• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.111-115
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• 2011

Purpose: In vitro uses dose response curve with 6 to 7 standard concentrations in every examination to analyze examination results and this use of dose response curve comprises a large portion of the consumption of medicine material. At this present, some ones of in-hospital examination items have shown mostly low result of distribution in the analyzed features and these examinations have been judged that it would be unnecessary to use the last standard concentration. Hence, this study selects those examination items showing low result of distribution and reviews the cases contributed to less consumption of medicine material and revenue growth of hospital by reduction of medicine material used in the place of the last standard concentration. Materials and Methods: The study was made targeting 11 examination items out of total 43 items of the in-hospital examination and since these examination items were mostly low in the features as the examination results of patients or the examination results were distributed to show lower concentration than the previous last standard concentration, it carried out the examination without using the last standard concentration, which could generate the effect to reduce medicine material (examination tube) used in the last standard concentration as many as the number of examination carried out. For this, it examined the number of medicine material reduction by month during the period from July, 2009 to February, 2011 and estimated the reduction amount of medicine material calculated the number of reduction by the unit cost of medicine material as well as the profit generated by the reduced medicine material to use for the medicine material of patient examination. Results: The total number of medicine material reduced during the period from July, 2009 to February, 2011 was 3,131 pieces, which had the effect to reduce the medicine material equivalent to about 31 kits of reagent. To calculate this by the unit cost of the medicine material, it analyzed to reduce about 6.4 million won of medicine material cost. Also the reduced medicine materials were used for medicine materials of patient examination and this was analyzed to generate about 13.75 million won of profit based on the ABC cost accounting. Conclusion: It showed no problem in the analysis of examination result even without using the last standard concentration regarding those examination items with low distribution of the patient examination result. For these examination items, it was able to reduce medicine material used for the last standard as many as the number of examination carried out. Also, the adjustment of concentration range was found to have no problem in the reliability of examination result. Therefore, this case will be applicable in those occasions of when the analysis of patient examination result is mostly distributed at the lower level or when an examination with the distribution of patient results in the range of lower concentration than the previous last standard concentration is carried out and this is considered to increase the efficiency in the use of medicine material in vitro as well as contribute to the profit of hospitals.

• Journal of radiological science and technology
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• v.44 no.2
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• pp.109-115
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• 2021

In this study, a physical evaluation of internal radiation exposure in children was conducted using nuclear medicine test(Renal DTPA Dynamic Study) to simulate the distribution and effects of the radiation throughout the tracer kinetics over time. Monte Carlo simulations were performed to determine the internal medical radiation exposure during the tests and to provide basic data for medical radiation exposure management. Specifically, dose variability based on changes in the tracer kinetic was simulated over time. The internal exposure to the target organ (kidney) and other surrounding organs was then quantitatively evaluated and presented. When kidney function was normal, the dose to the target organ(kidney) was approximately 0.433 mGy/mCi, and the dose to the surrounding organs was approximately 0.138-0.266 mGy/mCi. When kidney function was abnormal, the dose to the surrounding organs was 0.228-0.419 mGy/mCi. This study achieved detailed radiation dose measurements in highly sensitive pediatric patients and enabled the prediction of radiation doses according to kidney function values. The proposed method can provide useful insights for medical radiation exposure management, which is particularly important and necessary for pediatric patients.

• The Korean Journal of Nuclear Medicine Technology
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• v.26 no.1
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• pp.42-46
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• 2022

Purpose In the meantime, there have been not many samples that require dilution, and it has been difficult for the examiner to set an appropriate dilution multiple for RIA test item and report the results. Accordingly, it was judged that it was necessary to set the maximum dilution multiple for each test and to verify the upper limit of the clinical reportable range. Therefore, in this study, the maximum dilution multiple for each RIA test was set and the upper limit of the clinical reportable range was verified accordingly Materials and Methods Among all RIA tests conducted at Asan Medical Center, the study treated on 30 types of tests which also conduct the dilution test. Data from March to July 2021 were collected and analyzed. The study was conducted on samples subjected to serial dilutions such as X2, X4 or X10, X10², X10³, X10⁴, X10⁵. Results Among a total of 30 test types, 18 test types have more than 5 N values in the tolerance range of 80~120%. As a result of the verification of maximum dilution multiples, the test set to 10⁴ is 𝛼-fetoprotein and thyroglobulin, and the test set to 10³ is CA-125, CEA, and 𝛽-hCG, and the test set to 10² is Free PSA, PSA, CA15-3, SCC, Ferritin, PTH, Cortisol, and Calcitonin. Tests set to 10 include three categories: 𝛽2-Microglobulin, C-peptide, and Testosterone. Conclusion It is expected that it will contribute to improving the quality of nuclear medicine blood tests as the results of dilution experiments can be reported quickly and accurately through the verification of the clinical reportable range.

• Journal of the Korean Society of Radiology
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• v.5 no.5
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• pp.295-302
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• 2011

To n the field of nuclear medicine, with regard to checking regular patients, from the moment they register up to the doctor's diagnosis, the person in charge of the checks can find errors in the diagnosis, reexamine, reanalyze the results or save images to PACS. Through this process, the results obtained from the readings are delayed due to checks and additional tests which occur in hospitals, causing patient satisfaction and affected reliability. Accordingly, the purpose is to include visual inspection of the results to minimize error, improve efficiency and increase patient satisfaction. Nuclear medicine and imaging tests from examines at Asan Medical Center, Seoul, from March 2008 to December 2008, were analyzed for errors. The first stage, from January 2009 to December 2009, established procedures and know-how. The second stage from January 2010 until June 2010 conducted Pre-and Post-filtering assessment, and the third stage from July 2010 until October 2010 consisted of cross-checks and attaching stickers and comparing error cases. Of 92 errors, the 1st, 2nd and 3rd stage had 32 cases, and there were 46 cases after the 4th stage, with the overall errors reduced by 74.3% from 94.6%. In the field of general nuclear medicine, where various kinds of checks are performed according to the patient's needs, analysis, image composition, differing images in PACS, etc, all have the potential for mistakes to be made. In order to decrease error rates, the image can continuously Cross-Check and Confirm diagnosis.

• The Korean Journal of Nuclear Medicine Technology
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• v.26 no.2
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• pp.43-47
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• 2022

Purpose Radioimmunoassay implement quality control by systematizing the internal quality control system for quality assurance of test results. This study aims to contribute to the quality assurance of radioimmunoassay results and to implement systematic quality control by measuring the average CV of internal quality control and external quality control by plenty of institutions for reference when setting the laboratory's own acceptable range. Materials and Methods We measured the average CV of internal quality control and the bounce rate of more than 10.0% for a total of 42 items from October 2020 to December 2021. According to the CV result, we classified and compared the upper group (5.0% or less), the middle group (5.0~10.0%) and the lower group (10.0% or more). The bounce rate of 10.0% or more was compared by classifying the item of five or more institutions into tumor markers, thyroid hormones and other hormones. The average CV was measured by the overall average and standard deviation of the external quality control results for 28 items from the first quarter to the fourth quarter of 2021. In addition, the average CV was measured by the overall average and standard deviation of the proficiency results between institutions for 13 items in the first half and the second half of 2021. The average CV of internal quality control and external quality control was compared by item so we compared and analyzed the items that implement well to quality control and the items that require attention to quality control. Results As a result of measuring the precision average of internal quality control for 42 items of six institutions, the top group (5.0% or less) are Ferritin, HGH, SHBG, and 25-OH-VitD, while the bottom group (≤10.0%) are cortisol, ATA, AMA, renin, and estradiol. When comparing more than 10.0% bounce rate of CV for tumor markers, CA-125 (6.7%), CA-19-9 (9.8%) implemented well, while SCC-Ag (24.3%), CA-15-3 (26.7%) were among the items that require attention to control. As a result of comparing the bounce rate of more than 10.0% of CV for thyroid hormones examination, free T4 (2.1%), T3 (9.3%) showed excellent performance and AMA (39.6%), ATA (51.6%) required attention to control. When comparing the bounce rate of 10.0% or more of CV for other hormones, IGF-1 (8.8%), FSH (9.1%), prolactin (9.2%) showed excellent performance, however estradiol (37.3%), testosterone (37.7%), cortisol (44.4%) required attention to control. As a result of measuring the average CV of the whole institutions participating at external quality control for 28 items, HGH and SCC-Ag were included in the top group (≤10.0%), however ATA, estradiol, TSI, and thyroglobulin included in bottom group (≥30.0%). Conclusion As a result of evaluating 42 items of six institutions, the average CV was 3.7~12.2% showing a 3.3 times difference between the upper group and the lower group. Cortisol, ATA, AMA, Renin and estradiol tests with high CV will require continuous improvement activities to improve precision. In addition, we measured and compared the overall average CV of the internal quality control, the external quality control and the proficiency between institutions participating of six institutions for 41 items excluding HBs-Ab. As a result, ATA, AMA, Renin and estradiol belong to the same subgroup so we require attention to control and consider setting a higher acceptable range. It is recommended to set and control the acceptable range standard of internal quality control CV in consideration of many things in the laboratory due to the different reagents and instruments, and the results vary depending on the test's proficiency and quality control materials. It is thought that the accuracy and reliability of radioimmunoassay results can be improved if systematic quality control is implemented based on the set acceptable range.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.101-105
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• 2011

Purpose: Estradiol in the menstrual cycle and ovulation induction as an important test of currently national nuclear medicine laboratory in the normal patients and patients with infertility tests are being performed. For the diagnosis of menopause is an important test with follicle stimulating hormone (FSH) and Luteinizing hormone (LH). Currently participating in external quality control of the nation's hospitals that is 54 percent of 37 hospitals, 20 hospitals have been using A's reagent. The kit's test results are highly different from other kit comes with the test results of specimens have been found. And for the phenomenon is to study the problem. Materials and Methods: Estraiol test were referred to our hospital which results of samples as more than 100pg/ml 75 specimens measured by radioimmunoassay(RIA) test with company A company B company C company D Kit, Chemiluminescent assay (CMIA) to examine and compare to the results from april to August in 2010. Results: Kit for each manufacturing company as measured by the results obtained using the average value of the correlation coefficient (R2) and A company 0.8906 B 0.9527 C 0.9547 and D company correlation coefficient of 0.873 showed a good correlation that measuring the results of A company high concentrations when Company B Company C Company D with CMIA test concentrations measured low results that the two cases were discovered specimens. Conclusion: Most of the test results of 75 samples came up with a similar trend, but two cases were reported in the patients very differently. A company result reported higher than 700 pg/ml, while the rest of other test results report was approximately 10 pg/ml. The common point of two samples more than 50 years patients are estimated to be diagnosed with cancer in postmenopausal patients receiving treatment and levels of FSH were found to be greater than 50 mIU/ml. Did not identify the exact cause. I suggest if you are using A company kit that need to again check when Estradiol result and follicle stimulating hormone results is higher.

• The Journal of the Korea Contents Association
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• v.8 no.12
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• pp.236-245
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• 2008

The cancer patient who leads Bone scan and the PET study from in the nuclear medical study what is enforced with the link of early detection and the time which spreads, it will be able to accomplish a positive treatment with the data which presumes that time it researches a degree as cancer discovery initially and only difference of final period the bay it knows. The patient who receives a cancer decision it will be able to accomplish the necessary defense it will be able to delay the time in order, the maximum control the possibility of doing will be becomes the judgement. Cancer decision to initially the nuclear study and treatment it will be in parallel with effort and the investment which are constant and the schedule hour will elapse and to after difficulty some the case which comes to be negligent will be frequent and it will appear with him there to be a possibility of knowing, it will be caused by and the transfer of the cancer sell will be activity. It has a treatment objective and are to each medical treatment agency against and the medical treatment agency worker it will be able to overlook is not the portion is the private plan which needs a more positive disposal, it does.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.106-112
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• 2011

Purpose: Until now, the process was improved by the needs of experimenters personally. But recently, suggestion system in hospital has been activated in various ways. So the department of nuclear medicine laboratory is also aware of the need of operation improvement using suggestion system. It is intend to assist in the development by sharing excellent suggestion cases with other hospitals. Material & Method: A total of 124 suggestion cases from January 2007 to March 2010 were analyzed. Suggestion cases were divided into customer satisfaction, cost reduction, improved testing methods, equipment, environmental improvement, and computational system. Result: Suggestion cases of environmental improvement and computational system were accounted for 26.6% as 33 cases, respectively. Suggestion for customer satisfaction is 25.8% as 32 in a total of 124 cases. Conclusion: Activation of the awareness of operation improvement is induced by suggestion system. By securing system of operation improvement, employees' ideas can lead to the production and systematization. Furthermore, it enhances hospital competitiveness and promotes the development of the hospital.

• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.1
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• pp.44-49
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• 2017

Purpose Radiation exposure management has been strictly regulated for the radiation workers, but there are only a few studies on potential risk of radiation exposure to non-radiation workers, especially nurses in a general ward. The present study aimed to estimate the exact total exposure of the nurse in a general ward by close contact with the patient undergoing nuclear medicine examinations. Materials and Methods Radiation exposure rate was determined by using thermoluminescent dosimeter (TLD) and optical simulated luminescence (OSL) in 14 nurses in a general ward from October 2015 to June 2016. External radiation rate was measured immediately after injection and examination at skin surface, and 50 cm and 1 m distance from 50 patients (PET/CT 20 pts; Bone scan 20 pts; Myocardial SPECT 10 pts). After measurement, effective half-life, and total radiation exposure expected in nurses were calculated. Then, expected total exposure was compared with total exposures actually measured in nurses by TLD and OSL. Results Mean and maximum amount of radiation exposure of 14 nurses in a general ward were 0.01 and 0.02 mSv, respectively in each measuring period. External radiation rate after injection at skin surface, 0.5 m and 1 m distance from patients was as following; $376.0{\pm}25.2$, $88.1{\pm}8.2$ and $29.0{\pm}5.8{\mu}Sv/hr$, respectively in PET/CT; $206.7{\pm}56.6$, $23.1{\pm}4.4$ and $10.1{\pm}1.4{\mu}Sv/hr$, respectively in bone scan; $22.5{\pm}2.6$, $2.4{\pm}0.7$ and $0.9{\pm}0.2{\mu}Sv/hr$, respectively in myocardial SPECT. After examination, external radiation rate at skin surface, 0.5 m and 1 m distance from patients was decreased as following; $165.3{\pm}22.1$, $38.7{\pm}5.9$ and $12.4{\pm}2.5{\mu}Sv/hr$, respectively in PET/CT; $32.1{\pm}8.7$, $6.2{\pm}1.1$, $2.8{\pm}0.6$, respectively in bone scan; $14.0{\pm}1.2$, $2.1{\pm}0.3$, $0.8{\pm}0.2{\mu}Sv/hr$, respectively in myocardial SPECT. Based upon the results, an effective half-life was calculated, and at 30 minutes after examination the time to reach normal dose limit in 'Nuclear Safety Act' was calculated conservatively without considering a half-life. In oder of distance (at skin surface, 0.5 m and 1 m distance from patients), it was 7.9, 34.1 and 106.8 hr, respectively in PET/CT; 40.4, 199.5 and 451.1 hr, respectively in bone scan, 62.5, 519.3 and 1313.6 hr, respectively in myocardial SPECT. Conclusion Radiation exposure rate may differ slightly depending on the work process and the environment in a general ward. Exposure rate was measured at step in the general examination procedure and it made our results more reliable. Our results clearly showed that total amount of radiation exposure caused by residual radioactive isotope in the patient body was neglectable, even comparing with the natural radiation exposure. In conclusion, nurses in a general ward were much less exposed than the normal dose limit, and the effects of exposure by contacting patients undergoing nuclear medicine examination was ignorable.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.26-32
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• 2010

Purpose: It is to find the way to minimize occupationally exposed dose for workers in vivo tests in each working stage within the range of the working environment which does not ruin the examination and the performance efficiency. Materials and Methods: The process of the nuclear tests in vivo using a radioactive isotope consists of radioisotope distribution, a radioisotope injection ($^{99m}Tc$, $^{18}F$-FDG), and scanning and guiding patients. Using a measuring instrument of RadEye-G10 gamma survey meter (Thermo SCIENTIFIC), the exposure doses in each working stage are measured and evaluated. Before the radioisotope injection the patients are explained about the examination and educated about matters that require attention. It is to reduce the meeting time with the patients. In addition, workers are also educated about the outside exposure and have to put on the protected devices. When the radioisotope is injected to the patients the exposure doses are measured due to whether they are in the protected devices or not. It is also measured due to whether there are the explanation about the examination and the education about matters that require attention or not. The total exposure dose is visualized into the graph in using Microsoft office excel 2007. The difference of this doses are analyzed by wilcoxon signed ranks test in using SPSS (statistical package for the social science) program 12.0. In this case of p<0.01, this study is reliable in the statistics. Results: It was reliable in the statistics that the exposure dose of injecting $^{99m}Tc$-DPD 20 mCi in wearing the protected devices showed 88% smaller than the dose of injecting it without the protected devices. However, it was not reliable in the statistics that the exposure dose of injecting $^{18}F$-FDG 10 mCi with wearing protected devices had 26% decrease than without them. Training before injecting $^{99m}Tc$-DPD 20 mCi to patient made the exposure dose drop to 63% comparing with training after the injection. The dose of training before injecting $^{18}F$-FDG 10 mCi had 52% less then the training after the injection. Both of them were reliable in the statistics. Conclusion: In the examination of using the radioisotope $^{99m}Tc$, wearing the protected devices are more effective to reduce the exposure dose than without wearing them. In the case of using $^{18}F$-FDG, reducing meeting time with patients is more effective to drop the exposure dose. Therefore if we try to protect workers from radioactivity according to each radioisotope characteristic it could be more effective and active radiation shield from radioactivity.