• Title/Summary/Keyword: quality diagnosis

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A Literature Review on Unmet Needs of High-Prevalence Cancer Survivors: Focus on Breast Cancer, Thyroid Cancer, Colorectal Cancer, and Lung Cancer (호발암 생존자의 미충족 수요에 대한 문헌 고찰: 유방암, 갑상선암, 대장암, 폐암을 중심으로)

  • Da-Seul Kim;Sun-Mi Kim;Jeong Seok Seo
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.50-62
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    • 2023
  • Objectives : This study aimed to identify unmet needs and influencing factors for patients who have breast cancer, colorectal cancer, lung cancer, and thyroid cancer. Methods : We reviewed the SCIE publications on unmet need of four prevalent cancer patients published after 2010 through a web search. Results : The measurement tools primarily used were Cancer Survivors' Unmet Needs and Supportive Care Needs Survey questionnaire. Lung cancer patients reported a relatively higher rate of unmet needs. Breast cancer patients frequently reported unmet needs in the healthcare system and information, while thyroid cancer patients in post-treatment management and psychological issues. Colorectal cancer patients reported unmet needs in psychological and comprehensive care domain, and lung cancer patients reported unmet needs in physical and daily life management. Younger age, a shorter time since diagnosis or treatment, and higher levels of anxiety, depression, distress, and reduced quality of life were associated with more significant unmet needs. Conclusions : Unmet needs and influencing factors vary by cancer type. Considering the characteristics of each patient group and unmet needs can help in development of more effective treatment and support programs.

Implementation and Evaluation of Optimal Dose Control for Portable Detectors with SiPM (SiPM을 통한 휴대용 검출기의 최적 선량 제어에 대한 구현 및 평가)

  • Byung-Wuk Kang;Sun-Kook Yoo
    • Journal of the Korean Society of Radiology
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    • v.17 no.7
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    • pp.1139-1147
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    • 2023
  • The purpose of this paper is to present and evaluate the performance of a method for controlling the dose for optimal image acquisition while minimizing patient exposure by applying a small-sized Photomultiplier(SiPM) sensor inside a portable detector. Portable detectors have the advantage of being able to quickly access the patient's location for rapid diagnosis, but this mobility comes with the challenge of dose control. This paper presents a method to identify the dose that can have the DQE and optimal image quality of the detector through image evaluation based on IEC62220-1-1, an international standard for X-ray imaging devices, and to identify the optimal dose by matching the ADU of the image and the output of the SiPM Sensor. The Skull AP image was acquired by implementing the detector manufacturer's reference dose. The optimal dose was 342.8 µGy, and the optimal controlled dose was 148.3 µGy, which is 57 % of the manufacturer's reference dose. The Chest AP image was 81.9 µGy and the optimal controlled dose was 27.9 µGy, which is a high dose reduction effect of 66 %. In addition, the two images were analyzed by five radiologists and found to have no clinically significant difference in anatomical delineation.

A Research on Applicability of Drone Photogrammetry for Dam Safety Inspection (드론 Photogrammetry 기반 댐 시설물 안전점검 적용성 연구)

  • DongSoon Park;Jin-Il Yu;Hojun You
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.27 no.5
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    • pp.30-39
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    • 2023
  • Large dams, which are critical infrastructures for disaster prevention, are exposed to various risks such as aging, floods, and earthquakes. Better dam safety inspection and diagnosis using digital transformation technologies are needed. Traditional visual inspection methods by human inspectors have several limitations, including many inaccessible areas, danger of working at heights, and know-how based subjective inspections. In this study, drone photogrammetry was performed on two large dams to evaluate the applicability of digital data-based dam safety inspection and propose a data management methodology for continuous use. High-quality 3D digital models with GSD (ground sampling distance) within 2.5 cm/pixel were generated by flat double grid missions and manual photography methods, despite reservoir water surface and electromagnetic interferences, and severe altitude differences ranging from 42 m to 99.9 m of dam heights. Geometry profiles of the as-built conditions were easily extracted from the generated 3D mesh models, orthomosaic images, and digital surface models. The effectiveness of monitoring dam deformation by photogrammetry was confirmed. Cracks and deterioration of dam concrete structures, such as spillways and intake towers, were detected and visualized efficiently using the digital 3D models. This can be used for safe inspection of inaccessible areas and avoiding risky tasks at heights. Furthermore, a methodology for mapping the inspection result onto the 3D digital model and structuring a relational database for managing deterioration information history was proposed. As a result of measuring the labor and time required for safety inspection at the SYG Dam spillway, the drone photogrammetry method was found to have a 48% productivity improvement effect compared to the conventional manpower visual inspection method. The drone photogrammetry-based dam safety inspection is considered very effective in improving work productivity and data reliability.

Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Management of the Underlying Etiologies and Comorbidities of Heart Failure

  • Sang Min Park;Soo Youn Lee;Mi-Hyang Jung;Jong-Chan Youn;Darae Kim;Jae Yeong Cho;Dong-Hyuk Cho;Junho Hyun;Hyun-Jai Cho;Seong-Mi Park;Jin-Oh Choi;Wook-Jin Chung;Seok-Min Kang;Byung-Su Yoo;Committee of Clinical Practice Guidelines, Korean Society of Heart Failure
    • Korean Circulation Journal
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    • v.53 no.7
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    • pp.425-451
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    • 2023
  • Most patients with heart failure (HF) have multiple comorbidities, which impact their quality of life, aggravate HF, and increase mortality. Cardiovascular comorbidities include systemic and pulmonary hypertension, ischemic and valvular heart diseases, and atrial fibrillation. Non-cardiovascular comorbidities include diabetes mellitus (DM), chronic kidney and pulmonary diseases, iron deficiency and anemia, and sleep apnea. In patients with HF with hypertension and left ventricular hypertrophy, renin-angiotensin system inhibitors combined with calcium channel blockers and/or diuretics is an effective treatment regimen. Measurement of pulmonary vascular resistance via right heart catheterization is recommended for patients with HF considered suitable for implantation of mechanical circulatory support devices or as heart transplantation candidates. Coronary angiography remains the gold standard for the diagnosis and reperfusion in patients with HF and angina pectoris refractory to antianginal medications. In patients with HF and atrial fibrillation, longterm anticoagulants are recommended according to the CHA2DS2-VASc scores. Valvular heart diseases should be treated medically and/or surgically. In patients with HF and DM, metformin is relatively safer; thiazolidinediones cause fluid retention and should be avoided in patients with HF and dyspnea. In renal insufficiency, both volume status and cardiac performance are important for therapy guidance. In patients with HF and pulmonary disease, beta-blockers are underused, which may be related to increased mortality. In patients with HF and anemia, iron supplementation can help improve symptoms. In obstructive sleep apnea, continuous positive airway pressure therapy helps avoid severe nocturnal hypoxia. Appropriate management of comorbidities is important for improving clinical outcomes in patients with HF.

Optimization of MRI Protocol for the Musculoskeletal System (근골격계 자기공명영상 프로토콜의 최적화)

  • Hong Seon Lee;Young Han Lee;Inha Jung;Ok Kyu Song;Sungjun Kim;Ho-Taek Song;Jin-Suck Suh
    • Journal of the Korean Society of Radiology
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    • v.81 no.1
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    • pp.21-40
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    • 2020
  • Magnetic resonance imaging (MRI) is an essential modality for the diagnosis of musculoskeletal system defects because of its higher soft-tissue contrast and spatial resolution. With the recent development of MRI-related technology, faster imaging and various image plane reconstructions are possible, enabling better assessment of three-dimensional musculoskeletal anatomy and lesions. Furthermore, the image quality, diagnostic accuracy, and acquisition time depend on the MRI protocol used. Moreover, the protocol affects the efficiency of the MRI scanner. Therefore, it is important for a radiologist to optimize the MRI protocol. In this review, we will provide guidance on patient positioning; selection of the radiofrequency coil, pulse sequences, and imaging planes; and control of MRI parameters to help optimize the MRI protocol for the six major joints of the musculoskeletal system.

Computed Tomography of the Left Atrium and Left Atrial Appendage: A Pictorial Essay on the Anatomy, Normal Variants, and Pathology (좌심방과 좌심방이의 전산화단층촬영 소견: 해부학, 정상변이 및 질환에 관한 임상화보 )

  • Minji Song; Sung Jin Kim;Hyun Jung Koo;Moon Young Kim;Jin Young Yoo
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.272-289
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    • 2020
  • Current advances in CT techniques allow thorough evaluation of the beating heart. The strengths of cardiac CT relative to echocardiography and magnetic resonance imaging are its high availability in most institutions, rapid production of high-quality images, and outstanding delineation of the anatomy. For many normal variants and pathologic conditions, such as thrombi, masses, and congenital abnormalities of the left atrium, CT findings are sufficient to make a presumptive diagnosis. Assessments of the left atrium and left atrial appendage are particularly important for the management of atrial fibrillation, as various catheter-based procedures are aimed at the mechanical and electrical isolation of these structures. CT offers information crucial to a successful catheter-based procedure or surgery. Therefore, a comprehensive review of the geometry (shape, size, and relative position), along with various CT imaging features of pathologic states, should be provided in radiology reports to be of clinical value.

Development of a Synthetic Method for [68Ga]Ga-FAPI-04 Using a Cassette-based Synthesizer (카세트 기반 자동합성장치를 사용한 [68Ga]Ga-FAPI-04의 합성방법 연구)

  • Jun Young PARK;Won Jun KANG
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.1
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    • pp.43-51
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    • 2024
  • [68Ga]Ga-FAPI-04 is a promising radiopharmaceutical that binds specifically to fibroblast activation protein, which is overexpressed in more than 90% of malignant epithelial tumors but not in normal healthy tissue. This study aimed to develop an efficient method for producing 68Ga-labelled FAPI-04 using a cassette-based automated synthesizer. [68Ga]GaCl3 was eluted from an Eckert & Ziegler Medical germanium-68/gallium-68 generator using 2.5 mL of 0.1 M HCl. The synthesis of the [68Ga]Ga-FAPI-04 was performed using different concentrations of HEPES (1~2.5 M; 4-(2-hydroxyethyl) piperazine-1-ethanesulfonic acid) in 3~10 minutes; amounts of FAPI-04 precursor (5~50 ㎍) and reaction temperature (25℃~100℃) were optimized on the BIKBox® synthesizer. The labeling efficiency of [68Ga]Ga-FAPI-04 was greater than 96% (decay corrected) using 25 ㎍ FAPI-04 synthesized in 10 minutes at 100℃ in 2 M HEPES (pH 3.85), and its stability was greater than 99% at 6 hours. The total synthesis time of [68Ga]Ga-FAPI-04 was 32.4 minutes, and the product met all quality control criteria. In this study, we developed and optimized a labeling method using [68Ga]Ga-FAPI-04 using a cassette-based synthesizer. The devised method is expected to be useful for supplying [68Ga]Ga-FAPI-04 for diagnosis in clinical practice.

A Service Life Prediction for Unsound Concrete Under Carbonation Through Probability of Durable Failure (탄산화에 노출된 콘크리트 취약부의 확률론적 내구수명 평가)

  • Kwon, Seung Jun;Park, Sang Soon;Nam, Sang Hyeok;Lho, Byeong Cheol
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.12 no.2
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    • pp.49-58
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    • 2008
  • Generally, steel corrosion occurs in concrete structures due to carbonation in down-town area and underground site and it propagates to degradation of structural performance. In general diagnosis and inspection, only carbonation depth in sound concrete is evaluated but unsound concrete such as joint and cracked area may occur easily in a concrete member due to construction process. In this study, field survey of carbonation for RC columns in down-town area is performed and carbonation depth in joint and cracked concrete including sound area is measured. Probability of durable failure with time is calculated through probability variables such as concrete cover depth and carbonation depth which are obtained from field survey. In addition, service life of the structures is predicted based on the intended probability of durable failure in domestic concrete specification. It is evaluated that in a RC column, various service life is predicted due to local condition and it is rapidly decreased with insufficient cover depth and growth of crack width. It is also evaluated that obtaining cover depth and quality of concrete is very important because the probability of durable failure is closely related with C.O.V. of cover depth.

The Location of Medical Facilities and Its Inhabitants' Efficient Utilization in Kwangju City (광주시(光州市) 의료시설(醫療施設)의 입지(立地)와 주민(住民)의 효율적(效率的) 이용(利用))

  • Jeon, Kyung-Sook
    • Journal of the Korean association of regional geographers
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    • v.3 no.2
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    • pp.163-193
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    • 1997
  • Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

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Evaluation on Usefulness of Stereotactic Radio Surgery using $Fraxion^{(R)}$ System ($Fraxion^{(R)}$ System을 이용한 뇌 정위적 방사선 수술 유용성 평가)

  • Kim, Tae Won;Park, Kwang Woo;Ha, Jin Sook;Jeon, Mi Jin;Cho, Yoon Jin;Kim, Sei Joon;Kim, Jong Dae;Shin, Dong Bong
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.345-354
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    • 2014
  • Purpose : We evaluated the usefulness of $Fraxion^{(R)}$ system and s-thermoplastic mask by analyzing setup error when stereotactic radiousurgery (SRS) was treated for brain metastasis. Materials and Methods : 6 patients who received definite diagnosis as brain metastasis between May 2014 and October 2014 were selected. 3 patients were immobilized s-thermoplastic mask and mouthpiece (group1), while $Fraxion^{(R)}$ system was used for the other 3 patients (group2). Cone Beam Computerized Tomography (CBCT) scan was acquired to register planning CT scan. The registration offset was compared for each group. We compared and reported the errors using maximum, minimum, mean, and standard deviation of registration offsets. Furthermore, We used the same method as patient specific quality assurance to verify absorbed dose of PTV. Results : The setup error which is registration offset was reduced 83% in x, 40% in y, and 92% in z-direction when $Fraxion^{(R)}$ system was used compared to the case of using s-thermoplastic mask and mouthpiece. In addition, using $Fraxion^{(R)}$ system showed improved results in rotational components, pitch (rotation along x-axis), roll (y), and yaw (z) which were reduced 64, 88, and 87% respectively compared to the case of using s-thermoplastic mask and mouthpiece. In dosimetry results, when s-thermoplastic mask and mouthpiece used, absorbed dose was reduce 83% compared to before and after registration. However, using $Fraxion^{(R)}$ system showed only 1.9%. All percentage were calculated with respect to average value. Conclusion : Using $Fraxion^{(R)}$ system including mouthpiece, Fraxion frame, frontpiece, and thermoplastic mask, showed better repeatability and precision compared to using s-thermoplastic mask and mouthpiece, which is consequently considered as more improved immobilization system.