• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.54-69
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• 2022

Early detection of potential asymptomatic coronary artery disease is very important, as patients with sudden cardiac death often do not show symptoms such as chest pain or motor dyspnea. Coronary CT angiography (CCTA) has long been unjustified as a screening tool for asymptomatic patients because of the risks posed by radiation exposure. However, there are still various opinions regarding the usefulness of CCTA for screening for coronary artery disease (CAD) in asymptomatic healthy individuals or patients. This review investigated the usefulness of coronary artery calcium score and CCTA as screening tests for CAD in asymptomatic healthy individuals or patients through various literature reviews. With the development of CT technology, recent studies have been conducted in asymptomatic CAD patients with a reduced radiation dose of less than 1 mSv. A total of 2.6% of asymptomatic subjects on CCTA found significant CAD over 70%, and it was concluded that screening CCTA for CAD showed prognostic power in predicting the future occurrence of CAD in asymptomatic people. However, after the completion of the current NIH SCOT-HEART 2 study, it may be possible to determine whether CCTA is appropriate as a screening tool for CAD in asymptomatic healthy individuals.

• Journal of the Korean Society of Radiology
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• v.83 no.6
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• pp.1259-1272
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• 2022

Purpose As part of ongoing efforts to improve the current e-learning center, a survey was conducted regarding user experience and satisfaction to identify areas of improvement. Materials and Methods Radiologists (n = 454/617) and radiology residents (n = 163/617) of the Korean Society of Radiology were asked to answer a survey via email. The questionnaire asked for basic user information as well as user experiences relating to the e-learning center, such as workplace, frequency of use, overall satisfaction levels, reasons for satisfaction or dissatisfaction, and other suggestions for improvement. Results Annual members and all members of the e-learning center reported above average satisfaction levels of 67% and 42%, respectively. Approximately 30% of respondents viewed e-learning center lectures more than 5 times a month, with residents having a particularly high usage frequency. There was a high demand for additional lectures covering more diverse specialties (e-learning for annual members only: n = 28/97, e-learning for all members: n = 72/166), a smoother and more convenient searching platform/interface (n = 37/97 and n = 58/166, respectively), and regular content updates. In addition, many of the members suggested the addition of user-friendly functions such as playback speed control, a way to save viewing history, as well as requests for improved system stability. Conclusion Based on survey results, the educational committee plans to continue its efforts to improve the e-learning center by increasing the quality and quantity of available lectures, and increasing technical support to improve the stability and convenience of the e-learning digital system.

• Journal of the Korean Society of Radiology
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• v.18 no.1
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• pp.53-63
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• 2024

The purpose of this study was to analyze radiological technologists' (RT) task perceptions of intravenous injection behavior of contrast medium and use it as basic data for future workforce response plans. We surveyed a total of 172 RT using questionnaire terms consisting of demographic characteristics, job priorities, and RT' task perceptions of intravenous injection behavior. Statistical analysis was performed using descriptive statistics, frequency analysis, independent samples T-test, and ANOVA analysis. As a result, first, current clinical RT were highly aware of the need for intravenous injection behavior as a response to the future workforce of them, and the workload burden resulting from this was evaluated as low. Second, the fear of intravenous injection behavior was found to be significant, so it is judged to be useful to perform them as selective job actions rather than all RT' task. Third, the need for training courses and certification for RT' intravenous injection behavior is being raised, and additional specific research on this is required. Last, RT' positive perception of intravenous injection behavior could be expected as a foundation for improving national medical services, strengthening RT expertise, and expanding tasks.

• Journal of the Korean Society of Radiology
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• v.84 no.3
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• pp.736-744
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• 2023

Adult-onset Alexander Disease (AOAD) is a rare genetically determined leukoencephalopathy that presents with ataxia, spastic paraparesis, or brain stem signs including speech abnormalities, swallowing difficulties, and frequent vomiting. The diagnosis of AOAD is frequently proposed based on the findings on MRI. We demonstrate two cases (37-year-old female and 61-year-old female) with characteristic imaging findings and changes in follow-up MRI in patients with AOAD, which were confirmed via glial fibrillary acidic protein (GFAP) mutation analysis. On MRI, the typical tadpole-like brainstem atrophy and periventricular white matter abnormalities were noted. The presumptive diagnoses were made based on the typical MRI appearances and, subsequently, confirmed via GFAP mutation analysis. Follow-up MRI demonstrated the progression of atrophy in the medulla and upper cervical spinal cord. Our report could help raise awareness of characteristic MRI findings of AOAD, thus helping clinicians use GFAP analysis for AOAD diagnosis confirmation.

• Health Policy and Management
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• v.34 no.1
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• pp.26-37
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• 2024

Background: The purpose of this study was to compare and analyze the differences in charges and length of stay per case between spine specialty hospitals and non-specialty hospitals, and to identify the factors that influenced them. Methods: This study used claims data from the Health Insurance Review and Assessment Service, including inpatient visits from January 2021 to December 2022. The healthcare facility status data was used to identify the characteristics of study hospitals. Multilevel analysis was conducted to identify factors associated with the charges and Poisson regression analysis was conducted to analyze the length of stay between spine specialty hospitals and non-specialty hospitals. There were 32,015 cases of spine specialty hospitals and 17,555 cases of non-specialty hospitals. Results: For four of five common spinal surgeries, specialty hospitals shaped longer length of stay than those of non-specialty hospitals. Multilevel and Poisson regression analysis revealed that regardless of the type of surgery, higher age and higher Charlson comorbidity index scores were significantly associated with an increase in both the charges per case and length of stay (p<0.05). However, when hospitals were located in metropolitan areas, there was a significant decrease (p<0.05). Conclusion: This study found that specialty hospital had higher inpatient charges and loner length of stay contrary to the previous study results. Further studies will be needed to find which contribute to the differences.

• Journal of The Korean Society of Clinical Toxicology
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• v.21 no.2
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• pp.117-127
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• 2023

Purpose: No consensus currently exists regarding the maximal pressure of hyperbaric oxygen (HBO₂) therapy performed within 24 hours of acute carbon monoxide (CO) poisoning. This study aimed to evaluate the difference in therapeutic effects according to the first HBO₂ pressure (3.0 atmospheres absolute [ATA] vs. 2.8 ATA). Methods: We used prospectively collected registry data on CO poisoning at a tertiary academic hospital in the Republic of Korea. Adult patients with acute CO poisoning treated with HBO₂ within 24 hours after arrival at the emergency department and without the use of additional HBO₂ after 24 hours between January 2007 and February 2022 were included. Data from 595 patients were analyzed using propensity score matching (PSM). Patients with mild (non-intubated) and severe (intubated) poisoning were also compared. Neurocognitive outcomes at 1 month after CO poisoning were evaluated using the Global Deterioration Scale combined with neurological impairment. Results: After PSM, the neurocognitive outcomes at 1-month post-CO exposure were not significantly different between the 2.8 ATA (110 patients) and 3.0 ATA (55 patients) groups (p=1.000). Similarly, there was also no significant difference in outcomes in a subgroup analysis according to poisoning severity in matched patients (165 patients) (mild [non-intubated]: p=0.053; severe [intubated]: p=1.000). Conclusion: Neurocognitive sequelae at 1 month were not significantly different between HBO₂ therapy pressures of 2.8 ATA and 3.0 ATA in patients with acute CO poisoning. In addition, the 1-month neurocognitive sequelae did not differ significantly between intubated and non-intubated patients.

• Tuberculosis and Respiratory Diseases
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• v.54 no.2
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• pp.219-229
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• 2003

Background : The management of thoracic empyema and complicated parapneumonic effusion requires adequate antibiotics use and prompt drainage of infected pleural space. Tube thoracostomy for loculated empyema has low success rate and is also an invasive procedure with potential morbidity. Complications include hemothorax, perforation of intra-abdominal or intra-thoracic organs, diaphragmatic laceration, empyema, pulmonary edema, and Horner's syndrome. Given the potential morbidity of traditional chest tube insertion, use of the image-guided pigtail catheter drainage(PCD) of empyema has been employed. We retrospectively analyzed the medical records of patients with empyema or complicated parapneumonic effusion to determine the efficacy of percutaneous pigtail catheter drainage. Materials and Methods : 45 patients with complicated parapneumonic effusions or empyema were treated at Gil medical center from January 1998 to June, 1999. All were initially given PCD procedure and the following data were collected: clinical symptoms at the time of diagnosis, alcohol and smoking history, the characteristics of pleural effusion, radiologic findings (at the time of catheter insertion, removal and 1 month after catheter removal), the amount of effusion drained for initial 24 hours, the time from catheter insertion to removal and the use of surgical approach. Results : Male gender was more frequent (42 men vs. 3 women), the mean age of the study population was 52(range: 21~74) years. Empyema was found in 23 patients, complicated parapneumonic effusion in 22 patients. Four patients(three, parapneumonic effusion and one, with empyema) with PCD only treated, were cast off. Among the available patients, 36(80%) patients were treated with PCD only or PCD with urokinase. Among the 23 patients with empyema, surgical approach was required in five patients(27.1%, one required decortication, four open thoracostomy), one patient, treated with surgical procedure, died of sepsis. There was no significant difference of the duration of catheter insertion, the duration of hospital admission after catheter insertion and the mean amount of effusion drained for initial 24 hours between the patients with only PCD treated and the patients treated with PCD and urokinase. The duration of catheter insertion($9.4{\pm}5.25days$ vs. $19.2{\pm}9.42days$, p<0.05) and the duration of hospital admission after catheter insertion($15.9{\pm}10.45days$ vs. $38.6{\pm}11.46days$, p<0.01) of the patients with only PCD treated were more longer than those of the patients treated with surgical procedure after PCD. They were same between the patients treated with urokinase after PCD and the patients treated with surgical procedure after PCD($11.1{\pm}7.35days$ vs. $19.2{\pm}9.42days$, p<0.05, $17.5{\pm}9.17days$ vs. $38.6{\pm}11.46days$, p<0.01). In 16 patients(44.4%) with only PCD treated or PCD and urokinase treated, the amount of effusion at the time of catheter removal was decreased more than 75% and in 17 patients(47.2%) effusion decreased 50~75%. .In one patient effusion decreased 25~50%, in two patients effusion decreased less than 25%. One month after catheter removal, in 35 patients(97.2%, four patients were cast off), the amount of pleural effusion was successfully decreased more than 50%. There were no complications related to pigtail catheter insertion. Conclusion : In this study, PCD seemed to be an early efficacious procedure in treating the patients with complicated parapneumonic effusion or empyema without any serious procedure related complication.

• The Journal of Korean society of community based occupational therapy
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• v.9 no.2
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• pp.33-42
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• 2019

Objective : The aim of this study was to evaluate the current knowledge regarding constraint-induced movement therapy (CIMT) and its application in clinical practice by physiatrists and therapists in pediatric rehabilitation area in Korea. Methods : Online survey via E-mails was sent to a total of 510 members (204 physiatrists and 306 therapists) of the Korean Society of Pediatric Rehabilitation and Developmental Medicine (KSPRDM). Results : The response rate was 35.1% (179 of 510). A total of 179 questionnaires was completed by 39 physiatrists, 89 physiotherapists, 48 occupational therapists, and 3 speech therapists. 45.8% of responders had worked over 6 years in the pediatric rehabilitation setting and a total of 58.1% (n=104) of the sample had used CIMT. The main limitations of clinically applying CIMT included limited staff and inappropriate clinical setting (35.1%, n=61), lack of understanding (19.5%, n=34), and developmental issues of function on the unaffected side (13.8%, n=24). The cooperation of patients (77.6%, n=76), cognitive/behavioral factors (42.9%, n=42), and cooperation of caregivers (25.5%, n=25) were the 3 major concerns that could be limitations with CIMT. Conclusions : Although considerable evidence supports the use of CIMT, many of physiatrist and therapists do not apply this method in practice. The improvement of limitations is necessary for wide use of CIMT in clinical practice in Korea.

• Pediatric Infection and Vaccine
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• v.12 no.2
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• pp.124-134
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• 2005

Purpose : It has been known that the diagnostic confirmation of group A streptococcal pharyngitis is accompanied with the results of throat culture and/or rapid antigen detection test(RADT). This study was designed to evaluate the usefulness and cost benefits of the RADT in patients with a sore throat compared the empirical antibiotic treated group without using RADT or throat culture with the antibiotic treated group according to the results of RADT test and/or throat culture. Methods : From April 2003 to August 2003, total 369 patients were enrolled this study. They were redistributed into two groups. In one group, the RADT test and throat culture were used and the patients received antibiotic treatment according to the results of test and in the other group, no diagnostic examinations were used and the patients were treated with antibiotics which were chosen empirically. The flow sheet with questionnaire was drawing up and obtained the clinical symptoms, signs and the name of antibiotics that were administered. Results : A total of 244 patients were treated after the throat culture and/or RADT, and 125 patients were treated empirically. The prevalence of bacteriologically confirmed group A streptococcal pharyngitis was 20.1%. The sensitivity and specificity of RADT were 89.8% and 86.1%, respectively. Positive predictive value and negative predictive value were 62.0% and 97.1%, respectively. The rate of antibiotic use was high in both groups. Because the physician used the antibiotics even if the result of RADT was negative. So about 37% of reduction of antibiotics use might be possible if we used antibiotics according to the results of RADT. There were no cost differences between the RADT applied group and the empirically treated antibiotic group if we could reduce the price of RADT to 63% of the current price. Conclusion : The RADT could be applied for the easy and rapid diagnosis and prompt treatment for group A streptococcal pharyngitis, and RADT could reduced the number of antibiotics used if the price of RADT was reduced to 63% of current price. For accurate evaluation of efficacy and cost effect, further controlled study is needed.

• Pediatric Infection and Vaccine
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• v.14 no.2
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• pp.162-170
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• 2007

Purpose : While cases of vancomycin-resistant enterococci (VRE) have increasingly been reported worldwide since it was first reported in the late 1980s, there have been few systemic studies on the pediatric population. The purpose of this study is to contribute to the planning of VRE prevention by investigating the prevalence, risk factors and transmission of VRE infection. Methods : We studied 230 patients under age 15 years who were isolated VRE between January 2001 and December 2006 retrospectively. The patients were classified into the intensive care unit (ICU) and the non-ICU groups. We reviewed the procedures before VRE detection as well as antibiotic sensitivity of detected organisms. Results : The number of VRE-isolation cases was higher in the ICU group than the non-ICU group. Instances of VRE-isolation were also more prevalent in patients who underwent operations or active procedures while taking 3rd-generation cephalosporins or glycopeptides. Almost all antibiotics except tetracycline were resistant to VRE. The proportion of 3rd-generation cephalosporin use was higher than those of any other antibiotics before VRE detection. Additionally, the use of 3rd-generation cephalosporins has increased annually, but that of glycopeptides had decreased in 2006. Also, the rates of VRE isolation have been increasing since 1998. Conclusion : VRE infection is increasing in pediatric population. Strict adherence to appropriate infection control guidelines for the prevention of VRE transmission in hospitals, and tracking of VRE colonization through active surveillance in high risk units are recommended.