• Title/Summary/Keyword: Medical Information Standard Technology

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Application of Westgard Multi-Rules for Improving Nuclear Medicine Blood Test Quality Control (핵의학 검체검사 정도관리의 개선을 위한 Westgard Multi-Rules의 적용)

  • Jung, Heung-Soo;Bae, Jin-Soo;Shin, Yong-Hwan;Kim, Ji-Young;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.1
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    • pp.115-118
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    • 2012
  • Purpose: The Levey-Jennings chart controlled measurement values that deviated from the tolerance value (mean ${\pm}2SD$ or ${\pm}3SD$). On the other hand, the upgraded Westgard Multi-Rules are actively recommended as a more efficient, specialized form of hospital certification in relation to Internal Quality Control. To apply Westgard Multi-Rules in quality control, credible quality control substance and target value are required. However, as physical examinations commonly use quality control substances provided within the test kit, there are many difficulties presented in the calculation of target value in relation to frequent changes in concentration value and insufficient credibility of quality control substance. This study attempts to improve the professionalism and credibility of quality control by applying Westgard Multi-Rules and calculating credible target value by using a commercialized quality control substance. Materials and Methods : This study used Immunoassay Plus Control Level 1, 2, 3 of Company B as the quality control substance of Total T3, which is the thyroid test implemented at the relevant hospital. Target value was established as the mean value of 295 cases collected for 1 month, excluding values that deviated from ${\pm}2SD$. The hospital quality control calculation program was used to enter target value. 12s, 22s, 13s, 2 of 32s, R4s, 41s, $10\bar{x}$, 7T of Westgard Multi-Rules were applied in the Total T3 experiment, which was conducted 194 times for 20 days in August. Based on the applied rules, this study classified data into random error and systemic error for analysis. Results: Quality control substances 1, 2, and 3 were each established as 84.2 ng/$dl$, 156.7 ng/$dl$, 242.4 ng/$dl$ for target values of Total T3, with the standard deviation established as 11.22 ng/$dl$, 14.52 ng/$dl$, 14.52 ng/$dl$ respectively. According to error type analysis achieved after applying Westgard Multi-Rules based on established target values, the following results were obtained for Random error, 12s was analyzed 48 times, 13s was analyzed 13 times, R4s was analyzed 6 times, for Systemic error, 22s was analyzed 10 times, 41s was analyzed 11 times, 2 of 32s was analyzed 17 times, $10\bar{x}$ was analyzed 10 times, and 7T was not applied. For uncontrollable Random error types, the entire experimental process was rechecked and greater emphasis was placed on re-testing. For controllable Systemic error types, this study searched the cause of error, recorded the relevant cause in the action form and reported the information to the Internal Quality Control committee if necessary. Conclusions : This study applied Westgard Multi-Rules by using commercialized substance as quality control substance and establishing target values. In result, precise analysis of Random error and Systemic error was achieved through the analysis of 12s, 22s, 13s, 2 of 32s, R4s, 41s, $10\bar{x}$, 7T rules. Furthermore, ideal quality control was achieved through analysis conducted on all data presented within the range of ${\pm}3SD$. In this regard, it can be said that the quality control method formed based on the systematic application of Westgard Multi-Rules is more effective than the Levey-Jennings chart and can maximize error detection.

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A Survey on the Knowledge of Radiation Safety Management (RSM) in the Context of Industrial Use of Radiation (방사선의 산업적 이용에 따른 방사선 안전관리 지식 조사)

  • Ryu, Young-Hwan;Dong, Kyung-Rae;Chung, Woon-Kwan;Cho, Jae-Hwan;Park, Yong-Soon;Jung, Hong-Ryang
    • Journal of the Korean Society of Radiology
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    • v.6 no.3
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    • pp.159-166
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    • 2012
  • The purpose of this study was examine via a survey the knowledge related to radiation safety management (RSM) among radiation workers who operated or used a radiation generator or radioactive isotopes (radioactive isotopes, etc. hereinafter) for industrial use and to systematically analyze the changes in the survey results in order to promote a radiation safety culture for facilities where radiation is used. We administered a questionnaire to 861 radiation workers in the period from August 1 to September 5, 2011. As for the analysis method, a frequency analysis was made for the general characteristics and organization information of survey respondents, while the average and standard deviation were calculated and compared for the knowledge level of the RSM. According to the analysis results, the knowledge level of the RSM was evaluated to be high in all of the radiation workers. In conclusion, it is required to conduct a study on various factors in regards to the RSM among radiation workers. This can contribute to establishing educational programs in a timely manner to increase the awareness of safe and efficient use of radioactive materials and equipments by radiation workers.

A Distributed address allocation scheme based on three-dimensional coordinate for efficient routing in WBAN (WBAN 환경에서 효율적인 라우팅을 위한 3차원 좌표 주소할당 기법의 적용)

  • Lee, Jun-Hyuk
    • Journal of Digital Contents Society
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    • v.15 no.6
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    • pp.663-673
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    • 2014
  • The WBAN technology means a short distance wireless network which provides each device interactive communication by connecting devices inside and outside of body. Standardization on the physical layer, data link layer, network layer and application layer is in progress by IEEE 802.15.6 TG BAN. Wireless body area network is usually configured in energy efficient using sensor and zigbee device due to the power limitation and the characteristics of human body. Wireless sensor network consist of sensor field and sink node. Sensor field are composed a lot of sensor node and sink node collect sensing data. Wireless sensor network has capacity of the self constitution by protocol where placed in large area without fixed position. In this paper, we proposed the efficient addressing scheme for improving the performance of routing algorithm by using ZigBee in WBAN environment. A distributed address allocation scheme used an existing algorithm that has wasted in address space. Therefore proposing x, y and z coordinate axes from divided address space of 16 bit to solve this problems. Each node was reduced not only bitwise but also multi hop using the coordinate axes while routing than Cskip algorithm. I compared the performance between the standard and the proposed mechanism through the numerical analysis. Simulation verified performance about decrease averaging multi hop count that compare proposing algorithm and another. The numerical analysis results show that proposed algorithm reduced the multi hop better than ZigBee distributed address assignment

Analysis of Automatic Rigid Image-Registration on Tomotherapy (토모테라피의 자동영상정합 분석)

  • Kim, Young-Lock;Cho, Kwang Hwan;Jung, Jae-Hong;Jung, Joo-Young;Lim, Kwang Chae;Kim, Yong Ho;Moon, Seong Kwon;Bae, Sun Hyun;Min, Chul Kee;Kim, Eun Seog;Yeo, Seung-Gu;Suh, Tae Suk;Choe, Bo-Young;Min, Jung-Whan;Ahn, Jae Ouk
    • Journal of radiological science and technology
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    • v.37 no.1
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    • pp.37-47
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    • 2014
  • The purpose of this study was to analyze translational and rotational adjustments during automatic rigid image-registration by using different control parameters for a total of five groups on TomoTherapy (Accuray Inc, Sunnyvale, CA, USA). We selected a total of 50 patients and classified them in five groups (brain, head-and-neck, lung, abdomen and pelvic) and used a total of 500 megavoltage computed tomography (MVCT) image sets for the analysis. From this we calculated the overall mean value(M) for systematic and random errors after applying the different control parameters. After randomization of the patients into the five groups, we found that the overall mean value varied according to three techniques and resolutions. The deviation for the lung, abdomen and pelvic groups was approximately greater than the deviation for the brain and head-and-neck groups in all adjustments. Overall, using a "full-image" produces smaller deviations in the rotational adjustments. We found that rotational adjustment has deviations with distinctly different control parameters. We concluded that using a combination of the "full-image" technique and "standard" resolution will be helpful in assisting with patients' repositioning and in correcting for set-up errors prior to radiotherapy on TomoTherapy.

Clinical Usefulness of PET-MRI in Lymph Node Metastasis Evaluation of Head and Neck Cancer (두경부암 림프절 전이 평가에서 PET-MRI의 임상적 유용성)

  • Kim, Jung-Soo;Lee, Hong-Jae;Kim, Jin-Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.26-32
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    • 2014
  • Purpose: As PET-MRI which has excellent soft tissue contrast is developed as integration system, many researches about clinical application are being conducted by comparing with existing display equipments. Because PET-MRI is actively used for head and neck cancer diagnosis in our hospital, lymph node metastasis before the patient's surgery was diagnosed and clinical usefulness of head and neck cancer PET-MRI scan was evaluated using pathological opinions and idiopathy surrounding tissue metastasis evaluation method. Materials and Methods: Targeting 100 head and neck cancer patients in SNUH from January to August in 2013. $^{18}F-FDG$ (5.18 MBq/kg) was intravenous injected and after 60 min of rest, torso (body TIM coil, Vibe-Dixon) and dedication (head-neck TIM coil, UTE, Dotarem injection) scans were conducted using $Bio-graph^{TM}$ mMR 3T (SIEMENS, Munich). Data were reorganized using iterative reconstruction and lymph node metastasis was read with Syngo.Via workstation. Subsequently, pathological observations and diagnosis before-and-after surgery were examined with integrated medical information system (EMR, best-care) in SNUH. Patient's diagnostic information was entered in each category of $2{\times}2$ decision matrix and was classified into true positive (TP), true negative (TN), false positive (FP) and false negative (FN). Based on these classified test results, sensitivity, specificity, accuracy, false negative and false positive rate were calculated. Results: In PET-MRI scan results of head and neck cancer patients, positive and negative cases of lymph node metastasis were 49 and 51 cases respectively and positive and negative lymph node metastasis through before-and-after surgery pathological results were 46 and 54 cases respectively. In both tests, TP which received positive lymph node metastasis were analyzed as 34 cases, FP which received positive lymph node metastasis in PET-MRI scan but received negative lymph node metastasis in pathological test were 4 cases, FN which received negative lymph node metastasis but received positive lymph node metastasis in pathological test was 1 case, and TN which received negative lymph node metastasis in both two tests were 50 cases. Based on these data, sensitivity in PET-MRI scan of head and neck cancer patient was identified to be 97.8%, specificity was 92.5%, accuracy was 95%, FN rate was 2.1% and FP rate was 7.00% respectively. Conclusion: PET-MRI which can apply the acquired functional information using high tissue contrast and various sequences was considered to be useful in determining the weapons before-and-after surgery in head and neck cancer diagnosis or in the evaluation of recurrence and remote detection of metastasis and uncertain idiopathy cervical lymph node metastasis. Additionally, clinical usefulness of PET-MRI through pathological test and integrated diagnosis and follow-up scan was considered to be sufficient as a standard diagnosis scan of head and neck cancer, and additional researches about the development of optimum MR sequence and clinical application are required.

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Metal artifact SUV estimation by using attenuation correction image and non attenuation correction image in PET-CT (PET-CT에서 감쇠보정 영상과 비감쇠보정 영상을 통한 Metal Artifact 보정에 대한 고찰)

  • Kim, June;Kim, Jae-II;Lee, Hong-Jae;Kim, Jin-Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.2
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    • pp.21-26
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    • 2016
  • Purpose Because of many advantages, PET-CT Scanners generally use CT Data for attenuation correction. By using CT based attenuation correction, we can get anatomical information, reduce scan time and make more accurate correction of attenuation. However in case metal artifact occurred during CT scan, CT-based attenuation correction can induce artifacts and quantitative errors that can affect the PET images. Therefore this study infers true SUV of metal artifact region from attenuation corrected image count -to- non attenuation corrected image count ratio. Materials and Methods Micro phantom inserted $^{18}F-FDG$ 4mCi was used for phantom test and Biograph mCT S(40) is used for medical test equipment. We generated metal artifact in micro phantom by using metal. Then we acquired both metal artifact region of correction factor and non metal artifact region of correction factor by using attenuation correction image count -to- non attenuation correction image count ratio. In case of clinical image, we reconstructed both attenuation corrected images and non attenuation corrected images of 10 normal patient($66{\pm}15age$) who examined PET-CT scan in SNUH. After that, we standardize several organs of correction factor by using attenuation corrected image count -to- non attenuation corrected count ratio. Then we figured out metal artifact region of correction factor by using metal artifact region of attenuation corrected image count -to- non attenuation corrected count ratio And we compared standard organs correction factor with metal artifact region correction factor. Results according to phantom test results, metal artifact induce overestimation of correction factor so metal artifact region of correction factors are 12% bigger than the non metal artifact region of correction factors. in case of clinical test, correction factor of organs with high CT number(>1000) is $8{\pm}0.5%$, correction factor of organs with CT number similar to soft tissue is $6{\pm}2%$ and correction factor of organs with low CT number(-100>) is $3{\pm}1%$. Also metal artifact correction factors are 20% bigger than soft tissue correction factors which didn't happened metal artifact. Conclusion metal artifact lead to overestimation of attenuation coefficient. because of that, SUV of metal artifact region is overestimated. Thus for more accurate quantitative evaluation, using attenuation correction image count -to-non attenuation correction image count ratio is one of the methods to reduce metal artifact affect.

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A new diagnostic method for diabetic neuropathy using $TcpO_2$ ($TcpO_2$ 이용한 당뇨병성 신경병증 환자의 조기진단)

  • Hong, Hyun-Ki;Kim, Sung-Woo;Nam, Ki-Chang;Cha, Eun-Jong;Kim, Deok-Won
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.44 no.3
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    • pp.1-8
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    • 2007
  • PDiabetic neuropathy is one of the most common diabetes related complications including diabetic nephropathy and retinopahty. In clinical practices, nerve conduction velocity (NCV) has been used as a standard method for diagnosing diabetic neuropathy. However, it applies maximum current of 100mA to nerves causing stress and pain to patients. In this study, as a non-invasive method, $TcpO_2$ was utilized to investigate the difference and relationship between $TcpO_2$ and $SpO_2$ of normal and diabetic neuropathy subjects. In addition, a new method of diagnosing diabetic neuropathy using $TcpO_2$ is suggested. 50 normal subjects and 50 diabetic patients with neuropathy diagnosed by NCV participated in this study. Parameters used in this study were $TcpO_2$, $TcpCO_2$, and $SpO_2$. As a result of the $TcpO_2$ measurements, statistical significances were found from $TcpO_2$ of hands and feet from normal and patients group(p<0.01). $SpO_2$ measured from index finger of normal and patient groups showed no statistical significance(p>0.05). On the other hand, $SpO_2$ measured from great toes of normal and patient groups showed statistical significance(p<0.01). Correlation coefficient between $SpO_2$ of finger and $TcpO_2$ of hand was 0.400 (p<0.01) and $SpO_2$ of toe and $TcpO_2$ of foot was 0.471(p<0.01). Both correlation values were statistically significant. Sensitivities and specificities of the $TcpO_2$ method were found to be 66 % and 92 %, respectively. If the suggested $TcpO_2$ method is used periodically, prevention and early diagnosis of diabetic neuropathy would be possible.

Analysis of Research Trends in Journal of Distribution Science (유통과학연구의 연구 동향 분석 : 창간호부터 제8권 제3호까지를 중심으로)

  • Kim, Young-Min;Kim, Young-Ei;Youn, Myoung-Kil
    • Journal of Distribution Science
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    • v.8 no.4
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    • pp.5-15
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    • 2010
  • This study investigated research trends of JDS that KODISA published and gave implications to elevate quality of scholarly journals. In other words, the study classified scientific system of distribution area to investigate research trends and to compare it with other scholarly journals of distribution and to give implications for higher level of JDS. KODISA published JDS Vol.1 No.1 for the first time in 1999 followed by Vol.8 No.3 in September 2010 to show 109 theses in total. KODISA investigated subjects, research institutions, number of participants, methodology, frequency of theses in both the Korean language and English, frequency of participation of not only the Koreans but also foreigners and use of references, etc. And, the study investigated JDR of KODIA, JKDM(The Journal of Korean Distribution & Management) and JDA that researched distribution, so that it found out development ways. To investigate research trends of JDS that KODISA publishes, main category was made based on the national science and technology standard classification system of MEST (Ministry Of Education, Science And Technology), table of classification of research areas of NRF(National Research Foundation of Korea), research classification system of both KOREADIMA and KLRA(Korea Logistics Research Association) and distribution science and others that KODISA is looking for, and distribution economy area was divided into general distribution, distribution economy, distribution, distribution information and others, and distribution management was divided into distribution management, marketing, MD and purchasing, consumer behavior and others. The findings were as follow: Firstly, main category occupied 47 theses (43.1%) of distribution economy and 62 theses (56.9%) of distribution management among 109 theses in total. Active research area of distribution economy consisted of 14 theses (12.8%) of distribution information and 9 theses (8.3%) of distribution economy to research distribution as well as distribution information positively every year. The distribution management consisted of 25 theses (22.9%) of distribution management and 20 theses (18.3%) of marketing, These days, research on distribution management, marketing, distribution, distribution information and others is increasing. Secondly, researchers published theses as follow: 55 theses (50.5%) by professor by himself or herself, 12 theses (11.0%) of joint research by professors and businesses, Professors/students published 9 theses (8.3%) followed by 5 theses (4.6%) of researchers, 5 theses (4.6%) of businesses, 4 theses (3.7%) of professors, researchers and businesses and 2 theses (1.8%) of students. Professors published theses less, while businesses, research institutions and graduate school students did more continuously. The number of researchers occupied single researcher (43 theses, 39.5%), two researchers (42 theses, 38.5%) and three researchers or more (24 theses, 22.0%). Thirdly, professors published theses the most at most of areas. Researchers of main category of distribution economy consisted of professors (25 theses, 53.2%), professors and businesses (7 theses, 14.9%), professors and businesses (7 theses, 14.9%), professors and researchers (6 theses, 12.8%) and professors and students (3 theses, 6.3%). And, researchers of main category of distribution management consisted of professors (30 theses, 48.4%), professors and businesses (10 theses, 16.1%), and professors and researchers as well as professors and students (6 theses, 9.7%). Researchers of distribution management consisted of professors, professors and businesses, professors and researchers, researchers and businesses, etc to have various types. Professors mainly researched marketing, MD and purchasing, and consumer behavior, etc to demand active participation of businesses and researchers. Fourthly, research methodology was: Literature research occupied 45 theses (41.3%) the most followed by empirical research based on questionnaire survey (44 theses, 40.4%). General distribution, distribution economy, distribution and distribution management, etc mostly adopted literature research, while marketing did empirical research based on questionnaire survey the most. Fifthly, theses in the Korean language occupied 92.7% (101 theses), while those in English did 7.3% (8 theses). No more than one thesis in English was published until 2006, and 7 theses (11.9%) were published after 2007 to increase. The theses in English were published more to be affirmative. Foreigner researcher published one thesis (0.9%) and both Korean researchers and foreigner researchers jointly published two theses (1.8%) to have very much low participation of foreigner researchers. Sixthly, one thesis of JDS had 27.5 references in average that consisted of 11.1 local references and 16.4 foreign references. And, cited times was 0.4 thesis in average to be low. The distribution economy cited 24.2 references in average (9.4 local references and 14.8 foreign references and JDS had 0.6 cited reference. The distribution management had 30.0 references in average (12.1 local references and 17.9 foreign references) and had 0.3 reference of JDS itself. Seventhly, similar type of scholarly journal had theses in the Korean language and English: JDR( Journal of Distribution Research) of KODIA(Korea Distribution Association) published 92 theses in the Korean language (96.8%) and 3 theses in English (3.2%), that is to say, 95 theses in total. JKDM of KOREADIMA published 132 theses in total that consisted of 93 theses in the Korean language (70.5%) and 39 theses in English (29.5%). Since 2008, JKDM has published scholarly journal in English one time every year. JDS published 52 theses in the Korean language (88.1%) and 7 theses in English (11.9%), that is to say, 59 theses in total. Sixthly, similar type of scholarly journals and research methodology were: JDR's research methodology had 65 empirical researches based on questionnaire survey (68.4%), followed by 17 literature researches (17.9%) and 11 quantitative analyses (11.6%). JKDM made use of various kinds of research methodologies to have 60 questionnaire surveys (45.5%), followed by 40 literature researches (30.3%), 21 quantitative analyses (15.9%), 6 system analyses (4.5%) and 5 case studies (3.8%). And, JDS made use of 30 questionnaire surveys (50.8%), followed by 15 literature researches (25.4%), 7 case studies (11.9%) and 6 quantitative analyses (10.2%). Ninthly, similar types of scholarly journals and Korean researchers and foreigner researchers were: JDR published 93 theses (97.8%) by Korean researchers except for 1 thesis by foreigner researcher and 1 thesis by joint research of the Korean researchers and foreigner researchers. And, JKDM had no foreigner research and 13 theses (9.8%) by joint research of the Korean researchers and foreigner researchers to have more foreigner researchers as well as researchers in foreign countries than similar types of scholarly journals had. And, JDS published 56 theses (94.9%) of the Korean researchers, one thesis (1.7%) of foreigner researcher only, and 2 theses (3.4%) of joint research of both the Koreans and foreigners. Tenthly, similar type of scholarly journals and reference had citation: JDR had 42.5 literatures in average that consisted of 10.9 local literatures (25.7%) and 31.6 foreign literatures (74.3%), and cited times accounted for 1.1 thesis to decrease. JKDM cited 10.5 Korean literatures (36.3%) and 18.4 foreign literatures (63.7%), and number of self-cited literature was no more than 1.1. Number of cited times accounted for 2.9 literatures in 2008 and then decreased continuously since then. JDS cited 26,8 references in average that consisted of 10.9 local references (40.7%) and 15.9 foreign references (59.3%), and number of self-cited accounted for 0.2 reference until 2009, and it increased to be 2.1 references in 2010. The author gives implications based on JDS research trends and investigation on similar type of scholarly journals as follow: Firstly, JDS shall actively invite foreign contributors to prepare for SSCI. Secondly, ratio of theses in English shall increase greatly. Thirdly, various kinds of research methodology shall be accepted to elevate quality of scholarly journals. Fourthly, to increase cited times, Google and other web retrievals shall be reinforced to supply scholarly journals to foreign countries more. Local scholarly journals can be worldwide scholarly journal enough to be acknowledged even in foreign countries by improving the implications above.

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