• Title/Summary/Keyword: Precision medicine

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THREE-DIMENSIONAL VERIFICATION OF INTRACRANIAL TARGET POINT DEVIATION USING MRI-BASED POLYMER-GEL DOSIMETRY FOR CONVENTIONAL AND FRACTIONATED STEREOTACTIC RADIOSURGERY

  • Lee, Kyung-Nam;Lee, Dong-Joon;Suh, Tae-Suk
    • Journal of Radiation Protection and Research
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    • v.36 no.3
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    • pp.107-118
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    • 2011
  • Conventional (SRS) and fractionated (FSRS) stereotactic radiosurgery necessarily require stringent overall target point accuracy and precision. We determine three-dimensional intracranial target point deviations (TPDs) in a whole treatment procedure using magnetic resonance image (MRI)-based polymer-gel dosimetry, and suggest a technique for overall system tests. TPDs were measured using a custom-made head phantom and gel dosimetry. We calculated TPDs using a treatment planning system. Then, we compared TPDs using mid bi-plane and three-dimensional volume methods with spherical and elliptical targets to determine their inherent analysis errors; finally, we analyzed regional TPDs using the latter method. Average and maximum additive errors for ellipses were 0.62 and 0.69 mm, respectively. Total displacements were 0.92 ${\pm}$ 0.25 and 0.77 ${\pm}$ 0.15 mm for virtual SRS and FSRS, respectively. Average TPDtotal at peripheral regions was greater than that at central regions for both. Overall system accuracy was similar to that reported previously. Our technique could be used as an overall system accuracy test that considers the real radiation field shape.

Quality Assurance for High Dose Rate Brachytherapy (고선량율 근접치료의 정도관리)

  • Bang, Dong-Wan;Cho, Chung-Hee;Park, Jae-Il
    • The Journal of Korean Society for Radiation Therapy
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    • v.10 no.1
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    • pp.30-44
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    • 1998
  • Accurate delivery of doses using a high dose rate(HDR) brachytherapy, remote afterloading system(RALS) depends on knowing the strength of the radioactive source at the time of treatment, the precision and consistency of the timer, and the ability of the unit to position the source at the proper dwell location along the applicator. Periodic Quality Assurance(QA) on HDR machines is a part of the standard protocol of any user. The safety of the patient & staff, positional accuracy, temporal accuracy, and dose delivery accuracy are periodically(weekly, quarterly, monthly) estimated using HDR source(Ir-192), treatment planning devices, measurement devices, and overall treatment devices with regard to treatment delivery. The overall measurement results are estimated successfully and assessed its clinical significance. As a result, our HDR brachytherapy units has been very accurate until now. The QA program protocol permits routine clinical use and provides a high confidence level in the accurate operation of HDR units. Therefore, regular QA of HDR brachytherapy is essential for successful treatment.

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Lateral Osteotomy with Sawing Technique in Open Rhinoplasty (개방 코성형술에서 톱을 이용한 외절골술)

  • Kim, Youn-Hwan;Lee, Hak-Sung;Naidu, Shenthilkumar;Kim, Jeong-Tae
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.499-530
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    • 2010
  • Purpose: Lateral osteotomy is an essential step in the correction of nasal bony asymmetry. Direct visualization allows accurate repositioning of the nasal bones compared to blind techniques, which require precision and manual dexterity. We propose direct visualization procedures in open corrective rhinoplasty. Methods: The technique was used on 16 patients. All patients underwent open rhinoplasty with a columellar incision. The marginal incisions were extended on either side to allow access to the piriform aperture. A double hook was used to caudally retract the lower lateral cartilages and the fibrous connections between the upper and lower lateral cartilages were released until the piriform aperture was visualized. Through the incision, lateral osteotomy was performed using a reciprocating saw at that time with direct visualization. Additional procedures including augmentation rhinoplasty, hump resection, septoplasty and tip plasty were performed simultaneously. Results: This method provided excellent exposure to the lateral nasal bones and allowed the lateral osteotomy to be carried out precisely using the reciprocating saw. Conclusion: This extended open rhinoplasty method is suitable for most individuals, allowing a wide surgical field.

STADIUM: Species-Specific tRNA Adaptive Index Compendium

  • Yoon, Jonghwan;Chung, Yeun-Jun;Lee, Minho
    • Genomics & Informatics
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    • v.16 no.4
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    • pp.28.1-28.6
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    • 2018
  • Due to the increasing interest in synonymous codons, several codon bias-related terms were introduced. As one measure of them, the tRNA adaptation index (tAI) was invented about a decade ago. The tAI is a measure of translational efficiency for a gene and is calculated based on the abundance of intracellular tRNA and the binding strength between a codon and a tRNA. The index has been widely used in various fields of molecular evolution, genetics, and pharmacology. Afterwards, an improved version of the index, named specific tRNA adaptation index (stAI), was developed by adapting tRNA copy numbers in species. Although a subsequently developed webserver (stAIcalc) provided tools that calculated stAI values, it was not available to access pre-calculated values. In addition to about 100 species in stAIcalc, we calculated stAI values for whole coding sequences in 148 species. To enable easy access to this index, we constructed a novel web database, named STADIUM (Species-specific tRNA adaptive index compendium). STADIUM provides not only the stAI value of each gene but also statistics based on pathway-based classification. The database is expected to help researchers who have interests in codon optimality and the role of synonymous codons. STADIUM is freely available at http://stadium.pmrc.re.kr.

Convolutional Neural Network-Based Automatic Segmentation of Substantia Nigra on Nigrosome and Neuromelanin Sensitive MR Images

  • Kang, Junghwa;Kim, Hyeonha;Kim, Eunjin;Kim, Eunbi;Lee, Hyebin;Shin, Na-young;Nam, Yoonho
    • Investigative Magnetic Resonance Imaging
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    • v.25 no.3
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    • pp.156-163
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    • 2021
  • Recently, neuromelanin and nigrosome imaging techniques have been developed to evaluate the substantia nigra in Parkinson's disease. Previous studies have shown potential benefits of quantitative analysis of neuromelanin and nigrosome images in the substantia nigra, although visual assessments have been performed to evaluate structures in most studies. In this study, we investigate the potential of using deep learning based automatic region segmentation techniques for quantitative analysis of the substantia nigra. The deep convolutional neural network was trained to automatically segment substantia nigra regions on 3D nigrosome and neuromelanin sensitive MR images obtained from 30 subjects. With a 5-fold cross-validation, the mean calculated dice similarity coefficient between manual and deep learning was 0.70 ± 0.11. Although calculated dice similarity coefficients were relatively low due to empirically drawn margins, selected slices were overlapped for more than two slices of all subjects. Our results demonstrate that deep convolutional neural network-based method could provide reliable localization of substantia nigra regions on neuromelanin and nigrosome sensitive MR images.

Glomerular Detection for Diagnosis of Lupus Nephritis using Deep Learning (딥러닝을 활용한 루푸스 신염 진단을 위한 생검 조직 내 사구체 검출)

  • Jung, Jehyun;Ha, Sukmin;Lim, Jongwoo;Kim, Hyunsung;Park, Hosub;Myung, Jaekyung
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2022.07a
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    • pp.85-87
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    • 2022
  • 루푸스 신염을 정확히 진단하기 위해서는 신장의 침 생검을 통한 조직검사를 통해 사구체들을 찾아내고, 각각의 염증 정도를 분류해야 한다. 하지만 이에는 의료진의 많은 시간과 노력이 소요된다. 따라서 본 연구에서는 이러한 한계를 극복하기 위해 합성곱 신경망 (Convolutional neural network, CNN)에 기반한 검출 및 분할에 딥 러닝 접근법을 적용하는 YOLOv5 알고리즘을 통해 검체 이미지 내에서 사구체를 자동으로 검출해 내도록 하였다. 그리고 루푸스 신염 환자의 슬라이드 이미지에 대한 태깅 작업을 거쳐 학습을 위한 데이터와 테스트를 위한 데이터를 생성하여 학습 및 테스트에 활용하였다. 그 결과 고화질의 검체 이미지 내에서 대부분의 사구체를 0.9 이상의 높은 precision과 recall로 검출해 낼 수 있었다. 이를 통해 신장 내부의 사구체 검출을 자동화하고 추후 연구를 통해 사구체 염증 정도를 단계화 할 수 있는 발판을 마련하였다.

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2020 Clinical Practice Guideline for Percutaneous Transthoracic Needle Biopsy of Pulmonary Lesions: A Consensus Statement and Recommendations of the Korean Society of Thoracic Radiology

  • Soon Ho Yoon;Sang Min Lee;Chul Hwan Park;Jong Hyuk Lee;Hyungjin Kim;Kum Ju Chae;Kwang Nam Jin;Kyung Hee Lee;Jung Im Kim;Jung Hee Hong;Eui Jin Hwang;Heekyung Kim;Young Joo Suh;Samina Park;Young Sik Park;Dong-Wan Kim;Miyoung Choi;Chang Min Park
    • Korean Journal of Radiology
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    • v.22 no.2
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    • pp.263-280
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    • 2021
  • Percutaneous transthoracic needle biopsy (PTNB) is one of the essential diagnostic procedures for pulmonary lesions. Its role is increasing in the era of CT screening for lung cancer and precision medicine. The Korean Society of Thoracic Radiology developed the first evidence-based clinical guideline for PTNB in Korea by adapting pre-existing guidelines. The guideline provides 39 recommendations for the following four main domains of 12 key questions: the indications for PTNB, pre-procedural evaluation, procedural technique of PTNB and its accuracy, and management of post-biopsy complications. We hope that these recommendations can improve the diagnostic accuracy and safety of PTNB in clinical practice and promote standardization of the procedure nationwide.

Cone-beam computed tomography analysis of accessory maxillary ostium and Haller cells: Prevalence and clinical significance

  • Ali, Ibrahim K.;Sansare, Kaustubh;Karjodkar, Freny R.;Vanga, Kavita;Salve, Prashant;Pawar, Ajinkya M.
    • Imaging Science in Dentistry
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    • v.47 no.1
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    • pp.33-37
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    • 2017
  • Purpose: This study aimed to evaluate the prevalence of Haller cells and accessory maxillary ostium (AMO) in cone-beam computed tomography (CBCT) images, and to analyze the relationships among Haller cells, AMO, and maxillary sinusitis. Materials and Methods: Volumetric CBCT scans from 201 patients were retrieved from our institution's Digital Imaging and Communications in Medicine archive folder. Two observers evaluated the presence of Haller cells, AMO, and maxillary sinusitis in the CBCT scans. Results: AMO was observed in 114 patients, of whom 27 (23.7%) had AMO exclusively on the right side, 26 (22.8%) only on the left side, and 61 (53.5%) bilaterally. Haller cells were identified in 73 (36.3%) patients. In 24 (32.9%) they were present exclusively on the right side, in 17 (23.3%) they were only present on the left side, and in 32 (43.8%) they were located bilaterally. Of the 73 (36.3%) patients with Haller cells, maxillary sinusitis was also present in 50 (68.5%). On using chi-square test, a significant association was observed between AMO and maxillary sinusitis in the presence of Haller cells. Conclusion: Our results showed AMO and Haller cells to be associated with maxillary sinusitis. This study provides evidence for the usefulness of CBCT in imaging the bony anatomy of the sinonasal complex with significantly higher precision and a smaller radiation dose.

Evaluation of three glucometers for whole blood glucose measurements at the point of care in preterm or low-birth-weight infants

  • Hwang, Joon Ho;Sohn, Yong-Hak;Chang, Seong-Sil;Kim, Seung Yeon
    • Clinical and Experimental Pediatrics
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    • v.58 no.8
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    • pp.301-308
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    • 2015
  • Purpose: We evaluated three blood glucose self-monitoring for measuring whole blood glucose levels in preterm and low-birth-weight infants. Methods: Between December 1, 2012 and March 31, 2013, 230 blood samples were collected from 50 newborns, who weighed, ${\leq}2,300g$ or were ${\leq}36$ weeks old, in the the neonatal intensive care unit of Eulji University Hospital. Three blood glucose self-monitoring (A: Precision Pcx, Abbott; B: One-Touch Verio, Johnson & Johnson; C: LifeScan SureStep Flexx, Johnson & Johnson) were used for the blood glucose measurements. The results were compared to those obtained using laboratory equipment (D: Advia chemical analyzer, Siemens Healthcare Diagnostics Inc.). Results: The correlation coefficients between laboratory equipment and the three blood glucose self-monitoring (A, B, and C) were found to be 0.888, 0.884, and 0.900, respectively. For glucose levels ${\leq}60mg/dL$, the correlation coefficients were 0.674, 0.687, and 0.679, respectively. For glucose levels>60 mg/dL, the correlation coefficients were 0.822, 0.819, and 0.839, respectively. All correlation coefficients were statistically significant. And the values from the blood glucose self-monitoring were not significantly different from the value of the laboratory equipment, after correcting for each device's average value (P>0.05). When using laboratory equipment (blood glucose ${\leq}60mg/dL$), each device had a sensitivity of 0.458, 0.604, and 0.688 and a specificity of 0.995, 0.989, and 0.989, respectively. Conclusion: Significant difference is not found between three blood glucose self-monitoring and laboratory equipment. But correlation between the measured values from blood glucose self-monitoring and laboratory equipment is lower in preterm or low-birth-weight infants than adults.

Simultaneous Determination of Liquiritin, Nodakenin, Hesperidin and Glycyrrhizin in Bojungikgi-tang Using HPLC-PDA (HPLC-PDA를 이용한 보중익기탕 중 Liquiritin, Nodakenin, Hesperidin 및 Glycyrrhizin의 동시분석)

  • Seo, Chang-Seob;Kim, Jung-Hoon;Shin, Hyeun-Kyoo
    • YAKHAK HOEJI
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    • v.57 no.3
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    • pp.187-193
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    • 2013
  • Bojungikgi-tang has been widely used for enhancement of physical fitness in Korea. The convenient, simple, and accurate high-performance liquid chromatography (HPLC) method was established for simultaneous determination of four marker compounds, liquiritin, nodakenin, hesperidin, and glycyrrhizin in Bojungikgi-tang (Buzhongyiqi-tang in Chinese, Hochuekkito in Japanese), a traditional Korean herbal prescription. The column for optimizing HPLC separation was used a Gemini $C_{18}$ column at column oven temperature of $40^{\circ}C$ with 1.0% (v/v) aqueous acetic acid (A) and 1.0% (v/v) acetic acid in acetonitirle (B) by gradient flow. The flow rate was 1.0 ml/min and the detector was a photodiode array (PDA) set at 254 nm, 280 nm, and 335 nm. Calibration curves of four components were acquired with $r^2$ values ${\geq}0.9999$. The recoveries were found to range 92.11~105.68% with relative standard deviations (RSDs, %) value less than 2.50%. The RSD values of intraand inter-day precision were 0.07~2.50% and 0.16~1.99%, respectively. The contents of liquiritin, nodakenin, hesperidin and glycyrrhizin in Bojungikgi-tang were 3.85~3.92 mg/g, 2.27~2.32 mg/g, 4.14~4.19 mg/g, and 3.39~3.45 mg/g, respectively. The established simultaneous analysis method will be effective for quality control of Bojungikgi-tang.