• 대한방사선기술학회지:방사선기술과학
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• 제30권4호
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• pp.329-334
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• 2007

의료영상에서 화질저하를 최소화 하면서 Noise를 감소시키기 위하여 Noise가 첨가되어 있는 영상을 대상으로 Low Pass Filter(LPF) 5종, High Pass Filter(HPF) 4종, Median Filter(MF) 11종의 모두 20개의 필터를 복합적으로 사용하여 Noise 제거효과를 검토하였다. Noise를 나타내는 지표로 Peak Signal to Noise Ratio(PSNR), Mean Square Error(MSE)를 비교하였다. 그 결과 Noise 감소효과가 가장 높은 필터의 조합은 LPF3*3#1 + HPF3*3#1 + Vertical3*1로 나타났다. 이 필터의 조합을 흉부, 골반, 머리 등의 의료영상에 적용하여 임상적인 Noise 제거효과를 확인하였다.

• 대한통합의학회지
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• 제8권4호
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• pp.307-321
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• 2020

Purpose : A person infected by SARS-CoV2 may present various symptoms such as fever, pain in lower respiratory tract, and pneumonia. Measuring body temperature is a simple method to screen patients. However, changes in the surrounding environment may cause errors in infrared measurement. Hence, a non-contact thermometer controls this error by setting a correction value, but it is difficult to correct it for all environments. Therefore, we investigate device error values according to changes in the surrounding environment (temperature and humidity) and propose guidelines for reliable patient detection. Methods : For this study, the temperature was measured using three types of non-contact thermometers. For accurate temperature measurement, we used a water bath kept at a constant temperature. During temperature measurement, we ensured that the temperature and humidity were maintained using a thermo-hygrometer. The conditions of the surrounding environment were changed by an air conditioner, humidifier, warmer, and dehumidifier. Results : The temperature of the water bath was measured using a non-contact thermometer kept at various distances ranging from 3~10 cm. The value measured by the non-contact thermometer was then verified using a mercury thermometer, and the difference between the measured temperatures was compared. It was observed that at normal surrounding temperature (24 ℃), there was no difference between the values when the non-contact thermometer was kept at 3 cm. However, as the distance of the non-contact thermometer was increased from the water bath, the recorded temperature was significantly different compared with that of mercury thermometer. Moreover, temperature measurements were conducted at different surrounding temperatures and the results obtained significantly varied from when the thermometer was kept at 3 cm. Additionally, it was observed that the effect on temperature decreases with an increase in humidity Conclusion : In conclusion, non-contact thermometers are lower in lower temperature and dry weather in winter.

• 응용통계연구
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• 제30권3호
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• pp.453-462
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• 2017

성향점수 매칭은 관찰연구에서 처리효과 추정 시 혼란변수에 의한 편의를 줄이기 위해 자주 사용되는 방법이다. 매칭을 위해 처리군에 대응되는 대조군 선정 시 처리군의 일부가 탈락되는 경우가 발생할 수 있는데, 이로 인해 편의가 발생할 수 있다. 최근, Austin (2017)의 연구에서 이중 성향점수 보정(double propensity score adjustment)방법을 사용하는 것이 이에 대한 해결책이 될 수 있음을 제시하였다. 하지만, 처리효과 추정치의 표준오차는 이론적 추정치가 제시되지 않아 추정에 어려움이 있다. 본 연구에서는 이중 성향점수 보정 방법을 이용한 처리효과 추정치의 표준오차 추정을 위하여 두 가지 붓스트랩 방법을 제안한다. 첫 번째는 원 자료에서 성향점수 매칭 후 매칭 된 표본에서 붓스트랩 표본을 얻는 방법(simple 붓스트랩)이고, 두 번째는 원 자료에서 붓스트랩을 먼저 시행하고 각 붓 스트랩 표본에서 성향점수 매칭을 하는 방법(complex 붓스트랩)이다. 두 방법의 성능을 비교하기 위하여 다양한 상황을 가정하여 모의실험을 시행한 결과 complex 붓스트랩 방법이 경험적 표준오차와 더 가까운 값으로 추정함을 알 수 있었다. 95% 신뢰구간의 포함확률도 complex 방법을 사용했을 때 0.95에 훨씬 가까웠다. 실제 자료에 적용하였을 때에도 simple 방법은 complex 방법에 비해 표준오차를 작게 추정하였다.

• 한국의학물리학회지:의학물리
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• 제22권2호
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• pp.72-78
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• 2011

본 연구의 목적은 토모테라피(Hi-ArtII, TomoTherapy, USA) 치료 시 Bodyfix system (Medical Intelligence, Ele-kta, Schwabmuchen, Germany)에서 진공압박(Vacuum compression)에 따라 환자 위치잡이오차(Patient's setup-errors)를 평가하고자 하였다. Bodyfix system와 진공압박을 적용한 토모테라피를 이용하여 치료를 시행한 흉복부 환자 21명을 선정하였으며, 모든 환자는 치료 전 촬영된 총 477개의 메가볼테이지 전산화단층촬영(Mega-voltage computed tomography, MVCT)영상을 얻었다. 이를 통하여 확인된 좌우방향(Medial-Lateral direction, ML), 앞뒤방향(Anterior-Posterior direction, AP), 상하방향(Superior-Inferior direction, SI)과 SI중심축 회전각(Rotational angle of SI axis direction, Roll)에 대한 오차를 기록하고, 분석하였다. 세 방향 및 Roll에 대한 상관관계와 진공압박 정도가 다르게 적용된 다섯 그룹에 대하여 setup-errors를 분석하기 위해 각각 Pearson's product-moment coefficient와 One-way ANOVA를 이용하여 통계적으로 분석하였다(p<0.05). 분석결과 Systematic errors의 평균은 AP에서 6.00 mm, 표준편차는 SI에서 5.95 mm로 큰 오차를 보였다. Random errors의 평균은 SI방향에서 4.72 mm로 큰 오차가 발생하였다. 관계분석에서는 상관계수가 ML-Roll과 AP-Vector는 0.485, 0.244이고, SI-Vector에서 관계가 제일 높았다(0.637). 또한, 진공압박 정도가 다르게 적용된 다섯 그룹(Pressure range: 30~70 mbar) 사이의 setup errors를 분석한 결과 ML, SI방향과 Roll에서 모두 p=0.00 (p<0.05)로써 유의한 차이를 보였으며, SI방향에서 진공압박에 따른 오차 평균은 40 mbar과 70 mbar그룹에서 4.78 mm, -0.74 mm였다. 본 연구에서는 진공압박과 setup-errors의 평가를 통계적으로 분석하였으며, 압박 정도에 따라 SI방향에서 setup-errors의 차이를 확인하였다. 최종적으로 setup-errors와 내부장기의 움직임을 고려하자면 Bodyfix system을 이용한 진공압박을 적용시 최소 50 mbar 이상을 사용해야 할 것이다. 본 연구결과를 토대로 진공압박의 정확성과 내부장기 및 종양의 움직임을 정량적으로 분석할 필요가 있다고 판단된다.

• Korean Journal of Radiology
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• 제22권6호
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• pp.901-911
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• 2021

Objective: To evaluate the technical applicability of a semiautomatic three-dimensional (3D) hybrid CT segmentation method for the quantification of right ventricular mass in patients with cardiovascular disease. Materials and Methods: Cardiac CT (270 cardiac phases) was used to quantify right ventricular mass using a semiautomatic 3D hybrid segmentation method in 195 patients with cardiovascular disease. Data from 270 cardiac phases were divided into subgroups based on the extent of the segmentation error (no error; ≤ 10% error; > 10% error [technical failure]), defined as discontinuous areas in the right ventricular myocardium. The reproducibility of the right ventricular mass quantification was assessed. In patients with no error or < 10% error, the right ventricular mass was compared and correlated between paired end-systolic and end-diastolic data. The error rate and right ventricular mass were compared based on right ventricular hypertrophy groups. Results: The quantification of right ventricular mass was technically applicable in 96.3% (260/270) of CT data, with no error in 54.4% (147/270) and ≤ 10% error in 41.9% (113/270) of cases. Technical failure was observed in 3.7% (10/270) of cases. The reproducibility of the quantification was high (intraclass correlation coefficient = 0.999, p < 0.001). The indexed mass was significantly greater at end-systole than at end-diastole (45.9 ± 22.1 g/m² vs. 39.7 ± 20.2 g/m², p < 0.001), and paired values were highly correlated (r = 0.96, p < 0.001). Fewer errors were observed in severe right ventricular hypertrophy and at the end-systolic phase. The indexed right ventricular mass was significantly higher in severe right ventricular hypertrophy (p < 0.02), except in the comparison of the end-diastolic data between no hypertrophy and mild hypertrophy groups (p > 0.1). Conclusion: CT quantification of right ventricular mass using a semiautomatic 3D hybrid segmentation is technically applicable with high reproducibility in most patients with cardiovascular disease.

• 대한한의학회지
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• 제42권4호
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• pp.1-9
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• 2021

Objectives: This study aimed to evaluate the feasibility of the Korean medical examination protocol, which included 14 questionnaires and 20 medical examination devices. Methods: We conducted a pilot observational study of 90 subjects to measure the time required to fulfill each item of the Korean medical examination, to evaluate patient satisfaction, and to report improvements that can be made to the Korean medical examination protocol based on clinical coordinator and subject feedback. Results: Among the 90 subjects included in the study (59 women and 31 men; mean [standard deviation] age, 37.2 [12.3] years), over 80% intended to receive a Korean medical examination if hospitals provided it and would recommend a Korean medical examination to others. The average time spent on the overall Korean medical examination was approximately 88.0 (21.4) minutes. Three areas for improvements were reported: survey issues, including the number of items, understanding, and readability; error issues in device measurements; and environmental issues affecting the sequence of medical examinations and temperature. Conclusions: Most subjects were satisfied with the Korean medical examination. Future studies should be conducted with larger samples to collect data continuously.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.53-60
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• 2002

Motion of lung tumors from respiration has been reported in the literature to be as large as of 1-2 cm. This motion requires an additional margin between the Clinical Target Volume (CTV) and the Planning Target Volume (PTV). While such a margin is necessary, it may not be sufficient to ensure proper delivery of Intensity Modulated Radiotherapy (IMRT) to the CTV during the simultaneous movement of the DMLC. Gated treatment has been proposed to improve normal tissues sparing as well as to ensure accurate dose coverage of the tumor volume. The following questions have not been addressed in the literature: a) what is the dose error to a target volume without gated IMRT treatment\ulcorner b) what is an acceptable gating window for such treatment. In this study, we address these questions by proposing a novel technique for calculating the 3D dose error that would result if a lung IMRT plan were delivered without gating. The method is also generalized for gated treatment with an arbitrary triggering window. IMRT plans for three patients with lung tumor were studied. The treatment plans were generated with HELIOS for delivery with 6 MV on a CL2100 Varian linear accelerator with a 26 pair MLC. A CTV to PTV margin of 1 cm was used. An IMRT planning system searches for an optimized fluence map ${\Phi}$ (x,y) for each port, which is then converted into a dynamic MLC file (DMLC). The DMLC file contains information about MLC subfield shapes and the fractional Monitor Units (MUs) to be delivered for each subfield. With a lung tumor, a CTV that executes a quasi periodic motion z(t) does not receive ${\Phi}$ (x,y), but rather an Effective Incident Fluence EIF(x,y). We numerically evaluate the EIF(x,y) from a given DMLC file by a coordinate transformation to the Target's Eye View (TEV). In the TEV coordinate system, the CTV itself is stationary, and the MLC is seen to execute a motion -z(t) that is superimposed on the DMLC motion. The resulting EIF(x,y)is inputted back into the dose calculation engine to estimate the 3D dose to a moving CTV. In this study, we model respiratory motion as a sinusoidal function with an amplitude of 10 mm in the superior-inferior direction, a period of 5 seconds, and an initial phase of zero.

• Journal of Preventive Medicine and Public Health
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• 제33권1호
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• pp.76-82
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• 2000

Objectives : We attempted to assess He accuracy of ICD codes for cerebrovascular diseases in medical insurance claims (ICMIC) and to investigate the reasons for error. This study was designed as a preliminary study to establish a nationwide surveillance system. Methods : A total of 626 patients with medical insurance claims who indicated a diagnosis of cerebrovascular diseases during the period from 1993 to 1997 was selected from the Korea Medical Insurance Corporation cohort (KMIC cohort: 115,600 persons). The KMIC cohort was 10% of those insured who had taken health examinations in 1990 and 1992 consecutively. The registered medical record administrators were trained in the survey technique and gathered data from March to May 1999. The definition of cerebrovascular diseases in this study included cases which met ore of two criteria (Minnesota, WHO) or 'definite stroke' in CT/MRI finding. We questioned the medical record administrators to explain the error if the final diagnoses were not coded as stroke. Results : The accuracy rate of the ICMIC was 83.0% (425 cases) Medical records were not available for 8.2% (51 cases) due to the closing of hospitals, the absence of a computer system or omission of medical record, etc. Sixty-three cases (10.0%) were classified as impossible to interpret due to insufficient records in 'major clinical symptoms' or 'neurological deficits'. The most common reason was 'to meet review criteria of medical insurance benefits (52.9%)'. The department where errors in the ICMIC occurred most frequently was the department for medical insurance claims in the hospital. Conclusion : The accuracy rate of the ICMIC was 83.0%.

• 한국지능정보시스템학회:학술대회논문집
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• 한국지능정보시스템학회 2006년도 춘계학술대회
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• pp.327-335
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• 2006

Case Based Reasoning (CBR) has come to be considered as an appropriate technique for diagnosis, prognosis and prescription in medicine. However, canventional CBR has a limitation in that it cannot incorporate asymmetric misclassification cast. It assumes that the cast of type1 error and type2 error are the same, so it cannot be modified according ta the error cast of each type. This problem provides major disincentive to apply conventional CBR ta many real world cases that have different casts associated with different types of error. Medical diagnosis is an important example. In this paper we suggest the new knowledge extraction technique called Cast-Sensitive Case Based Reasoning (CSCBR) that can incorporate unequal misclassification cast. The main idea involves a dynamic adaptation of the optimal classification boundary paint and the number of neighbors that minimize the tatol misclassification cast according ta the error casts. Our technique uses a genetic algorithm (GA) for finding these two feature vectors of CSCBR. We apply this new method ta diabetes datasets and compare the results with those of the cast-sensitive methods, C5.0 and CART. The results of this paper shaw that the proposed technique outperforms other methods and overcomes the limitation of conventional CBR.

• Journal of Periodontal and Implant Science
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• 제43권5호
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• pp.221-226
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• 2013

Purpose: This study aimed to assess the combined effect of dismantling before sterilization and aging on the accuracy (${\pm}10%$ of the target torque) of spring-style mechanical torque devices (S-S MTDs). Methods: Twenty new S-SMTDs from two different manufacturers (Nobel Biocare and Straumann: 10 of each type) were selected and divided into two groups, namely, case (group A) and control (group B). For sterilization, 100 cycles of autoclaving were performed in 100 sequences. In each sequence, 10 repetitions of peak torque values were registered for aging. To measure and assess the output of each device, a Tohnichi torque gauge was used (P<0.05). Results: Before steam sterilization, all of the tested devices stayed within 10% of their target values. After 100 cycles of steam sterilization and aging with or without dismantling of the devices, the Nobel Biocare devices stayed within 10% of their target torque. In the Straumann devices, despite the significant difference between the peak torque and target torque values, the absolute error values stayed within 10% of their target torque. Conclusion: Within the limitations of this study, there was no significant difference between the mean and absolute value of error between Nobel Biocare and Straumann S-S MTDs.