• Title/Summary/Keyword: Clinical guideline

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Development of portable digital radiography system with device for sensing X-ray source-detector angle and its application in chest imaging (엑스선촬영 각도를 측정할 수 있는 장치 개발과 흉부 X선 영상촬영에서의 적용)

  • Kim, Tae-Hoon;Heo, Dong-Woon;Ryu, Jong-Hyun;Jeong, Chang-Won;Jun, Hong Young;Kim, Kyu Gyeom;Hong, Jee Min;Jang, Mi Yeon;Kim, Dae Won;Yoon, Kwon-Ha
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2017.01a
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    • pp.235-238
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    • 2017
  • This study was to develop a portable digital radiography (PDR) system with a function measuring the X-ray source-with-detector angle (SDA) and to evaluate the imaging performance for the diagnosis of chest imaging. The SDA device consisted of an Arduino, an accelerometer and gyro sensor, and a Bluetooth module. According to different angle degrees, five anatomical landmarks on chest images were assessed using a 5-point scale. Mean signal-to-noise ratio and contrast-to-noise ratio were 182.47 and 141.43. Spatial resolution (10% MTF) and entrance surface dose were 3.17 lp/mm ($157{\mu}m$) and 0.266mGy. The angle values of SDA device were not significant difference as compared to those of the digital angle meter. In chest imaging, SNR and CNR values were not significantly different according to different angle degrees (repeated-measures ANOVA, p>0.05). The visibility scores of the border of heart, 5th rib and scapula showed significant differences according to different angles (rmANOVA, p<0.05), whereas the scores of the clavicle and 1st rib were not significant. It is noticeable that the increase in SDA degree was consistent with the increase of visibility score. Our PDR with SDA device would be useful to be applicable to clinical radiography setting according to the standard radiography guideline at various fields.

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A Study on Organophosphate Poisoning Patients: Comparison of the Survivor Group and Dead Group (생존군과 사망군의 비교 분석을 통한 유기인계 살충제 중독환자에 대한 연구)

  • Choi, Youn-Gyu;Lee, Dong-Hyeon;Kim, Woo-Hyung;Lee, Gang-Wook;Kim, Sun-Pyo;Kim, Seong-Jung;Cho, Soo-Hyung;Cho, Nam-Soo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.8 no.1
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    • pp.16-23
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    • 2010
  • Purpose: Organophosphate insecticide poisoning is common in Korea, but there is no definitive guideline for determining the severity of the poisoning and the predictive factors. Therefore, we evaluated the organophosphate poisoned patients and we divided them into two groups, the survivors and the dead, and the results might be useful for treating organophosphate poisoning patients. Methods: We performed a retrospective analysis of 68 organophosphate poisoned patients who visited the Chosun University Hospital Emergency Medical Center during a 24-month period from January, 2007 to December, 2008. We made a work sheet of the patients' characteristics and the collected data was analyzed and we compared this data between the survivor group and the dead patient group. Results: There were significant differences between the survivor group and the dead patient group for the mean age, the alcohol intake state and the typically expressed signs. The dead patients had lower blood pressure, tachycardia and a lower Glasgo Coma Score (GCS) score than the survivor group. On the arterial blood gas analysis, the dead patients had more severe acidemia and they had lower saturations. Increased serum amylase levels were found in the dead patients. The survivors'initial and follow up serum pseudocholinesterase activity (after 6~8 days) was significantly higher than that of the dead group. The total amount of atropine injected to patient was less in the survivors than that in the dead patients. Conclusion: Old age and expressing the typical intoxication signs, a lower GCS score and blood pressure, showing acidosis on the gas analysis and low serum cholinesterase activity may be useful as poor prognostic indicators for patients with organophosphate poisoning. We suggest that physicians must pay careful attention to the signs and prognostic factors of organophosphate insecticide poisoned patients.

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Evaluation of Image Quality by Parameter Change in Onco Flash (Onco Flash에서 매개변수 변화에 따른 영상의 질 평가)

  • Cha, Eun-Sun;Noh, Ik-Sang;Kim, Ki;Choi, Choon-Ki;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.30-34
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    • 2009
  • Purpose: Many companies developed a lot of programs with continuous effort for program upgrading. With this acquire superior image quality for the purpose of quick examination and progress in spatial resolution. This study was to obtained clinical usefulness on a appropriate parameter of FWHM for speed and alpha value for superior image quality. Materials and Methods: Gamma camera by Siemens (e.cam) and spatial resolution phantom and four quadrant bar phantom used. Compared for FWHM by changed scan speed 15, 20, 25, 30, 35, 40 cm/min in scatter and non scatter in Onco Flash of spatial resolution phantom. Visual evaluation of count rate and bar phantom image for increased of alpha value of 10% in 0~100%. Results: FWHM by the scan speed was 9.37, 9.40, 9.28, 9.30, 9.31, 9.53 mm in the scatter. Count rate increased alpha value 10% increased. Visual evaluation was suitable to below 30%, Therefore spatial resolution improved on FWHM at the scan speed 25~35 cm/min applying for alpha value 30% in Onco Flash was average 9.3 mm less than FWHM of below 15 cm/min and above 40 cm/min. Conclusion: We found on appropriate parameter to progress of image quality. And there be a useful guideline for you that appropriate scan speed on vary in parameters of reduction on examination time and advancing image quality.

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Evaluation the absorbed dose in brain of dental radiography (치과방사선 검사에서 두부(brain)의 흡수선량 평가)

  • Jeon, Woon-Sun;Han, Dong-Kyoon
    • Journal of the Korean Society of Radiology
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    • v.5 no.6
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    • pp.343-349
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    • 2011
  • This study was aimed to evaluate the absorbed dose in brain of dental radiography. For radiographic exposure, PLD(photoluminescence dosimetry) chips placed in Rando phantom to measurement the absorbed dose to pituitary gland, orbit, maxillary sinus and submandibular glands, thyroid gland, esophagus. Equipments were used Kodak 2200, Kodak 8000C dental radiographic systems and computed tomography(Lightspeed VCT). The absorbed doses were measured at the same exposure parameters and distance by the clinical factor(kV, mA, sec). The result were as follows ; The absorbed dose for intra-oral radiography were 0.02~2.47cGy, the greatest absorbed dose was 2.47cGy for thyroid gland in maxillary right molar projection. the lowest adsorbed dose was 0.02cGy for submandibular glands in lower anterior projection. The absorbed dose for extra-oral radiography were 0.36~3.44cGy of cephalometric method, 0.14~12.82cGy of panoramic method, 8.17~253.63cGy of computed tomography, the greatest adsorbed dose was 253.63cGy for submandibular glands in maxillary CT scan. the lowest adsorbed dose was 0.14cGy for orbit in panoramic method. As a result, extra-oral radiography was measured more than intra-oral radiography. In particular, method which used computed tomography was measured more than 100 times than intra-oral radiography highly. Therefore, you must show a guideline in extra-oral radiography and an effort to reduce absorbed dose is demanded.

Drug Use Evaluation of Letrozole in Breast Cancer Patients at Regional Cancer Hospitals in Thailand

  • Ketkaew, Chaninun;Kiatying-Angsulee, Niyada
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6055-6059
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    • 2015
  • Background: Medication policy development in Thailand is continually promoting rational drug use. Letrozole, an endocrine therapy drug, is usually prescribed for post-menopausal status early and advanced stage breast cancer. After Ministry of Public Health announced Letrozole as compulsory licensed drug in 2009, more breast cancer patients can access to this drug at low cost especially those within universal coverage schemes. To ensure that Letrozole is rationally prescribed, the drug utilization study was conducted. Objectives: The aim of this study was to describe the appropriate use of Letrozole in breast cancer and the relationship between appropriate use and health benefit schemes. Materials and Methods: A retrospective study to evaluate use of Letrozole in breast cancer patients was performed for six months between January - June 2010 in seven regional cancer hospitals, Thailand. All prescriptions of Letrozole were identified from pharmacy dispensing databases and prescription papers. A medical record review was also performed to evaluate appropriate use referring to the drug use evaluation criteria. The approved criterion of this study was referred from the guideline of Thai National Formulary version 2010. Results: There were 681 prescriptions of Letrozole for 254 breast cancer patients with an average age of $58.6{\pm}10.0years$. The patients in universal coverage scheme (UCS), civil servant medication benefit scheme (CSMBS) and social security scheme (SSS) were 77.7%, 18.5% and 8.7% respectively. 10.6% were prescribed Letrozole for the first time. Letrozole were prescribed by oncologists (82.8%). The average number of tablets per prescription was $58{\pm}10$. Calcium supplements were prescribed concomitant with Letrozole for 19.4%. To assess drug use evaluation criteria, 45 prescriptions were excluded because of uncompleted clinical data, 636 prescriptions were evaluated. The study showed 86 prescriptions (13.5%) with inappropriate use including 6 (0.9%) not prescribed for estrogen receptor (ER) and/or progesterone receptor (PR) positive, 31 (4.9%) not prescribed for post-menopausal and 49 (7.7%) not prescribed for an appropriate duration. Appropriate use percentages in different health benefit schemes were similar, 85.7% of CSMBS, 86.4% of SSS and 86.7% of UCS. The relationship between health benefit scheme and appropriate use of Letrozole was not significantly different, ${\chi}^2$ (2, N = 636) = 0.081, p > 0.05. Conclusions: The study showed inappropriate use in breast cancer patients because of non-compliance with duration, menopausal status and hormone receptor requirements. To prescribe appropriate indication did not referred to the appropriate practice along the treatment. Drug use evaluation proved very useful for detecting the sign of inappropriate use and allows immediate feedback to the stakeholder for developing medication policy in the future. Importantly, there was no significantly difference in appropriate use of Letrozole across health benefit schemes.

A Survey for Needs and Preference of Food and Nutrition information on Mass Media for Korean Female Adults (대중매체 식품영양정보에 대한 성인 여성의 요구도 조사)

  • Kwak, Jeong-Eun;Lee, Seo-Yeon;Lee, Sang-Hoon;Ko, Kwang Suk
    • Korean Journal of Community Nutrition
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    • v.19 no.6
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    • pp.550-557
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    • 2014
  • Objectives: This study was conducted to examine the preferences and needs of typical Korean females adults for food and nutrition information provided by the mass media. Methods: A total of 343 females (77 in their 20s, 85 in their 30s, 88 in their 40s and 93 in their 50s) residing in the Seoul/Gyeonggido area was surveyed on general characteristics, main sources of food and nutrition information and needs for sources and contents of nutrition information. Results: The survey showed that typical Korean females obtained knowledge of food and nutrition mainly through the Internet (30.4%) and broadcasting (29.0%). Typical Korean females were interested in 'dietary management for weight control' (21.9%), 'the prevention and treatment of disease' (20.0%), 'food safety' (16.8%), 'proper dietary habits' (14.6%), 'cookery' (11.8%), 'functional foods' (9.6%), 'restaurant details' (3.5%) and 'life-cycle-specific dietary guideline' (1.6%). Needs for food and nutrition program forms on TV were 'educational programs' (34.3%), 'documentaries' (20.8), 'expert lecture-style' (13.0%), 'entertainment programs' (11.9%), 'expert conversation' (11.4%), 'news-style' (4.6%) and 'public campaign advertisements' (4.0%). On the Internet, 38.6% of the respondents preferred to get information provided by food and nutrition-related institutions (38.6%) while 26.1% preferred webtoons for nutritional information. The favored forms in mobile applications were 'monitoring their diets' (29.5%), 'data-based texts information' (21.4%), 'experts feedback' (20.6%), 'communities' (15.1%) and 'games' (13.1%). The rates of the preference to obtain information from experts such as nutritionists and dietitians and doctorsor dietitian turned reporters increased markedly with older ages. Conclusions: Since the mass media is a main source of food and nutrition information for the general public, the effectiveness and accuracy of the information provided should be enhanced by taking the needs of the public into account. The quality of information should be improved by involving more nutrition experts.

Assessment of the Effective Dose to the Human Body and Estimation of Lifetime Attributable Risk by CT Examination (CT 검사별 노출되는 유효선량과 생애 암 귀속 위험도 평가)

  • Cho, Yong In;Kim, Jung Hoon
    • Journal of the Korean Society of Radiology
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    • v.14 no.2
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    • pp.169-178
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    • 2020
  • The number of CT scans is increasing every year due to the improvement of the medical standards of the public, and thus the annual dose of medical radiation is also increasing. In this study, we evaluated the effective dose of the human body exposed to CT scans and estimated LAR. First, five region were selected from the CT diagnostic reference level guideline, and the effective dose of human body exposed to each examination was evaluated by clinical CT device. Second, the human organs and effective dose were calculated using the ALARA-CT program under the same conditions. Third, lifetime attributable risk (LAR) estimated by the effective dose exposed through the previous CT scan was estimated. As a result, the most effective dose was 21.18 mSv during the abdomen 4 phase scan, and the dose level was below DRL for all other tests except for the abdominal examination. As a result of evaluating effective dose using a dose calculation program under the same conditions, the results showed about 1.1 to 1.9 times higher results for each examination. In the case of organ dose, the closer the organ to the scan site, the higher the scattering ray. The lifetime attributable risk to CT radiation dose in adults was gradually decreased with age, and the results were somewhat different according to gender.

Toxicity Assessment of Polygalae Radix Aqueous Extract Orally Administered to Rats for 2 Consecutive Weeks (원지 추출물의 랫드에서 2주 반복 경구투여 독성평가)

  • Han, Hyoung-Yun;Kim, Soo Nam;Yang, Young-Su;Han, Su-Cheol;Seok, Ji-Hyeon;Roh, Hang Sik;Lee, Jong-Kwon;Jeong, Jayoung;Jeong, Yeon Woo;Kim, Jeong Ah;Min, Byung Sun
    • Korean Journal of Pharmacognosy
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    • v.46 no.1
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    • pp.44-51
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    • 2015
  • The objective of this study is to characterize a toxicity of Polygalae Radix (PR) in F344 rats and to find a dose levels for the 13 weeks toxicity study. PR is well known as medicinal herb in many Asian countries for treatment of expectorant, tonic, tranquillizer, antipsychotic agent and functional diet for improving memory. However, there is insufficient background information on toxicological evaluation of PR extract to support its safe use. Therefore, we conducted toxicological evaluation of this drug in compliance with OECD and KFDA guideline in this study. The extract of PR was administered orally to F344 rats at dose levels of 0, 500, 1000, 2000, 3500 and 5000 mg/kg/day for 2 weeks. Each group was composed to five male and five female rats. In the result, there were no treatment PR-related adverse changes in food consumption, hematology, clinical chemistry, urinalysis, gross finding at necropsy, organ weight examination. Four males at 5000 mg/kg/day were found dead during the treatment period. These animals showed salivation. The cause of death is still under investigation. The animals treated at 500, 1000, 2000, 3500 and 5000 mg/kg/day showed salivation and all animals at 5000 mg/kg/day exhibited lower body weight and cumulative weight gain in compared to those of control animals. Therefore, we recommend that a dose group of 3500 mg/kg/day is a highest treatment group in 13-week exposure study.

Compared the Causes of Problematic Chemo-Ports According to the Types of Chemo-Ports(Valved, vs. Non-Valved) (Valve포트와 Non-Valved포트 사용에 따른 문제점의 비교 분석)

  • You, In-Gyu;Lim, Cheong-Hwan;Han, Beom-Hee;Jung, Hong-Ryang;Joo, Yeong-Cheol
    • Journal of radiological science and technology
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    • v.34 no.1
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    • pp.35-41
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    • 2011
  • Total implanted central venous port (TIAP, Chemoport) is widely used in oncology patients because it does not require external dressing and restricts patient activity. Chemoport only requires monthly flushes of heparinized saline to keep the patency of the catheter and probably less prone to infectious complications than tunneled catheter. Despite the extensive use of permanent central venous access in oncology patients, there are only few reports about clinical experience of the Groshong catheter. The purpose of this study is to compare the complication rate between the traditional open-ended (non-valved) chemoports and valved chemoports (Groshong catheter connected to TIAP). During 5 years (Jan 2006 to May 2010), 438 patients received chemoport insertion procedure in our interventional radiology department. Among them 30 patients was referred to our department for problematic chemoports. We compared the cause of problematic chemoports between two types of chemoports (valved, vs. non-valved). Valved chemoports had higher referral rates than non-valved chemoports. When there is a need to insert valved port, different method of insertion and maintenance procedure seems to be necessary. More than 20 ml of flusing with heparinized saline after blood sampling could be a good suggestion. Adequate care of chemoport is essential for long patency. Also following the guideline from the manufacturing company is necessary.

A Treatment Outcomes and Prognostic Factors of Malignant Submandibular Gland Tumor (악하선 암의 치료성적과 예후인자)

  • Lim Chi-Young;Nam Kee-Hyun;Lee Jan-Dee;Chang Hang-Seok;Chung Woong-Youn;Cha In-Ho;Lee Chang-Geol;Choi Eun-Chan;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.2
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    • pp.201-207
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    • 2005
  • Purpose: Submandibular gland tumor is rare, less than 6% of head and neck tumor. The purpose of this article is to analysis the clinical experience and treatment outcomes of malignant submandibular gland tumor, suggesting a guideline of management. Methods: We retrospectively evaluated 26 patients who underwent operation for malignant submandibular gland tumor at Severence hospital between 1986 and 2004. Statistical analysis was performed by Kaplan-Meier method, log rank test, Chi-square test, Fisher's exact test using SPSS v12.0 for Windows. Results: They consisted of 18 males and 8 females whose median age was 47 years(range: 20-71). 10 cases of adenocystic carcinoma, 8 cases of carcinoma ex pleomorphic adenoma, 4 cases of mucoepidermoid carcinoma, 1 case each for acinic cell carcinoma, undifferentiated carcinoma, adeno carcinoma, epithelioid hemangioendothelioma. Sialoadenectomy only was performed in 10 cases(36.5%) and sialoadenectomy with neck node dissection was performed in 16 cases(63.5%). Adjuvant radiotherapy was done in 22 cases(84.6%). 10 year disease free survival rate for malignant submandibular gland tumor was 63.1 % and 10 year overall survival rate for malignant submandibular gland tumor was 70.1%. In univariate analysis, prognostic factors affecting recurrence of malignant submandibular gland tumor was initially papable lateral neck node in physical examination and metastasis of lateral neck node in pathologic confirmation. The prognostic factors affecting survival of malignant submandibular gland tumor was tumor size, TNM stage, recurrence and type of recurrence. Conclusion: In this study, prognostic factors affecting recurrence of malignant submandibular gland tumor was initially papable lateral neck node in physical examination and metastasis of lateral neck node in pathologic confirmation. The prognostic factors affecting survival of malignant submandibular gland tumor was tumor size, TNM stage, recurrence and type of recurrence. To prevent recurrence and to improve survival, early diagnosis and aggressive surgery must be considered.