• Korean Journal of Radiology
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• 제23권10호
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• pp.959-975
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• 2022

Objective: To investigate the agreement and reliability of estimating the volumes and normative percentiles (N%) of segmented brain regions among NeuroQuant (NQ), DeepBrain (DB), and FreeSurfer (FS) software programs, focusing on the comparison between NQ and DB. Materials and Methods: Three-dimensional T1-weighted images of 145 participants (48 healthy participants, 50 patients with mild cognitive impairment, and 47 patients with Alzheimer's disease) from a single medical center (SMC) dataset and 130 participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset were included in this retrospective study. All images were analyzed with DB, NQ, and FS software to obtain volume estimates and N% of various segmented brain regions. We used Bland-Altman analysis, repeated measures ANOVA, reproducibility coefficient, effect size, and intraclass correlation coefficient (ICC) to evaluate inter-method agreement and reliability. Results: Among the three software programs, the Bland-Altman plot showed a substantial bias, the ICC showed a broad range of reliability (0.004-0.97), and repeated-measures ANOVA revealed significant mean volume differences in all brain regions. Similarly, the volume differences of the three software programs had large effect sizes in most regions (0.73-5.51). The effect size was largest in the pallidum in both datasets and smallest in the thalamus and cerebral white matter in the SMC and ADNI datasets, respectively. N% of NQ and DB showed an unacceptably broad Bland-Altman limit of agreement in all brain regions and a very wide range of ICC values (-0.142-0.844) in most brain regions. Conclusion: NQ and DB showed significant differences in the measured volume and N%, with limited agreement and reliability for most brain regions. Therefore, users should be aware of the lack of interchangeability between these software programs when they are applied in clinical practice.

• Korean Journal of Radiology
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• 제24권7호
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• pp.681-689
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• 2023

Objective: Three-dimensional rotational angiography (3D-RA) is increasingly used for the evaluation of intracranial aneurysms (IAs); however, radiation exposure to the lens is a concern. We investigated the effect of head off-centering by adjusting table height on the lens dose during 3D-RA and its feasibility in patient examination. Materials and Methods: The effect of head off-centering during 3D-RA on the lens radiation dose at various table heights was investigated using a RANDO head phantom (Alderson Research Labs). We prospectively enrolled 20 patients (58.0 ± 9.4 years) with IAs who were scheduled to undergo bilateral 3D-RA. In all patients' 3D-RA, the lens dose-reduction protocol involving elevation of the examination table was applied to one internal carotid artery, and the conventional protocol was applied to the other. The lens dose was measured using photoluminescent glass dosimeters (GD-352M, AGC Techno Glass Co., LTD), and radiation dose metrics were compared between the two protocols. Image quality was quantitatively analyzed using source images for image noise, signal-to-noise ratio, and contrast-to-noise ratio. Additionally, three reviewers qualitatively assessed the image quality using a five-point Likert scale. Results: The phantom study showed that the lens dose was reduced by an average of 38% per 1 cm increase in table height. In the patient study, the dose-reduction protocol (elevating the table height by an average of 2.3 cm) led to an 83% reduction in the median dose from 4.65 mGy to 0.79 mGy (P < 0.001). There were no significant differences between dose-reduction and conventional protocols in the kerma area product (7.34 vs. 7.40 Gy·cm², P = 0.892), air kerma (75.7 vs. 75.1 mGy, P = 0.872), and image quality. Conclusion: The lens radiation dose was significantly affected by table height adjustment during 3D-RA. Intentional head off-centering by elevation of the table is a simple and effective way to reduce the lens dose in clinical practice.

• Korean Journal of Radiology
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• 제24권11호
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• pp.1102-1113
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• 2023

Objective: To elucidate the use of radiological studies, including nuclear medicine, and biopsy for the diagnosis and staging of prostate cancer (PCA) in clinical practice and understand the current status of PCA in Asian countries via an international survey. Materials and Methods: The Asian Prostate Imaging Working Group designed a survey questionnaire with four domains focused on prostate magnetic resonance imaging (MRI), other prostate imaging, prostate biopsy, and PCA backgrounds. The questionnaire was sent to 111 members of professional affiliations in Korea, Japan, Singapore, and Taiwan who were representatives of their working hospitals, and their responses were analyzed. Results: This survey had a response rate of 97.3% (108/111). The rates of using 3T scanners, antispasmodic agents, laxative drugs, and prostate imaging-reporting and data system reporting for prostate MRI were 21.6%-78.9%, 22.2%-84.2%, 2.3%-26.3%, and 59.5%-100%, respectively. Respondents reported using the highest b-values of 800-2000 sec/mm² and fields of view of 9-30 cm. The prostate MRI examinations per month ranged from 1 to 600, and they were most commonly indicated for biopsy-naïve patients suspected of PCA in Japan and Singapore and staging of proven PCA in Korea and Taiwan. The most commonly used radiotracers for prostate positron emission tomography are prostate-specific membrane antigen in Singapore and fluorodeoxyglucose in three other countries. The most common timing for prostate MRI was before biopsy (29.9%). Prostate-targeted biopsies were performed in 63.8% of hospitals, usually by MRI-ultrasound fusion approach. The most common presentation was localized PCA in all four countries, and it was usually treated with radical prostatectomy. Conclusion: This survey showed the diverse technical details and the availability of imaging and biopsy in the evaluation of PCA. This suggests the need for an educational program for Asian radiologists to promote standardized evidence-based imaging approaches for the diagnosis and staging of PCA.

• 대한한의학방제학회지
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• 제31권4호
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• pp.361-371
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• 2023

Objectives : Gastric cancer is a malignant tumor of the digestive tract that not only has a high mortality rate, but also affects quality of life. In Traditional Korean Medicine, acupuncture and herbal medicines can increase the survival rate for Gastric cancer and improve the quality of life. Traditional Korean Medicine treatment played an important role when used alone or in combination with chemotherapy. However, there is still insufficient evidence to support the efficacy and safety of Traditional Korean Medicine in patients undergoing chemotherapy after surgery. Therefore, the purpose of this study is to systematically evaluate the effect of oriental medicine treatment on patients as a complementary therapy for Gastric cancer. Methods : 2 researchers will search using EMBASE, Pubmed, CNKI, Cochrane Library, CiNii, KMBASE, KISS, OASIS, RISS, ScienceON. The search period of the database is from inception until June 2022. This study will include a randomized controlled trial of GC for acupuncture and herbal treatment. Primary outcomes include anti-cancer effects. Secondary outcomes evaluate survival rates and improvements in quality of life. The data uses Review Manager Software 5.4. Results : This study will provide a systematic evaluation by synthesizing the anti-cancer effect, survival rate and quality of life of Gastric cancer when Traditional Korean Medicine is combined with chemotherapy. Conclusion : The conclusion of this study will provide a basis for determining whether Traditional Korean Medicine treatment for Gastric cancer treatment is an effective and safe treatment method in clinical practice.

• 대한영상의학회지
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• 제85권1호
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• pp.3-23
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• 2024

임상에서 자주 접하게 되는 추간판탈출증 중 분리추간판은 추간판의 성분이 원래의 수질핵과 완전히 분리되는 특별한 경우를 의미한다. 이러한 분리추간판은 척추관 내부뿐만 아니라 외부에도 위치할 수 있으며, 주변 구조물에 압력을 가하거나 신경 경로를 압박하게 되고 이로 인해 다양한 임상 증상을 유발할 수 있다. 특히 경막 내에 위치한 분리추간판의 경우, 경막절개술을 통해서만 병변을 식별할 수 있다. 따라서 수술 전에 분리추간판의 정확한 위치와 범위를 파악하는 것은 수술 계획을 세우는 데 중요하다. 자기공명영상에서 분리추간판은 초기에는 모체 추간판과 유사한 신호강도를 보이지만 이후 독립적인 퇴행 변화를 거치며 신호강도가 달라질 수 있다. 또한 대부분의 분리추간판 조각은 염증 반응의 결과로 인해 인접한 혈관발생과 육아조직의 형성 정도에 따라 다양한 정도의 주변 조영증강을 보일 수 있다. 이종설에서는 분리추간판의 다양한 영상 소견과 위치를 소개하여 환자에게 정확한 진단과 적절한 치료 방향을 제시하는 데 도움이 되고자 한다.

• Clinical Endoscopy
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• 제55권6호
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• pp.801-809
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• 2022

Background/Aims: Current society guidelines recommend antibiotic prophylaxis for 3 to 5 days after endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic cystic lesions (PCLs). The overall quality of the evidence supporting this recommendation is low. In this study, we aimed to assess cyst infection and adverse event rates after EUS-FNA of PCLs among patients treated with or without postprocedural prophylactic antibiotics. Methods: We retrospectively reviewed all patients who underwent EUS-FNA of PCLs between 2015 and 2019 at two large-volume academic medical centers with different practice patterns of postprocedural antibiotic prophylaxis. Data on patient demographics, cyst characteristics, fine-needle aspiration technique, periprocedural and postprocedural antibiotic prophylaxis, and adverse events were retrospectively extracted. Results: A total of 470 EUS-FNA procedures were performed by experienced endosonographers for the evaluation of PCLs in 448 patients, 58.7% of whom were women. The mean age was 66.3±12.8 years. The mean cyst size was 25.7±16.9 mm. Postprocedural antibiotics were administered in 274 cases (POSTAB+ group, 58.3%) but not in 196 cases (POSTAB- group, 41.7%). None of the patients in either group developed systemic or localized infection within the 30-day follow-up period. Procedure-related adverse events included mild abdominal pain (8 patients), intra-abdominal hematoma (1 patient), mild pancreatitis (1 patient), and perforation (1 patient). One additional case of pancreatitis was recorded; however, the patient also underwent endoscopic retrograde cholangiopancreatography. Conclusions: The incidence of infection after EUS-FNA of PCLs is negligible. Routine use of postprocedural antibiotics does not add a significant benefit.

• Clinical Endoscopy
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• 제55권2호
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• pp.215-225
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• 2022

Background/Aims: The Thai Association for Gastrointestinal Endoscopy published recommendations on safe endoscopy during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to assess the practicality and applicability of the recommendations and the perceptions of endoscopy personnel on them. Methods: A validated questionnaire was sent to 1290 endoscopy personnel globally. Of these, the data of all 330 responders (25.6%) from 15 countries, related to the current recommendations on proper personal protective equipment (PPE), case selection, scope cleaning, and safety perception, were analyzed. Ordinal logistic regression was used to determine the relationships between the variables. Results: Despite an overwhelming agreement with the recommendations on PPE (94.5%) and case selection (95.5%), their practicality and applicability on PPE recommendations and case selection were significantly lower (p=0.001, p=0.047, p<0.001, and p=0.032, respectively). Factors that were associated with lower sense of safety in endoscopy units were younger age (p=0.004), less working experience (p=0.008), in-training status (p=0.04), and higher national prevalence of COVID-19 (p=0.003). High prevalent countries also had more difficulty implementing the guidelines (p<0.001) and they considered the PPE recommendations less practical and showed lower agreement with them (p<0.001 and p=0.008, respectively). A higher number of in-hospital COVID-19 patients was associated with less agreement with PPE recommendations (p=0.039). Conclusions: Using appropriate PPE and case selection in endoscopic practice during a pandemic remains a challenge. Resource availability and local prevalence are critical factors influencing the adoption of the current guidelines.

• 한방재활의학과학회지
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• 제19권1호
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• pp.135-143
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• 2009

목적 : 요통은 임상에서 가장 흔하게 접할 수 있는 질환이며, 동시에 통증으로 인한 근무 결손도나 생활 불편감이 높은 질병이다. 그래서, 많은 연구들이 요통을 일으키는 원인 혹은 악화시키는 유발 인자를 밝혀내려는데 초점이 맞추어져 있다. 이번 연구의 목적은 편측 요통을 호소하는 환자에 있어서 MRI에서 조사된 척추 주위 근육의 지방량과 통증과의 관계에 대해서 알아보는데 있다. 방법 : 2007년 11월부터 2008년 4월까지 본원에 요통으로 내원한 환자를 대상으로, 편측 요통을 호소하며, 체질량 지수가 $25kg/m^2$ 이하이며, 만 20세이상 40세미만인 환자 24명을 대상으로 연구를 진행하였다. MRI에서 조사되어진 L4-5 디스크 레벨의 척추 주위 근육의 지방량을 객관적인 pseudocoloring technique을 이용해 측정하고, paired t-test로 결과를 분석하여 요통이 유발된 측과 지방량의 관계에 대해서 연구하였다. 결과 : 요통이 있는 측의 지방량과 요통이 없는 측의 지방량을 측정하여 데이터를 분석하였다. 양측의 지방량과 통증의 유무에 대한 관계는 통계적으로 유의한 수치를 나타냈다(P <0.05). 요통이 있는 측과 없는 측과의 성별, 나이, BMI의 통계적인 차이는 없었으며, 지방량 측정시 남자들이 여자들에 비해 지방량이 더 높게 측정되었다(남자 $8.5{\pm}5.1%$, 여자 $6.5{\pm}3.6%$). 결론 : 이 연구를 통해 척추 주위 근육의 지방량과 요통에 대한 상관성의 증거를 제시하였다. 잘 선별되어진 환자의 MRI를 통해 객관적인 방법으로 지방량을 체크를 하였으며, 추후 더 많은 개체수를 이용해 보다 더 정확한 관련성을 파악하고, 나아가 지방량에 따른 통증 강도의 상관성에 대해서 연구가 필요하리라 생각된다.

• 대한간호학회지
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• 제4권3호
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• pp.63-79
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• 1974

1. The purpose of this study. The purpose of this study is to plan and investigate short-term nursing education of two-years associate degree program to produce middle-level professional nurses which are needed by-society and nation. Current nursing education in Korea is divided into four years degree program, three years diploma program Even (though) there are differences in the aims of their education, the curriculums are not much different between the education for producing leaders which is its basic purpose and training middle-level professional nurses. Therefore the purpose of associate degree program lies in minimizing the waste of time and finance which are invested for long-term education for middle-level professional nurses. And also this coincide with the policy of national technical training and definite supply of nurse manpower according to health policy for effective role and ability of nurse. 2. The method of study. This is based on the study of literature, research on the actual condition and investigation of opinion- through questionnaire. L) The study of literature: Domestic and foreign literatures for two years associate degree program were studied and investigated. 2) Research on the actual condition : Current three years nursing education program was collected and analysed. 3) Investigation of opinion. The problem of curried nursing education system and the possibility of two years associate degree program were investigated through questionnaire. 3. The result of the study. 1) The trend of recent nursing education. a. The aims of nursing in past chiefly taking care of physical disease of patient has recently changed to nursing of character including physical, mental, socio-economic, educational and psychological condition. b. For the performing systematic and effective nurse's duty according to her role, the-change of educational system which is classified as a range of education the period of education and certificate after graduation has been enforced or fulfilled. c. Nursing education also has a trend to become a collage or two years associate degree program which can get same legal protection as other educational institutions whose basic purpose is education. Attached nursing school to hospital is getting disappeared because of disadvantage of educational system. 2) Problems. Depending upon research on actual condition of current 3 years nursing education program. a. There are too many subjects. b. Contents of education could be doubled because major subjects are subdivided in detail. c. The credits for graduation are too heavy comparing to the period of study or the ability of students. (The necessary credits are 150.8 for three years according to actual investigation 4. There is no certain standard in organizing curriculum therefore there are too much differences between schools. 4. Basic Plan. The plan for two years associate degree program in nursing education depending on demand of professional nursing field of society is based on following items. 1) Training middle-level professional nurse lay emphasis on liberal arts and basic major field. 2) Liberal arts are divided into required and optional subjects and students could take courses by choice. 3) Major subjects are compound together by fields and they become the sciences of nursing Ⅰ,Ⅱ,Ⅲ,Ⅳ and every items has its educational purposes and contents major study includes laboratory practice and clinical experience. 4) The required credits for graduation are to which means 17-18 credits a semester. The above has been planned to solve the problems of current three years nursing education program. In conclusion for the achievement of this system, following items are needed. 1) It is necessary to change educational administration and system such as amendment of educational law or order of educational application of law. 2) Qualified professors should be available to understand and develope the idea or purpose of this educational system. 3) Local medical institutions should be opened widely and educational for clinical training. 4) The job after graduation should he secured positively.

• 대한치과교정학회지
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• 제39권4호
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• pp.234-247
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• 2009

본 연구의 목적은 세라믹 브라켓 제거 후 재접착 시에 브라켓의 종류, 브라켓의 제거 방법, 브라켓 베이스의 처리 방법에 따른 전단 결합 강도를 평가하여 임상에서 적절한 전단 결합 강도를 얻을 수 있는 세라믹 브라켓의 재접착 방법을 찾고자 하는 것이었다. 총 312개의 치아로, 144개는 재접착을 위한 브라켓을 만들기 위해 이용되었고, 나머지 168개는 재생 브라켓의 베이스 처리 후 접착을 위해 사용되었다. 브라켓의 종류(단결정 세라믹 브라켓, 다결정 세라믹 브라켓), 브라켓의 제거 방법(만능 시험기를 이용한 전단력에 의한 제거, 레이저에 의한 제거), 브라켓 베이스의 처리 방법(저속 라운드 버로 선택적 삭제, 샌드블라스팅 처리, 샌드블라스팅 후 실란 처리)에 따라 12개의 실험군과 2개의 대조군(단결정, 다결정 새 브라켓)으로 분류하여 각 군당 12개의 치아를 할당하였다. 각 실험군의 조건에 따라 브라켓을 재접착한 후에 전단 결합 강도와 접착제 잔류 지수를 평가하고 베이스 처리 방법에 따른 브라켓 베이스의 변화를 관찰하였다. 연구 결과, 단결정 세라믹 브라켓군은 샌드블라스팅 처리하고 재접착한 군에서만 다결정 세라믹 브라켓군보다 전단 결합 강도가 유의하게 높았다 (p < 0.05). 전단력으로 브라켓을 제거하고 재접착한 군과 레이저로 브라켓을 제거하고 재접착한 군 간에 전단 결합 강도는 유의한 차이가 없었다. 브라켓 종류와 제거 방법에 관계없이 샌드블라스팅 후 실란 처리하고 재접착한 군은 저속 라운드 버로 선택적 삭제하고 재접착한 군과 샌드블라스팅 처리하고 재접착한 군보다 전단 결합 강도가 유의하게 높았다 (p < 0.001). 베이스 형태는 전단력으로 제거한 군보다 레이저로 제거한 군에서 더 잘 유지되었으며, 재접착을 위해 베이스 처리된 모든 브라켓에서 새 브라켓보다 부드러운 표면을 나타내었다. 이상의 결과를 토대로, 제거된 세라믹 브라켓에 샌드블라스팅 후 실란을 처리하고 재접착하는 것이 전단 결합 강도를 증가시켰으며, 저속 라운드 버를 이용한 선택적 삭제나 샌드블라스팅만 처리하여 재접착하는 방법도 임상적으로 수용 가능한 결합 강도를 보였다고 할 수 있다.