to stage 4. Value of ${\alpha}$ from C3/A2, C4/A1, O1/A2, O2/A1 were significantly lower in OSAS than in control (1.36${\pm}4.3$0.05 vs. 1.41${\pm}4.3$0.04, 1.37${\pm}4.3$0.04 vs. 1.41${\pm}4.3$0.04, 1.37${\pm}4.3$0.05 vs. 1.41${\pm}4.3$0.05, and 1.36${\pm}4.3$0.07 vs. 1.41${\pm}4.3$0.05, p<0.05). Higher stage 1 sleep (%) in OSAS children was consistent finding with OSAS adults. Lower $'{\alpha}'$ in OSAS children suggests decrease of self-organized criticality or the decreased piling-up energy of brain system during sleep in OSAS children.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.1
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• pp.127-135
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• 2014

Purpose : By taking advantage of each imaging modality, the use of fused CT/MRI image has increased in prostate cancer radiation therapy. However, fusion uncertainty may cause partial target miss or normal organ overdose. In order to complement such limitation, our hospital acquired MRI image (Planning MRI) by setting up patients with the same fixing tool and posture as CT simulation. This study aims to evaluate the usefulness of the Planning MRI through comparing and analyzing the diagnostic MRI image and Planning MRI image. Materials and Methods : This study targeted 10 patients who had been diagnosed with prostate cancer and prescribed nonhormone and definitive RT 70 Gy/28 fx from August 2011 to July 2013. Each patient had both CT and MRI simulations. The MRI images were acquired within one half hour after the CT simulation. The acquired CT/MRI images were fused primarily based on bony structure matching. This study measured the volume of prostate in the images of Planning MRI and diagnostic MRI. The diameters at the craniocaudal, anteroposterior and left-to-right directions from the center of prostate were measured in order to compare changes in the shape of prostate. Results : As a result of comparing the volume of prostate in the images of Planning MRI and diagnostic MRI, they were found to be $25.01cm^3$(range $15.84-34.75cm^3$) and $25.05cm^3$(range $15.28-35.88cm^3$) on average respectively. The diagnostic MRI had an increase of 0.12 % as compared with the Planning MRI. On the planning MRI, there was an increase in the volume by $7.46cm^3$(29 %) at the transition zone directions, and there was a decrease in the volume by $8.52cm^3$(34 %) in the peripheral zone direction. As a result of measuring the diameters at the craniocaudal, anteroposterior and left-to-right directions in the prostate, the Planning MRI was found to have on average 3.82cm, 2.38cm and 4.59cm respectively and the diagnostic MRI was found to have on average 3.37cm, 2.76cm and 4.51cm respectively. All three prostate diameters changed and the change was significant in the Planning MRI. On average, the anteroposterior prostate diameter decrease by 0.38cm(13 %). The mean right-to-left and craniocaudal diameter increased by 0.08cm(1.6 %) and 0.45cm(13 %), respectively. Conclusion : Based on the results of this study, it was found that the total volumes of prostate in the Planning MRI and the diagnostic MRI were not significantly different. However, there was a change in the shape and partial volume of prostate due to the insertion of prostate balloon tube to the rectum. Thus, if the Planning MRI images were used when conducting the fusion of CT/MRI images, it would be possible to include the target in the CTV without a loss as much as the increased volume in the transition zone. Also, it would be possible to reduce the radiation dose delivered to the rectum through separating more clearly the reduction of peripheral zone volume. Therefore, the author of this study believes that acquisition of Planning MRI image should be made to ensure target delineation and localization accuracy.