• Title/Summary/Keyword: Improvement of medical quality

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Prostate Imaging Reporting and Data System (PI-RADS) v 2.1: Overview and Critical Points (전립선영상 판독과 자료체계 2.1 버전: 개요와 비판적인 의견)

  • Chan Kyo Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.75-91
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    • 2023
  • The technical parameters and imaging interpretation criteria of the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) using multiparametric MRI (mpMRI) are updated in PI-RADS v2.1. These changes have been an expected improvement for prostate cancer evaluation, although some issues remain unsolved, and new issues have been raised. In this review, a brief overview of PI-RADS v2.1 is and several critical points are discussed as follows: the need for more detailed protocols of mpMRI, lack of validation of the revised transition zone interpretation criteria, the need for clarification for the revised diffusion-weighted imaging and dynamic contrast-enhanced imaging criteria, anterior fibromuscular stroma and central zone assessment, assessment of background signal and tumor aggressiveness, changes in the structured report, the need for the parameters for imaging quality and performance control, and indications for expansion of the system to include other indications.

The Effect of Voice Therapy in Vocal Polyp Patients (성대용종 환자의 음성치료 효과)

  • Kim, Seong-Tae;Jeong, Go-Eun;Kim, Sang-Yoon;Choi, Seung-Ho;Lim, Gil-Chai;Han, Ju-Hee;Nam, Soon-Yuhl
    • Phonetics and Speech Sciences
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    • v.1 no.2
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    • pp.43-49
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    • 2009
  • Vocal polyps are benign phonotraumatic lesions which are traditionally treated using phonomicrosurgical techniques. In the case of hyperfunctional voice use, voice therapy is effective and results in voice improvement. However, the utility of voice therapy about vocal polyp is in great demand. The purpose of this study was to evaluate the effects of voice therapy in patients with vocal polyps. The authors reviewed the medical records of 193 patients with vocal nodules or vocal polyps, and 64 patients (31 nodules and 33 polyps) were enrolled. All of the subjects had received explanation of problems, vocal hygiene education, and been treated by the $SKMVTT^{(R)}$ (Seong-Tae Kim's multiple voice therapy technique) ranging from 4 to 16 sessions (mean: 8.6 sessions). All subjects were examined by perceptual assessment, acoustic and aerodynamic measures, and VRP (voice range profile). In perceptual assessment, patients with vocal nodules had more breathy and strained voices than the vocal polyp group. Both groups significantly reduced rough, breathy voice after voice therapy. Patients with vocal polyps had worse voice quality than patients with nodules in acoustic measures. Both groups showed reduced jitter and shimmer after voice therapy. In aerodynamic measures, MPT and Psub were increased, and MFR was reduced (p<.05). Participants' frequency range and intensity range were increased after voice therapy, but only frequency range resulted in a significant difference (p<.05). In conclusion, the therapeutic effect of voice therapy in patients with vocal nodules and polyps was demonstrated perceptually and acoustically. We can suggest that voice therapy, including advice, vocal hygiene, and $SKMVTT^{(R)}$ is a useful as an initial choice of treatment for patients with vocal polyps before considering a surgical approach.

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Hybrid Filter Based on Neural Networks for Removing Quantum Noise in Low-Dose Medical X-ray CT Images

  • Park, Keunho;Lee, Hee-Shin;Lee, Joonwhoan
    • International Journal of Fuzzy Logic and Intelligent Systems
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    • v.15 no.2
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    • pp.102-110
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    • 2015
  • The main source of noise in computed tomography (CT) images is a quantum noise, which results from statistical fluctuations of X-ray quanta reaching the detector. This paper proposes a neural network (NN) based hybrid filter for removing quantum noise. The proposed filter consists of bilateral filters (BFs), a single or multiple neural edge enhancer(s) (NEE), and a neural filter (NF) to combine them. The BFs take into account the difference in value from the neighbors, to preserve edges while smoothing. The NEE is used to clearly enhance the desired edges from noisy images. The NF acts like a fusion operator, and attempts to construct an enhanced output image. Several measurements are used to evaluate the image quality, like the root mean square error (RMSE), the improvement in signal to noise ratio (ISNR), the standard deviation ratio (MSR), and the contrast to noise ratio (CNR). Also, the modulation transfer function (MTF) is used as a means of determining how well the edge structure is preserved. In terms of all those measurements and means, the proposed filter shows better performance than the guided filter, and the nonlocal means (NLM) filter. In addition, there is no severe restriction to select the number of inputs for the fusion operator differently from the neuro-fuzzy system. Therefore, without concerning too much about the filter selection for fusion, one could apply the proposed hybrid filter to various images with different modalities, once the corresponding noise characteristics are explored.

Relationship between Knowledge Management Process and Organizational Effectiveness in Clinical Nurses (간호사의 지식관리활동과 조직유효성과의 관계)

  • Jeong, Seok-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.3
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    • pp.415-427
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    • 2003
  • Purpose: The purpose of this study was to investigate the degree and pattern of knowledge management process, and to identify the relationship between knowledge management process and organizational effectiveness in clinical nurses. Method: Participants were 665 regular clinical nurses who had worked for over 1 year in general units of 9 tertiary medical hospitals including 2 national university hospitals, 5 university hospitals, and 2 hospitals founded by business enterprises. Data were collected from March to May 2003 through questionnaires. Four structured instruments were used to collect the data: Knowledge Management Process Scale(Jeong, Lee, Lee, & Kim, 2003), cCommitment Questionnaire(Mowday, Steers, & Porter, 1979), General Satisfaction Scale(CooK, Hepworth, Wall, & Warr, 1981), and one for general characteristics. The data were analyzed using factor analysis, reliability analysis, descriptive analysis, cluster analysis, one-way ANOVA, Scheffe test, correlation analysis with the SPSS for Windows 10.0 program. Result: 1) The average score for knowledge management process in nurses was $3.08{\pm}.54$ on a 5-point Likert scale. In order from highest mean score, the elements of knowledge management process, were Knowledge $Utilization(3.35{\pm}.57)$, Knowledge $Sharing(3.07{\pm}.58)$, Knowledge $Creation(2.99{\pm}.63)$, and Knowledge $Storage(2.91{\pm}.82)$. 2) Four knowledge management patterns for nurses, which were derived from cluster analysis, were inactivate pattern, delayed pattern, activate pattern, and high-activate pattern of knowledge management. 3) The degree of knowledge management process activation and 4 elements of knowledge management process, Knowledge Creation, Knowledge Storage, Knowledge Sharing, and Knowledge Utilization, were significantly correlated with nurses' organizational commitment and job satisfaction(p=.000). 4) The nurses' organizational commitment and job satisfaction showed significant differences according to the knowledge management patterns derived from cluster analysis of high-activate pattern, activate pattern, delayed pattern, inactivate pattern(p=.000). Conclusion: These results suggest that there are four knowledge management patterns for nurses, and knowledge management process positively affects the nurses' organizational commitment and job satisfaction. From the above findings, knowledge management process is empirically verified as a useful and effective method to increase organizational effectiveness, and develop the organization.

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Expectation and Satisfaction of Parents with Inpatient Hospital Service (입원 아동 부모의 병원서비스 기대수준과 만족도)

  • Choi, Eun Kyoung;Kim, Sun Hee;Jung, Song Yi;Cho, Eun Hee;Choi, Kyung Sook;Sim, So Jung;Mok, Mi Soo;Kang, Eun Kyung;Cho, Youn Kyoung;Byun, Eun Sook;Kim, Kyung Hee;Yoo, Il Young
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.2
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    • pp.228-238
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    • 2011
  • Purpose: The purpose of this study was to investigate parent expectation and satisfaction with respect to pediatric inpatient care and to identify the variables related to parent satisfaction. Methods: The study was conducted in pediatric wards of a tertiary children's hospital in Korea. The participants were 361 parents of children who were inpatients. Data were collected using a structured questionnaire (The Pediatric Family Satisfaction Questionnaire) at the time of discharge. Results: The highest parent expectation domain was medical service. The parents were most satisfied with nursing service and least satisfied with general hospital service and accommodation. The parents expressed lower satisfaction with hospital facilities, equipment, noise, cleanliness, and communication by health care professionals. Parents with younger children reported higher expectation from the complete hospital service and those who had a longer length of stay reported higher expectation from the nursing service. Conclusion: To improve the quality of hospital services, we need to understand parent expectation and improve and provide clear communication. In addition, the general hospital service and accommodation should not be overlooked for improvement.

A Study on the Impact of COVID-19 and Patient-Related Social Stress on Healthcare Providers (의료서비스 제공자들의 코로나 및 환자 관련 사회적 스트레스의 영향력에 관한 연구)

  • Sa-Ra Park;Young-Hye Jang
    • Journal of the Health Care and Life Science
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    • v.10 no.2
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    • pp.285-293
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    • 2022
  • This study is to confirm the effects of COVID-19 stress and patient-related social stress (unreasonable demand, aggression) on emotional exhaustion and patient-friendly orientation. In addition, it is to confirm the role of moderating variables in the relationship between the meaning of work of health care providers and patient-related stress caused by COVID-19 and emotional exhaustion. Data were collected through an online survey targeting health care service providers, and the final 219 copies were used for analysis. As a result of the analysis, it was confirmed that corona stress is a factor that increases emotional burnout for health care providers. In the case of patient-related stress, it was confirmed that the patient's unreasonable demands increased emotional exhaustion, but aggression did not show statistically significant results. These research results can provide not only theoretical implications for health care service quality improvement, but also managerial implications for preparing plans for internal employee management.

Using CR System at the Department of Radiation Oncology PACS Evaluation (방사선 종양학과에서 CR System을 이용한 PACS 유용성 평가)

  • Hong, Seung-Il;Kim, Young-Jae
    • Journal of the Korean Society of Radiology
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    • v.6 no.2
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    • pp.143-149
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    • 2012
  • Today each hospital is trend that change rapidly by up to date, digitization and introducing newest medical treatment equipment. So, we introduce new CR system and supplement film system's shortcoming and PACS, EMR, RTP system's network that is using in hospital harmoniously and accomplish quality improvement of medical treatment and service elevation about business efficiency enlargement and patient Accordingly, we wish to introduce our case that integrate reflex that happen with radiation oncology here upon to PACS using CR system and estimate the availability. We measured that is Gantry, Collimator Star Shot, Light vs. Radiation, HDR QA(Dwell position accuracy) with Medical LINAC(MEVATRON-MX) Then, PACS was implemented on the digital images on the monitor that can be confirmed through the QA. Also, for cooperation with OCS system that is using from present source and impose code that need in treatment in each treatment, did so that Order that connect to network, input to CR may appear, did so that can solve support data mistake (active Pinacle's case supports DICOM3 file from present source but PACS does not support DICOM3 files.) of Pinacle and PACS that is Planning System and look at Planning premier in PACS. All image and data constructed integration to PACS as can refer and conduct premier in Hospital anywhere using CR system. Use Dosimetry IP in Filmless environment and QA's trial such as Light/Radition field size correspondence, gantry rotation axis' accuracy, collimator rotation axis' accuracy, brachy therapy's Dwell position check is available. Business efficiency by decrease and so on of unnecessary human strength consumption was augmented accordingly with session shortening as that integrate premier that is neted with radiation oncology using CR system to PACS. and for the future patient information security is essential.

Still Image Improvement of Adaptative DWT(Discrete wavelet transform) Decomposition Level Through the Implementation of JPEG2000 Hardware (JPEG2000의 하드웨어 구현을 통한 최적 DWT 레벨의 정지영상 화질개선)

  • Lee, Cheol;Ryu, Jae-Jung;Lee, Jung-Suk
    • The Journal of the Korea institute of electronic communication sciences
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    • v.13 no.6
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    • pp.1343-1352
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    • 2018
  • This paper is designed for hardware to be applied to JPEG2000 standard in the fields of digital photography, remote sensing, aerial remote telemetry, medical imaging, high resolution, and high compression telemetry applications. The software implementation of the JPEG2000 standard for image compression has disadvantages that the processing speed is very slow compared to the conventional JPEG, also the degradation occurs when the DWT level of the JPEG2000 standard is improved. In order to solve this problem, we designed and applied JPEG2000 compression/decompressor. In this paper, the hardware of the JPEG 2000 compression/storage device shows optimal compression speed, faster processing speed, and the image quality for still images by changing the optimal DWT level.

A Study on Promoting the Linkage between Hospital Care and Community Health Services for the Low-income Elderly with Chronic Disease (입원·외래서비스 이용경험이 지역사회 보건복지서비스 이용(욕구)에 미치는 영향 : 저소득 만성질환보유 노인을 대상으로)

  • Lee, Su Yun;Bae, Ji Young
    • Korean Journal of Social Welfare Studies
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    • v.42 no.2
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    • pp.303-322
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    • 2011
  • The increased needs for medical cost containment and the quality of life improvement for the low-income elderly with chronic disease require the complementary relationship between hospital care and community health services. This study investigated the current status of the linkage between Korean hospital care and community services using Seoul Welfare Panel Study(SWPS) data. Logistic regression analysis was used to examine the effects of experiences of hospitalization and outpatient health services on use and needs of community health services. The analysis results indicated that the elderly with chronic disease who have not experienced outpatient health services were unlikely to receive health and social services in the community. Even those who have experienced hospitalization were not provided complementary health services in the community despite the increasing demand.

A Study on Usefulness of Clinical Application of Metal Artifact Reduction Algorithm in Radiotherapy (방사선치료 시 Metal artifact reduction Algorithm의 임상적용 유용성평가)

  • Park, Ja Ram;Kim, Min Su;Kim, Jeong Mi;Chung, Hyeon Suk;Lee, Chung Hwan;Back, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.2
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    • pp.9-17
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    • 2017
  • Purpose: The tissue description and electron density indicated by the Computed Tomography(CT) number (also known as Hounsfield Unit) in radiotherapy are important in ensuring the accuracy of CT-based computerized radiotherapy planning. The internal metal implants, however, not only reduce the accuracy of CT number but also introduce uncertainty into tissue description, leading to development of many clinical algorithms for reducing metal artifacts. The purpose of this study was, therefore, to investigate the accuracy and the clinical applicability by analyzing date from SMART MAR (GE) used in our institution. Methode: and material: For assessment of images, the original images were obtained after forming ROIs with identical volumes by using CIRS ED phantom and inserting rods of six tissues and then non-SMART MAR and SMART MAR images were obtained and compared in terms of CT number and SD value. For determination of the difference in dose by the changes in CT number due to metal artifacts, the original images were obtained by forming PTV at two sites of CIRS ED phantom CT images with Computerized Treatment Planning (CTP system), the identical treatment plans were established for non-SMART MAR and SMART MAR images by obtaining unilateral and bilateral titanium insertion images, and mean doses, Homogeneity Index(HI), and Conformity Index(CI) for both PTVs were compared. The absorbed doses at both sites were measured by calculating the dose conversion constant (cCy/nC) from ylinder acrylic phantom, 0.125cc ionchamber, and electrometer and obtaining non-SMART MAR and SMART MAR images from images resulting from insertions of unilateral and bilateral titanium rods, and compared with point doses from CTP. Result: The results of image assessment showed that the CT number of SMART MAR images compared to those of non-SMART MAR images were more close to those of original images, and the SD decreased more in SMART compared to non-SMART ones. The results of dose determinations showed that the mean doses, HI and CI of non-SMART MAR images compared to those of SMART MAR images were more close to those of original images, however the differences did not reach statistical significance. The results of absorbed dose measurement showed that the difference between actual absorbed dose and point dose on CTP in absorbed dose were 2.69 and 3.63 % in non-SMRT MAR images, however decreased to 0.56 and 0.68 %, respectively in SMART MAR images. Conclusion: The application of SMART MAR in CT images from patients with metal implants improved quality of images, being demonstrated by improvement in accuracy of CT number and decrease in SD, therefore it is considered that this method is useful in dose calculation and forming contour between tumor and normal tissues.

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