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Evaluate Utility of Thyroid Incidentaloma Discrimination by $^{18}F$-FDG PET/CT Delay Scan Images ($^{18}F$-FDG PET/CT검사에서 지연영상을 이용한 갑상선 우연종 감별의 유용성 평가)

  • Lee, Hyun-Kuk;Yang, Seoung-Oh;Song, Gi-Deok;Song, Chi-Ock;Lee, Gi-Heun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.3
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    • pp.184-191
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    • 2008
  • Purpose: To evaluate the degree of malignancy of incident thyroid lesion found in $^{18}F$-FDG PET/CT findings and the usefulness of the method suggested in this study, we applicate the Delay Scan Method that differentiate a false positive benign tumor, inflammation and malignancy, as well as make the criteria of SUV. Materials and Methods: A retrograde study was conducted of 800 patients who were admitted in E hospital to receive $^{18}F$-FDG PET/CT examination. One patient who was diagnosed as primary thyroid cancer and received $^{18}F$-FDG PET/CT examination was excluded. The number of final patients of this study was 799, the reasons of $^{18}F$-FDG PET/CT examination of these patients were follow-up of old cancer or suspicious tumorous lesion in 696 and disease screening in 103. $^{18}F$-FDG PET/CT image photographing was taken in Biograph-Duo made by SIEMENS, after taking normal $^{18}F$-FDG PET/CT image (1 hr) and then 1 hr later we took the thyroid 1 bed-delayed image for the patients who showed abnormal thyroid $^{18}F$-FDG uptake and above 2.0 SUV for 2 minutes every 1 bed. For the patients who showed abnormal thyroid uptake and above 2.0 SUV, 1 hr later, we took a 1 bed-delayed image and then made a comparative study between measured $SUV_{max}$ of 1 hr-abnormal uptake image and that of 2 hr-delayed image. Results and Conclusion: In this $^{18}F$-FDG PET/CT study among the patients who showed incidental $^{18}F$-FDG thyroidal uptake the number of thyroid incidentaloma was 5 (0.63%), all of then showed benign findings. And in the case of incidental $^{18}F$-FDG uptake in thyroid, $SUV_{max}$ variance obtained from 2 hr delayed image can be a indirect criteria in differentiating benign tumor from malignancy and decrease finding error. In the cases found thyroid incidentaloma when 1) $SUV_{max}$ of focal thyroid lesion is above 5.0 and 2) $SUV_{max}$ variance between normal $^{18}F$-FDG PET/CT exam and 2 hr delayed is $1.0{\pm}0.5$, they are suspected as malignancy and confirming biopsy is to be followed. Otherwise, I also think that distinct follow-up PET or CT image study is a reasonable diagnostic method.

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Biological Stream Health and Physico-chemical Characteristics in the Keum-Ho River Watershed (금호강 수계에서 생물학적 하천 건강도 및 이화학적 특성)

  • Kwon, Young-Soo;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
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    • v.39 no.2 s.116
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    • pp.145-156
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    • 2006
  • The objective of this study was to evaluate biological health conditions and physicochemical status using multi-metric models at five sites of the Keum-Ho River during August 2004 and June 2005. The research approach was based on a qualitative habitat evaluation index (QHEI), index of biological integrity (IBI) using fish assemblage, and long-term chemical data (1995 ${\sim}$ 2004), which was obtained from the Ministry of Environment, Korea. For the biological health assessments, regional model of the IBI in Korea (An,2003), was applied for this study. Mean IBI in the river was 30 and varied from 23 to 48 depending on the sampling sites. The river health was judged to be "fair condition", according to the stream health criteria of US EPA (1993) and Barbour et al. (1999). According to the analysis of the chemical water quality data of the river, BOD, COD, conductivity, TP, TN, and TSS largely varied epending on the sampling sites, seasons and years. Variabilities of some parameters including BOD, COD, TP, TN, and conductivity were greater in the downstream than in the upstream reach. This phenomenon was evident in the dilution by the rain during the monsoon. This indicates that precipitation is a very important factor of the chemical variations of water quality. Community analyses showed that species diversity index was highest (H=0.78) in the site 1, while community dominance index was highest in the site 3, where Opsariichthys uncirostris largely dominated. In contrast, the proportions of omnivore and tolerant species were greater in the downstream reach, than in the upstream reach. Overall, this study suggests that some sites in the downstream reach may need to restore the aquatic ecosystem for better biological health.

Parameters Estimation of Clark Model based on Width Function (폭 함수를 기반으로 한 Clark 모형의 매개변수 추정)

  • Park, Sang Hyun;Kim, Joo-Cheol;Jung, Kwansue
    • Journal of Korea Water Resources Association
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    • v.46 no.6
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    • pp.597-611
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    • 2013
  • This paper presents the methodology for construction of time-area curve via the width function and thereby rational estimation of time of concentration and storage coefficient of Clark model within the framework of method of moments. To this end time-area curve is built by rescaling the grid-based width function under the assumption of pure translation and then the analytical expressions for two parameters of Clark model are proposed in terms of method of moments. The methodology in this study based on the analytical expressions mentioned before is compared with both (1) the traditional optimization method of Clark model provided by HEC-1 in which the symmetric time-area curve is used and the difference between observed and simulated hydrographs is minimized (2) and the same optimization method but replacing time-area curve with rescaled width function in respect of peak discharge and time to peak of simulated direct runoff hydrographs and their efficiency coefficient relative to the observed ones. The following points are worth of emphasizing: (1) The optimization method by HEC-1 with rescaled width function among others results in the parameters well reflecting the observed runoff hydrograph with respect to peak discharge coordinates and coefficient of efficiency; (2) For the better application of Clark model it is recommended to use the time-area curve capable of accounting for irregular drainage structure of a river basin such as rescaled width function instead of symmetric time-area curve by HEC-1; (3) Moment-based methodology with rescaled width function developed in this study also gives rise to satisfactory simulation results in terms of peak discharge coordinates and coefficient of efficiency. Especially the mean velocities estimated from this method, characterizing the translation effect of time-area curve, are well consistent with the field surveying results for the points of interest in this study; (4) It is confirmed that the moment-based methodology could be an effective tool for quantitative assessment of translation and storage effects of natural river basin; (5) The runoff hydrographs simulated by the moment-based methodology tend to be more right skewed relative to the observed ones and have lower peaks. It is inferred that this is due to consideration of only one mean velocity in the parameter estimation. Further research is required to combine the hydrodynamic heterogeneity between hillslope and channel network into the construction of time-area curve.

Research on Visitor Behavior and Satisfaction with the Nature Trail in Hallasan National Park (한라산국립공원 자연학습탐방로의 이용행태와 이용객만족에 관한 연구)

  • Kim, Jeong-Min
    • Korean Journal of Environment and Ecology
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    • v.21 no.3
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    • pp.223-234
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    • 2007
  • The study, executed with Hallasan National Park, which deserves to be a typical ecotourism destination, aims to provide basic information on park management for early establishment of ecotourism in a national park by assessing its visitors' behavior and satisfaction with a nature trail established as a series of an environmental interpretation program. The questionnaire survey was conducted at Eorimok Square in the weekday and on the weekend for two months of August and September in 2006, and finally 144 valid samples were used for the analysis. As a result of the research, it revealed that the demographic characteristics of the visitors to Hallasan National Park tended to coincide with those of the visitors to other national parks In Korea. On the whole, it showed their low recognition level of nature trails built up in national parks and less experience in using them. However, the visitors' satisfaction level and intention of re-visit, and recommendation to others were comparatively higher after actually using the nature trail at the site of Hallasan National Park, which hints at the possibility of national parks' much weightier role as the ground for ecology education and the functional expansion of the environmental interpretation-related facilities and programs. As for the attributes having effects on users' satisfaction with a nature trail, substantial aspects such as accessibility, safety, uniqueness and interest in environmental interpretation, and educational quality as well as physical facility management were revealed to have equal effects on users' satisfaction level, so there still remain a lot of pending issues over the reality of national parks in the initial stage of ecotourism staying at the level of the introduction and establishment of the facilities for environmental interpretation. This research had surveyed visitors to Hallasan National Park and limited to the nature trail only. For more systematic and practical ecological management of a national park, the in-depth understanding of the attributes affecting satisfaction of ecotourists, including nature trails and other environmental interpretation programs, and more sophisticated measuring tools are needed.

A Study on the Ecosystem Services Value Assessment According to City Development: In Case of the Busan Eco-Delta City Development (도시개발에 따른 생태계서비스 가치 평가 연구: 부산 에코델타시티 사업을 대상으로)

  • Choi, Jiyoung;Lee, Youngsoo;Lee, Sangdon
    • Journal of Environmental Impact Assessment
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    • v.28 no.5
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    • pp.427-439
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    • 2019
  • Natural environmental ecology ofthe environmental impact assessment(EIA)is very much lacking in quantitative evaluation. Thus, this study attempted to evaluate quantitative assessment for ecosystem service in the site of Eco-delta project in Busan. As a part of climate change adaptation, this study evaluated and compared with the value for carbon fixation and habitat quality using the InVEST model before and after development with three alternatives of land-use change. Carbon fixation showed 216,674.48 Mg of C (year 2000), and 203,474.25 Mg of C (year 2015)reducing about 6.1%, and in the future of year 2030 the value was dropped to 120,490.84 Mg of C which is 40% lower than year 2015. Alternative 3 of land use planning was the best in terms of carbon fixation showing 6,811.31 Mg of C. Habitat quality also changed from 0.57 (year 2000), 0.35 (year 2015), and 0.21 (year 2030) with continued degradation as development goes further. Alternative 3 also was the highest with 0.21(Alternative 1 : 0.20, Alternative 2 : 0.18). In conclusion,this study illustrated that quantitative method forland use change in the process of EIA can helpdecision making for stakeholders anddevelopers with serving the best scenario forlow impact of carbon. Also it can help better for land use plan, greenhouse gas and natural environmental assets in EIA. This study could be able to use in the environmental policy with numerical data of ecosystem and prediction. Supplemented with detailed analysis and accessibility of basic data, this method will make it possible for wide application in the ecosystem evaluation.

Development Process and Methods of Audit and Certification Toolkit for Trustworthy Digital Records Management Agency (신뢰성 있는 전자기록관리기관 감사인증도구 개발에 관한 연구)

  • Rieh, Hae-young;Kim, Ik-han;Yim, Jin-Hee;Shim, Sungbo;Jo, YoonSun;Kim, Hyojin;Woo, Hyunmin
    • The Korean Journal of Archival Studies
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    • no.25
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    • pp.3-46
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    • 2010
  • Digital records management is one whole system in which many social and technical elements are interacting. To maintain the trustworthiness, the repository needs periodical audit and certification. Thus, individual electronic records management agency needs toolkit that can be used to self-evaluate their trustworthiness continuously, and self-assess their atmosphere and system to recognize deficiencies. The purpose of this study is development of self-certification toolkit for repositories, which synthesized and analysed such four international standard and best practices as OAIS Reference Model(ISO 14721), TRAC, DRAMBORA, and the assessment report conducted and published by TNA/UKDA, as well as MoRe2 and current national laws and standards. As this paper describes and demonstrate the development process and the framework of this self-certification toolkit, other electronic records management agencies could follow the process and develop their own toolkit reflecting their situation, and utilize the self-assessment results in-house. As a result of this research, 12 areas for assessment were set, which include (organizational) operation management, classification system and master data management, acquisition, registration and description, storage and preservation, disposal, services, providing finding aids, system management, access control and security, monitoring/audit trail/statistics, and risk management. In each 12 area, the process map or functional charts were drawn and business functions were analyzed, and 54 'evaluation criteria', consisted of main business functional unit in each area were drawn. Under each 'evaluation criteria', 208 'specific evaluation criteria', which supposed to be implementable, measurable, and provable for self-evaluation in each area, were drawn. The audit and certification toolkit developed by this research could be used by digital repositories to conduct periodical self-assessment of the organization, which would be used to supplement any found deficiencies and be used to reflect the organizational development strategy.

Efficacy of Preliminary Magnetic Resonance Imaging Measurement in Ultrasonography-Guided L4 Selective Nerve Root Block (초음파 유도하 요추 4번 선택적 신경근 차단술 시 자기공명영상 계측의 유용성)

  • Shim, Dae Moo;Kweon, Seok Hyun;Cho, Hyung Gyu;Yu, Hyun Kyu;Lim, Kyeong Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.229-236
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    • 2020
  • Purpose: This study examined the utility of preliminary magnetic resonance imaging (MRI) measurements in the ultrasound-guided L4 selective nerve root block. Materials and Methods: As a retrospective study, 71 patients, who met the criteria for outpatient visits from March 2016 to December 2017, were included. From March 2016 to February 2017, 31 patients who underwent an L4 nerve root block without MRI were classified as group A, and 40 patients who underwent an L4 nerve root block through MRI measurements from March 2017 to December 2017 were classified as group B. Group A was injected under ultrasound-guidance through the pararadicular approach without a pre-interventional MRI evaluation, and group B was injected under ultrasound-guidance according to the preliminary MRI measurements. The results were assessed using the numeric rating scale scores before, three hours, and two, six, and 12 weeks after the procedure. Results: At three hours after the procedure, the proportion of patients better than good results were 51.6% in group A and 67.5% in group B. At two weeks after the procedure, the proportion of patients with better than good results were 48.4% and 70.0% in groups A and B, respectively; 58.1% and 62.5% of patient of groups A and B, respectively, showed better than good results after six weeks. In 12 weeks after the procedure, the results of group A and B were 67.7% and 62.5%, respectively. At three hours and two weeks after the procedure, group B showed significant symptom improvement than group A (p<0.05). The procedures were repeated 2.8 and 1.7 times in groups A and B, respectively, between two and six weeks for satisfactory pain relief (p<0.05). Conclusion: A pre-interventional MRI evaluation might improve pain relief within the initial two weeks after ultrasound-guided L4 selective nerve root block by improving the success rate of the procedure.

A Study of Postural Control Characteristics in Schoolchild with Intellectual Disability (초등학교 지적장애아동의 자세조절 특성)

  • Lee, Hyoung Soo
    • 재활복지
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    • v.14 no.3
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    • pp.225-256
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    • 2010
  • This study aims to provide the basic data of the rehabilitation program for the schoolchild with intellectual disability by designing new framework of the features of postural control for the schoolchild with intellectual disability. For this, the study investigated what sensations the schoolchild are using to maintain posture by selectively or synthetically applying vision, vestibular sensation and somato-sensation, and how the coordinative sensory system of the schoolchild is responding to any sway referenced sensory stimulus. The study intended to prove the limitation of motor system in estimating the postural stability by providing the cognitive motor task, and provided the features of postural control of the schoolchild with intellectual disability by measuring the onset times and orders of muscle contraction of neuron-muscle when there is a postural control taking place due to the exterior disturbance. Furthermore, by comparatively analyzing the difference between the normal schoolchild and the intellectually disabled schoolchild, this study provided an optimal direction for treatment planning when the rehabilitation program is applied in the postural control ability training program for the schoolchild with intellectual disability. Taking gender and age into consideration, 52 schoolchild including 26 normal schoolchild and 26 intellectually disabled schoolchild were selected. To measure the features of postural control, CTSIB test, and postural control strategy test were conducted. The result of experiment is as followed. First, the schoolchild with intellectual disability showed different feature in using sensory system to control posture. The normal schoolchild tended to depend on somato-sensory or vision, and showed a stable postural control toward a sway referenced stimulus on somato-sensory system. The schoolchild with intellectual disability tended to use somato-sensory or vision, and showed a very instable postural control toward a sway referenced vision or a sway referenced stimulus on somato-sensory system. In sensory analysis, the schoolchild with intellectual disability showed lower level of proficiency in somato-sensation percentile, vision percentile and vestibular sensation percentile compare to the normal schoolchild. Second, as for the onset times and orders of muscle contraction for strategies of postural control when there is an exterior physical stimulus, the schoolchild with intellectual disability showed a relatively delayed onset time of muscle control, and it was specially greater when the perturbation is from backward. As for the onset orders of muscle contraction, it started from muscles near coax then moved to the muscles near ankle joint, and the numbers and kinds of muscles involved were greater than the normal schoolchild. The normal schoolchild showed a fast muscle contracting reaction from every direction after the perturbation stimulus, and the contraction started from the muscles near the ankle joint and expanded to the muscles near coax. From the results of the experiments, the special feature of the postural control of the schoolchild with intellectual disability is that they have a higher dependence on vision in sensory system, and there was no appropriate integration of swayed sensation observed in upper level of central nerve system. In the motor system, the onset time of muscle contraction for postural control was delayed, and it proceeded in reversed order of the normal schoolchild. Therefore, when use the clinical physical therapy to improve the postural control ability, various sensations should be provided and should train the schoolchild to efficiently use the provided sensations and use the sensory experience recorded in upper level of central nerve system to improve postural control ability. At the same time, a treatment program that can improve the processing ability of central nerve system through meaningful activities with organizing and planning adapting reaction should be provided. Also, a proprioceptive motor control training program that can induce faster muscle contraction reaction and more efficient onset orders from muscularskeletal system is need to be provided as well.

A Preliminary Study on Depressive Symptoms and Glycemic Controls in Diabetic Patients (당뇨병 환자에서의 우울 및 관련증상에 관한 예비적 연구)

  • Ko, Seung-Hyun;Jeong, Jong-Hyun;Hong, Seung-Chul;Han, Jin-Hee;Lee, Seung-Pil;Ahn, Yoo-Bae;Song, Ki-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.2
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    • pp.165-173
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    • 2004
  • Objectives: Diabetes mellitus is a heterogeneous, chronic, progressive disease characterized by hyperglycemia and abnormality in protein, carbohydrate, fat metabolism. Recent studies have reorted two times prevalence of depression in individuals with diabetes compared to individuals without diabetics. This study was designed to investigate glycemic controls, anxiety, alexithymia, stress responses between depressed diabetic patients and non-depressed diabetic patients. Methods The subjects were 60 diabetic patients(mean age : $50.3{\pm}9.7$ years, 31 men and 29 women) who were confirmed to have diabetes depending on the laboratory findings as welt as clinical symptoms at the St. Vincent Hospital Diabetes Clinic, from Mar. 2004 to Sep. 2004. Laboratory test including, blood chemistry. glycated hemoglobin, urinalysis for proteinuria and Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI), Toronto Alexithymia Scale(TAS) and Stress Response Inventory(SRI) were used for assessment. Based on BDI scores, all diabetics were divided into 13 depressed-diabetics group(above 20 point) and 47 non-depressed group(below 20 point). We compared demographic data. glycemic controls, STAI, TAS and SRI scores between two groups by independent t-test. Results : 1) Depressed diabetic groups were 13(mean age : $55.4{\pm}7.2$ years, 7 men and 6 women) and non depressed groups were 47(mean age $48.9{\pm}9.8$ years, 24 men and 23 women). In depressed diabetics, compared with non-depressed group, manifested aged(p=0.031), but other demographic data showed no difference between two groups. 2) No significant differences were noted in FBS, PP2h, Hb A1C, total cholesterol, HDL-cholesterol, SGOT/SGPT, BUN levels between depressed and non-depressed groups. But, blood creatine levels of depressed group were significantly increased than non-depressed group(p=0.026). 3) No significant differences were found in the score of STAI, STAI-S, STAI-T, TAS between depressed and non-depressed groups. 4) The SRI scores of depressed groups were significantly higher than non-depressed groups$(59.7{\pm}24.9\;vs.\;31.5{\pm}22.0)(p=0.000)$. Conclusion : The above results suggest that depressed diabetic patients are have more stress responses and higher blood creatine levels. However, there were no differences in laboratory data related to glycemic controls, and anxiety. alexithymia levels between two groups. We suggest that physicians should consider integrated approaches for psychiatric problems in the management of diabetes.

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Case Analysis of the Promotion Methodologies in the Smart Exhibition Environment (스마트 전시 환경에서 프로모션 적용 사례 및 분석)

  • Moon, Hyun Sil;Kim, Nam Hee;Kim, Jae Kyeong
    • Journal of Intelligence and Information Systems
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    • v.18 no.3
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    • pp.171-183
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    • 2012
  • In the development of technologies, the exhibition industry has received much attention from governments and companies as an important way of marketing activities. Also, the exhibitors have considered the exhibition as new channels of marketing activities. However, the growing size of exhibitions for net square feet and the number of visitors naturally creates the competitive environment for them. Therefore, to make use of the effective marketing tools in these environments, they have planned and implemented many promotion technics. Especially, through smart environment which makes them provide real-time information for visitors, they can implement various kinds of promotion. However, promotions ignoring visitors' various needs and preferences can lose the original purposes and functions of them. That is, as indiscriminate promotions make visitors feel like spam, they can't achieve their purposes. Therefore, they need an approach using STP strategy which segments visitors through right evidences (Segmentation), selects the target visitors (Targeting), and give proper services to them (Positioning). For using STP Strategy in the smart exhibition environment, we consider these characteristics of it. First, an exhibition is defined as market events of a specific duration, which are held at intervals. According to this, exhibitors who plan some promotions should different events and promotions in each exhibition. Therefore, when they adopt traditional STP strategies, a system can provide services using insufficient information and of existing visitors, and should guarantee the performance of it. Second, to segment automatically, cluster analysis which is generally used as data mining technology can be adopted. In the smart exhibition environment, information of visitors can be acquired in real-time. At the same time, services using this information should be also provided in real-time. However, many clustering algorithms have scalability problem which they hardly work on a large database and require for domain knowledge to determine input parameters. Therefore, through selecting a suitable methodology and fitting, it should provide real-time services. Finally, it is needed to make use of data in the smart exhibition environment. As there are useful data such as booth visit records and participation records for events, the STP strategy for the smart exhibition is based on not only demographical segmentation but also behavioral segmentation. Therefore, in this study, we analyze a case of the promotion methodology which exhibitors can provide a differentiated service to segmented visitors in the smart exhibition environment. First, considering characteristics of the smart exhibition environment, we draw evidences of segmentation and fit the clustering methodology for providing real-time services. There are many studies for classify visitors, but we adopt a segmentation methodology based on visitors' behavioral traits. Through the direct observation, Veron and Levasseur classify visitors into four groups to liken visitors' traits to animals (Butterfly, fish, grasshopper, and ant). Especially, because variables of their classification like the number of visits and the average time of a visit can estimate in the smart exhibition environment, it can provide theoretical and practical background for our system. Next, we construct a pilot system which automatically selects suitable visitors along the objectives of promotions and instantly provide promotion messages to them. That is, based on the segmentation of our methodology, our system automatically selects suitable visitors along the characteristics of promotions. We adopt this system to real exhibition environment, and analyze data from results of adaptation. As a result, as we classify visitors into four types through their behavioral pattern in the exhibition, we provide some insights for researchers who build the smart exhibition environment and can gain promotion strategies fitting each cluster. First, visitors of ANT type show high response rate for promotion messages except experience promotion. So they are fascinated by actual profits in exhibition area, and dislike promotions requiring a long time. Contrastively, visitors of GRASSHOPPER type show high response rate only for experience promotion. Second, visitors of FISH type appear favors to coupon and contents promotions. That is, although they don't look in detail, they prefer to obtain further information such as brochure. Especially, exhibitors that want to give much information for limited time should give attention to visitors of this type. Consequently, these promotion strategies are expected to give exhibitors some insights when they plan and organize their activities, and grow the performance of them.