• Title/Summary/Keyword: Hospital departments

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Interobserver Reproducibility of Segmental Scoring of $^{99m}Tc$-MIBI Myocardial SPECT ($^{99m}Tc$-MIBI 심근 SPECT의 분절 육안 분석시 판독자간의 일치도)

  • Yeo, Jeong-Seok;Lee, Dong-Soo;Lee, Kyung-Han;Kim, Jong-Ho;Shon, Kyung-Soo;Cho, Sung-Wook;Kwark, Cheol-Eun;Chung, June-Key;Lee, Myung-Chul;Seo, Jeong-Don;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.317-325
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    • 1994
  • The accuracy of dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial imaging for detection of ischemia depends on reproducible image interpretation. To evaluate the reproducibility of visual assessment, agreement in interpretation among two independent observers, blind-ed to clinical data, was evaluated in SPECT images of 131 patients (94 males, 38 females; mean age $58{\pm}7yr$) with suspected coronary artery disease who underwent both dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial SPECT and coronary angiography. The left ventricle was divided into twenty-nine segments in stress and rest SPECT images and each segment was visually graded according to a five-point scale (segmental score : 0=normal, 1=equivocal, 2=mild decrease, 3=severe decrease and 4=absent uptake). Overall concordance of segmental scoring between the two observers was 80%. The Pear-son's correlation coefficient (r) of the segmental scores for stress and rest images were 0.67 and 0.65, respectively, while the difference in score between the two images showed a correlation of 0.45 (all p<0.001). Agreement between two observers in final SPECT diagnosis as absence or presence of disease was 93%. The degree of agreement in segmental scoring showed no difference between patients with or without agreement as to the presence of disease. Therefore it appeared that cases with inconcordant diagnosis between the 2 observers were mainly due to a difference in individual threshold for interpretating the significance of a particular decreased uptake area rather than to a difference in perceiving the degree of the hypoactivity Thus, establishment of individual optimum thresholds in visual interpretation of myocardial SPECT may be helpful to improve reproducibility and accuracy of scan diagnosis.

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Exploring Treatment Collaboration Network Characteristics: Focusing on 'A' University Hospital in Seoul (진료 협업 네트워크 특성에 대한 탐색: 서울 소재 A 대학병원 중심으로)

  • Song, Hye Ji;Park, Ji-Hong
    • Journal of the Korean Society for information Management
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    • v.37 no.2
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    • pp.71-93
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    • 2020
  • Today, in order to more effectively cope with the emergence of various diseases and the rapidly-changing medical environment, several medical departments are conducting treatment collaborations within the university hospital. This collaborative care is very important and is already common in the medical field. Nevertheless, there is no research on this, especially how the departments are collaborating. Therefore, the purpose of this study is to investigate how the characteristics of the treatment collaboration networks vary by year and season by exploring the relationship between the medical departments within the university hospital. This study analyzed the collaboration networks of 29 medical departments of 'A' university in Korea by dividing the collaborative care by year and season. Directed networks were constructed in response to departments requesting and departments requested for collaborative care. Betweenness centrality, eigenvector centrality, closeness centrality analysis, ego network analysis, and faction analysis were also conducted. This study performed the first treatment collaboration network analysis among medical departments, and is expected to present new insights into the location and spatial composition of medical departments in consideration of the knowledge transfer paths within medical institutions.

Crush Cytology Features and Differential Diagnosis of Meningiomas and Schwannomas in Central Nervous System (중추신경계 수막종과 신경초종의 압착도말 세포학적 소견 및 감별진단)

  • Kim, Young-Ju;Jeon, Mi-Yeong;Yang, Young-Il;Kim, Chan-Hwan;Yoon, Hae-Kyoung;Khang, Shin-Kwang
    • The Korean Journal of Cytopathology
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    • v.7 no.2
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    • pp.169-176
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    • 1996
  • This study was peformed in order to evaluate the usefulness of the crush cytologic features and differential diagnosis between meningiomas and schwannomas in the central nervous system. Deeply seated and unusually located meningiomas and schwannomas with equivocal or erroneous frozen section diagnosis can be correctly diagnosed cytologically in crush preparations. Twenty-four meningiomas and nine schwannomas were studied by frozen section and crush preparation technique. These tumors displayed distinctive cytologic features. in meningiomas, the tumor tissue fragments were easy to crush, and the tumor cells were arranged in small clusters, flat sheets, papilla-like, whorling pattern or singly. Individual tumor cells displayed round or oval nuclei with finely granular chromatin pattern and inconspicuous small nucleoli. Occasionally psammoma bodies, nuclear pseudoinclusion or nuclear grooves were found. In schwannomas, tissue fragments were hard in consistency and difficult to crush. The crushed tissue presented as thick, irregular fragments with shard borders. The cells showed ill-defined cytoplasm and round, oval, cigar-shaped or curved nuclei. It is important to emphasize that the smear pattern under low-power view and cytologic features are helpful in discriminating between these two tumors.

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Quality of Life in Patients with Stomach Cancer after Operation (위암 수술 환자에서의 삶의 질)

  • Jeon Yang-Whan;Han Sang-Ick;Jeon Chul-Eun;Kim Jin-Jo;Park Seung-Man
    • Journal of Gastric Cancer
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    • v.4 no.1
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    • pp.27-31
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    • 2004
  • Purpose: This study was designed to explore quality of life (QOL) in patients with stomach cancer by using the World Health Organization Quality of Life (WHOQOL) Instrument- Korean version. Materials and Methods: Thirty-one (31) patients with stomach cancer after curative resection were recruited with informed consent. Age- and gender-matched hospital staff served as controls. The 100-item WHOQOL Instrument, including physical domain, psychological domain, social domain, independence domain, environment domain, and spiritual domain, was employed for the all subjects. Results: In patients with stomach cancer after operation, only two domains, physical and independence, were associated with worse quality of life. In those domains, patients with advanced stage, with total gastrectomy, with adjuvant chemotherapy, and early or late postoperative period ($\leqq$2 years or >5 years after operation), could be perceived of having a worse quality of life. Conclusion: Not only scientific objective success but also individual subjective perception of condition could be important for managing patients with stomach carcinomas after curative resection. In this context, the WHOQOL reflecting multi-dimensional state of well being could be a useful tool across a variety of cultural and value systems in the world.

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Evaluation of the Pathogenesis of Tumor Development from Endometriosis by Estrogen Receptor, P53 and Bcl-2 Immunohistochemical Staining

  • Esmaili, Haidarali;Vahedi, Amir;Mohajeri, Shiva;Mostafidi, Elmira;Azimpouran, Mahzad;Behzad, Mohammad Naghavi
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.12
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    • pp.5247-5250
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    • 2016
  • Objective: Endometriosis, one of the most common estrogen dependent gynecological disorders, can present as both benign and malignant disease. The prevalence of tumoral transformation is 0.7-1.6% and the most common tumors are clear cell and endometrioid carcinomas. Unfortunately, the pathogenesis of transformation is unknown. For this purpose, we examined molecular alterations in ovarian endometriosis and endometriosis-associated tumors. Methods: Using the data bank of Alzahra hospital pathology department and paraffin blocks from appropriate cases were identified. Sections were cut and stained for 3 markers: estrogen receptor, P53 and bcl2. Correlations between findings were investigated. Results: Nineteen cases of endometriosis-associated tumor and 19 cases of endometriosis were identified. Staining for bcl2 was documented in 14 of 19 (73.7%) of endometriosis-associated tumor cases and also 7 of 19 (36.8%) endometriosis cases (P=0.02). Only 3 of the 19 (15.8%) endometriosis-associated tumors exhibited positive staining for estrogen receptors, compared with 14 of 19 (73.7%) endometriosis cases (P<0.001). Positive staining for P53 was noted in 5 of 19 (31.6%) endometriosis-associated ovarian tumor samples but was absent in endometriosis samples (0%), (P =0.008). Conclusions: Endometriosis-associated tumors appear to be associated with overexpression of bcl2 and P53 and reduced expression of Estrogen receptor. These finding may help to diagnose tumoral transformation with a background of endometriosis.