• Quality Improvement in Health Care
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• v.27 no.2
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• pp.73-82
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• 2021

Purpose: This study aims to examine the quality of tuberculosis (TB) care after the 1st to 3rd national quality assessment (QA) program for TB healthcare service in Korea was conducted. Methods: We analyzed Health Insurance Review & Assessment Service (HIRA) claims data of new TB patients during the period of January to June from 2018-2020. The new TB patients were defined as TB patients reported to Korea Centers for Disease Control and Prevention Agency (KCDA). The unit of analysis was the patient. Chi-square tests were used to analyze the differences in indicator value according to the types of medical facilities. The QA indicators of TB care were divided into 3 areas consisting of the following 7 quality indicators: 4 indicators of diagnosis test (the rate of acid-fast bacilli smear, the rate of acid-fast bacilli culture, the rate of Mycobacterium tuberculosis-polymerase chain reaction, drug susceptibility test), 1 compliance of treatment guideline, and 2 indicators of care management of TB patients (encounter rate, day of therapy). Results: The QA program for TB care was conducted among 8,246 patients from 534 facilities in 2020. The value of the 7 quality indicators was shown to increase as a result of the QA program. The indicators of the diagnostic test were all higher than 95%, with the exception of the drug susceptibility test which was 84.8%. Both indicators for care management of TB patients were 88.5%. Conclusion: The quality of TB care has been improving with the implementation of the QA program. In order to continue to improve the quality of TB care, it will be necessary to disclose the results of the QA program in medical facilities in the future.

• Journal of Microbiology and Biotechnology
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• v.31 no.11
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• pp.1583-1590
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• 2021

Studies have demonstrated that PE_PGRS45 is constitutively expressed under various environmental conditions (such as nutrient depletion, hypoxia, and low pH) of the in vitro growth conditions examined, indicating that PE_PGRS45 protein is critical to the basic functions of Mycobacterium tuberculosis. However, there are few reports about the biochemical function and pathogenic mechanism of PE_PGRS45 protein. The fact that this M. tuberculosis gene is not easily expressed in E. coli may be mainly due to the high content of G+C and the use of unique codons. Fusion tags are indispensable tools used to improve the soluble expression of recombinant proteins and accelerate the characterization of protein structure and function. In the present study, His6, Trx, and His6-MBP were used as fusion tags, but only MBP-PE_PGRS45 was expressed solubly. The purification using His6-MBP tag-specific binding to the Ni column was easy to separate after the tag cleavage. We used the purified PE_PGRS45 to immunize New Zealand rabbits and obtained anti-PE_PGRS45 serum. We found that the titer of polyclonal antibodies against PE_PGR45 was higher than 1:256000. The result shows that purified PE_PGRS45 can induce New Zealand rabbits to produce high-titer antibodies. In conclusion, the recombinant protein PE_PGRS45 was successfully expressed in E. coli and specific antiserum was prepared, which will be followed by further evaluation of these specific antigens to develop highly sensitive and specific diagnostic tests for tuberculosis.

• Korean Journal of Clinical Laboratory Science
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• v.54 no.4
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• pp.249-255
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• 2022

Alzheimer's disease (AD) represents a major public health concern and has been identified as a research priority. Clinical research evidence supports that the core cerebrospinal fluid (CSF) biomarkers for AD, including amyloid-β (Aβ42), total tau (T-tau), and phosphorylated tau (P-tau), reflect key elements of AD pathophysiology. Nevertheless, advances in the clinical identification of new indicators will be critical not only for the discovery of sensitive, specific, and reliable biomarkers of preclinical AD pathology, but also for the development of tests that facilitate the early detection and differential diagnosis of dementia and disease progression monitoring. The early detection of AD in its presymptomatic stages would represent a great opportunity for earlier therapeutic intervention. The chance of successful treatment would be increased since interventions would be performed before extensive synaptic damage and neuronal loss would have occurred. In this study, the importance of developing an early diagnostic method using cognitive decline biomarkers that can discriminate between normal, mild cognitive impairment (MCI), and AD preclinical stages has been emphasized.

• Journal of the Korean Society of Radiology
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• v.15 no.3
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• pp.273-279
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• 2021

Metal material inserted into the body have a large difference in density from human tissues or bones around the Metal during CT scans.. Therefore, the Metal material inserted into the body produces Artifact. Metal Artifact, which occurs around Metals, can degrade the quality of CT images, causing confusion when medical team diagnose lesions. Through this experiment, we confirm that the occurrence of Artifacts decrease by using Dual energy CT and MAR algorithm in Single source Dual energy CT. We also want to present basic data on clinical application methods by comparing and analyzing the characteristics of images obtained by each method. Using GE 750HD CT, artificial implants were scanned using general method and Dual energy. Then we apply the MAR algorithm to each image obtained. And all previously acquired images were compared and analyzed the characteristics of the examination, such as image quality evaluation and dose evaluation. Images with MAR algorithm and Dual Energy confirmed a decrease in Metal Artifact. Images with MAR algorithm have reduced Metal Artifact, but have the disadvantage of distorting the details of artificial joint implants. On the other hand images teseted with Dual Energy have the advantage of being able to implement details than those applied with MAR algorithms, it takes longer to reconstruct the image and the exposure dose was about four times higher than those applied with MAR algorithm. In order to locate Metals, such as the post-operative follow-up period, it is useful to apply MAR algorithm to obtain images. And it is more useful to examine with Dual Energy when micro lesion identification, such as cardiac examination, and surgical planning or when tests are performed in diagnostic way.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.23 no.1
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• pp.17-24
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• 2023

Purpose: In the past, detection of metabolic abnormalities in plasma amino acid (PAA) and urine organic acid (UOA) has been widely used to diagnose clinical mitochondrial diseases, such as mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS). In this study, the diagnostic values of PAA and UOA were reviewed, and their effectiveness in the diagnosis of MELAS was examined retrospectively. Methods: Blood and urine samples at the time of diagnosis were collected from all clinically diagnosed MELAS patients (n=31), and PAA and UOA tests were performed. All samples were collected in a fasting state to minimize artifacts in the results. The difference in the ratio of abnormal metabolites of PAA and UOA at initial diagnosis was statistically compared between the MELAS with genetic confirmation (n=19, m.3243A>G mutation) and MELAS without genetic confirmation (n=12) groups. The MELAS without genetic confirmation group was used as control. Results: Comparison of PAA and UOA between the two groups revealed that no abnormal metabolites showed characteristic differences between gene-confirmed MELAS patients with and those without genetic confirmation. Conclusions: Abnormal values of metabolites in PAA or UOA might be useful as a screening test but are not sufficient to diagnose MELAS patients.

• Korean Journal of Clinical Laboratory Science
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• v.55 no.2
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• pp.71-81
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• 2023

This study examined the transition process of clinical laboratory technologists' national examination and job definition in Korea and compared the differences in the national examination between Korea and neighboring countries, such as Japan and Taiwan. In Korea, the number of questions made for it was 200 (1965), 200 (1977), 300 (1982), 250 (1992), 330 (2006), and 280 (2015). The practice of clinical physiology is important for real-time monitoring, given the characteristics of physiological testing. On the other hand, there are conflicts between other occupations in the working area. Clinical molecular biology needs to be established as a new major subject considering the diagnostic importance of molecular biological tests and the speed of science and technology development. Clinical laboratory operations provide policy and guidance recommendations to technologist staff. The proposed clinical laboratory technologists' national examination comprises major subjects: clinical biochemistry, clinical hematology, clinical transfusionology, clinical immunology, clinical microbiology, clinical molecular biology, clinical histology, clinical cytology, clinical physiology, and clinical laboratory operations. In addition, this study proposes the job definition of clinical laboratory technologists, revising various chemical or physiological testing to biomedical or physiological testing required for medical practice.

• Journal of Korean Medicine Rehabilitation
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• v.33 no.3
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• pp.97-113
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• 2023

Objectives This study examined the trends in domestic and international research on the treatment of sarcopenia and analyzed the effectiveness of the treatment. Based on the results, we suggest directions for future Korean medicine research on sarcopenia. Methods The study was conducted using Arksey and O'Malley's scoping review methodology. It included three international databases (PubMed, EMBASE, Cochrane Library) and five domestic databases (Korean studies Information Service System, Korean Medical database, Oriental Medicine Advanced Search Integrated System, Research Information Sharing Service, ScienceON) were used. Literatures published until April 30, 2023, including the contents of 'sarcopenia' and Korean Medicine treatment', were searched. Results A total of 45 studies were included in the analysis. The number of studies on Korean medicine treatments for sarcopenia is steadily increasing, with the majority of studies coming from Asian countries. Of the 45 studies, 30 were conducted in the field of medicine, and the study design was analyzed into 10 clinical studies and 35 non-clinical studies. Among the 10 clinical studies, the most common treatment interventions were herbs (n=4), followed by Daoist exercises (n=3). The most common diagnostic criteria used in clinical studies were those published by the Asian working group for sarcopenia, and various physical examinations and laboratory tests were used as outcome measures. Conclusions The future direction of Korean medicine research on sarcopenia should be to expand the number of clinical studies applying Korean medicine treatment interventions.

• Educational Technology International
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• v.6 no.2
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• pp.23-41
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• 2005

One of the main factors that determine the quality of instruction is the teaching ability of the instructor administering the class. To evaluate teaching ability, methods such as peer review, student feedback, and teaching portfolio can be used. Among these, because feedback from the students is directly associated with how well the students feel they have learned, it is essential to improving instruction and teaching ability. The principal aim of instruction evaluation lies in the evaluation of instructor's qualification and the improvement of instruction quality by enhancing professionalism. However, the mandatory instruction evaluations currently being carried out at the term's end in universities today have limitations in improving instruction in terms of its evaluation items and times. To improve the quality of instruction and raise teaching abilities, instruction evaluations should not stop at simply being carried out but also be utilized as useful data for students and teachers. In other words, they need to be used to develop teaching and improve instruction for teachers, and consequently, should also exert a positive influence on students' scholastic achievements and learning ability. The most important thing in evaluation is the acquisition of accurate information and how to utilize it to improve instruction. The online instruction diagnosis item pool is a more realistic feedback device developed to improve instruction quality. The instruction diagnosis item pool is a cafeteria-like collection of hundreds of feedback questions provided to enable instructors to diagnose their instruction through self-diagnosis or students' feedback, and the instructors can directly select the questions that are appropriate to the special characteristics of their instruction voluntarily make use of them whenever they are needed. The current study, in order to find out if the online instruction diagnosis item pool is truly useful in reforming and improving instruction, conducted pre and post tests using 256 undergraduate students from Y university as subjects, and studied the effects of student feedback on instructions. Results showed that the implementation of instruction diagnosis improved students' responsibility regarding their classes, and students had positive opinions regarding the usefulness of online instruction diagnosis item pool in instruction evaluation. Also, after instruction diagnosis, analyzing the results through consultations with education development specialists, and then establishing and carrying out instruction reforms were shown to be more effective. In order to utilize the instruction diagnostic system more effectively, from planning the execution of instruction diagnosis to analyzing the results, consulting, and deciding how those results could be utilized to instruction, a systematic strategy is needed. In addition, professors and students need to develop a more active sense of ownership in order to elevate the level of their instruction.

• Journal of the Korean Society of Radiology
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• v.17 no.6
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• pp.801-808
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• 2023

In order to minimize radiation exposure and secure diagnostic value images during CT examination of the head of children, the usefulness of volume axial mode is evaluated through comparison and analysis of exposure dose and images of volume axial mode, high pitch mode, and helical mode. Image evaluation and dose evaluation were performed in CT high pitch mode, helical mode, and volume axial mode for infants under the age of 1 according to the voltages of 70, 80, and 100 kVp tubes. The image evaluation was conducted by comparing image quality by setting ROI for each image, calculating SNR and CNR, using ONE-WAY (ANOVA) to evaluated statistical significance, and cross-examining the dose evaluation using DLP values displayed in the Dose Report. When inspected using volume axial mode, DLP values were generally low, and SNR and CNR values differed by ROI and kVp. When volume axial mode evaluated the quality of the image compared to other scan modes, the difference is not uniform. For the reason, certain modes are not considered excellent, but the exposure dose was reduced the most in terms of dose. In addition, the point that the volume axial mode can be examined at its original location, short scanning time and needless of table movement is useful for CT tests for children under 1 year of age with high radiation sensitivity.

• Korean Journal of Radiology
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• v.25 no.4
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• pp.363-373
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• 2024

Objective: To develop and evaluate a deep learning model for automated segmentation and detection of bone metastasis on spinal MRI. Materials and Methods: We included whole spine MRI scans of adult patients with bone metastasis: 662 MRI series from 302 patients (63.5 ± 11.5 years; male:female, 151:151) from three study centers obtained between January 2015 and August 2021 for training and internal testing (random split into 536 and 126 series, respectively) and 49 MRI series from 20 patients (65.9 ± 11.5 years; male:female, 11:9) from another center obtained between January 2018 and August 2020 for external testing. Three sagittal MRI sequences, including non-contrast T1-weighted image (T1), contrast-enhanced T1-weighted Dixon fat-only image (FO), and contrast-enhanced fat-suppressed T1-weighted image (CE), were used. Seven models trained using the 2D and 3D U-Nets were developed with different combinations (T1, FO, CE, T1 + FO, T1 + CE, FO + CE, and T1 + FO + CE). The segmentation performance was evaluated using Dice coefficient, pixel-wise recall, and pixel-wise precision. The detection performance was analyzed using per-lesion sensitivity and a free-response receiver operating characteristic curve. The performance of the model was compared with that of five radiologists using the external test set. Results: The 2D U-Net T1 + CE model exhibited superior segmentation performance in the external test compared to the other models, with a Dice coefficient of 0.699 and pixel-wise recall of 0.653. The T1 + CE model achieved per-lesion sensitivities of 0.828 (497/600) and 0.857 (150/175) for metastases in the internal and external tests, respectively. The radiologists demonstrated a mean per-lesion sensitivity of 0.746 and a mean per-lesion positive predictive value of 0.701 in the external test. Conclusion: The deep learning models proposed for automated segmentation and detection of bone metastases on spinal MRI demonstrated high diagnostic performance.