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Performance Evaluation of Siemens CTI ECAT EXACT 47 Scanner Using NEMA NU2-2001 (NEMA NU2-2001을 이용한 Siemens CTI ECAT EXACT 47 스캐너의 표준 성능 평가)

  • Kim, Jin-Su;Lee, Jae-Sung;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.3
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    • pp.259-267
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    • 2004
  • Purpose: NEMA NU2-2001 was proposed as a new standard for performance evaluation of whole body PET scanners. in this study, system performance of Siemens CTI ECAT EXACT 47 PET scanner including spatial resolution, sensitivity, scatter fraction, and count rate performance in 2D and 3D mode was evaluated using this new standard method. Methods: ECAT EXACT 47 is a BGO crystal based PET scanner and covers an axial field of view (FOV) of 16.2 cm. Retractable septa allow 2D and 3D data acquisition. All the PET data were acquired according to the NEMA NU2-2001 protocols (coincidence window: 12 ns, energy window: $250{\sim}650$ keV). For the spatial resolution measurement, F-18 point source was placed at the center of the axial FOV((a) x=0, and y=1, (b)x=0, and y=10, (c)x=70, and y=0cm) and a position one fourth of the axial FOV from the center ((a) x=0, and y=1, (b)x=0, and y=10, (c)x=10, and y=0cm). In this case, x and y are transaxial horizontal and vertical, and z is the scanner's axial direction. Images were reconstructed using FBP with ramp filter without any post processing. To measure the system sensitivity, NEMA sensitivity phantom filled with F-18 solution and surrounded by $1{\sim}5$ aluminum sleeves were scanned at the center of transaxial FOV and 10 cm offset from the center. Attenuation free values of sensitivity wire estimated by extrapolating data to the zero wall thickness. NEMA scatter phantom with length of 70 cm was filled with F-18 or C-11solution (2D: 2,900 MBq, 3D: 407 MBq), and coincidence count rates wire measured for 7 half-lives to obtain noise equivalent count rate (MECR) and scatter fraction. We confirmed that dead time loss of the last flame were below 1%. Scatter fraction was estimated by averaging the true to background (staffer+random) ratios of last 3 frames in which the fractions of random rate art negligibly small. Results: Axial and transverse resolutions at 1cm offset from the center were 0.62 and 0.66 cm (FBP in 2D and 3D), and 0.67 and 0.69 cm (FBP in 2D and 3D). Axial, transverse radial, and transverse tangential resolutions at 10cm offset from the center were 0.72 and 0.68 cm (FBP in 2D and 3D), 0.63 and 0.66 cm (FBP in 2D and 3D), and 0.72 and 0.66 cm (FBP in 2D and 3D). Sensitivity values were 708.6 (2D), 2931.3 (3D) counts/sec/MBq at the center and 728.7 (2D, 3398.2 (3D) counts/sec/MBq at 10 cm offset from the center. Scatter fractions were 0.19 (2D) and 0.49 (3D). Peak true count rate and NECR were 64.0 kcps at 40.1 kBq/mL and 49.6 kcps at 40.1 kBq/mL in 2D and 53.7 kcps at 4.76 kBq/mL and 26.4 kcps at 4.47 kBq/mL in 3D. Conclusion: Information about the performance of CTI ECAT EXACT 47 PET scanner reported in this study will be useful for the quantitative analysis of data and determination of optimal image acquisition protocols using this widely used scanner for clinical and research purposes.

A Refined Method for Quantification of Myocardial Blood Flow using N-13 Ammonia and Dynamic PET (N-13 암모니아와 양전자방출단층촬영 동적영상을 이용하여 심근혈류량을 정량화하는 새로운 방법 개발에 관한 연구)

  • Kim, Joon-Young;Lee, Kyung-Han;Kim, Sang-Eun;Choe, Yearn-Seong;Ju, Hee-Kyung;Kim, Yong-Jin;Kim, Byung-Tae;Choi, Yong
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.1
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    • pp.73-82
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    • 1997
  • Regional myocardial blood flow (rMBF) can be noninvasively quantified using N-13 ammonia and dynamic positron emission tomography (PET). The quantitative accuracy of the rMBF values, however, is affected by the distortion of myocardial PET images caused by finite PET image resolution and cardiac motion. Although different methods have been developed to correct the distortion typically classified as partial volume effect and spillover, the methods are too complex to employ in a routine clinical environment. We have developed a refined method incorporating a geometric model of the volume representation of a region-of-interest (ROI) into the two-compartment N-13 ammonia model. In the refined model, partial volume effect and spillover are conveniently corrected by an additional parameter in the mathematical model. To examine the accuracy of this approach, studies were performed in 9 coronary artery disease patients. Dynamic transaxial images (16 frames) were acquired with a GE $Advance^{TM}$ PET scanner simultaneous with intravenous injection of 20 mCi N-13 ammonia. rMBF was examined at rest and during pharmacologically (dipyridamole) induced coronary hyperemia. Three sectorial myocardium (septum, anterior wall and lateral wall) and blood pool time-activity curves were generated using dynamic images from manually drawn ROIs. The accuracy of rMBF values estimated by the refined method was examined by comparing to the values estimated using the conventional two-compartment model without partial volume effect correction rMBF values obtained by the refined method linearly correlated with rMBF values obtained by the conventional method (108 myocardial segments, correlation coefficient (r)=0.88). Additionally, underestimated rMBF values by the conventional method due to partial volume effect were corrected by theoretically predicted amount in the refined method (slope(m)=1.57). Spillover fraction estimated by the two methods agreed well (r=1.00, m=0.98). In conclusion, accurate rMBF values can be efficiently quantified by the refined method incorporating myocardium geometric information into the two-compartment model using N-13 ammonia and PET.

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Internal Changes and Countermeasure for Performance Improvement by Separation of Prescribing and Dispensing Practice in Health Center (의약분업(醫藥分業) 실시(實施)에 따른 보건소(保健所)의 내부변화(內部變化)와 업무개선방안(業務改善方案))

  • Jeong, Myeong-Sun;Kam, Sin;Kim, Tae-Woong
    • Journal of agricultural medicine and community health
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    • v.26 no.1
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    • pp.19-35
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    • 2001
  • This study was conducted to investigate the internal changes and the countermeasure for performance improvement by Separation of Prescribing and Dispensing Practice (SPDP) in Health Center. Data were collected from two sources: Performance report before and after SPDP of 25 Health Centers in Kyongsangbuk-do and 6 Health Centers in Daegu-City and self-administerd questionnaire survey of 221 officials at health center. The results of this study were summarized as follows: Twenty-four health centers(77.4%) of 31 health centers took convenience measures for medical treatment of citizens and convenience measures were getting map of pharmacy, improvement of health center interior, introduction of order communication system in order. After the SPDP in health centers, 19.4% of health centers increased doctors and 25.8% decreased pharmacists. 58.1% of health centers showed that number of medical treatments were decreased. 96.4%, 80.6% 80.6% 96.7% of health centers showed that number of prescriptions, total medical treatment expenses, amounts paid by the insureds and the expenses to purchase drugs, respectively, were decreased. More than fifty percent(54.2%) of health centers responded that the relative importance of health works increased compared to medical treatments after the SPDP, and number of patients decreased compared to those in before the SPDP. And there was a drastic reduction in number of prescriptions, total medical treatment expenses, amounts paid by insureds, the expenses to purchase drugs after the SPDP. Above fifty percent(57.6%) of officers at health center responded that the function of medical treatment should be reduced after the SPDP. Fields requested improvement in health centers were 'development of heath works contents'(62.4%), 'rearrangement of health center personnel'(51.6%), 'priority setting for health works'(48.4%), 'restructuring the organization'(36.2%), 'quality impro­vement for medical services'(32.1%), 'replaning the budgets'(23.1%) in order. And to better the image of health centers, health center officers replied that 'health information management'(60.7%), 'public relations for health center'(15.8%), 'kindness of health center officers'(15.3%) were necessary in order. Health center officers suggested that 'vaccination program', 'health promotion', 'maternal and children health', 'communicable disease management', 'community health planning' were relatively important works, in order, performed by health center after SPDP. In the future, medical services in health centers should be cut down with a momentum of the SPDP so that health centers might reestablish their functions and roles as public health organizations, but quality of medical services must be improved. Also health centers should pay attention to residents for improving health through 'vaccination program', 'health promotion', 'mother-children health', 'acute and chronic communicable disease management', 'community health planning', 'oral health', 'chronic degenerative disease management', etc. And there should be a differentiation of relative importance between health promotion services and medical treatment services by character of areas(metropolitan, city, county).

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Showing Filial Piety: Ancestral Burial Ground on the Inwangsan Mountain at the National Museum of Korea (과시된 효심: 국립중앙박물관 소장 <인왕선영도(仁旺先塋圖)> 연구)

  • Lee, Jaeho
    • MISULJARYO - National Museum of Korea Art Journal
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    • v.96
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    • pp.123-154
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    • 2019
  • Ancestral Burial Ground on the Inwangsan Mountain is a ten-panel folding screen with images and postscripts. Commissioned by Bak Gyeong-bin (dates unknown), this screen was painted by Jo Jung-muk (1820-after 1894) in 1868. The postscripts were written by Hong Seon-ju (dates unknown). The National Museum of Korea restored this painting, which had been housed in the museum on separate sheets, to its original folding screen format. The museum also opened the screen to the public for the first time at the special exhibition Through the Eyes of Joseon Painters: Real Scenery Landscapes of Korea held from July 23 to September 22, 2019. Ancestral Burial Ground on the Inwangsan Mountain depicts real scenery on the western slopes of Inwangsan Mountain spanning present-day Hongje-dong and Hongeun-dong in Seodaemun-gu, Seoul. In the distance, the Bukhansan Mountain ridges are illustrated. The painting also bears place names, including Inwangsan Mountain, Chumohyeon Hill, Hongjewon Inn, Samgaksan Mountain, Daenammun Gate, and Mireukdang Hall. The names and depictions of these places show similarities to those found on late Joseon maps. Jo Jung-muk is thought to have studied the geographical information marked on maps so as to illustrate a broad landscape in this painting. Field trips to the real scenery depicted in the painting have revealed that Jo exaggerated or omitted natural features and blended and arranged them into a row for the purposes of the horizontal picture plane. Jo Jung-muk was a painter proficient at drawing conventional landscapes in the style of the Southern School of Chinese painting. Details in Ancestral Burial Ground on the Inwangsan Mountain reflect the painting style of the School of Four Wangs. Jo also applied a more decorative style to some areas. The nineteenth-century court painters of the Dohwaseo(Royal Bureau of Painting), including Jo, employed such decorative painting styles by drawing houses based on painting manuals, applying dots formed like sprinkled black pepper to depict mounds of earth and illustrating flowers by dotted thick pigment. Moreover, Ancestral Burial Ground on the Inwangsan Mountain shows the individualistic style of Jeong Seon(1676~1759) in the rocks drawn with sweeping brushstrokes in dark ink, the massiveness of the mountain terrain, and the pine trees simply depicted using horizontal brushstrokes. Jo Jung-muk is presumed to have borrowed the authority and styles of Jeong Seon, who was well-known for his real scenery landscapes of Inwangsan Mountain. Nonetheless, the painting lacks an spontaneous sense of space and fails in conveying an impression of actual sites. Additionally, the excessively grand screen does not allow Jo Jung-muk to fully express his own style. In Ancestral Burial Ground on the Inwangsan Mountain, the texts of the postscripts nicely correspond to the images depicted. Their contents can be divided into six parts: (1) the occupant of the tomb and the reason for its relocation; (2) the location and geomancy of the tomb; (3) memorial services held at the tomb and mysterious responses received during the memorial services; (4) cooperation among villagers to manage the tomb; (5) the filial piety of Bak Gyeong-bin, who commissioned the painting and guarded the tomb; and (6) significance of the postscripts. The second part in particular is faithfully depicted in the painting since it can easily be visualized. According to the fifth part revealing the motive for the production of the painting, the commissioner Bak Gyeongbin was satisfied with the painting, stating that "it appears impeccable and is just as if the tomb were newly built." The composition of the natural features in a row as if explaining each one lacks painterly beauty, but it does succeed in providing information on the geomantic topography of the gravesite. A fair number of the existing depictions of gravesites are woodblock prints of family gravesites produced after the eighteenth century. Most of these are included in genealogical records and anthologies. According to sixteenth- and seventeenth-century historical records, hanging scrolls of family gravesites served as objects of worship. Bowing in front of these paintings was considered a substitute ritual when descendants could not physically be present to maintain their parents' or other ancestors' tombs. Han Hyo-won (1468-1534) and Jo Sil-gul (1591-1658) commissioned the production of family burial ground paintings and asked distinguished figures of the time to write a preface for the paintings, thus showing off their filial piety. Such examples are considered precedents for Ancestral Burial Ground on the Inwangsan Mountain. Hermitage of the Recluse Seokjeong in a private collection and Old Villa in Hwagae County at the National Museum of Korea are not paintings of family gravesites. However, they serve as references for seventeenth-century paintings depicting family gravesites in that they are hanging scrolls in the style of the paintings of literary gatherings and they illustrate geomancy. As an object of worship, Ancestral Burial Ground on the Inwangsan Mountain recalls a portrait. As indicated in the postscripts, the painting made Bak Gyeong-bin "feel like hearing his father's cough and seeing his attitudes and behaviors with my eyes." The fable of Xu Xiaosu, who gazed at the portrait of his father day and night, is reflected in this gravesite painting evoking a deceased parent. It is still unclear why Bak Gyeong-bin commissioned Ancestral Burial Ground on the Inwangsan Mountain to be produced as a real scenery landscape in the folding screen format rather than a hanging scroll or woodblock print, the conventional formats for a family gravesite paintings. In the nineteenth century, commoners came to produce numerous folding screens for use during the four rites of coming of age, marriage, burial, and ancestral rituals. However, they did not always use the screens in accordance with the nature of these rites. In the Ancestral Burial Ground on the Inwangsan Mountain, the real scenery landscape appears to have been emphasized more than the image of the gravesite in order to allow the screen to be applied during different rituals or for use to decorate space. The burial mound, which should be the essence of Ancestral Burial Ground on the Inwangsan Mountain, might have been obscured in order to hide its violation of the prohibition on the construction of tombs on the four mountains around the capital. At the western foot of Inwangsan Mountain, which was illustrated in this painting, the construction of tombs was forbidden. In 1832, a tomb discovered illegally built on the forbidden area was immediately dug up and the related people were severely punished. This indicates that the prohibition was effective until the mid-nineteenth century. The postscripts on the Ancestral Burial Ground on the Inwangsan Mountain document in detail Bak Gyeong-bin's efforts to obtain the land as a burial site. The help and connivance of villagers were necessary to use the burial site, probably because constructing tombs within the prohibited area was a burden on the family and villagers. Seokpajeong Pavilion by Yi Han-cheol (1808~1880), currently housed at the Los Angeles County Museum of Art, is another real scenery landscape in the format of a folding screen that is contemporaneous and comparable with Ancestral Burial Ground on the Inwangsan Mountain. In 1861 when Seokpajeong Pavilion was created, both Yi Han-cheol and Jo Jung-muk participated in the production of a portrait of King Cheoljong. Thus, it is highly probable that Jo Jung-muk may have observed the painting process of Yi's Seokpajeong Pavilion. A few years later, when Jo Jungmuk was commissioned to produce Ancestral Burial Ground on the Inwangsan Mountain, his experience with the impressive real scenery landscape of the Seokpajeong Pavilion screen could have been reflected in his work. The difference in the painting style between these two paintings is presumed to be a result of the tastes and purposes of the commissioners. Since Ancestral Burial Ground on the Inwangsan Mountain contains the multilayered structure of a real scenery landscape and family gravesite, it seems to have been perceived in myriad different ways depending on the viewer's level of knowledge, closeness to the commissioner, or viewing time. In the postscripts to the painting, the name and nickname of the tomb occupant as well as the place of his surname are not recorded. He is simply referred to as "Mister Bak." Biographical information about the commissioner Bak Gyeong-bin is also unavailable. However, given that his family did not enter government service, he is thought to have been a person of low standing who could not become a member of the ruling elite despite financial wherewithal. Moreover, it is hard to perceive Hong Seon-ju, who wrote the postscripts, as a member of the nobility. He might have been a low-level administrative official who belonged to the Gyeongajeon, as documented in the Seungjeongwon ilgi (Daily Records of Royal Secretariat of the Joseon Dynasty). Bak Gyeong-bin is presumed to have moved the tomb of his father to a propitious site and commissioned Ancestral Burial Ground on the Inwangsan Mountain to stress his filial piety, a conservative value, out of his desire to enter the upper class. However, Ancestral Burial Ground on the Inwangsan Mountain failed to live up to its original purpose and ended up as a contradictory image due to its multiple applications and the concern over the exposure of the violation of the prohibition on the construction of tombs on the prohibited area. Forty-seven years after its production, this screen became a part of the collection at the Royal Yi Household Museum with each panel being separated. This suggests that Bak Gyeong-bin's dream of bringing fortune and raising his family's social status by selecting a propitious gravesite did not come true.

Dual Path Model in Store Loyalty of Discount Store (대형마트 충성도의 이중경로모형)

  • Ji, Seong-Goo;Lee, Ihn-Goo
    • Journal of Distribution Research
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    • v.15 no.1
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    • pp.1-24
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    • 2010
  • I. Introduction The industry of domestic discount store was reorganized with 2 bigs and 1 middle, and then Home Plus took over Home Ever in 2008. In present, Oct, 2008, E-Mart has 118 outlets, Home Plus 112 outlets, and Lotte Mart 60 stores. With total number of 403 outlets, they are getting closer to a saturation point. We know that the industry of discount store has been getting through the mature stage in retail life cycle. There are many efforts to maintain existing customers rather than to get new customers. These competitions in this industry lead firms to acknowledge 'store loyalty' to be the first strategic tool for their sustainable competitiveness. In other words, the strategic goal of discount store is to boost up the repurchase rate of customers throughout increasing store loyalty. If owners of retail shops can figure out main factors for store loyalty, they can easily make more efficient and effective retail strategies which bring about more sales and profits. In this practical sense, there are many papers which are focusing on the antecedents of store loyalty. Many researchers have been inspecting causal relationships between antecedents and store loyalty; store characteristics, store image, atmosphere in store, sales promotion in store, service quality, customer characteristics, crowding, switching cost, trust, satisfaction, commitment, etc., In recent times, many academic researchers and practitioners have been interested in 'dual path model for service loyalty'. There are two paths in store loyalty. First path has an emphasis on symbolic and emotional dimension of service brand, and second path focuses on quality of product and service. We will call the former an extrinsic path and call the latter an intrinsic path. This means that consumers' cognitive path for store loyalty is not single but dual. Existing studies for dual path model are as follows; First, in extrinsic path, some papers in domestic settings show that there is 'store personality-identification-loyalty' path. Second, service quality has an effect on loyalty, which is a behavioral variable, in the mediation of customer satisfaction. But, it's very difficult to find out an empirical paper applied to domestic discount store based on this mediating model. The domestic research for store loyalty concentrates on not only intrinsic path but also extrinsic path. Relatively, an attention for intrinsic path is scarce. And then, we acknowledge that there should be a need for integrating extrinsic and intrinsic path. Also, in terms of retail industry, this study is meaningful because retailers want to achieve their competitiveness by using store loyalty. And so, the purpose of this paper is to integrate and complement two existing paths into one specific model, dual path model. This model includes both intrinsic and extrinsic path for store loyalty. With this research, we would expect to understand the full process of forming customers' store loyalty which had not been clearly explained. In other words, we propose the dual path model for discount store loyalty which has been originated from store personality and service quality. This model is composed of extrinsic path, discount store personality$\rightarrow$store identification$\rightarrow$store loyalty, and intrinsic path, service quality of discount store$\rightarrow$customer satisfaction$\rightarrow$store loyalty. II. Research Model Dual path model integrates intrinsic path and extrinsic path into one specific model. Intrinsic path put an emphasis on quality characteristics and extrinsic path focuses on brand characteristics. Intrinsic path is based on information processing perspective, and extrinsic path emphasizes symbolic and emotional dimension of brand. This model is composed of extrinsic path, discount store personality$\rightarrow$store identification$\rightarrow$store loyalty, and intrinsic path, service quality of discount store$\rightarrow$customer satisfaction$\rightarrow$store loyalty. Hypotheses are as follows; Hypothesis 1: Service quality perceived by customers in discount store has an positive effect on customer satisfaction Hypothesis 2: Store personality perceived by customers in discount store has an positive effect on store identification Hypothesis 3: Customer satisfaction in discount store has an positive effect on store loyalty. Hypothesis 4: Store identification has an positive effect on store loyalty. III. Results and Implications We examined consumers who patronize discount stores for samples of this study. With the structural equation model(SEM) analysis, we empirically tested the validity and fitness of the dual path model for store loyalty in discount stores. As results, the fitness indices of this model were well fitted to data obtained. In an intrinsic path, service quality(SQ) is positively related to customer satisfaction(CS), customer satisfaction(CS) has very significantly positive effect on store loyalty(SL). Also, in an extrinsic path, the store personality(SP) is positively related to store identification(SI), it shows significant effect on store loyalty. Table 1 shows the results as follows; There are some theoretical and practical implications. First, Many studies on discount store loyalty have been executed from various perspectives. But there has been no integrative view on this issue. And so, this research was theoretically designed to integrate various and controversial arguments into one systematic model. We empirically tested dual path model forming store loyalty, and brought up a systematic and integrative framework for future studies. We want to expect creative and aggressive research activities. Second, a few established papers are focused on the relationship between antecedents and store loyalty; store characteristics, atmosphere, sales promotion in store, service quality, trust, commitment, etc., There has been some limits in understanding thoroughly the formation process of store loyalty with a singular path, intrinsic or extrinsic. Beyond these limits in single path, we could propose the new path for store loyalty. This is meaningful. Third, discount store firms make and execute marketing strategies for increasing store loyalty. This research provides real practitioners with reference framework needed for actual strategy formation. Because this paper shows integrated and systematic path for store loyalty. A special feature of this study is to represent 6 sub dimensions of service quality in intrinsic path and 4 sub dimensions of store personality in extrinsic path. Marketers can make more analytic marketing planning with concrete sub dimensions of service quality and store personality. When marketers of discount stores make strategic planning like MPR, Ads, campaign, sales promotion, they can use many items which are more competitive than competitors.

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