• Tuberculosis and Respiratory Diseases
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• v.58 no.3
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• pp.257-266
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• 2005

Background : The study of pneumonia among young men living in a group is rare. prospective study was conducted to determine the etiology, and compare the effects of macrolide and second-generation cephalosporin on the treatment of pneumonia among combat policemen. Patients and Methods : From January 2003 to April 2004, Fifty-two patients with pneumonia were treated with either azithromycin(n=25) or cefuroxime(n=27). In order to determine the cause of the pneumonia, culture studies and serologic tests for antibodies to Mycoplasma pneumoniae and Chlamydia pneumoniae were carried out. During the two weeks of medication, the Chest X-rays, blood tests and culture studies(if necessary) were followed weekly. A serologic study was followed at the end of the second week. Results : The main pathogens for pneumonia among combat policemen were Mycoplasma pneumoniae(50.0%), Chlamydia pneumoniae(10.8%), and Streptococcus pneumoniae(3.8%). The treatment was successful in most cases(51/52 cases, 98.1%). The effects of azithromycin and cefuroxime were similar (96.0% vs 100%, p>0.05). In one patient who had taken azithromycin, the clinical and radiological findings did not improved until intravenous second generation ce phalosporin had been infused. Conclusion : Atypical pathogens were the main causes of the pneumonia in the combat policemen, and the effects of macrolide and second generation cephalosporin for pneumonia were similar. However, further studies will be needed to determine if single therapy with macrolide is possible.

• Tuberculosis and Respiratory Diseases
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• v.58 no.3
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• pp.248-256
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• 2005

Background : Nontuberculous mycobacterial (NTM) infections are increasingly being recognized as a cause of chronic pulmonary disease. This study describes the prevalence of NTM species from clinical specimens and the clinical characteristics of NTM pulmonary disease. Material and Methods : The NTM isolated from March 2003 to December 2003 at the Kosin Medical Center were identified using an oligonucleotide chip containing the internal transcribed space (ITS) sequence. The medical records of the patients with the NTM isolates, who fulfilled the 1997 ATS diagnostic criteria for NTM pulmonary disease, were analyzed, retrospectively. Results : Twenty four species (24.2%) of NTM were isolated from 99 cultured AFB specimens. M. avium complex (MAC) (13 isolates), M. szulgai (3), M. kansasii (2), M. malmoense (2), M. abscessus (1), M. chelonae (1), M. scrofulaceum (1), and unclassified (1). Of the 23 patients with isolated NTM, 11 patients were found to be compatible with a NTM pulmonary infection according to the ATS criteria; MAC was found in 6 cases (54.5%), M. szulgai in 2 cases (18.2%), and M. abscessus, M. szulgai, M. kansasii and M. malmoense in 1 case each (9.1%). Ten patients (91%) were male and the median age at diagnosis was 61 years. In the pre-existing diseases, malignant disease was found in 6 cases including 5 patients with lung cancer, and history of old pulmonary tuberculosis was identified in 4 cases. The radiological patterns showed lung destruction lung in 3 cases, a cavitary mass in 3 cases, a nodular pattern in 2 cases, and reticulonodular, consolidation and a bronchiectasis pattern were in 1 case each. Conclusion : Various types of NTM pulmonary diseases were found in a tertiary hospital at Busan, Korea. The NTM pulmonary diseases were caused by MAC, M. szugai, M. kansasii, M. malmoense, M. abscessus, M. chelonae, and M. scrofulaceum in the order of frequency.

• Journal of the Korean Society of Food Science and Nutrition
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• v.39 no.9
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• pp.1305-1312
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• 2010

The purpose of this study was to investigate the perception and satisfaction on the nutrition counseling service for patients consuming a therapeutic diet at hospitals in Busan. The subjects were 153 inpatients at five hospitals with over 400 beds each. The research was performed through the interviewing process using questionnaires conducted from January to February, 2008. In a total of 88 patients, 57.5% had experienced nutrition counseling and were through the motives of counseling with doctors 64.2% and themselves 29.3% of the patients. In the method of nutrition counseling, 58% of the patients had an individual counseling. In the patients' perception on the nutrition counseling, 75.0% of the patients understood very well, 83.0% of them perceived the explanation as very important, 79.5% were very satisfied and 78.7% were helped in nutrition-management. On a scale of 5.00 for the nutrition counseling satisfaction, the average scores were 3.80 for 'explanation of knowledge', 3.71 for 'cognitive communication skills', 4.05 for 'effective communication skills' and 3.60 for 'facilitation skills'. The items of low scores in the nutrition counseling satisfaction were 'follow up diet-therapy after discharge', 'providing to personalized nutrition information', 'presentation of specific menu' and 'methods of menu planning'. There were significant (p<0.01) positive correlation between perception and satisfaction on the nutrition counseling. Therefore, it was suggested that dietitians increase the patients' satisfaction on the nutrition counseling with developing the model based on the patient-centered counseling.

• Progress in Medical Physics
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• v.20 no.4
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• pp.208-215
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• 2009

This study is to compare the accuracy of evaluation regarding the volume of the prostate, which three-dimensional volume rendering was produced the shape of protrusion, by measuring two kinds of craniocaudal length from the top of the protrusion and from the exclusion of the protrusion as the starting points. For the imaginary protrusion prostate models, total of 10 models were roughly made by using devils-tongue jelly and changing each of the 10 ml of capacity from 10 ml to 100 ml. For the protrusion prostate models aimed at estimating the real volume, through 64 cannel computed tomography (CT) and 3.0 tesla magnetic resonance image (MRI) were conducted by planimetry technique from three-dimensional volume rendering. And then we performed to evaluate on significance of these volumes by wilcoxon signed rank test. Also the obtained volumes data by ellipsoid volume formula were measured the volume of protrusion prostate models two times with each method using the two kinds of craniocaudal length from top of the protrusion and from exclusion of the protrusion as the starting points. Finally, the significance of differences using wilcoxon signed rank test was evaluated between the real volume by planimetry technique and the measured volume by ellipsoid volume formula from three-dimensional volume rendering. The average of the protrusion length on the models was $0.90{\pm}0.18\;mm$ in CT and was $0.75{\pm}0.11\;mm$ in MRI. There were not statistically significant difference between MRI and CT from the volume of protrusion prostate models (p=0.414). In MRI (p=0.139) and CT (p=0.057), there were not statistically significant difference between the real volume by planimetry technique and the measured volume by ellipsoid volume from exclusion of the protrusion as the starting points. While, there were statistically significant difference between the real volume by planimetry technique and the measured volume by ellipsoid volume from top of the protrusion as the starting points in MRI (p=0.005) and CT (p=0.005). For the accurate measurement of the protrusion prostate models, the craniocaudal length of the prostate should be measured from the exclusion of the protrusion as the starting points.

• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.2
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• pp.93-101
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• 2015

Purpose In SPECT image, scatter count is the cause of quantitative count error and image quality degradation. Thus, a wide range of scatter correction(SC) methods have been studied and this study is to evaluate the accuracy of CT based SC(CTSC) used in SPECT/CT as the comparison with existing energy window based SC(EWSC). Materials and Methods SPECT/CT images were obtained after filling air in order to acquire a reference image without the influence of scatter count inside the Triple line insert phantom setting hot rod(74.0 MBq) in the middle and each SPECT/CT image was obtained each separately after filling water instead of air in order to derive the influence of scatter count under the same conditions. In both conditions, Astonish(iterative : 4 subset : 16) reconstruction method and CT attenuation correction were commonly applied and three types of SC methods such as non-scatter correction(NSC), EWSC, CTSC were used in images filled with image. For EWSC, 9 sub-energy windows were set additionally in addition to main(=peak) energy window(140 keV, 20%) and then, images were acquired at the same time and five types of EWSC including DPW(dual photo-peak window)10%, DEW(dual energy window)20%, TEW(triple energy window)10%, TEW5.0%, TEW2.5% were used. Under the condition without fluctuations in primary count, total count was measured by drawing volume of interest (VOI) in the images of the two conditions and then, the ratio of scatter count of total counts was calculated as percent scatter fraction(%SF) and the count error with image filled with water was evaluated with percent normalized mean-square error(%NMSE) based on the image filled with air. Results Based on the image filled with air, %SF of images filled with water to which each SC method was applied is NSC 37.44, DPW 27.41, DEW 21.84, TEW10% 19.60, TEW5% 17.02, TEW2.5% 14.68, CTSC 5.57 and the most scattering counts were removed in CTSC and %NMSE is NSC 35.80, DPW 14.28, DEW 7.81, TEW10% 5.94, TEW5% 4.21, TEW2.5% 2.96, CTSC 0.35 and the error in CTSC was found to be the lowest. Conclusion In SPECT/CT images, the application of each scatter correction method used in the experiment could improve the quantitative count error caused by the influence of scatter count. In particular, CTSC showed the lowest %NMSE(=0.35) compared to existing EWSC methods, enabling relatively accurate scatter correction.

• Korean Journal of Digital Imaging in Medicine
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• v.9 no.1
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• pp.37-43
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• 2007

1. Purpose : This study is to present effective exposure conditions to acquire the best image of simple abdomen in Film Screen (F.S) system and Computed Radiography (C.R) system. 2. Method : In the F.S system, while an exposure condition was fixed as 70kVp, images of a patients simple abdomen were taken under the different mAs exposure conditions. Among these images, the best one was chosen by radiologists and radiological technologists. In the C.R system, the best image of the same patient was acquired with the same method from the F.S system. Both characteristic curves from F.S system and C.R system were analyzed. 3. Results : In the F.S system, the best exposure condition of simple abdomen was 70kVp and 20mAs. In the CR system, with the fixed condition at 70kVp, the image densities of human organs, such as liver, kidney, spleen, psoas muscle, lumbar spine body and iliac crest, were almost same despite different environments (3.2mAs, 8mAs, 12mAs, 16mAs and 20mAs). However, when the exposure conditions were over or under (below) 12mAs, the images between the abdominal wall and the directly exposed part became blurred because the gap of density was decreased. In the C.R system, while the volume of mAs was decreased, an artifact of quantum mottle was increased. 4. Conclusion : This study shows that the exposure condition in the C.R system can be reduced 40% than in the F.S system. This paper concluded that when the exposure conditions are set in CR environment, after the analysis of equipment character, such as image processing system(EDR : Exposure Data Recognition processing), PACS and so on, the high quality of image with maximum information can be acquired with a minimum exposure dose.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.2
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• pp.39-47
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• 2014

Purpose As breast cancer patients continue to increase every year, cases of BSGI are on the rise with a heavier reliance on it. However, BSGI protocol in hospitals was not studied enough despite it was covered by hospital's condition and recommendation of manufacturers. The objective of the study was an examination of methods to be applicable to BSGI protocols, putting the self-development phantom to use in quality assessment of the images. Materials and Methods Dilon 6800 (Dilon Technologies Inc, Newport News, USA) was used in the study and five different sizes of sphere were distinctively produced in the phantom. The study used $^{99m}TcO_4$. The cases were classified in to three categories that background radioactivity to region of interest as ratio of 2: 4: 8, They were acquired images for 5, 7, 10mins. The acquired image was set region of interest according to the size of sphere, and We analyzed quantitative and qualitative analysis. The acquired data statistically analyzed with SPSS ver.18.0. Results As the result of quantitative and qualitative analysis, count rate of each sphere in accordance with difference of injection dose showed that higher count rate as injection dose and sphere size increased (P<0.005). Count rate of each sphere in accordance with difference of acquisition time showed that higher count rate as acquisition time and sphere size increased (P<0.005). Contrast noise ratio of each sphere in accordance with difference of injection dose showed that higher contrast noise ratio as injection dose increased. Particularly, Contrast noise ratio of eight times ratio images was the highest among. Contrast noise ratio of each sphere in accordance with difference of acquisition time showed that higher contrast noise ratio as acquisition time increased. And, Contrast noise ratio of seven minute image was the highest among (P<0.005). Conclusion There was significant change of Contrast noise ratio through quantitative and qualitative analysis. Moreover, We found usefulness of phantom. If Institutions identified image through the phantom study and they made BSGI protocol, We expected to help the improvement of diagnostic value of the images.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.2
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• pp.48-56
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• 2014

Purpose $^{99m}Tc$-DTPA renal scintigraphy serves as a key indicator to measure a kidney donor's Glomerular Filtration Rate (GFR) and determine the possibility of kidney transplant. The Gates method utilized to measure GFR considers 3 variables of renal depth, injection dose, and net kidney counts. In this research, we seek to compare changes in kidney donors' GFR according to renal depth measurement methods of the 3 variables. Materials and Methods We investigated 32 kidney donors who had visited the hospital from October, 2013 to March, 2014 and received abdominal CT and $^{99m}Tc$-DTPA GFR examination. With the cross-section image of the CT and the lateral image from a gamma camera, we measured the renal depth and compared with renal depth calculation equations-Tonnesen, Taylor, and Itoh methods. Renal depth-specific GFR was calculated by using Xeleris Ver. 2.1220 of GE. Then the results were compared with MDRD (Modification of Diet Renal Disease) GFRs based on serum creatinine level. Results The renal depths measured based on the CT and gamma camera images showed high correlation. Tonessen equation gave the lowest GFR value while the value calculated by using the renal depth of CT image was the highest with a 16.62% gap. MDRD GFR showed no statistically significant difference among values calculated through Taylor, Itoh, CT and gamma camera renal depth application (P>0.05), but exhibited a statistically significant change in the value based on Tonnesen equation (P<0.05). Conclusion This research has found that, in GFR evaluation in kidney donors by utilizing $^{99m}Tc$-DTPA, Tonnesen equation-based Gates method underestimated the value than the MDRD GFR. Therefore, if a MDRD GFR value shows a huge difference from the actual examination value, using an image-based renal depth measurement, instead of Tonnesen equation applied to Gates method, is expected to give an accurate GFR value to kidney donors.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.2
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• pp.33-38
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• 2014

Purpose Auto exposure control (AEC) in SPECT/CT automatically controls the exposure dose (mA) according to patient's shape and size. The aim of this study was to evaluate the effect of AEC in SPECT/CT on exposure dose reduction and image quality. Materials and Methods The model of SPECT/CT used in this study was Discovery 670 (GE, USA), Smart mA for AEC; and $^{99m}Tc$ as a radioisotope. To compare SPECT and CT images by CT exposure dose variation, we used a standard technique set at 80, 100, 120, 140 kVp, 10, 30, 50, 100, 150, 200, 250 mA, and AEC at 80, 100, 120, 140 kVp, 10-250 mA. To evaluate resolution and contrast of SPECT images, triple line phantom and flangeless Esser PET phantom were used. For CT images, noise and uniformity were checked by anthropomrphic chest phantom. For dose evaluation to find DLP value, anthropomorphic chest phantom was used and the CT protocol of torso was applied by standard technique (120 kVp, 100 mA) and AEC (120 kVp, 10-250 mA). Results When standard and AEC were applied, the resolutions at SPECT images with attenuation correction (AC) were the same as FWHM by center 3.65 mm, left 3.48 mm, right 3.61 mm. Contrasts of standard and AEC showed no significant difference: standard 53.5, 29.8, 22.5, 15.8, 6.0, AEC 53.5, 29.6, 22.4, 15.7, 6.1 In CT images, noise values at standard and AEC were 15.4 and 18.5 respectively. The application of AEC increases noise but the value of coefficient variation were 33.8, 24.9 respectively, obtaining uniform noise image. The values of DLP at standard and AEC were 426.78 and 352.09 each, which shows that the application of AEC decreases exposure dose more than standard by approximately 18%. Conclusion The results of our study show that there was no difference of AC in SPECT images based on the CT exposure dose variation at SPECT/CT images. It was found that the increased CT exposure dose leads to the improvement of CT image quality but also increases the exposure dose. Thus, the use of AEC in SPECT/CT contributes to obtaining equal AC SPECT images, and uniform noise in CT images while reducing exposure dose.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.138-144
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• 2010

Purpose: Despite the rapidly changing healthcare environment, healthcare organizations have recognized the importance of patient safety management. But patient safety management has the problem of the lack of participation of members due to the process of focusing on the follow-up service and punishment. The department of nuclear medicine in Uijeongbu St. Mary's Hospital started this research to reduce the near miss and prevent patient safety accidents by both initiating the participatory near-miss-proof activities as an advance management and constructing a system without disadvantages of reporting. In addition, this research aims to establish a differentiated patient safety management system in the department of nuclear medicine. Materials and Methods: 1. Colleting cases of team members' past and present near miss and accidents(First data collection). 2. Quantifying the cases of near miss and accidents after identifying the degree of importance and urgency through surveys(Second data collection). 3. Quantifying cases and indentifying important points of contact through data analysis. 4. Making and standardizing a manual for important points of contact, and initiating participatory activities to prevent errors. 5. Activating web-based community for establishing the report system of near miss. 6. Estimating the result of before and after activities through surveys and focus group interviews. Results: 1) Quantified safety accidents and near miss in the department of nuclear medicine. About 50 near misses a month and one safety accident a year. 2) Establishing improvement measurements based on quantified data. About 11 participatory activities, the improvement of process, a manual for standardization. 3) Creating a system of safety culture and high participation rate of team members. Constructing a report system, making a check list and a slogan for safety culture, and establishing assessment index. 4) Activating communities for sharing the information of cases of near misses and accidents. 5) As the result of activities, the rate of near miss occurrence declined by 50% and the safety accident did not happen. Conclusion: The best service in the department of nuclear medicine is to provide patients with safety-guaranteed high-quality examination and cure. This research started from the question, 'what is the most faithful-to-the-basics way to provide the best service for patients?' and team members' common answer for this question was building a system with participation of all members. Building a system through the participatory improvement activities for preventing near miss and creating safety culture resulted in the 50% decline of near miss occurrence and no accident. This is a meaningful result from the perspective of advance management for patient safety. Moreover, this research paved the way for creating a culture to report and admit near miss or accidents by establishing a report system with no disadvantage of reporting. The system which sticks to the basics is the best service for patients and will form a patient safety culture system, which will lead to the customer satisfaction. Therefore, all members of the department of nuclear medicine will develop a differentiated patient safety culture with stabilizing the established system.