• Title/Summary/Keyword: Clinical standards

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Comparison of Noise and Doses of Low Dose and High Resolution Chest CT for Automatic Tube Current Modulation and Fixed Tube Current Technique using Glass Dosimetry (유리선량계를 이용한 관전류자동조절기법과 고정관전류기법에서 저선량 및 고해상 흉부CT의 노이즈 및 선량 비교)

  • Park, Tae Seok;Han, Jun Hee;Jo, Seung Yeon;Lee, Eun Lim;Jo, Kyu Won;Kweon, Dae Cheol
    • Journal of Radiation Industry
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    • v.11 no.3
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    • pp.131-137
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    • 2017
  • To compare the radiation dose and image noise of low dose computed tomography (CT) and high resolution CT using the fixed tube current technique and automatic tube current modulation (CARE Dose 4D). Chest CT and human anthropomorphic phantom were used the RPL (radiophotoluminescence) dosimeters. For image evaluation, standard deviation of mean CT attenuation coefficient and CT attenuation coefficient was measured using ROI analysis function. The effective dose was calculated using CTDIvol and DLP. CARE Dose 4D was reduced by 74.7% and HRCT by 64.4% compared to the fixed tube current technique in low dose CT of chest phantom. In CTDIvol and DLP, the dose of CARE Dose 4D was reduced by fixed tube current technique. For effective dose, CARE Dose 4D was reduced by 47% and HRCT by 46.9% compared to the fixed tube current method, and the dose of CARE Dose 4D was significantly different (p<.05). Noise in the image was higher than that in the fixed tube current technique. Noise difference in the image of CARE Dose 4D in low dose CT was significant (p<.05). The low radiation dose and the noise difference of the CARE Dose 4D were compared with the fixed tube current technique in low dose CT and HRCT using chest phantom. The radiation doses using CARE Dose 4D were in accordance with the national and international dose standards. CARE Dose 4D should be applied to low dose CT and HRCT for clinical examination.

Clinical study of Chronic Urticaria (만성두드러기에 대한 임상적 고찰)

  • Kim, Hye-Jeong
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.15 no.2
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    • pp.252-260
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    • 2002
  • Introduction Urticaria is widely spread disease. About 15-20 $\%$ of population has experienced at least once in a life time. The etiology of urticaria is uncertain till now, and the affcting factors are various chemical material, physical factors, alcohol, fever, exercise, and hormone, etc. The symptoms of urticaria are small or large wheal-erythema reaction and itching or tingling sense. Cause there is no probe to detect the urticaria clearly, the treatment of urticaria is symptomatic. And mostly urticaria can be chronic and very hard to treat it fundamentally. Nowadays, many trials to treat the urticaria in oriental medical way show good curability. In this paper I'd like to report the treatment rate and degree of urticaria patients mostly using anti-histamine medication. Subjects From the outpatients who visited Korean Hospital of Kyunghee Kangnam during 2000-4 and 2002-1, the 36 chronic urticaria patients, at least more than 4 weeks from onset and 2weeks of treatment period, were chosen. Methods I evaluated the results of treatment with the following scale. Very Good: The all symptoms are clearly disappeared or one third of symptoms remain and sometimes eruption is appeared. Good: Half of the symptoms are improved but most of symptoms remain. No Change: No change appears before and after treatment. Worse: The degree and duration of eruption get worse than pre-treatment state. Results For Acupuncture treatment, I chose the several Acu points like Hapgok(합곡), Taichung(대충), Gokji(곡지), Yanggok(양곡), Yanggea(양계), and lmeup(족임읍), and usually lasted it 15 minutes. With the acupuncture treatment and herb medicine, 2-3 times a week, the patients whose treatment period was 2 to 4 weeks were 17(47.2$\%$), 4 to 8 weeks were 11(30.5$\%$), 8 to 12 weeks were 3(8.3$\%$), 12 to 16 weeks were 3(8.3$\%$), longer than 16 weeks were 2(5.5$\%$) Collecting the statistics of the frequency of prescripted herb medicine, Hyangsosan(향소산) was prescripted 21 times(58.3$\%$), Hyangsapyungwisan(향사평위산) was 15 times(41.6$\%$), Hwapisan(화피산) was 9 times(25$\%$), Yangwitang(양위탕) was 6 times(16.6$\%$), Bojungikkitang(보중익기탕가미) was 4 times(11.1$\%$), Yongdamsagantang (용담사간탕가미) was 4 times(11.1$\%$). The result of the treatments, evaluating with mentioned rate scale, was 11 cases(30.5$\%$) were Very Good degree, 19 cases(52.7$\%$) were Good , 6 cases(16.6$\%$) were No Change. No cases were Worse degree. Conclusion According to this research, we could say that chronic urticaria can be treated with Oriental medical methods. But more precise probes in both Oriental and Western medicine to diagnose the chronic urticaria should be established and we need to make standards for testing and diagnosing the chronic urticaria.

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A Case Study of Health Information Service for Patient Users in Overseas Hospital Libraries (국외 병원도서관에서의 환자이용자를 위한 건강정보서비스 사례연구)

  • Rhee, Hey Young
    • Journal of the Korean BIBLIA Society for library and Information Science
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    • v.30 no.3
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    • pp.195-221
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    • 2019
  • The purpose of this study is to suggest implications from the case of health information service for patients in overseas hospital libraries. A total of 89 overseas hospital libraries were selected, including general hospitals, specialized hospitals, women's hospitals, children's hospitals, and veterans' hospitals. The health information service that is provided in general and common in 89 hospital libraries was surveyed and the differentiated health information service was investigated next. As a result, first, it can be seen that the establishment of hospital libraries and the provision of health information services are common outside of Korea. Second, various human resources such as librarians, health information specialists, medical specialists, social workers, clinical librarians, health education specialists, and volunteers are utilized. Third, it provides not only print materials but also various information sources such as electronic materials, websites, pamphlets, brochures, and provides health information in various languages. Fourth, in providing health (information literacy) education and programs, services are provided through linkage with hospitals, local public libraries, and local communities. The implications for domestic hospital libraries are as follows: First, the change of awareness of the establishment of hospital libraries and the provision of health information services; second, the support of the curriculum and associations and the need for continuing education; third, it is necessary to link with related organizations for mandatory and diversification of health information services in hospital libraries.

The New Understanding of Korean Medicine Practice in Korean Medicine Doctor's Medical Devices Using and Duty of Care (한의사의 의료기기 사용과 주의의무에 있어서 한방의료행위의 새로운 이해)

  • Park, Yong-Sin
    • Journal of Society of Preventive Korean Medicine
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    • v.23 no.2
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    • pp.117-127
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    • 2019
  • Objectives : Korean medicine practice is not specifically described in medical law, and then has always been a quarrel. So far The criteria for judgment in Korean Medicine Doctor's Medical Devices Using should clinically prove it only by Korean medicine theory and academic Traditionally descending from old ancestors. Comprehensively review of Korean Medicine Doctor's Medical Devices Using and Duty of Care, and then present a new understandings to determine future Korean Medicine Practice. Method : An existing court cases of Korean Medicine Doctor's Medical Devices Using and Duty of Care were reviewed. After reviewing various papers published for several years, various opinions were reviewed and suggested. Results : The range of Korean Medicine Doctor's Medical Devices Using has changed since the 1951 National Medical Law stipulated Korean medicine as medical professionals. The issue of the recent ruling that distinguishes medical practice from Korean medicine practice were condensed into what emphasis to interpret amongst 1) The basic principles of learning, 2) Curriculum and professionalism, 3) Risks. The Constitutional Court's ruling was important in order of 'Risk', 'curriculum and expertise', and 'basic principles of learning.' A duty of Care means an obligation to pay attention to something. A duty of Care does not mean a "highest level," but requires a "best care" and does "best under given conditions." Even in the duty of Care, Because Korean medicine has a purpose to protect and promote the health of the people, Some standards of western medicine have to be adapted to the current general medical technology. Korean Medicine doctors can recognize the duty of care in the "some basic range" of knowledge belonging to western medicine. Conclusions : The interpretation of Korean Medicine practice are currently in compatible the argument that should clearly divide Korean medicine from Western medicine, and that should be changed in light of the changing medical environment. Therefore If Korean medicine's standard is applied to the extent to which Korean Medicine doctors are educated, it is necessary to define a new definition to actively interpret Korean Medical practice. The academic basis of Korean medicine and the level of Korean medicine practice based on the books that are traditionally available, and then current textbooks of Korean Medicine College, Korean Medicine Clinical Care Guidelines, and classification of Korean standard medical practices should be standardized. Increasingly, Korean Medicine practice should be interpreted according to reality, focusing on protecting and promoting the health of the people rather than academic differences.

The Necessity of Resetting the Filter Criteria for the Minimization of Dose Creep in Digital Imaging Systems (디지털 영상 시스템에서 선량 크리프 최소화를 위한 부가 필터 두께 권고 기준의 재설정에 대한 연구)

  • Kim, Kyo Tae;Kim, Kum Bae;Kang, Sang Sik;Park, Ji Koon
    • 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.

Current Status and Prospects for Standards, Regulations, and Detection of Probiotic Yogurt: Review (프로바이오틱 요구르트의 기준, 규정, 검출에 관한 현황 및 전망: 총설)

  • Jung-Whan Chon;Kun-Ho Seo;Tae-Jin Kim;Hye-Young Youn;Seok-Hyeong Kang;Won-Uk Hwang;Hajeong Jeong;Dongkwan Jeong;Kwang-Young Song
    • Journal of Dairy Science and Biotechnology
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    • v.41 no.1
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    • pp.9-25
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    • 2023
  • Yogurt fermentation is known to be beneficial because it provides a low pH and harsh environment for foodborne pathogens and improves organoleptic properties. Additionally, organic acids produced through fermentation have a good effect on the viscosity and gelling properties of yogurt. Several potential health benefits of probiotic and generally recognized as safe strains have been suggested. Yogurt is the preferred vehicle for delivering probiotics to health-conscious consumers. Therefore, manufacturers of probiotic beverages must comply with the relevant regulations. The development of probiotic yogurt begins with the selection of strains with safety and functional properties of probiotics. The selected probiotic strain should be technically suitable for viability and improve organoleptic quality while maintaining the number of bacteria above the standard value during processing and storage conditions. In addition, the efficacy of probiotic strains contained in yogurt should be investigated, confirmed, and approved according to well-designed clinical trials. Although various methods are used to detect probiotic strains, the recently widely used next generation sequencing method can be actively utilized. In the future, more research should be conducted with the latest methods to identify probiotic functions and accurately detect probiotic strains.

Considerations for Implementing Online Art-Based Peer Supervision (온라인 미술기반 동료 슈퍼비전 실행에 대한 고려사항)

  • Yoon, Ra-Mi;Kim, Soo-In;Jung, HeeJae
    • The Journal of the Korea Contents Association
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    • v.22 no.5
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    • pp.404-415
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    • 2022
  • The purpose of this study is to propose considerations to help actual application based on the characteristics of the online art-based peer supervision execution process. Colleagues in the clinical art therapy doctoral program, including the researcher, attempted to repeatedly identify problems and apply improvements in the implementation process as research participants, and qualitatively analyzed the various data collected in the process. Looking at the characteristics of the analysis results, extensibility of materials and space was confirmed in terms of 'art-based' and initiative, convenience, and speed in terms of 'online'. The considerations identified through this are as follows. First, 'pre-structuring' should be based on clear boundaries and setting, prior consultation of the group, and self-directed preparation and attitude. Second, for the 'structural aspect of art', space and media to help immersion through creation, and stable implementation structure should be established. Third, in the 'technical aspect', it is necessary to apply a method that can deliver a work of art and a method that can communicate the creator's clear intention. Lastly, for the 'ethical aspect', it is necessary to use online software in accordance with the minimum security standards and to make efforts to repeatedly maintain confidentiality. This study is meaningful in that it suggested a practical method for maintaining the professional competence of art therapists and expanding networks among art therapists in various situations including pandemics.

erratum : A Study on Developing Safety and Performance Assessment Guideline for Electronic Warm-Acupuncture Apparatus (erratum : 전기식 온침기에 대한 안전성 및 성능평가 가이드라인 개발 연구)

  • Hansol Jang;U-Ryeong Chung;Jeong-Hyun Moon;Seong-Kyeong Choi;Won-Suk Sung;Min-Seop Hwang;Seung-Deok Lee;Kyung-Ho Kim;Jong-Hwa Yoon;Eun-Jung Kim
    • The Journal of Korean Medicine
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    • v.44 no.1
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    • pp.128-128
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    • 2023
  • Objectives: This research aimed to develop a guideline for evaluating safety and performance of electronic warm-acupuncture apparatus. With the development of medical devices like electronic warm-acupuncture apparatus with improved performance, convenience and safety measures compared to traditional warm-acupuncture needling, safety and performance guideline is a necessity. Methods: By referring to existing standards and guidelines of other electronic devices for Korean medicine with heating function, guideline for safety and performance assessment of electronic warm-acupuncture apparatus was drafted Results: The guideline, presents explanation for adequate temperature and settings of the apparatus, and safety measurements providing against thermal runaway situations along with guidelines for the manual. Guideline for detailed test method for the performance of the apparatus such as accuracy of temperature increase and the timer, and safety unit was also provided. The test items and suggested test methods for the requirements of biological, electrical and electromagnetic safety were referred to Korean approval documents of ministry of Food and Drug Safety. Conclusion: We proposed the relevant items to verify performance and safety of warm-acupuncture apparatus to assure patient safety and improve the quality of currently developing devices for application in clinical field.

Developing the speech screening test for 4-year-old children and application of Korean speech sound analysis tool (KSAT) (4세 말소리발달 선별검사 개발과 한국어말소리분석도구(Korean Speech Sound Analysis Tool, KSAT)의 활용)

  • Soo-Jin Kim;Ki-Wan Jang;Moon-Soo Chang
    • Phonetics and Speech Sciences
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    • v.16 no.1
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    • pp.49-55
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    • 2024
  • This study aims to develop a three-sentence speech screening test to evaluate speech development in 4-year-old children and provide standards for comparison with peers. Screening tests were conducted on 24 children each in the first and second halves of 4 years old. The screening test results showed a correlation of .7 with the existing speech disorder evaluation test results. We compared whether there was a difference between the two groups of 4-year-old in the phonological development indicators and error patterns obtained through the screening test. The developmental indicators of the children in the second half were high, but there were no statistically significant differences. The Korean Speech Sound Analysis Tool (KSAT) was used for all analyses, and the automatic analysis results and contents of the clinician's manual analysis were compared. The degree of agreement between the automatic and manual error pattern analyses was 93.63%. The significance of this study is that the standard of speech of a 4-year-old child of the speech screening test according to three sentences at the level of elicited sentences, and the applicability of the KSAT were reviewed in both clinical and research fields.

Interpretation of Complete Tumor Response on MRI Following Chemoradiotherapy of Rectal Cancer: Inter-Reader Agreement and Associated Factors in Multi-Center Clinical Practice

  • Hae Young Kim;Seung Hyun Cho;Jong Keon Jang;Bohyun Kim;Chul-min Lee;Joon Seok Lim;Sung Kyoung Moon;Soon Nam Oh;Nieun Seo;Seong Ho Park
    • Korean Journal of Radiology
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    • v.25 no.4
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    • pp.351-362
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    • 2024
  • Objective: To measure inter-reader agreement and identify associated factors in interpreting complete response (CR) on magnetic resonance imaging (MRI) following chemoradiotherapy (CRT) for rectal cancer. Materials and Methods: This retrospective study involved 10 readers from seven hospitals with experience of 80-10210 cases, and 149 patients who underwent surgery after CRT for rectal cancer. Using MRI-based tumor regression grading (mrTRG) and methods employed in daily practice, the readers independently assessed mrTRG, CR on T2-weighted images (T2WI) denoted as mrCRT2W, and CR on all images including diffusion-weighted images (DWI) denoted as mrCRoverall. The readers described their interpretation patterns and how they utilized DWI. Inter-reader agreement was measured using multi-rater kappa, and associated factors were analyzed using multivariable regression. Correlation between sensitivity and specificity of each reader was analyzed using Spearman coefficient. Results: The mrCRT2W and mrCRoverall rates varied widely among the readers, ranging 18.8%-40.3% and 18.1%-34.9%, respectively. Nine readers used DWI as a supplement sequence, which modified interpretations on T2WI in 2.7% of cases (36/1341 [149 patients × 9 readers]) and mostly (33/36) changed mrCRT2W to non-mrCRoverall. The kappa values for mrTRG, mrCRT2W, and mrCRoverall were 0.56 (95% confidence interval: 0.49, 0.62), 0.55 (0.52, 0.57), and 0.54 (0.51, 0.57), respectively. No use of rectal gel, larger initial tumor size, and higher initial cT stage exhibited significant association with a higher interreader agreement for assessing mrCRoverall (P ≤ 0.042). Strong negative correlations were observed between the sensitivity and specificity of individual readers (coefficient, -0.718 to -0.963; P ≤ 0.019). Conclusion: Inter-reader agreement was moderate for assessing CR on post-CRT MRI. Readers' varying standards on MRI interpretation (i.e., threshold effect), along with the use of rectal gel, initial tumor size, and initial cT stage, were significant factors associated with inter-reader agreement.