• Proceedings of the Korea Contents Association Conference
• /
• 2009.05a
• /
• pp.1141-1149
• /
• 2009

In Bone Mineral Density(BMD) measurements, accuracy and precision must be superior in order to know the small changes in bone mineral density and actual biological changes. Therefore the purpose of this study is to increase the reliability of bone mineral density inspection through appropriate management of image quality from machines and inspectors. For the machine management method, the recommended phantom from each bone mineral density machine manufacturer was used to take 10~25 measurements to determine the standard amount and permitted limit. On each inspection day, measurements were taken everyday or at least three times per week to verify the whether or not change existed in the amount of actual bone mineral density. Also evaluations following Shewhart control chart and CUSUM control chart rules were made for the bone mineral density figures from the phantoms used for measurements. Various forms of management became necessary for machine installation and movement. For the management methods of inspectors, evaluation of the measurement precision was conducted by testing the reproducibility of the exact same figures without any real biological changes occurring during reinspection. There were two measurement methods followed: patients were either measured twice with 30 measurements or three times with 15 measurements. An important point to make regarding measurements is that after the first inspection and any other inspection following, the patient was required to come off the inspection table completely and then get back on for any further measurements. With a 95% confidence level, the precision error produced from the measurement bone mineral figures produced a precision error of 2.77 times the minimum of the biological bone mineral density change (Least significant change: LSC). In order to assure reliability in inspection, there needs to be good oversight of machine management and measurer for machine operation and inspection error. Accuracy error in machines needs to be reduced to under 1% for scientific development in bone mineral density machines.

• Clinical and Experimental Pediatrics
• /
• v.55 no.12
• /
• pp.481-486
• /
• 2012

Purpose: Precocious puberty is defined as breast development before the age of 8 years in girls. The present study aimed to reveal the diagnosis of Korean girls referred for precocious puberty and to compare the constitutional and endocrinological features among diagnosis groups. Methods: The present study used a retrospective chart review of 988 Korean girls who had visited a pediatric endocrinology clinic from 2006 to 2010 for the evaluation of precocious puberty. Study groups comprised fast puberty, true precocious puberty (PP), pseudo PP, premature thelarche, and control. We determined the height standard deviation score (HSDS), weight standard deviation score (WSDS), and body mass index standard deviation score (BMISDS) of each group using the published 2007 Korean growth charts. Hormone tests were performed at our outpatient clinic. Results: The PP groups comprised fast puberty (67%), premature thelarche (17%), true PP (15%), and pseudo PP (1%). Advanced bone age and levels of estradiol, basal luteinizing hormone (LH), and peak LH after gonadotropin-releasing hormone stimulation testing were significantly high in the fast puberty and true PP groups compared with the control group. HSDS, WSDS, and BMISDS were significantly higher in the true PP group than in the control group (P<0.05). Conclusion: The frequent causes of PP were found to be fast puberty, true PP, and premature thelarche. Furthermore, BMISDS were significantly elevated in the true PP group. Therefore, we emphasize the need for regular follow-up of girls who are heavier or taller than others in the same age group.

• Convergence Security Journal
• /
• v.5 no.1
• /
• pp.19-27
• /
• 2005

This paper presents the content regarding electronic medical examination chart and data processing for efficient medical examination and fast treatment by realizing remote medical examination system of mutual conversation type among 3 parties(patient, doctor, pharmacist) on internet base, and establishment of database enabled system integration for efficient data processing in both on-line and off-line mode by interconnecting ASP and SQL on IIS 4.0 web server, consultation between patient and doctor, medical examination on off-line mode, transmission of prescription sheet to the pharmacist designated by patient, preparation of medicine, semieternal storage of medical examination data owing to storage and check of medical examination data, more accurate medical examination and prescription using this medical examination data by patient and doctor, and so on. And, data processing between doctor and pharmacist is differently performed based on class such as general member and charge member, and service access right pursuant to this is endowed, so that certification of each member must follow by all means.

• Parasites, Hosts and Diseases
• /
• v.59 no.3
• /
• pp.227-233
• /
• 2021

Eosinophilic meningitis is defined as the presence of more than 10 eosinophils per µl in the cerebrospinal fluid (CSF), or eosinophils accounting for more than 10% of CSF leukocytes in patients with acute meningitis. Parasites are the most common cause of eosinophilic meningitis worldwide, but there is limited research on patients in Korea. Patients diagnosed with eosinophilic meningitis between January 2004 and June 2018 at a tertiary hospital in Seoul, Korea were retrospectively reviewed. The etiology and clinical characteristics of each patient were identified. Of the 22 patients included in the study, 11 (50%) had parasitic causes, of whom 8 (36%) were diagnosed as neurocysticercosis and 3 (14%) as Toxocara meningitis. Four (18%) patients were diagnosed with fungal meningitis, and underlying immunodeficiency was found in 2 of these patients. The etiology of another 4 (18%) patients was suspected to be tuberculosis, which is endemic in Korea. Viral and bacterial meningitis were relatively rare causes of eosinophilic meningitis, accounting for 2 (9%) and 1 (5%) patients, respectively. One patient with neurocysticercosis and 1 patient with fungal meningitis died, and 5 (23%) had neurologic sequelae. Parasite infections, especially neurocysticercosis and toxocariasis, were the most common cause of eosinophilic meningitis in Korean patients. Fungal meningitis, while relatively rare, is often aggressive and must be considered when searching for the cause of eosinophilic meningitis.

• Journal of Genetic Medicine
• /
• v.20 no.2
• /
• pp.60-69
• /
• 2023

Purpose: Despite enzyme replacement therapy (ERT) and/or allogeneic hematopoietic stem cell transplantation, individuals with mucopolysaccharidosis (MPS) I or II often experience significant growth deficiencies. This study aimed to assess the safety and efficacy of recombinant human growth hormone (hGH) treatment in children diagnosed with MPS I or II. Materials and Methods: A total of nine pediatric patients-four with MPS I and five with MPS II-underwent treatment with ERT and hGH at Samsung Medical Center. Results: The mean hGH dose administered was 0.26±0.03 mg/kg/week. In the MPS I group, three patients showed an increase in height Z-score from -4.09±0.83 to -3.68±0.43 after 1 year of hGH treatment, and to -3.10±0.72 by the end of the hGH regimen. In the MPS II group, while the height Z-score of four patients decreased according to standard growth charts, it improved from 1.61±1.79 to 2.71±1.68 based on the disease-specific growth chart through hGH treatment. Two patients discontinued hGH treatment due to lack of efficacy after 22 and 6 months each of treatment, respectively. No new-onset neurological symptoms or necessity for prosthetic or orthopedic surgery were reported during hGH treatment. Conclusion: This study provides insights into the impact of hGH on MPS patients, demonstrating its potential to reverse growth deceleration in some cases. Further research is needed to explore the long-term effects of hGH on changes in body composition, muscle strength, and bone health in this population.

• Progress in Medical Physics
• /
• v.10 no.2
• /
• pp.95-101
• /
• 1999

The aims of this report are to classify the incorrect data of patients and the errors of dose and dose distribution observed in QA activities on teleradiotherapy chart, and to analyze their frequency. In our department, radiation physicists check several sheets of patient chart to reduce numeric errors before starting radiation therapy and at least once a week, which include history, port diagram, MU calculation or treatment planning summary and daily treatment sheet. The observed errors are classified as followings. 1) Identity of patient, 2) Omitted or unrecorded history sheet even though not including the item related to dose, 3) Omission of port diagram, or omitted or erroneous data, 4) Erroneous calculation of MU and point dose, and important causes, 5) Loss of summary sheet of treatment planning, and erroneous data of patient in the sheet, 6) Erroneous record of radiation therapy, and errors of daily dose, port setup, MU and accumulated dose in the daily treatment sheet, 7) Errors leading inexact dose or dose distribution, errors not administerd even though its possibility, and simply recorded errors, 8) Omission of sign. Number of errors was counted rather than the number of patients. In radiotherapy chart QA from Jun 17, 1996 to Jul 31, 1999, no error of patient identity had been observed. 431 Errors in 399 patient charts had been observed and there were 405 physical errors, 9 cases of omitted or unrecorded history sheet, and 17 unsigned. There were 23 cases (5.7%) of omitted port diagram, 21 cases (5.2%) of omitted data and 73 cases (18.0 %) of erroneous data in port diagram, 13 cases (3.2 %) treated without MU calculation, 68 cases (16.3 %) of erroneous MU, 8 cases (2.0%) of erroneous point dose, 1 case (0.2 %) of omitted treatment planning summary, 11 cases (2.7%) of erroneous input of patient data, 13 cases (3.2%) of uncorrected record of treatment, 20 cases (4.9%) of discordant daily doses in MU calculation sheet and daily treatment sheet, 33 cases (8.1%) of erroneous setup, 52 cases (12.8%) of MU setting error, 61 cases (15.1%) of erroneous accumulated dose. Cases of error leading inexact dose or dose distribution were 239 (59.0 %), cases of error not administered even though its possibility were 142 (35.1 %), and cases of simply recorded error were 24 (5.9 %). The numeric errors observed in radiotherapy chart ranged over various items. Because errors observed can actually contribute to erroneous dose or dose distribution, or have the possibility to lead such errors, thorough QA activity in physical aspects of radiotherapy charts is required.

• The Korean Journal of Health Service Management
• /
• v.11 no.3
• /
• pp.23-35
• /
• 2017

Objectives : This study analyzed the trends of patient costs in 7diagnosis-related groups(DRG) since July 2013 when the government made it mandatory for all hospitals and clinics. Methods : Data were collected from the 7DRG score chart published by the Ministry of Health and Welfare(MoHW) from July 2013 to January 2017. The average value of the weekday relative value scale was multiplied by unit price, referred to as'- "patient costs by disease group"-' and they were analyzed by time series. Results : Patient costs had increased among all patients with a comprehensive disease. Small and medium-sized hospitals (hospitals and clinics) showed a slight increase in patient costs. Conclusions : Enforcement of the Korean diagnosis-related groups has led to management crisis in small and medium-sized hospitals and deterioration medical service quality. To solve this problem, The weekday relative value scale of small and medium-sized hospitals should be increased significantly.

• The Journal of Korean Medical History
• /
• v.31 no.1
• /
• pp.57-70
• /
• 2018

Much research has already been done on Donguibogam. However, comparison of specific characters was not done because researchers found it difficult to compare different editions of the text in one place. Recently, important editions have been published on the Internet, making comparison possible. In this paper, researchers compare eight editions Donguibogam, including the original edition published in 1613 and seven other editions corrected by the Naeuiwon (Joseon Dynasty National Medical Center). The comparison results were summarized and tabulated. The results of the comparison are analyzed and presented in this article as a chart. The result of comparing the characters and the analyzed graph were in agreement. The authors propose that all written and electronic publications of Donguibogam should refer to other editions implied, quoted or referenced within the text and including with proper citations, and reference the original and first edition. Inadequate referencing will pollute future knowledge of this foundational text of Traditional Korean Medicine and may result in perpetration of mis-information. Based on accumulated knowledge and study of historical Korean Medicine texts, the Namsan edition made a mistake in the editing process. The year of publication of Gabsul-yoengyoeng-gegan Edition needs to be studied again and corrections made where appropriate.

• Progress in Medical Physics
• /
• v.26 no.2
• /
• pp.59-71
• /
• 2015

The goal of quality assurance (QA) is to minimize systematic errors in order to maintain the quality of a certain process. Statistical process control (SPC) has been utilized for QA in radiation therapy field since 2005 and is changing QA paradigm. Its purpose is to maintain a process within the given control limits while monitoring of error trends such as variation or dispersion. SPC can be applied to all QA aspects of radiotherapy; however, a medical physicist should have enough knowledge about the application of SPC to QC/QA procedures. In this paper, the author introduce a concept of SPC and review some previously reported studies those used SPC for QA in radiation therapy.

• The Journal of Korean Medicine
• /
• v.39 no.4
• /
• pp.16-29
• /
• 2018

Introduction: We aimed to investigate the predictive factors and optimal age for response to herbal medicine treatment for height gain in children. Methods: This retrospective chart review included 61 children (age range, 5-16 years) treated for height gain between 2011 and 2015. A predictive model was established by multiple linear regression analysis. Dependent variables were defined by the differences in percentile before and after herbal medicine treatment. The optimal cutoff value of patient age was determined by receiver operating curve analysis. Results : The age of initiation of herbal medicine therapy (p = 0.012) and administration of Forsythiae fructus (p = 0.002) were significant variables for treatment response. The adjusted R2 value was 0.231. The mean ages of the responder and non-responder groups were significantly different (p = 0.023). The optimal cutoff value of age for predicting treatment response was 9.75 years. Treatment response was better among children below 9.75 years of age. Conclusions: Patient age and administration of Forsythiae fructus were identified as determinants of response to herbal medicine treatment. Treatment of rhinitis and initiation of height gain treatment at an early age are critical for better response. These findings will provide fundamental data for further research.