• Tuberculosis and Respiratory Diseases
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• v.50 no.2
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• pp.222-228
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• 2001

Backgrounds : Recent technological developments have introduced a new method to identifying M. tuberculosis complex DNA in clinical samples directly. The direct amplification test (DAT) is approved for identifying M. tuberculosis complex in respiratory specimens that are smear-positive for acid-fast bacilli (AFB). When there is a discrepancy between the AFB smear and DAT, no information on their clinical utility is currently available. In this study, the diagnostic reliability of DAT was investigated in suspected pulmonary tuberculosis patients whose sputum AFB smear was negative. Methods : From June 1, 1998 through May 30, 1999, 909 patients with presumed active pulmonary tuberculosis were enrolled. A sputum AFB stain, culture, DAT and/or biopsy were performed. Using the criteria of clinical tuberculosis or confirmed tuberculosis, the positive predictive value of DAT in diagnosing pulmonary tuberculosis was investigated. Results : The positive predictive value of DAT was 82.1% by the clinically active tuberculosis criteria. However, it decreased to 61.5% when diagnosis was restricted to only to culture positive or biopsy proven cases. The false positive rate of DAT was 18.0%. Conclusion : The DAT is a valuable diagnostic method in suspected patients whose sputum AFB is was negative.

• Progress in Medical Physics
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• v.24 no.4
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• pp.237-242
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• 2013

In the intracranial regions, an accurate delineation of the target volume has been difficult with only the CT data due to poor soft tissue contrast of CT images. Therefore, the magnetic resonance images (MRI) for the delineation of the target volumes were widely used. To calculate dose distributions with MRI-based RTP, the electron density (ED) mapping concept from the diagnostic CT images and the pseudo CT concept from the MRI were introduced. In this study, the look up table (LUT) from the fifteen patients' diagnostic brain MRI images was created to verify the feasibility of MRI-based RTP. The dose distributions from the MRI-based calculations were compared to the original CT-based calculation. One MRI set has ED information from LUT (lMRI). Another set was generated with voxel values assigned with a homogeneous density of water (wMRI). A simple plan with a single anterior 6MV one portal was applied to the CT, lMRI, and wMRI. Depending on the patient's target geometry for the 3D conformal plan, 6MV photon beams and from two to five gantry portals were used. The differences of the dose distribution and DVH between the lMRI based and CT-based plan were smaller than the wMRI-based plan. The dose difference of wMRI vs. lMRI was measured as 91 cGy vs. 57 cGy at maximum dose, 74 cGt vs. 42 cGy at mean dose, and 94 cGy vs. 53 at minimum dose. The differences of maximum dose, minimum dose, and mean dose of the wMRI-based plan were lower than the lMRI-based plan, because the air cavity was not calculated in the wMRI-based plan. These results prove the feasibility of the lMRI-based planning for brain tumor radiation therapy.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.7
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• pp.1-8
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• 2017

As the IT environment becomes more sophisticated, various threats and their associated serious risks are increasing. Threats such as DDoS attacks, malware, worms, and APT attacks can be a very serious risk to enterprises and must be efficiently managed in a timely manner. Therefore, the government has designated the important system as the main information communication infrastructure in consideration of the impact on the national security and the economic society according to the 'Information and Communication Infrastructure Protection Act', which, in particular, protects the main information communication infrastructure from cyber infringement. In addition, it conducts management supervision such as analysis and evaluation of vulnerability, establishment of protection measures, implementation of protection measures, and distribution of technology guides. Even now, security consulting is proceeding on the basis of 'Guidance for Evaluation of Technical Vulnerability Analysis of Major IT Infrastructure Facilities'. There are neglected inspection items in the applied items, and the vulnerability of APT attack, malicious code, and risk are present issues that are neglected. In order to eliminate the actual security risk, the security manager has arranged the inspection and ordered the special company. In other words, it is difficult to check against current hacking or vulnerability through current system vulnerability checking method. In this paper, we propose an efficient method for extracting diagnostic data regarding the necessity of upgrading system vulnerability check, a check item that does not reflect recent trends, a technical check case for latest intrusion technique, a related study on security threats and requirements. Based on this, we investigate the security vulnerability management system and vulnerability list of domestic and foreign countries, propose effective security vulnerability management system, and propose further study to improve overseas vulnerability diagnosis items so that they can be related to domestic vulnerability items.

• Journal of Global Scholars of Marketing Science
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• v.18 no.1
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• pp.33-58
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• 2008

Previous research has presupposed that the evaluation of consumer who received any recovery after experiencing product failure should be better than the evaluation of consumer who did not receive any recovery. The major purposes of this article are to examine impacts of product defect failures rather than service failures, and to explore effects of recovery on postrecovery product attitudes. First, this article deals with the occurrence of severe and unsevere failure and corresponding service recovery toward tangible products rather than intangible services. Contrary to intangible services, purchase and usage are separable for tangible products. This difference makes it clear that executing an recovery strategy toward tangible products is not plausible right after consumers find out product failures. The consumers may think about backgrounds and causes for the unpleasant events during the time gap between product failure and recovery. The deliberation may dilutes positive effects of recovery efforts. The recovery strategies which are provided to consumers experiencing product failures can be classified into three types. A recovery strategy can be implemented to provide consumers with a new product replacing the old defective product, a complimentary product for free, a discount at the time of the failure incident, or a coupon that can be used on the next visit. This strategy is defined as "a rewarding effort." Meanwhile a product failure may arise in exchange for its benefit. Then the product provider can suggest a detail explanation that the defect is hard to escape since it relates highly to the specific advantage to the product. The strategy may be called as "a strengthening effort." Another possible strategy is to recover negative attitude toward own brand by giving prominence to the disadvantages of a competing brand rather than the advantages of its own brand. The strategy is reflected as "a weakening effort." This paper emphasizes that, in order to confirm its effectiveness, a recovery strategy should be compared to being nothing done in response to the product failure. So the three types of recovery efforts is discussed in comparison to the situation involving no recovery effort. The strengthening strategy is to claim high relatedness of the product failure with another advantage, and expects the two-sidedness to ease consumers' complaints. The weakening strategy is to emphasize non-aversiveness of product failure, even if consumers choose another competitive brand. The two strategies can be effective in restoring to the original state, by providing plausible motives to accept the condition of product failure or by informing consumers of non-responsibility in the failure case. However the two may be less effective strategies than the rewarding strategy, since it tries to take care of the rehabilitation needs of consumers. Especially, the relative effect between the strengthening effort and the weakening effort may differ in terms of the severity of the product failure. A consumer who realizes a highly severe failure is likely to attach importance to the property which caused the failure. This implies that the strengthening effort would be less effective under the condition of high product severity. Meanwhile, the failing property is not diagnostic information in the condition of low failure severity. Consumers would not pay attention to non-diagnostic information, and with which they are not likely to change their attitudes. This implies that the strengthening effort would be more effective under the condition of low product severity. A 2 (product failure severity: high or low) X 4 (recovery strategies: rewarding, strengthening, weakening, or doing nothing) between-subjects design was employed. The particular levels of product failure severity and the types of recovery strategies were determined after a series of expert interviews. The dependent variable was product attitude after the recovery effort was provided. Subjects were 284 consumers who had an experience of cosmetics. Subjects were first given a product failure scenario and were asked to rate the comprehensibility of the failure scenario, the probability of raising complaints against the failure, and the subjective severity of the failure. After a recovery scenario was presented, its comprehensibility and overall evaluation were measured. The subjects assigned to the condition of no recovery effort were exposed to a short news article on the cosmetic industry. Next, subjects answered filler questions: 42 items of the need for cognitive closure and 16 items of need-to-evaluate. In the succeeding page a subject's product attitude was measured on an five-item, six-point scale, and a subject's repurchase intention on an three-item, six-point scale. After demographic variables of age and sex were asked, ten items of the subject's objective knowledge was checked. The results showed that the subjects formed more favorable evaluations after receiving rewarding efforts than after receiving either strengthening or weakening efforts. This is consistent with Hoffman, Kelley, and Rotalsky (1995) in that a tangible service recovery could be more effective that intangible efforts. Strengthening and weakening efforts also were effective compared to no recovery effort. So we found that generally any recovery increased products attitudes. The results hint us that a recovery strategy such as strengthening or weakening efforts, although it does not contain a specific reward, may have an effect on consumers experiencing severe unsatisfaction and strong complaint. Meanwhile, strengthening and weakening efforts were not expected to increase product attitudes under the condition of low severity of product failure. We can conclude that only a physical recovery effort may be recognized favorably as a firm's willingness to recover its fault by consumers experiencing low involvements. Results of the present experiment are explained in terms of the attribution theory. This article has a limitation that it utilized fictitious scenarios. Future research deserves to test a realistic effect of recovery for actual consumers. Recovery involves a direct, firsthand experience of ex-users. Recovery does not apply to non-users. The experience of receiving recovery efforts can be relatively more salient and accessible for the ex-users than for non-users. A recovery effort might be more likely to improve product attitude for the ex-users than for non-users. Also the present experiment did not include consumers who did not have an experience of the products and who did not perceive the occurrence of product failure. For the non-users and the ignorant consumers, the recovery efforts might lead to decreased product attitude and purchase intention. This is because the recovery trials may give an opportunity for them to notice the product failure.

• Journal of the Institute of Electronics and Information Engineers
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• v.53 no.12
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• pp.131-138
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• 2016

In this study, we tried to analyze the influence of ICM(Iodinated Contrast Media) in MR imaging compare to GBCA(Gadolinium Based Contrast Agent), and as this result we discussed whether resonable or not the protocol which is MRI scan after enhanced CT scan without proper time interval in clinical field. For this research, we assembled two phantoms. which one was iodine and another one was gadolinium. We did test two phantoms in conventional MRI scan which is T1, T2, T2 FLAIR and 3D angio. After that, quantitative analysis was progressed. The results of study were as follow : SSI(Saline's Signal Intensity) was shown as each sequences 175, 1231, 333, 37 [a.u] at iodine. and 1297, 123, 757, 232 [a.u] was recorded at gadolinium. BDEPS(the Biggest Difference of EPS) was shown as each sequences 1297, 123, 757, 232 [a.u] at iodine and 793, 6, 1495, 365 [a.u] was recorded at gadolinium. At this time, EPS(Enhancement Percentage to Saline) was shown 641.1, -90.0, 127.3, 527% at iodine and 685.1, 99.4, 365.7, 1077.4% was recorded at gadolinium. BP(BDEPS's point) was shown 900, 900, 477, 900 mmol at iodine and 4, 0.2, 0.2, 40 mmol was recorded at gadolinium. CPSS(Change Point of SI to SSI) was shown 63, 423, 63, 29 mmol at iodine and each [50, 30], [4, 0.2], [4, 1], 0.2 mmol was recorded at gadolinium. According to this research, we could not only discover the fact that was iodine could effect on MR signal, but also the pattern is different as various sequences compare to gadolinium. Therefore, we expect useful diagnostic MR image in clinical field with this quantitative data for deciding protocol regarding MRI and CT scan order.

• Radiation Oncology Journal
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• v.18 no.1
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• pp.67-72
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• 2000

Background :The authors have developed a Digital image chart(DIC) and digital Radiotherapy Record System (DRRS). We have evaluated the DIC and DRRS for reliability, usefulness, ease of use, and efficiency. Materials and Methods :The basic design of the DIC and DRRS was to build an digital image database of radiation therapy Patient records for a more efficient and timely flow of critical image information throughout the department. This system is a submit of comprehensive radiation oncology management system (C-ROMS) and composed of a picture archiving and communication system (PACS), a radiotherapy information database, and a radiotherapy imaging database. The DIC and DRRS were programmed using Delphi under a Windows 95 environment and is capable of displaying the digital images of patients identification photos, simulation films, radiotherapy setup, diagnostic radiology images, gross lesion Photos, and radiotherapy Planning isodose charts with beam arrangements. Twenty-three clients in the department are connected by Ethernet (10 Mbps) to the central image server (Sun Ultra-sparc 1 workstation). Results :From the introduction of this system in February 1998 through December 1999, we have accumulated a total of 15,732 individual images for 2,556 patients. We can organize radiation therapy in a 'paperless' environment in 120 patients with breast cancer. Using this system, we have succeeded in the prompt, accurate, and simultaneous access to patient care information from multiple locations throughout the department. This coordination has resulted in improved operational efficiency within the department. Conclusion :The authors believe that the DIC and DRRS has contributed to the improvement of radiation oncology department efficacy as well as to time and resource savings by providing necessary visual information throughout the department conveniently and simultaneously. As a result, we can also achieve the 'paperless' and 'filmless' practice of radiation oncology with this system.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.18 no.1
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• pp.10-15
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• 2007

Probably the three most important components to a comprehensive evaluation of patients with attention-deficit hyperactivity disorder (ADHD) are the clinical interview, the medical examination, and the completion and scoring or behavior rating scales. Teachers and other school personnel are often the first to recognize that a child or adolescent might have ADHD, and often play an important role in the help-seeking/referral process. A diagnostic evaluation for ADHD should include questions about ADHD symptoms, other problems including alcohol and drug use, family history of ADHD, prior evaluation and treatment for ADHD. Screening interview or rating scales as well as interviews should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with objective assessments of the ADHD symptoms, such as psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but they may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. Screening for intellectual ability and academic achievement skills is also important in determining the presence of comorbid developmental delay or loaming disabilities. The number and type of symptoms required for a diagnosis of ADHD vary depending on the specific subtype. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in daily functioning, and must not meet criteria for other mental disorders which might better account for the observed symptoms such as mental retardation, autism or other pervasive developmental disorders, mood disorders, anxiety disorders. This report aims to suggest a practice guideline of assessment and diagnosis for children and adolescents with ADHD in Korea.

• Quality Improvement in Health Care
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• v.3 no.2
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• pp.86-97
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• 1997

Background : It is a primary goal for hospital personnel to improve the quality of patient care. In Korea the concept of quality assurance has been spread over the last five years. Many hospitals have implemented quality assurance programs that fit their own philosophy and needs. As a result, they are supposed to have different experiences and attitudes toward quality assurance. To investigate their diversity will be helpful to have a direction to the future and to enhance the quality assurance activities in Korean hospitals. Objectives : The aim of this study is to obtain information about hospital personnel's attitude and opinion toward quality assurance in hospitals. Methods : A questionnaire was developed which consisted of five parts; the general characteristics of respondent, the concepts of quality assurance, need for quality assurance program, current status of quality improvement activities, and participation in programs. Using the registry of Korean hospitals, 102 hospitals with more than 400 beds were selected. Questionnaires were mailed to hospital staffs of each hospital; top managers, clinical department heads, registered nurses, medical recorders, and administrators. Results : Of 2038 questionnaires sent, 877 were returned, giving response rate of 44%. Most respondents(70%) regarded quality assurance as efforts to provide patient with care in highest quality and to improve effectiveness or resource utilization. Ninety-nine percent of respondents agreed to need for quality assurance in their hospitals. There were current quality improvement programs implemented in the department of 553 respondents(62%), and most of the(85%) have participated in at least one program. Lack of motivation was pointed out as a barrier to implement the programs. Conclusion : Although most respondents have known of the concept and need for quality assurance, this study suggests that education and motivation of hospital personnel be needed to activate the quality assurance programs in hospitals.

• Annals of Clinical Neurophysiology
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• v.12 no.2
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• pp.61-65
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• 2010

Background: Orthostatic hypotension (OH) refers to a fall in systolic blood pressure (BP) of 20 mmHg or more, or in diastolic BP of 10 mm Hg or more within 3 minutes of standing up. The head-up tilt test (HUT) is the most useful, but potentially invasive test for the diagnosis of OH. The purpose of this study was to identify the usefulness of spontaneous baroreflex sensitivity (sBRS). Methods: Ninety one patients with orthostatic intolerance, in whom the HUT data were available, were included in the study. Patients were classified into HUT-positive (group I) and HUT-negative (group II) group. Twenty five healthy volunteers served as normal controls, and were designated as group III. In all subjects, beat-to-beat BP and heart rate were recorded using BeatScope 1.1a. We collected the 50 sBRS data in each patient in a supine position. The average value of one to ten of 50 sBRS data was defined as sBRS10, one to twenty as sBRS20, one to thirty as sBRS 30, one to forty as sBRS 40, and one to fifty as sBRS 50. Differences in sBRS10 and sBRS50 levels were statistically analyzed and compared between groups I, II, and III. Results: No significant difference in the sBRS50 level was found between Groups II and III. sBRS50 was significantly lower in Group I than in Groups II and III (p<0.05), and the same pattern of differences was observed for sBRS40, sBRS30, sBRS20, and sBRS10. Conclusions: Patients with OH showed significantly lower sBRS levels than HUT-negative patients or normal controls. Our study implies that a supine-position sBRS would provide additional diagnostic information for OH.

• KIPS Transactions on Software and Data Engineering
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• v.9 no.3
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• pp.101-108
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• 2020

Since the performance of deep learning techniques has recently been proven in the field of image processing, there are many attempts to perform classification, analysis, and detection of images using such techniques in various fields. Among them, the expectation of medical image analysis software, which can serve as a medical diagnostic assistant, is increasing. In this study, we are attention to the capsule endoscope image, which has a large data set and takes a long time to judge. The purpose of this paper is to distinguish the gastrointestinal landmarks and to estimate the gastrointestinal transition location that are common to all patients in the judging of capsule endoscopy and take a lot of time. To do this, we designed CNN-based Classifier that can identify gastrointestinal landmarks, and used it to estimate the gastrointestinal transition location by filtering the results. Then, we estimate gastrointestinal transition location about seven of eight patients entered the suspected gastrointestinal transition area. In the case of change from the stomach to the small intestine(pylorus), and change from the small intestine to the large intestine(ileocecal valve), we can check all eight patients were found to be in the suspected gastrointestinal transition area. we can found suspected gastrointestinal transition area in the range of 100 frames, and if the reader plays images at 10 frames per second, the gastrointestinal transition could be found in 10 seconds.