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Automated Measurement of Native T1 and Extracellular Volume Fraction in Cardiac Magnetic Resonance Imaging Using a Commercially Available Deep Learning Algorithm

  • Suyon Chang;Kyunghwa Han;Suji Lee;Young Joong Yang;Pan Ki Kim;Byoung Wook Choi;Young Joo Suh
    • Korean Journal of Radiology
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    • v.23 no.12
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    • pp.1251-1259
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    • 2022
  • Objective: T1 mapping provides valuable information regarding cardiomyopathies. Manual drawing is time consuming and prone to subjective errors. Therefore, this study aimed to test a DL algorithm for the automated measurement of native T1 and extracellular volume (ECV) fractions in cardiac magnetic resonance (CMR) imaging with a temporally separated dataset. Materials and Methods: CMR images obtained for 95 participants (mean age ± standard deviation, 54.5 ± 15.2 years), including 36 left ventricular hypertrophy (12 hypertrophic cardiomyopathy, 12 Fabry disease, and 12 amyloidosis), 32 dilated cardiomyopathy, and 27 healthy volunteers, were included. A commercial deep learning (DL) algorithm based on 2D U-net (Myomics-T1 software, version 1.0.0) was used for the automated analysis of T1 maps. Four radiologists, as study readers, performed manual analysis. The reference standard was the consensus result of the manual analysis by two additional expert readers. The segmentation performance of the DL algorithm and the correlation and agreement between the automated measurement and the reference standard were assessed. Interobserver agreement among the four radiologists was analyzed. Results: DL successfully segmented the myocardium in 99.3% of slices in the native T1 map and 89.8% of slices in the post-T1 map with Dice similarity coefficients of 0.86 ± 0.05 and 0.74 ± 0.17, respectively. Native T1 and ECV showed strong correlation and agreement between DL and the reference: for T1, r = 0.967 (95% confidence interval [CI], 0.951-0.978) and bias of 9.5 msec (95% limits of agreement [LOA], -23.6-42.6 msec); for ECV, r = 0.987 (95% CI, 0.980-0.991) and bias of 0.7% (95% LOA, -2.8%-4.2%) on per-subject basis. Agreements between DL and each of the four radiologists were excellent (intraclass correlation coefficient [ICC] of 0.98-0.99 for both native T1 and ECV), comparable to the pairwise agreement between the radiologists (ICC of 0.97-1.00 and 0.99-1.00 for native T1 and ECV, respectively). Conclusion: The DL algorithm allowed automated T1 and ECV measurements comparable to those of radiologists.

Sharing Experiences in Selecting Clinical Outcome and Approving Validated Questionnaires : Insights from an Elderly Registry Study (노인등록연구 사례를 통한 임상평가지표 선정 과정 및 검증된 설문도구 승인 경험의 공유)

  • Nahyun Cho;Hyungsun Jun;Won-Bae Ha;Junghan Lee;Mi Mi Ko;Young-Eun Kim;Jeeyoun Jung;Jungtae Leem
    • The Journal of Korean Medicine
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    • v.45 no.1
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    • pp.17-43
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    • 2024
  • Objectives: Underpinned by the context of a Korean traditional medicine cohort study on healthy aging, this research primarily aims to guide the selection of Clinical Outcome Assessments (COAs) for elderly healthy aging patient registry research, offering insights into the selection process; and secondly, to streamline the resource-intensive process of obtaining permissions for validated COAs, benefiting future traditional Korean medicine clinical researchers. Methods : In this study, we identified outcomes through a review of previous studies, followed by a process involving expert consultations to select the final outcomes. Subsequently, for the selected outcomes that were Clinical Outcome Assessments (COAs) developed tools, we searched in commercial databases to confirm the availability of Korean versions and the necessity of obtaining permissions. Finally, we obtained permissions for their utilization and, when needed, acquired the original instrument questionnaire through payment. Results: Through a literature review of existing observational studies, a total of 57 outcomes were selected, with 19 of them identified as COA instruments. Upon verifying usage permissions for these 19 instruments, it was found that 17 required author-specific permissions, and among these, 2 needed a purchase as they were commercially available. Conclusion: This study provides a detailed overview of outcome selection and permission acquisition for elderly patient registry research. It underscores the importance of Clinical Outcome Assessment (COA) tools and the rigorous approval process, aiming to enhance research reliability. Continuous verification of COA information is essential, and future research should explore Core Outcome Set (COS) development through consensus-building approaches like Delphi studies.

Plan to revitalize social and environmental education to improve the effectiveness of carbon neutrality in Jeju Special Self-Governing Province (제주특별자치도의 탄소중립 실효성 제고를 위한 사회환경교육 활성화 방안)

  • Kyung-Sam Moon;Tai-Hyun Ha
    • Journal of Digital Convergence
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    • v.22 no.1
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    • pp.1-14
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    • 2024
  • In order to improve the effectiveness of carbon neutrality in Jeju Special Self-Governing Province, this study identifies the current state of social environmental education through literature research, excluding school environmental education being implemented in elementary, middle, and high schools in the province, and identifies shortcomings or problems. The purpose is to establish a plan to systematically and integratedly operate social environmental education, and the derived plan can be used as a guide to change environmental awareness and induce eco-friendly behavior to improve the effectiveness of carbon neutrality. As a result of the study, Jeju Special Self-Governing Province established a consultative body with environmental education institutions, organizations and expert groups operating dispersed throughout the province through the substantial operation and support of the environmental education center currently being entrusted, to identify the current status and develop content necessary for establishing environmental education policies, establishing a platform to enable information sharing, role division, regular communication, empathy, and policy feedback, and on-site environmental education centered on the field to stimulate emotions and personalize environmental problems so that environmental problems can be properly recognized. Emphasizing the necessity.

Developing educational videos to inform rightly about school foodservice from kindergarten to high school: a case study

  • Gyoungok Gang;Chaewon Park;Haejin Kang;Wan Soo Hong;Yoo Kyoung Park;Sook Hee Choi;Seung Hye Kim;Jieun Choi;Jihyun Park;Hyeja Chang
    • Korean Journal of Community Nutrition
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    • v.29 no.2
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    • pp.97-113
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    • 2024
  • Objectives: Since the enactment of the School Nutrition Act in 1981, school lunch programs in South Korea have grown quantitatively and qualitatively with a current student participation rate of 99.8%. Nonetheless, educational materials are needed to reduce misunderstanding and ignorance about school lunch programs. This study aimed to develop 3 educational videos that help students of various ages (kindergarteners/lower-grade elementary, upper-grade elementary, and secondary school, respectively), understand the school lunch program. Methods: A scenario was created, was made, and the opinions on the scenario from experts in foodservice sectors were collected. A survey was conducted to students and parents to determine topics they wanted to know about school foodservice. The final videos were produced using this information and the expert opinions. The data were analyzed using SPSS 27.0 for Mac (IBM Corp., Armonk, NY, USA); a P-value of < 0.05 was considered significant. Results: Three videos on school foodservice were developed for various age levels of students: kindergarten/lower-grade elementary, upper-grade elementary, and secondary school. Additionally, English subtitles were included for the multicultural student population. These videos, each lasting about 7 minutes, cover topics such as nutrition, hygiene, and the cultural significance of the school lunch program. The survey results showed that parents and students wanted to know the following topics about the school lunch program: "nutritionally balanced diet" (11.9%), "purchasing safe food ingredients" (10.9%), and "healthy eating habits" (9.9%). Conclusions: The developed videos will serve as valuable educational resources on school foodservice, foster a deeper understanding of the school lunch program in parents and students, and potentially address their inquiries regarding production processes, nutrition, hygiene, cultural heritage, and health.

A Study on the Evaluation Indicators for the Establishment of Marine Fisheries Safety Education Facilities (해양수산안전 교육시설 설립을 위한 입지평가요인 도출에 관한 연구)

  • Shin-Young Ha;Bo-Young Kim;Sung-Ho Park
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.30 no.4
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    • pp.340-347
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    • 2024
  • In this study, an expert survey was conducted using the Delphi technique to select items and indicators for evaluation before installing educational facilities in the marine fisheries safety field, in which the educational infrastructure gap between regions is wide. Seven indicators were selected as geographic, social, and administrative factors. In order to objectively evaluate each indicator, evaluation indicators that could be evaluated using public data such as the "Comprehensive National Balanced Development Information System" and "National Statistical Portal" were developed. The Analytic Hierarchy Process (AHP) method was applied to select the weight for each indicator, resulting in 10 most important influencing factors on the selection of the location of educational facilities of the Marine Fisheries Safety Education Facilities: the distribution of marine officers, access to high-speed railways, the number of small ships less than 5 tons, access to highways interchange, the distribution of fishing boats, the close relationship of related industries, the planned new port, the distribution of commercial ports, the number of marine leisure riders, and the availability of long-term land leases in local government councils. The location evaluation index of marine and fishery safety education facilities developed in this study can be used to evaluate each region using national public data, and has the advantage of enabling objective evaluation. Therefore, it is judged that this evaluation index can be used to verify the feasibility of installing marine fisheries safety education facilities as well as other marine-related facilities.

2021 Korean Society of Gastrointestinal Endoscopy Clinical Practice Guidelines for Endoscopic Sedation

  • Hong Jun Park;Byung-Wook Kim;Jun Kyu Lee;Yehyun Park;Jin Myung Park;Jun Yong Bae;Seung Young Seo;Jae Min Lee;Jee Hyun Lee;Hyung Ku Chon;Jun-Won Chung;Hyun Ho Choi;Myung Ha Kim;Dong Ah Park;Jae Hung Jung;Joo Young Cho;Endoscopic Sedation Committee of Korean Society of Gastrointestinal Endoscopy
    • Clinical Endoscopy
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    • v.55 no.2
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    • pp.167-182
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    • 2022
  • Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Cardiopulmonary complications are usually temporary. Most patients recover without sequelae. However, they may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk.

Imaging follow-up strategy after endovascular treatment of Intracranial aneurysms: A literature review and guideline recommendations

  • Yong-Hwan Cho;Jaehyung Choi;Chae-Wook Huh;Chang Hyeun Kim;Chul Hoon Chang;Soon Chan KWON;Young Woo Kim;Seung Hun Sheen;Sukh Que Park;Jun Kyeung Ko;Sung-kon Ha;Hae Woong Jeong;Hyen Seung Kang;Clinical Practice Guideline Committee of the Korean Neuroendovascular Society
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.26 no.1
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    • pp.1-10
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    • 2024
  • Objective: Endovascular coil embolization is the primary treatment modality for intracranial aneurysms. However, its long-term durability remains of concern, with a considerable proportion of cases requiring aneurysm reopening and retreatment. Therefore, establishing optimal follow-up imaging protocols is necessary to ensure a durable occlusion. This study aimed to develop guidelines for follow-up imaging strategies after endovascular treatment of intracranial aneurysms. Methods: A committee comprising members of the Korean Neuroendovascular Society and other relevant societies was formed. A literature review and analyses of the major published guidelines were conducted to gather evidence. A panel of 40 experts convened to achieve a consensus on the recommendations using the modified Delphi method. Results: The panel members reached the following consensus: 1. Schedule the initial follow-up imaging within 3-6 months of treatment. 2. Noninvasive imaging modalities, such as three-dimensional time-of-flight magnetic resonance angiography (MRA) or contrast-enhanced MRA, are alternatives to digital subtraction angiography (DSA) during the first follow-up. 3. Schedule mid-term follow-up imaging at 1, 2, 4, and 6 years after the initial treatment. 4. If noninvasive imaging reveals unstable changes in the treated aneurysms, DSA should be considered. 5. Consider late-term follow-up imaging every 3-5 years for lifelong monitoring of patients with unstable changes or at high risk of recurrence. Conclusions: The guidelines aim to provide physicians with the information to make informed decisions and provide patients with high-quality care. However, owing to a lack of specific recommendations and scientific data, these guidelines are based on expert consensus and should be considered in conjunction with individual patient characteristics and circumstances.

Development of Intelligent Severity of Atopic Dermatitis Diagnosis Model using Convolutional Neural Network (합성곱 신경망(Convolutional Neural Network)을 활용한 지능형 아토피피부염 중증도 진단 모델 개발)

  • Yoon, Jae-Woong;Chun, Jae-Heon;Bang, Chul-Hwan;Park, Young-Min;Kim, Young-Joo;Oh, Sung-Min;Jung, Joon-Ho;Lee, Suk-Jun;Lee, Ji-Hyun
    • Management & Information Systems Review
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    • v.36 no.4
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    • pp.33-51
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    • 2017
  • With the advent of 'The Forth Industrial Revolution' and the growing demand for quality of life due to economic growth, needs for the quality of medical services are increasing. Artificial intelligence has been introduced in the medical field, but it is rarely used in chronic skin diseases that directly affect the quality of life. Also, atopic dermatitis, a representative disease among chronic skin diseases, has a disadvantage in that it is difficult to make an objective diagnosis of the severity of lesions. The aim of this study is to establish an intelligent severity recognition model of atopic dermatitis for improving the quality of patient's life. For this, the following steps were performed. First, image data of patients with atopic dermatitis were collected from the Catholic University of Korea Seoul Saint Mary's Hospital. Refinement and labeling were performed on the collected image data to obtain training and verification data that suitable for the objective intelligent atopic dermatitis severity recognition model. Second, learning and verification of various CNN algorithms are performed to select an image recognition algorithm that suitable for the objective intelligent atopic dermatitis severity recognition model. Experimental results showed that 'ResNet V1 101' and 'ResNet V2 50' were measured the highest performance with Erythema and Excoriation over 90% accuracy, and 'VGG-NET' was measured 89% accuracy lower than the two lesions due to lack of training data. The proposed methodology demonstrates that the image recognition algorithm has high performance not only in the field of object recognition but also in the medical field requiring expert knowledge. In addition, this study is expected to be highly applicable in the field of atopic dermatitis due to it uses image data of actual atopic dermatitis patients.

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A review of the contents about childhood health care in middle & high school textbooks (중·고등학교 교과서에 실린 소아 관련 정보의 조사)

  • Kim, Jung Hun;Park, Sung Won;Shin, Son Moon;Sung, In Kyung;Park, Mi Jung;Chung, Yoo Mi;Ha, Jeong Hun
    • Clinical and Experimental Pediatrics
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    • v.50 no.4
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    • pp.340-347
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    • 2007
  • Purpose : The purpose of this study is to investigate the material in middle school and high school textbooks covering child care and children's health for medically inaccurate content and to make sure that the correct information is given to students. Methods : We have examined 47 kinds of textbooks on the subjects 'Home economics' and 'Technology and home economics' published in 2007 to find out how much importance is placed on children's health and childcare and to search for incorrect definitions, inaccurate facts or insufficient explanations. We have also analyzed the credentials of the writers of these textbooks. Results : Textbooks of middle school cover psychological and physical changes during adolescence and nutrition, and those of high school cover marriage and childcare. These materials covering health made up 27.5%, 11.7% of middle & high school texts. Age definitions of neonate and infant were incorrect. Inaccurate facts were mostly about fontanelles, primitive reflexes, breastfeeding and weaning. There also were wrong informations on the umbilical cord care and developmental milestones during infancy. The childhood immunization schedules and the growth curves were not up to date. Most of the authors major in home economics and the others were school teachers. There was no evidence of any review by a medical society or an expert. Conclusions : When writing about children's health and childcare in textbooks, a board-certified pediatrician or The Korean Pediatric Society should be consulted to provide accurate medical information to middle and high school students.

Laying the Siting of High-Level Radioactive Waste in Public Opinion (고준위 방폐장 입지 선정의 공론화 기초 연구)

  • Lee, Soo-Jang
    • Journal of Environmental Policy
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    • v.7 no.4
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    • pp.105-134
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    • 2008
  • Local opposition and protest constitute single greatest hurdle to the siting of locally unwanted land uses(LULUs), especially siting of high-level radioactive disposal not only throughout Korea but also throughout the industrialized world. It can be attributed mainly to the NIMBYism, equity problem, and lack of participation. These problems are arisen from rational planning process which emphasizes instrumental rationality. But planning is a value-laden political activity, in which substantive rationality is central. To achieve this goals, we need a sound planning process for siting LULUs, which should improve the ability of citizens to influence the decisions that affects them. By a sound planning process, we mean one that is open to citizen input and contains accurate and complete information. In other word, the public is also part of the goal setting process and, as the information and analyses developed by the planners are evaluated by the public, strategies for solutions can be developed through consensus-building. This method is called as a co-operative siting process, and must be structured in order to arrive at publicly acceptable decisions. The followings are decided by consensus-building method. 1. Negotiation will be held? 2. What is the benefits and risks of negotiation? 3. What are solutions when collisions between national interests and local ones come into? 4. What are the agendas? 5. What is the community' role in site selection? 6. Are there incentives to negotiation. 7. Who are the parties to the negotiation? 8. Who will represent the community? 9. What groundwork of negotiation is set up? 10. How do we assure that the community access to information and expert? 11. What happens if negotiation is failed? 12. Is it necessary to trust each other in negotiations? 13. Is a mediator needed in negotiations?

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