• Journal of Biomedical Engineering Research
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• v.43 no.4
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• pp.259-270
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• 2022

Artificial intelligence (AI) has been studied in various fields of medical imaging. Currently, top-notch deep learning (DL) techniques have led to high diagnostic accuracy and fast computation. However, they are rarely used in real clinical practices because of a lack of reliability concerning their results. Most DL models can achieve high performance by extracting features from large volumes of data. However, increasing model complexity and nonlinearity turn such models into black boxes that are seldom accessible, interpretable, and transparent. As a result, scientific interest in the field of explainable artificial intelligence (XAI) is gradually emerging. This study aims to review diverse XAI approaches currently exploited in medical imaging. We identify the concepts of the methods, introduce studies applying them to imaging modalities such as computational tomography (CT), magnetic resonance imaging (MRI), and endoscopy, and lastly discuss limitations and challenges faced by XAI for future studies.

• Smart Media Journal
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• v.12 no.3
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• pp.30-37
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• 2023

Alzheimer's disease (AD) symptoms are being treated by early diagnosis, where we can only slow the symptoms and research is still undergoing. In consideration, using T1-weighted images several classification models are proposed in Machine learning to identify AD. In this paper, we consider the improvised feature selection, to reduce the complexity by using wrapping techniques and Restricted Boltzmann Machine (RBM). This present work used the subcortical and cortical features of 278 subjects from the ADNI dataset to identify AD and sMRI. Multi-class classification is used for the experiment i.e., AD, EMCI, LMCI, HC. The proposed feature selection consists of Forward feature selection, Backward feature selection, and Combined PCA & RBM. Forward and backward feature selection methods use an iterative method starting being no features in the forward feature selection and backward feature selection with all features included in the technique. PCA is used to reduce the dimensions and RBM is used to select the best feature without interpreting the features. We have compared the three models with PCA to analysis. The following experiment shows that combined PCA &RBM, and backward feature selection give the best accuracy with respective classification model RF i.e., 88.65, 88.56% respectively.

• Proceedings of the Korea Information Processing Society Conference
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• 2022.11a
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• pp.462-464
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• 2022

의료영상기반의 인공지능 연구는 질환의 조기진단 및 예측 분야에 눈부신 기술발전이 되어왔다. 장기 섬유증은 만성 염증성 질환의 질병 진행을 특징짓고 전 세계적으로 모든 원인으로 인한 사망률의 45%에 기여하며, 그중 간 섬유증은 주로 삶의 질과 예후를 결정한다. 해당 질환은 임상 현장에서 혈액데이터 분석 그리고 간생검을 통해 진단을 하고 있으나 최근 의료영상 분석을 통해 진단에 활용하고 있는 추세이다. 본 논문에서는 인공지능을 기반으로 하여, 간 섬유화를 진단하기 위해 MRI영상을 학습하여 질환에 대한 중증도 진단을 돕는 인공지능 모델을 제시하고자 한다. 이를 위해 인공지능 모델을 개발하는 과정과 그 결과를 보인다. 본 논문에서 제시한 모델을 통해 간 섬유화를 빠르게 진단할 수 있을 것으로 기대한다.

• Health Policy and Management
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• v.5 no.2
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• pp.35-69
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• 1995

The managerial environment of hospitals in Korea characterized by low levels of medical insurance fees is worsening by increasing government regulations as to the utilization of medical services, rising costs of labor, material, and medical equipments, growing patient expectations concerning the quality of services, and escalating competitions among large hospitals in the market. Hospitals should seek for their survival strategies in this harsh environment and they should have information about costs of their products in doing so. However, it has not been available due to the complexity of the production process of hospital services. The objectives of this study were to develop a service-based cost accounting model and to apply the developed model to a study hospital to obtain cost information of hospital services. A model commonly used for the job-order product cost accounting in the manufacturing industry was modified for the use in hospitals in Korea. Actual costs, instead of standard costs, incurred to produce a unit of services during a given period of time were estimated in the model. Data required to implement the model included financial information, statistics for the allocation of supportive cost center costs to final cost centers, statistics for the allocation of final cost center costs to services, and the volume of each services charged to patients during a study period. The model was executed using data of a university teaching hospital located in Seoul for the fiscal year 1992. Data for financial information, allocation statistics fo supportive service costs, and the volume of services, most of them in electronic form, were available to the study. Data for allocation statistics of final cost center costs were collected in the study. There were 15 types of evaluation and management service, 2, 923 types of technical service, and 2, 608 types of drug and material service charged to patients in the study hospital during the fiscal year 1992. Labor costs of each of seven types of pesonnel, material costs of 611 types of drugs and materials, and depreciation costs of 212 types of medical equipments, miscellaneous costs, and indirect costs incurred in producing a unit of each services were estimated. Medical insurance fees for basic services such as evaluation and management of inpatients and outpatients, injection, and filling prescriptions, and for operating procedures were found to be set lower than costs. Infrequent services which use expensive medical equipments showed negative revenuse as well. On the other hand, fees for services not covered by the insurance such as CT, MRI and Sonogram, and for laboratory tests were higher than costs. This study has a significance in making it possible for a hospital to obtain cost information for all types of services which produced income based on all types of expenses incurred during a given period of time. This information can assist the management of a hospital in finding an effective cost reduction strategy, an efficient service-mix strategy under a given fee structure, and an optimum strategy for within-hospital resource allocations.

• Journal of Biomedical Engineering Research
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• v.27 no.6
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• pp.392-401
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• 2006

Image Guided Surgery (IGS) system which has variously tried in medical engineering fields is able to give a surgeon objective information of operation process like decision making and surgical planning. This information is displayed through 3D images which are acquired from image modalities like CT and MRI for pre-operation. The technique of image registration is necessary to construct IGS system. Image registration means that 3D model and the object operated by a surgeon are matched on the common frame. Major techniques of registration in IGS system have been used by recognizing fiducial markers placed on the object. However, this method has been criticized due to additional trauma, its invasive protocol inserting fiducial markers in patient's bone and generating noise data when 2D slice images are acquired by image modality because many markers are made of metal. Therefore, this paper developed shape-based registration technique to improve the limitation of fiducial marker based IGS system. Iterative Closest Points (ICP) algorithm was used to match corresponding points and quaternion based rotation and translation transformation using closed form solution applied to find the optimized cost function of transformation. we assumed that this algorithm were used in Total Knee replacement (TKR) operation. Accordingly, we have developed region-based 3D registration technique based on anatomical landmarks and this registration algorithm was evaluated in a femur model. It was found that region-based algorithm can improve the accuracy in 3D registration.

• Journal of Biomedical Engineering Research
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• v.43 no.4
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• pp.193-198
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• 2022

Contrast enhanced magnetic resonance imaging using gadolinium-based contrast agent (GBCA) is a very useful in vivo technique to visualize the inner ear pathology including endolymphatic hydrops. Although systemic intravenous (IV) administration can visualize the perilymph space, the visualization was possible by indirect passage of contrast agent through blood-perilymph barrier. All animal experimental procedures were performed under anesthesia with 5% isoflurane. Lipopolysaccharide (LPS) was instilled into the left tympanic cavity through the tympanic membrane using a sterile 27gauge needle to induce hydrops model. Tucker-Davis Technologies system was used to measure Auditory Brainstem Responses (ABRs). For intracerebroven-tricular (ICV) administration, 25 µmol of GADOVIST (Bayer, Berlin, Germany) was used and diluted GADOVIST injection was 10 µl. MR imaging was acquired with a 9.4 Tesla MRI scanner. Transmit-receive volume coil with 40 mm inner diameter and 75 mm out diameter was used. ICV administration well demonstrated the strong enhancement along the cerebrospinal fluid (CSF) microcirculation pathway including CSF fluid in the subarachnoid space and CSF space of the inner ear structures. On the other hand, IV administration showed no contrast enhancement along the CSF microcirculation pathway and showed weak enhancement in the inner ear structures. In case of rat hydrops model, ICV administration showed that the reduced contrast enhancement in the perilymph space of the hydrops induced inner ear compared to the contrast enhancement in the perilymph space of the normal inner ear. New systemic ICV administration method provide contrast enhancement of GBCA in the inner ear through CSF microcirculation pathway.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1373-1377
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• 2016

Background: We vigorously reviewed patients' operation record who had adhesion of the Denonvilliers' fascia and found out most of these patients had prostatic bleeding after prostatic gland biopsies. We examined the magnitude of prostatic bleeding and frequency after biopsies and the relationship with oncological outcomes. Materials and Methods: A total of 285 patients were selected for the final analyses. Inclusion criteria were as follows: receiving MRI three weeks after biopsiesand laparoscopic radical prostatectomy within 300 days after biopsy. We divided the patients into two groups with (group A) or without (group B) prostatic bleeding. We examined the magnitude of prostatic bleeding after biopsies and the relationship with operation time (OT), positive surgical margin (PSM), biochemical recurrence (BCR) and other factors. Furthermore, we created a logistic-regression model to derive a propensity score for prostatic bleeding after biopsies, which included all patient and hospital characteristics as well as selected interaction terms, and we examined the relationship with PSM and BCR. Results: In all patients, the OT in the group B was shorter than the group A (p < 0.001). Prostatic bleeding was associated with PSM (p=0.000) and BCR (p=0.036). In this propensity-matched cohort, 11 of 116 patients in the group B had PSM as compared with 36 of 116 patients from group A (match-adjusted odds ratio, 4.30; 95%CI confidence interval, 2.06 to 8.96; P=0.000). In addition, eight of 116 patients in group B encountered BCR, as compared with 18 of 116 patients in group A (match-adjusted odds ratio, 2.48; 95%CI, 1.03 to 5.96; P=0.042). Kaplan-Meier analysis in the propensity matching cohort showed a significant biochemical recurrence-free survival advantage for being free of prostate bleeding after biopsies. Conclusions: Our findings in the present cohort should help equip surgeons to pay attention to careful excision especially for those who experienced deferred prostatic bleeding.

• Korean Journal of Family Social Work
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• no.55
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• pp.91-128
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• 2017

The purpose of this study is to develop an effective intervention strategy for marriage migrant woman in family therapy. For this purpose, we collected counseling cases of professional counselors who successfully completed counseling and attempted the qualitative analysis of treatment intervention strategies and effects. The results of the study were obtained by dividing the meaning units in the immigrant woman's statements made during the counseling process composed of a total of 6 sessions. The counselors were analyzed to have tried the following intervention strategies. They attempted the following six strategies: Helping emotional differentiation by searching for unresolved emotional problems, dealing with undifferentiation due to family projection process and love triangle, dealing with multi-generational transfer process of the original family relationship patterns and coping mechanism, shedding lihgt on ineffectiveness of inconsistent communication due to emotional oppression applying a communication model of MRI, switching client's awareness through reorganization, suggesting a way of communication that leads to real self. Such counselors' attempts resulted in positive changes and treatment effects were found to include first, cognitive insights and motivation for change, second, improved communication skills and third, anxiety reduction and self-differentiation. Due to their husbands' refusal to participate in counseling, marriage migrant women often get involved in counseling alone, so they tend to worry that the effectiveness of family therapy may be low but it was found that the proper intervention of the counselor could improve the ability of the wife to resolve conflicts, which would be a great help in solving problems such as family violence and this study is meaningful in that it provided the appropriate therapeutic intervention strategies needed.

• The korean journal of orthodontics
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• v.33 no.3 s.98
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• pp.211-222
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• 2003

The purpose of this study was to determine whether there is an association between disk displacement of the Temporomandibular Joint (TMJ) and dentofacial asymmetry In orthodontic patients. The subjects consisted of 60 female orthodontic patients between the ages of 18 and 38 years (mean age 23.3 years) who had visited the Department of Orthodontics at Seoul National University Dental Hospital from January 2000 to April 2002. On the basis of magnetic resonance imaging (MRI) of their bilateral TMJs, the subjects were divided Into four groups'. bilateral normal group (twenty-one persons); disk displacement of right TMJ group (six persons); disk displacement of left TMJ group (nine persons); and disk displacement of both TMJs group (twenty-four persons) Postero-anterior (PA) cephalograms and diagnostic models which had been taken before orthodontic treatment were measured. In the linear measurements, a line connecting the right and left Latero-Orbitale (Lo) represented the horizontal reference line (H). The vertical reference line (V) was constructed as a line bisecting and running perpendicular to H. One-way analysis of variance (ANOVA) was used to test whether the mean values of measurements between groups were significantly different. In addition, Bonferronil's multiple comparison test was performed at a level of 0.05. The results were as follows; 1 In the diagnostic model analysis, the overjet, nght molar relationship, and left molar relationship were significantly different among the four groups. 2. In the PA cephalometric analysis, differences in the right and left vertical position of the lower first molar and Ag were significantly dissimilar among the four groups. 3. If the disk displacement of TMJ was present on one side, the ipsilateral ramus was shorter, resulting in asymmetry in the vertical position of Ag. This study indicated that dentofacial asymmetry might be related to the disk displacement of TMJ.

• Investigative Magnetic Resonance Imaging
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• v.13 no.1
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• pp.81-87
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• 2009

Purpose : We sought to evaluate enhancement of plaque with gadolinium-based contrast agent by magnetic resonance imaging (MRI) in comparison with histopathology, namely lipid-rich and macrophage-rich components that were two representative characteristics of plaque vulnerability using atherosclerotic rabbit aorta in order to determine which histopathologic component is relevant to the enhancement. Materials and Methods : New Zealand white rabbit (n=4, weight 3.0 to 3.5 kg, all male) was used for animal model of atherosclerosis. Atherosclerotic aortic lesions were induced by high-cholesterol diet and double balloon injury. T1-weight axial images were acquired before and after gadolinium-based contrast agent using a 3-T MRI. MR images and the matched histopathological sections (n=35) were divided into 4 quadrants or 3 (n=130). Enhancement ratio (ER, ER=SIpost/SIpre) on MRI was calculated for each quadrant and compared with histopathology in regard to lipid-rich and macrophage-rich areas. Results : Lipid-rich quadrants were 72 and fibrous quadrants were 58. The number of quadrants which had macrophage-rich areas was 105 and that of quadrants which did not have macrophage-rich areas was 25. ER was significantly higher in lipid-rich quadrants than in fibrous quadrants (mean ER 2.25c$\pm$0.41 vs. 2.72$\pm$0.65, p=0.013). ER poorly correlated with macrophage-rich areas when lipid-component was controlled (correlation coefficient -0.203, p=0.236). Conclusion : Lipid-rich plaques showed stronger enhancement than fibrous plaques using a standard gadolinium-based extracellular contrast agent. Macrophage infiltration did not correlate with degree of enhancement. Further study is warranted that account for optimal time of imaging after contrast injection using various plaque models from early to advanced stages and all possible parameters associated with contrast enhancement.