• 한국의학물리학회지:의학물리
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• 제35권1호
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• pp.16-19
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• 2024

A new E_n score of the proficiency test (PT) is formulated; it is applicable when a correlation exists between the reference and participant's values. Based on the uncertainty propagation rule given in ISO/IEC Guide 98-3 (GUM:1995), the E_n score covering the correlation case is newly developed for the PT. The new E_n score will be applied in a future PT organized by the Korea Research Institute of Standards and Science (KRISS) dosimetry team. The new E_n score will enhance measurement traceability and contribute to improving the quality management system of participants in the KRISS PT by avoiding performance underestimation.

• 한국의학물리학회지:의학물리
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• 제24권4호
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• pp.315-322
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• 2013

전문가 그룹의 외부검사를 통하여 의료기관 자체적으로 시행되고 있는 품질관리를 평가하고 구조적 문제점에 대한 상호보완을 하고자 하였다. 외부 검사의 정당성 확보를 위해 전국 80여 개의 의료기관 중 지역 분포를 고려하여 30여 개를 선정하였고, 최종 25개의 의료기관이 자발적 참여의사를 신청하였다. 참여의료기관은 비공개를 원칙으로 하였고, 사전에 상호 비교하여 검증된 측정 장비를 가지고 직접 방문하여 측정하는 것을 원칙으로 하였다. 두 개 이상의 광자선을 대상으로 출력선량을 측정하였고, 갠트리회전 정확도, 콜리메이터 회전 정확도, 다엽콜리메이터 이동 위치 정확도 등을 측정하였다. 출력선량 측정에서 6 MV의 경우 -0.8%~4.5%까지 절대오차를 보였고, 10 MV의 경우 -0.79%~3.01%이었고, 15 MV에서 -0.7%~0.07% 절대오차를 나타내었다. 25개 의료 기관을 대상으로 한 50개의 광자선 중에서 절대 흡수선량이 2% 이상 되는 에너지가 8개(16%)로 나타났다. 조사면과 갠트리, 콜리메이터 회전축 일치도는 2개 의료기관을 제외하고 모두 ${\pm}2$ mm 이내의 결과를 보였다. 다엽콜리메이터 이동 위치 정확도는 모두 ${\pm}1$ mm 이내의 정확도를 보였다. 에너지 선질 조사에서 광자선 6 MV의 경우 KQ 값의 최고값과 최저값의 차이는 0.4%로 나타났다. 물 흡수선량 기반 측정 기준서 사용기관은 21개(84%), 공기 흡수선량 기반 측정 기준서 사용기관은 4개(16%)로 조사되었고, SSD 측정법을 사용하는 기관은 22개, SAD 측정법을 사용하는 기관은 3개 기관으로 조사되었다. 외부검사는 자체적으로 시행되고 있는 품질관리의 구조적인 문제점을 찾아 상호 보완하는 것임으로 매우 중요하다. 따라서 전문가 그룹 및 국가가 함께 주기적이고, 지속적인 외부검사가 시행 될 수 있도록 국제 수준의 전문가의 양성 및 국가지원 제도가 필요하다고 사료된다.

• 한국산학기술학회논문지
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• 제15권8호
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• pp.5009-5022
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• 2014

본 연구는 한 대학병원 건강검진센터에서 종합건강검진을 받은 일반 성인들을 대상으로 생활습관에 따른 혈청지질치의 수준을 알아보고, 생활습관 인자들이 혈청지질치에 미치는 영향을 파악하고자 하였다. 조사대상은 2012년 1월부터 2013년 12월까지의 기간에 대전광역시에 소재하고 있는 C대학교병원 건강검진센터에서 건강검진을 받았던 4,112명을 대상으로 하였다. 자료 수집은 건강검진 시에 수검자들에게 배포하여 기입하도록 한 문진표와 건강검진결과표로부터 인구사회학적 특성, 생활습관 및 혈청지질치 등의 자료를 수집하여 분석하였다. 연구결과, 조사대상자의 TC, HDL-C. LDL-C 및 TG 등의 혈청지질치나 동맥경화지수(AI)의 평균치는 남녀 모두 연령, 음주, 흡연, 규칙적인 운동, 과식 및 육류섭취 등의 생활습관 특성에 따라 유의한 차이를 보였다. 조사대상자의 TC, HDL-C. LDL-C, TG 및 AI는 남녀 모두 연령, AUDIT점수와 유의한 양의 상관관계를 나타낸 반면, HPI점수와는 유의한 음의 상관관계를 보였다. 조사대상자의 혈청지질치에 대한 생활습관의 영향요인으로 TC, HDL-C. LDL-C, TG 및 AI가 비정상치에 속할 위험비는 남녀 모두 과식을 매일 한다는 군, 육류섭취를 매일 한다는 군, 흡연군, 규칙적인 운동을 하지 않는다는 군, HPI가 낮은 군에서 그렇지 않다는 군보다 유의하게 증가하였다. 이상과 같은 결과는 조사대상자의 혈청지질치나 AI는 연령증가와 함께 음주, 흡연, 규칙적인 운동, 과식 및 육류 섭취 등의 생활습관 특성에 따라 영향을 받고 있음을 시사한다.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.19-22
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• 2002

The importance of accurate dose delivery in radiotherapy is well documented. Studies have shown that a mere 5% deviation of the prescribed dose can produce an undesirable treatment outcome. Uncertainties in the dose delivery can arise at different stages of the radiotherapy process. Therefore, a good quality assurance programme will ensure the best possible results and consistency of the radiotherapeutic treatment. Quality assurance in any radiotherapy department involves the responsibility of a multi-disciplinary team of radiation oncologists, medical physicists and radiation technologists. This paper will focus on the physical and technical aspects of QA. The organizational structure and responsibility of the physics QA team is outlined and also included the types and frequencies of QA checks. For a QA program to be effective, action levels should be clearly defined and understood by all staff concerned. Data of the Singapore National Cancer Centre's participation over the last ten years with the IAEA / WHO Postal TLD Dose Inter-comparison programme is presented. The data obtained were within the international criteria. For a QA program to be successfully implemented, there must be a commitment by management to provide adequate staff, test equipment, machine time as well as continual training and education. This is in addition to the positive attitudes of all the staff. A quality audit is also necessary to serve as a check and balance to ensure that the QA is in order.

• 한국병원경영학회지
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• 제21권4호
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• pp.45-54
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• 2016

The purpose of this study is to identify patient and hospital characteristics with pulmonary tuberculosis and to analyze factors which were influencing length of stay and treatment. The Korean National Hospital Discharge In-depth Injury Survey database from 2006 to 2012 was used for analysis. Study subjects were 4,704 patients and analyzed by using frequency, chi-square and logistic regression through using STATA 12.0. To avoid selection bias, we used propensity score matching. Analysis results show that the length of stay and treatment of pulmonary tuberculosis was different between insurance types. Patients characteristic(female, comorbidity, admission by outpatient department, medical insurance type) and hospital characteristic(500-999 beds, over 1000 beds) significantly influence length of stay. Admission by outpatient department and over 1000 beds are significantly influence treatment. Based on these findings, it is necessary to clarify between length of stay and treatment outcome by medical aids beneficiaries and audit hospitals follow discharge guidelines in pulmonary tuberculosis patients.

• Korean Circulation Journal
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• 제53권9호
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• pp.594-605
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• 2023

Acute myocardial infarction (AMI) is a major cause of morbidity and mortality in the Asia-Pacific region, and mortality rates differ between countries in the region. Systems of care have been shown to play a major role in determining AMI outcomes, and this review aims to highlight pre-hospital and in-hospital system deficiencies and suggest possible improvements to enhance quality of care, focusing on Korea, Japan, Singapore and Malaysia as representative countries. Time to first medical contact can be shortened by improving patient awareness of AMI symptoms and the need to activate emergency medical services (EMS), as well as by developing robust, well-coordinated and centralized EMS systems. Additionally, performing and transmitting pre-hospital electrocardiograms, algorithmically identifying patients with high risk AMI and developing hospital networks that appropriately divert such patients to percutaneous coronary intervention-capable hospitals have been shown to be beneficial. Within the hospital environment, developing and following clinical practice guidelines ensures that treatment plans can be standardised, whilst integrated care pathways can aid in coordinating care within the healthcare institution and can guide care even after discharge. Prescription of guideline directed medical therapy for secondary prevention and patient compliance to medications can be further optimised. Finally, the authors advocate for the establishment of more regional, national and international AMI registries for the formal collection of data to facilitate audit and clinical improvement.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3911-3916
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• 2016

Background: Triple negative (TN) and triple positive (TP) breast cancers both are aggressive types but TN generally has a shorter survival. Objectives: To compare the clinical characteristics and treatment outcomes for patients with TN versus TP breast cancer and to assess various prognostic factors affecting overall survival. Materials and Methods: A retrospective audit of 85 breast cancer patients was conducted in the Department of Radiation Oncology and Medical Oncology on patients from 2006 to 2013 for whom IHC for ER, PgR and Her-2 neu were available. The patients were stratified into: ER-, PR- and Her-2 neu- (Arm A, n=47) and ER+, PgR+ and Her-2 neu+ (Arm B, n=38). Results: TN subtype had higher numbers of premenopausal and advanced stage patients as compared to TP subtype. The locoregional recurrence (LRR) and distant metastatic rate was also higher in TN subtype but there was no definite pattern in both the arms. Among the prognostic factors, patients with premenopausal status and advanced stage in TN breast cancer had inferior survival (P=0.07) whereas for those with postmenopausal status and early stage there was no survival difference between the two arms. Conclusions: TN subtype tends to be more aggressive in terms of younger age and advanced stage at presentation, higher tumour grade, LRR and metastasis, suggesting need for future research efforts on providing aggressive treatment to these patients. We could attribute better outcome for TP subtype to receptor positivity enabling role of hormonal treatment and targeted therapy, although less number of patients received targeted therapy.

• 대한불안의학회지
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• 제9권2호
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• pp.121-127
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• 2013

Objective : Several studies have reported the association between posttraumatic stress disorder (PTSD) and hypertension (HTN). The aim of this study was to evaluate the impact of PTSD symptoms on blood pressure. Methods : Korean veterans of the Vietnam War with (n=62) or without PTSD (n=87) participated in this study. The clinician administered PTSD scale (CAPS) and alcohol use disorder identification test (AUDIT) were applied. Blood pressure, pulse rate, risk factors of HTN and demographic data of the subjects were collected. Effects of potential explanatory variables on HTN were analyzed with logistic regression. Results : Diastolic blood pressure was significantly higher in PTSD group (p=0.015). However, PTSD subjects showed significantly lower pulse rate than non-PTSD subjects (p=0.004). Logistic regression analysis showed that avoidance symptom might be a predictor for hypertension (OR=1.065, p=0.030). Conclusion : These results suggest that PTSD, especially avoidance symptom, might be a risk factor on HTN in the elderly with PTSD. Further studies are needed to evaluate the change of blood pressure according to the clinical improvement of PTSD.

• Journal of Preventive Medicine and Public Health
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• 제55권6호
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• pp.539-548
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• 2022

Objectives: The purpose of this study was to assess the organizational effectiveness of the introduction of a healthcare information system (electronic medical records and databases) in healthcare in Kazakhstan. Methods: The authors used a combination of 2 methods: expert assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis. SWOT analysis is a necessary element of research, constituting a mandatory preliminary stage both when drawing up strategic plans and for taking corrective measures in the future. The expert survey was conducted using 2 questionnaires. Results: The study involved 40 experts drawn from specialists in primary healthcare in Aktobe: 15 representatives of administrative and managerial personnel (chief doctors and their deputies, heads of medical statistics offices, organizational and methodological offices, and internal audit services) and 25 general practitioners. Conclusions: The following functional indicators of the medical and organizational effectiveness of the introduction of information systems in polyclinics were highlighted: first, improvement of administrative control, followed in descending order by registration and movement of medical documentation, statistical reporting and process results, and the cost of employees' working time. There has been no reduction in financial costs, namely in terms of the costs of copying, delivery of information in paper form, technical equipment, and paper.

• Korean Journal of Radiology
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• 제24권12호
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• pp.1179-1189
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• 2023

Objective: We aimed to evaluate the reporting quality of research articles that applied deep learning to medical imaging. Using the Checklist for Artificial Intelligence in Medical Imaging (CLAIM) guidelines and a journal with prominence in Asia as a sample, we intended to provide an insight into reporting quality in the Asian region and establish a journal-specific audit. Materials and Methods: A total of 38 articles published in the Korean Journal of Radiology between June 2018 and January 2023 were analyzed. The analysis included calculating the percentage of studies that adhered to each CLAIM item and identifying items that were met by ≤ 50% of the studies. The article review was initially conducted independently by two reviewers, and the consensus results were used for the final analysis. We also compared adherence rates to CLAIM before and after December 2020. Results: Of the 42 items in the CLAIM guidelines, 12 items (29%) were satisfied by ≤ 50% of the included articles. None of the studies reported handling missing data (item #13). Only one study respectively presented the use of de-identification methods (#12), intended sample size (#19), robustness or sensitivity analysis (#30), and full study protocol (#41). Of the studies, 35% reported the selection of data subsets (#10), 40% reported registration information (#40), and 50% measured inter and intrarater variability (#18). No significant changes were observed in the rates of adherence to these 12 items before and after December 2020. Conclusion: The reporting quality of artificial intelligence studies according to CLAIM guidelines, in our study sample, showed room for improvement. We recommend that the authors and reviewers have a solid understanding of the relevant reporting guidelines and ensure that the essential elements are adequately reported when writing and reviewing the manuscripts for publication.