• Journal of the Korean Society of Radiology
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• v.82 no.5
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• pp.1196-1206
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• 2021

Purpose To construct a standard dataset of contrast-enhanced CT images of liver tumors to test the performance and safety of artificial intelligence (AI)-based algorithms for clinical decision support systems (CDSSs). Materials and Methods A consensus group of medical experts in gastrointestinal radiology from four national tertiary institutions discussed the conditions to be included in a standard dataset. Seventy-five cases of hepatocellular carcinoma, 75 cases of metastasis, and 30-50 cases of benign lesions were retrieved from each institution, and the final dataset consisted of 300 cases of hepatocellular carcinoma, 300 cases of metastasis, and 183 cases of benign lesions. Only pathologically confirmed cases of hepatocellular carcinomas and metastases were enrolled. The medical experts retrieved the medical records of the patients and manually labeled the CT images. The CT images were saved as Digital Imaging and Communications in Medicine (DICOM) files. Results The medical experts in gastrointestinal radiology constructed the standard dataset of contrast-enhanced CT images for 783 cases of liver tumors. The performance and safety of the AI algorithm can be evaluated by calculating the sensitivity and specificity for detecting and characterizing the lesions. Conclusion The constructed standard dataset can be utilized for evaluating the machine-learning-based AI algorithm for CDSS.

• Korean Business Review
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• v.17 no.2
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• pp.63-87
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• 2004

To create and maintain comparative supremacy as a strategic tool of business, many organizations have introduced informational technology and system. By using this system, Some companies got a beneficial value for achieving organizational goals but others could not obtain their effectiveness and efficiency. In particular, a lot of organizations that tried to make strategic supremacy with e-commercial trade are under hard condition because of poor profit. It implies that it is essential to identify and analyse the consumer who uses e-commercial trade. This paper, therefore, focusing on internet shopping malls between business and consumer as one of areas of e-commercial trades, shows the difference between consumer expectation and performance. The results of this study are as follows: First, as for the significant difference of influencing factors to consumer satisfactions according to the types of internet shopping malls, there is a meaningful difference in consumer anxiety and internet usefulness, but not in consumer service. Prior to verify the differences in detail on consumer's anxiety and internet usefulness, we examined that there is any difference between expectation and performance. T-test was used for the variants of consumer anxiety and internet usefulness, and its meaningful probability was 0.000, which means that both showed statistically significant difference. Based on the results, we also found that regardless of the types of internet shopping malls, consumer expectation was greater than performance. although the difference between expectation and performance was not equal according to the internet shopping malls. Second, a regression analysis was performed to understand the relation between consumer service, internet usefulness, consumer anxiety, and consumer satisfaction, it was found that consumer service, internet usefulness, consumer anxiety had significantly effected on consumer satisfaction. Third, To verify the relation between consumer satisfaction and repurchase-intentions, intentions to spread out, Pearson correlation analysis was used. it was found that consumer satisfaction had positive effect on both intentions. This study has some limitations because of the shorts of money and time. since the sample of this study was consumers who have ever bought one or more products via internet shopping mall, this sample was appropriate. but the major parts of sample were college students, and the sample size was so small. therefore this results should carefully be generalized. For further study, it is required to select more precise samples and to include more variables.

• Journal of Hospice and Palliative Care
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• v.6 no.1
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• pp.22-33
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• 2003

Purpose : The purpose of this study was to evaluate the present status of patients' satisfaction and the reasons for any satisfaction or dissatisfaction in cancer pain management Methods : A cross-sectional survey was used to obtain the feedback about pain management. The results of the survey were collected from 59 in- or out-patient who had cancer treatment at two of the teaching hospitals in Seoul from July, 2002 to November, 2002. The data was obtained by a structured questionnaire based on the American Cancer Society Patient Outcome Questionnaire(APS-POQ) and other previous research. The clinical information for all patients were compiled by reviewing their medical records. Resuts : 1) The subjects' mean score of the worst pain was 6.77, the average pain score was 3.80, and the pain score after management was 2.93 for the past 24 hours. The mean score of total pain interference was $25.03{\pm}12.82$. Many of the subjects had false beliefs about pain such as 'the experience of pain is a sign that the illness has gotten worse', 'pain medicine should be 'saved' in case the pain gets worse' and 'people get addicted to pain medicine easily'. 2) 66.1% of the subjects were properly medicated with analgesics. 33.9% of the subjects reported use of various methods in controlling pain other than the prescribed medication. Only 33.9% of the subjects had a chance to be educated about pain management by doctors or nurses. 3) The mean score of patients' satisfaction with pain management was $4.19{\pm}1.14$. 72.9% of the subjects answered 'satisfied' with pain management. The reasons for dissatisfaction were 'the pain was not relieved even after the pain management', 'I was not quickly and promptly treated when I complained of pain', 'doctors and nurses didn't pay much attention to my complaints of pain.', and 'there was no appropriate information given on the methods of administration, effect duration and side effects of pain medicine.' The reasons for satisfaction were: 'the pain was relieved after the pain management.', 'doctors and nurses quickly and promptly controlled my pain.', 'doctors and nurses paid enough attention to my complaints of pain.' and 'trust in my physician'. 4) In pain severity or pain interference, no significant difference was found between the satisfied group and dissatisfied group. On the belief 'good patients avoid talking about pain', a significant difference was found between the satisfied group and dissatisfied group. Conclusions : The patients' satisfaction with cancer pain management has increased over the years but still about 30% of patients reported to be 'not satisfied' for various reasons. The results of this study suggest that patients' education should be done to improve satisfaction in the pain management program.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.2
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• pp.137-142
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• 2009

Purpose: This study was performed to find the current problems of positron emission tomography/computed tomography(PET/CT) data on CD for inter-hospital transfer. Materials and Methods: The subjects were 746 consecutive $^{18}F$-fluorodeoxyglucose PET/CT data CDs from 56 hospitals referred to our department for image interpretation. The formats and contents of PET/CT data CDs were reviewed and the email questionnaire survey about this was performed. Results: PET/CT data CDs from 21 of 56 hospitals(37.5%) included all transaxial CT and PET images with DICOM standard format which were required for authentic interpretation. PET/CT data from the others included only secondary capture images or fusion PET/CT images. According to this survey, the main reason of limited PET/CT data on CD for inter-hospital transfer was that the data volume of PET/CT was too large to upload to the Picture Archiving and Communication System. Conclusion: The majority of hospitals provided limited PET/CT data on CD for inter-hospital transfer, which could be inadequate for accurate interpretation and clinical decision making. It is necessary to standardize the format of PET/CT data on CD for inter-hospital transfer including all transaxial CT and PET images with DICOM standard format.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.2
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• pp.116-125
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• 2020

Objectives : Self-poisoning is the leading cause of visits to the emergency departments after a suicide attempts. This study is aimed to compare the patient characteristics according to the category of drugs ingested by the patients who attempted suicide. Methods : All medical charts were retrospectively reviewed from patients who visited the emergency center, at Seoul Medical Center, due to intentional self-poisoning from April of 2011 to July of 2019. We investigated the information regarding the subtype and quantity of the intoxication drug, how it was obtained, suicidal history, and psychiatric history, as well as, sociodemographic information. Variables were compared between prescription drug (PD) and non-prescription drug (NPD) poisoning groups. Results : The mean age of the NPD poisoning group was significantly lower than that of the PD poisoning group. The patient ratio of those enrolled in national health insurance and living with spouses were significantly higher in the NPD poisoning group. Compared to the NPD poisoning group, the PD poisoning group had a higher incidence of mental illnesses, underlying diseases and ratio of involuntary visit to the emergency department. Among the prescription drugs, the benzodiazepine poisoning group had a higher rate of self-prescription than the non-poisoning group, while the zolpidem poisoning group had a higher rate of the using someone else's prescription than other drugs. Each single drug poisoning group (benzodiazepine, zolpidem, and antidepressant single-agent) had a higher rate of no mental illness than each of the mixed-poisoning group. Conclusions : Guidelines for regulating non-prescription drugs are needed as a matter of suicide prevention. Also, this study suggests that clinicians need to be careful when issuing prescriptions and should suicidal risk according to patients' characteristics, duration of follow-up and type of drug packaging.

• Journal of Hospice and Palliative Care
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• v.14 no.3
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• pp.152-162
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• 2011

Purpose: This study was conducted to analyze a trend in studies of hospice care in Korea and to suggest future research directions. Methods: This study analyzed a total of 183 studies related to hospice care which were found at http://www.riss.kr. Results: Of the 183 studies, 62 (33.9%) were for thesis studies for a degree, 121 (66.1%) for academic journals. There were 159 (87.8%) quantitative studies, 18 (8.9%) qualitative studies, and 6 (3.3%) Q-Method studies. The most frequently used study design was a descriptive study. The majority of study participants were terminal cancer patients, patients' family members and health care personnel. The thesis articles were searched by using key words as follows: health, nursing, environment, children's hospice, and others. Conclusion: The number of studies of hospice care has increased, and research key words varied. Furthermore, more experimental research is needed on nursing intervention such as pain relief, alternative therapies and hospice care for children.

• Korean Journal of Clinical Laboratory Science
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• v.49 no.4
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• pp.366-373
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• 2017

Urinalysis is considered to be easier and simpler than other tests. It has been known to cause no burden to patients, while offering important information on diagnosing, treating, and determining the prognoses of kidney and urinary tract diseases. Urinary sediments are usually performed by microscopic examination of centrifuged urine by technologist. The guidelines proposed by the Korean Association of External Quality Assessment Service are actually different from those actually practiced by medical institutions and taught to biomedical students in textbooks. Therefore, we verified whether different sediment preparation methods lead different test results. Specimens that tested positive from the occult blood and leukocyte esterase in the urine dipstick test were randomly selected for a microscopic examination. The differences in the urine sediment preparation affected the sediment concentrations, which influenced the cell grade and cell number per HPF. The first factor in determining the sediment concentration is the centrifugal force. Many medical institutions use 1,500 rpm as the centrifugal speed without considering the radius of the centrifuge; such a value may not be accurate for 400 G. Consequently, there were differences in urine concentrations, which influenced the results. The second factor is the amount of sediment in urine. Different amounts of the remaining supernatant led to different sediment concentration factors, again, causing different results. Furthermore, not only by using a pipette to obtain an accurate amount as stipulated, but also by roughly obtaining a drop, the microscopic examination using such a volume of sediment examined affected the results. Therefore, this study highlights the importance of standardization of urine sediment preparation procedures to promote consistency and accuracy across institutions.

• The Journal of the Korea Contents Association
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• v.15 no.3
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• pp.199-205
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• 2015

This study was conducted with examinees who chose upper gastrointestinography (UGI) among those who visited the hospital for health examination in order to improve the visitors' satisfaction with services. A questionnaire survey was conducted with the examinees, and 147 examinees who visited the hospital during the two months from May 2014 participated in the survey as the subjects of pre education examination while 164 examinees who visited during the months from July 2014 participated as the subjects of post education examination. The pre education subjects were surveyed about anxiety, need of explanation, method of explanation, satisfaction with UGI, etc., and a video was prepared based on the results and provided to the post education subjects and then they were surveyed about change in anxiety, satisfaction with the explanation in the video, helpfulness of the video, intention to watch the video again, etc. In the pre education survey, the average value of anxiety was 2.62, and the need of explanation was 2.52, In addition, 78.2% of the subjects chose guide video as a method of explanation, and satisfaction with UGI was 1.55. In the post education survey, the average value of changed anxiety was 1.45, satisfaction with video explanation was 2.80, helpfulness was 2.79, and intention to watch the video again was 2.80. In the results of T-test between the pre and post education groups, they showed statistically significant in anxiety and satisfaction (p<0.05). Moreover, the findings of this study confirmed that video education and information on UGI provided in advance reduce patients' anxiety and increase their satisfaction with examination.

• Journal of the Korean Society of Radiology
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• v.13 no.5
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• pp.757-763
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• 2019

Recently, Following the recent development of flat panel detector with wide dynamic ranges, increasing numbers of healthcare providers have begun to use digital radiography. As a result, filter thickness standards should be reestablished, as current clinical practice requires the use of thicknesses recommended by the National Council on Radiation Protection and Measurements, which are based on information, acquired using conventional analog systems. Here we investigated the possibility of minimizing dose creep and optimizing patient dose using Al filters in digital radiography. The use of thicker Al filters resulted in a maximum 19.3% reduction in the entrance skin exposure dose when medical images with similar sharpness values were compared. However, resolution, which is a critical factor in imaging, had a significant change of 1.01 lp/mm. This change in resolution is thought to be due to the increased amount of scattered rays generated from the object due to the X-ray beam hardening effect. The increase in the number of scattered rays was verified using the scattering degradation factor. However, the FPD, which has recently been developed and is widely used in various areas, has greater response to radiation than analog devices and has a wide dynamic range. Therefore, the FPD is expected to maintain an appropriate level of resolution corresponding to the increase in the scattered-ray content ratio, which depends on filter thickness. Use of the FPD is also expected to minimize dose creep by reducing the exposure dose.

• Health Policy and Management
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• v.30 no.4
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• pp.479-492
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• 2020

Background: As the prevalence of hypertension is increasing in Korea, the government is seeking policy actions to manage patients with hypertension more efficiently. In this paper, we aimed to identify factors associated with the use of medical care at hospitals among outpatients with hypertension. Methods: We analyzed a total of 15,040 cases of 3,877 outpatients with hypertension obtained from the Korea Medical Panel database from 2010 to 2016. The dependent variable was whether a patient with hypertension visited a hospital or not; and independent variables were the patient's various socio-demographic, health-related, and heath-status characteristics. We conducted a generalized linear mixed model analysis with logit link for all the cases and then conducted it stratified by gender. Results: As a result of a multivariable analysis, women were less likely than to visit at a hospital (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.32-0.61) and people aged 65 years and older than those aged less than 65 years (OR, 0.71; 95% CI, 0.57-0.89). Residents in Busan, Ulsan, and Gyeongnam were more likely than those in than Seoul, Gyeonggi, Incheon, and Jeju to visit a hospital (OR, 1.40; 95% CI, 1.05-1.86). The likelihood of visiting a hospital was high in people belonging to a group of: the highest level of annual household income (OR, 1.73; 95% CI, 1.30-2.29); Medical care aid recipients (OR, 1.94; 95% CI, 1.34-2.83); people having three or more complex chronic diseases (OR, 1.59; 95% CI, 1.19-2.11); people having diabetes (OR, 1.81; 95% CI, 1.41-2.32); or people having ischemic heart disease or cerebrovascular disease (OR, 6.80; 95% CI, 5.28-8.76). Also, we found that factors associated with the use of medical care at hospitals among outpatients with hypertension differed between genders. Conclusion: A variety of factors seem to be associated with the use of medical care at hospitals among outpatients with hypertension. Future research needs to find a way to help patients with hypertension visit an appropriate medical institution between clinics and hospitals.