• Title/Summary/Keyword: Treatment Guideline

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A Study on the Evaluation of Patient Dose in Interventional Radiology (중재적방사선검사에서 환자 피폭선량에 관한 연구)

  • Park, Hyung-Sin;Lim, Cheong-Hwan;Kang, Byung-Sam;You, In-Gyu;Jung, Hong-Ryang
    • Journal of radiological science and technology
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    • v.35 no.4
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    • pp.299-308
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    • 2012
  • To perform patient dose surveys in major interventional radiography procedures as a mean of inter-institutional comparison and of establishing reference dose levels with the ultimate goal of optimizing patient doses in the field of interventional radiography. We reviewed international patient dose survey data in the literature and measured patient dose in major interventional radiography procedures (TACE, AVF, PTBD, TFCA, GDC embolization). ESD(Entrance Skin Dose) was measured using TLD chips attached to the patient skin and ED(Effective Dose) was calculated using angiography unit-derived DAP. A survey of patient dose in interventional radiography procedures were also performed with a questionnaire for interventional radiologists and we proposed a guideline for optimizing patient doses in the field of interventional radiology. The patient dose survey data in interventional radiography procedures were very rare in literature compared with those in diagnostic radiography procedures. In TACE, the mean ED was 25.43 mSv and the mean ESD was 511.75 mGy. The mean ED of TACE was not high, but the cumulative dose should be checked, due to longer procedure TACE. In TFCA, the mean ED was 22.6 mSv and it was relatively high compared with data of other countries. In GDC embolization, the mean ED was not available, because GDC embolization was performed with old Image-Intensifier-type unit and there has no unit-installed ionization chamber. Also, the mean ESD of GDC embolization was up to 2,264 mGy and further studies are needed to calculate the net ED of GDC embolization. Patient dose occurred during interventional radiography procedures are high related with the difficulty of the procedure, fluoroscopy time, the number of angiographies and the treatment protocol. Therefore, continuous education and efforts should be made to optimize the patient dose in the field of interventional radiology.

Extending the Shelf-life of Yukwa Using Secondary Packaging (이차포장을 통한 유과의 저장성 연장)

  • Jung, Jun-Jae;Lee, Keun-Taik
    • Korean Journal of Food Science and Technology
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    • v.42 no.4
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    • pp.452-458
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    • 2010
  • This study aimed at improving the packaging technology of Yukwa to improve the quality and extend the shelflife using secondary packaging. After packaging the Yukwa using an OPP film, P2, P3, and P4 packaging materials were applied secondarily. Various films including (1) P1: OPP (oriented polypropylene), (2) P2: P1+OPP/LLDPE (linear low density polyethylene), (3) P3: P1+PET (polyethylene terephthalate)/NY (nylon)/CPP (cast polypropylene) and (4) P4: P1+PET/AL (aluminum)/NY/CPP (P4) were used for packaging Yukwa. The experiment was conducted at $25^{\circ}C$ for 12 weeks. P1 showed the highest acid value score (1.26 mg KOH/g), and P3 had the highest peroxide value score (32.91 meq/kg) among all packaging groups. Nevertheless, these values did not exceed the guideline values of 2.0 g KOH/g and 40 meq/kg specified in the Korean food code. The overall color difference showed a tendency for decreasing Hunter 'L' values and increasing 'a' and 'b' values; however, no noticeable difference in the outer appearance was observed in any of the packaging treatments except in the P1 for greater than 10 weeks of storage. Some texture defects were observed in the Yukwa when the moisture contents dropped below 5%. The P4 packaging treatment had the lowest moisture permeability and showed the least rheological deterioration change, followed by P3 and P2. In conclusion, the use of a secondary packaging with less gas and moisture permeability was more effective for maintaining the quality and extending the shelf-life of Yukwa than other types of packaging material.

An assessment of statistical errors of articles in the Journal of Korean Academy of Prosthodontics: Comparison between Korean version and English version (대한치과보철학회지에 게재된 논문의 통계적 오류: 국문논문과 영문논문의 비교)

  • Park, Dong-Gyu;Choi, Yong-Geun;Kim, Young-Su;Shin, Sang-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.3
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    • pp.273-285
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    • 2009
  • Statement of problem: The aim of dental research is to advance scientific knowledge and leads to improvement in the treatment and prevention of dental disease. Utilizing an effective research design and adequate statistical methods are essential procedures ensuring that the results of researches are based on evidences. A research should utilize proper statistical methods without statistical errors; Otherwise, it could adversely affect clinical practice and future research. Purpose: This study was made to investigate the statistical methods used in the Journal of Korean Academy of Prosthodontics (JKAP) and then to assess them for the statistical errors. Material and methods: Among the total of 399 articles in the JKAP published from 2000 to 2006, 292 articles using statistics were reviewed. The validity of the statistical methods used in them were assessed using a checklist based on the guideline for statistical reporting in the uniform requirements for manuscripts submitted to biomedical journals by International Committee of Medical Journal Editors. The checklist consisted of three categories of statistical errors: 1) Unspecified computer statistical packages, 2) Inadequate description of statistical methods, 3) Misuse of statistical terms. Then, the results were compared between the Korean version and the English version in the JKAP. Results: Among the 212 articles using statistics in the Korean version, 115 articles (54%) and among the 80 articles using statistics in the English version, 47 articles (59%) were shown to have unspecified computer statistical packages without statistically significant difference (P = .66). Likewise, 101 articles (48%) in the Korean version and 25 articles (31%) in the English version were shown to have the inadequate description of statistical methods without statistically significant difference (P = .09). However, 114 articles (54%) in the Korean version and 19 articles (24%) in the English version were shown to have the misuse of statistical terms with statistically significant difference (P = .01). Conclusion: Some of the articles in the JKAP had inadequate statistical validity, given the statistical errors identified in this assessment. Hence, dental researchers should be more careful when it comes to describing and applying statistical methods.

Management of Tuberculosis Outbreak in a Small Military Unit Following the Korean National Guideline (국내 결핵관리지침에 따른 군내 결핵 집단발병 관리 사례 보고)

  • Ji, Sang Hoon;Kim, Hee Jin;Choi, Chang Min
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.5-10
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    • 2007
  • Background: Korean national guidelines for examining contacts with active pulmonary tuberculosis (TB) are a tuberculin skin test (TST) and chest radiographs. The treatment of a latent TB infection as performed only in those younger than six years of age who test positive for TST. Although there is a high incidence of active TB in young Korean soldiers, the current national guidelines for controlling contacts with active TB in soldiers are insufficient. This study highlights the problems with the Korean guidelines for controlling a TB outbreak in a small military unit. Material and Methods: In December of 2005, there was a tuberculosis outbreak in a military unit with a total of 464 soldiers in Kyung Gi province. The chest radiographs were taken of all the soldiers, and TST were carried out on 408 candidates. Results: In the first screening of the chest radiographs, two active TB patients were detected. By August of 2006, four additional cases were detected, making a total of six cases after the outbreak. All the patients showed active pulmonary TB or TB pleuritis. When the results of TST in the close contacts and non-close contacts were compared, there was a significant difference in the absolute size of the induration($9.70{\pm}7.50mm$ vs. $6.26{\pm}7.02mm$, p<0.001) as well as the ratio of patients showing an induration > 10mm (50.0% vs. 32.0%, p<0.001) and 15mm (33.2% vs. 20.9%, p= 0.005). Conclusion: Although the national guidelines for managing a TB outbreak in a military unit were followed, there were continuous instances of new active TB cases. This highlights the need for new guidelines to prevent the spread of TB.

Development and Validation of the Determination of Sorafenib in Human Plasma using Tandem Mass Spectrometry Coupled with Liquid Chromatography (고속액체크로마토그래피 텐덤질량분석기법을 이용한 사람 혈장 내 소라페닙 농도분석법의 개발 및 검정)

  • Park, Daejin;Lee, Sunggon;Kim, Woomi
    • Journal of Life Science
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    • v.22 no.11
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    • pp.1456-1462
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    • 2012
  • Sorafenib is a multikinase inhibitor and an oral anticancer drug approved for the treatment of patients with advanced renal cell carcinoma and those with unresectable hepatocellular carcinoma. The purpose of this study was to develop an efficient method of the determination of sorafenib in human plasma using tandem mass spectrometry coupled with liquid chromatography (LC/MS/MS) and validate the method by the guidelines of the Korean Food and Drug Administration (KFDA). Plasma samples ($100{\mu}l$) were added with chlorantraniliprole as an internal standard and then mixed with the 0.1% formic acid-containing extraction solution composed of isopropyl alcohol and ethyl acetate (1:4, v/v). After centrifugation, the supernatant was concentrated at $45^{\circ}C$ under negative pressure and centrifugal force. The residue was reconstituted with a mobile phase and injected into the HPLC instrument using a reverse phase Waters XTerra$^{TM}$ C18 column (particle size $3.5{\mu}m$). Liquid chromatography was carried out within the run time of 5 min using a mobile phase composed of buffer (0.1% formic acid and 10 mM ammonium formate), methanol, and acetonitrile (1:6:3, v/v/v). The analytes were monitored by tandem mass spectrometry in the multiple reaction monitoring method programmed to detect sorafenib at 'm/z 465.2 ${\rightarrow}$ 252.5' and chlorantraniliprole at 'm/z 484.4 ${\rightarrow}$ 286.2' with positive electrospray ionization mode ($ES^+$). The result showed the proper linearity ($r^2$ > 0.99) over the range of 2,000-5,000 ng/ml with good accuracy (90.7-103.9%) and precision (less than 10%). The newly developed method using LC/MS/MS was validated by the guideline of KFDA and identified as more sensitive compared to the previous methods.

A Study on Establishment of Technical Guideline of the Installation and Operation for the Biogas Utilization of Power generation and Stream - Results of the Precision Monitoring (바이오가스 이용 기술지침 마련을 위한 연구(II) - 정밀모니터링 결과 중심으로)

  • Moon, HeeSung;Bae, Jisu;Park, Hoyeun;Jeon, Taewan;Lee, Younggi;Lee, Dongjin
    • Journal of the Korea Organic Resources Recycling Association
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    • v.26 no.1
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    • pp.65-78
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    • 2018
  • According to the in social aspects such as population growth, urbanization and industrialization, development of livestock industry by meat consumption, amount of organic wastes (containing sewage sludge and food waste, animal manure, etc) has been increased annually in South Korea. Precise monitoring of 11 organic wastes biogas facilities were conducted. The organic decomposition rate of organic wastewater was 68.2 % for food wastes, 66.8 % for animal manure and 46.2 % for sewage sludge and 58.8 % for total organic wastes. As a result of analyzing the biogas characteristics before and after the pretreatment, the total average of the whole facility was measured to be 560 ppm using iron salts and desulfurization, and decreased to 40 ppm when the reduction efficiency was above 90 %. Particularly, when iron salt is injected into the digester, the treatment efficiency is about 93 %, and the average is reduced to 150 ppm. In the case of dehumidification, the absolute humidity and the relative humidity were analyzed. The dew point temperature of the facility where the dehumidification facility was well maintained as $14^{\circ}C$, the absolute humidity was $12.6g/m^3$, and the relative humidity was 35 %. Therefore, it is necessary to compensate for the disadvantages of biogasification facilities of organic waste resources and optimize utilization of biogas and improve operation of facilities. This study was conducted to optimize biogas utilization of type of organic waste(containing sewage sludge and food waste, animal manure) through precision monitoring.

MEASUREMENT OF PULPAL BLOOD FLOW USING A LASER DOPPLER FLOWMETER (Laser Doppler flowmeter를 이용한 치수혈류 측정)

  • Ban, Tae-Whan;Lee, Jae-Sang;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.24 no.4
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    • pp.560-569
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    • 1999
  • Blood supply rather than nerve supply implies pulp vitality. To evaluate pulp vitality clinically, electric pulp test and thermal test which are based on sensory nerve response have been used in addition to many auxiliary data such as past dental history, visual inspection, radiographic examination, percussion, palpation and transillumination test. However, reactivity of the nerves to the stimulation is not synonymous with normalcy. Therefore measurement of pulpal blood flow using a laser Doppler flowmeter became a new trial to test the pulp vitality. The purpose of the present study was to evaluate normal pulpal blood flow level of maxillary teeth in adult to provide a guideline in determining the vitality of dental pulp. Pulpal blood flow was measured in maxillary central and lateral incisors, canines, first and second premolars and first molars of seventy nine adults of 22 - 30 years old using a laser Doppler flowmeter (PeriFlux 4001, Perimed Co., Stockholm, Sweden, 780 nm infrared laser, 1mW). For directly-made splints, silicone rubber impressions were taken directly from the mouth. For indirectly-made splints, alginate impressions were taken from the mouth and stone cast were made. After making depressions on the buccal surfaces of the cast teeth to indicate the hole positions, second impressions with vinyl polysyloxane putty were taken from the cast. Holes for the laser probes were made at the putty impressions 4mm above the gingival level. Laser probe (PF416 dental probe, 1.5mm) was inserted in the prepared hole and the splint was set in the mouth. After 10 minutes of patient relaxing, pulpal blood flow was recorded for 5 minutes on each tooth. The recorded flow was saved in the computer and calculated with a software 'Perisoft' version 5.1. Pulpal blood flow was also recorded in six teeth of five individuals with no response to electric pulp test and cold test, with periapical radiolucency, or with history of root canal treatment to compare with nonvital teeth. The difference between the mean flow values of each group of teeth were analyzed using one-way ANOVA and Duncan's Multiple Range test. The results were as follows: 1. The average pulpal blood flow values of all the tested teeth of each location were between 9 - 16 Perfusion Unit. Pulpal blood flow value was highest in maxillary lateral incisors, followed by first premolars, second premolars, canines, central incisors, and then first molars (p<0.01). 2. In six anterior teeth, indirectly-made splint group showed higher pulpal blood flow values than directly-made splint group (p<0.01). In posterior teeth, however, there was no significant flow value difference between directly-made splint group and indirectly-made splint one (p>0.05). 3. Teeth with vital pulps showed higher signal values than teeth with nonvital pulps (p<0.01), and the flow photographs showed heartbeat-synchronous fluctuations and vasomotions, while those were absent in non vital tooth.

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Survey of Sedation Practices by Pediatric Dentists (소아치과의사의 진정법 사용에 대한 실태조사)

  • Yang, Yeonmi;Shin, Teojeon;Yoo, Seunghoon;Choi, Seongchul;Kim, Jiyeon;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.3
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    • pp.257-265
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    • 2014
  • The aim of this study was to establish the appropriate guidelines in the sedation techniques and to organize the continuing education programs for the sedation in future under the direction of Committee on Sedation, Education and Research under the Korean Academy of Pediatric Dentistry(KAPD). The surveys on the sedation technique were performed on 111 organizations which practices the sedation and responded to the survey via online and e-mail by February 2014. The collected survey were analyzed. The purpose of sedation was mainly to manage the children's behavior and its uses were primarily on 3~4 years old children. The most frequent duration of treatment was 1~2 hours to treat both maxillary and mandible. The preferred dosages of sedative drugs were chloral hydrate(CH) 50~70 mg/kg, hydorxyzine(Hx) 1~2 mg/kg, and intramuscular midazolam(Mida IM) 0.1~0.2 mg/kg. The preferred combination of the sedative drugs were CH + Hx + $N_2O/O_2$(67.6%), CH + Hx + Mida submucosal administration (SM) + $N_2O/O_2$(29.7%), and Mida IM + $N_2O/O_2$(23.4%). The administration of additional sedatives was carried out at 48%, mainly using Midazolam. 87.5% of the respondents experienced the adverse effects of the sedation such as vomiting/retching, agitation during recovery, subclinical respiratory depression, staggering, and etc. Among them, only 20% periodically retrain the emergency management protocol. About the discharge criteria for patients after the sedation, the respondents either showed a lack of clear criteria or did not follow the recommended discharge criteria. 86% of the respondents expressed the interests in taking a course on the sedation and they wanted to learn mostly about the sedation-related emergency management, the safe dosage of the sedative drugs, and etc. The use of sedation in pediatric dentistry must be consider a patient's safety as top priority and each dentist must show the evidence of sound practices for the prevention of any possible medical errors. Therefore, KAPD must establish the proper sedation guidelines and it needs to provide the systematic technical training program of sedation-related emergency management for pediatric dentists.

Study for Clinical Characteristics of Nontuberculous Mycobacterial Pulmonary Diseases (폐 비결핵향산균종의 임상적 특징에 관한 연구)

  • Pae, H.H.;Lee, J.H.;Yoo, C.G.;Lee, C.T.;Chung, H.S.;Kim, Y.W.;Shim, Y.S.;Han, S.K.
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.735-746
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    • 1999
  • Background: As the prevalence of nontuberculous mycobacteriosis has been increasing rapidly, there has been recent advance in diagnostic methods and drug therapies for disease. Although the incidence of pulmonary disease caused by nontuberculous mycobacteria(NTM) has been increasing in Korea since 1990, detailed clinical description about the disease were very few. In this study we described the clinical manifestations, radiologic findings, and therapeutic outcomes of nontuberculous mycobacterial pulmonary disease. Methods: Medical records and radiologic findings were retrospectively reviewed in 27 patients who were fulfilled the diagnostic criteria of ATS guideline for NTM pulmonary disease between January of 1990 and August of 1998 in Seoul National University Hospital(SNUH). Results: Of the 27 patients, 15 were male. The mean age was 51.5 yr($\pm$11.9). Twenty patients(74.1%) had preexisting pulmonary diseases. Among them, 19 patients had previous pulmonary tuberculosis. Sixteen patients(59.2%) had cavitary lesions and the majority showed slow progression over 1 yr during follow up period on radiography. Susceptibility test to standard antituberculous drugs showed 100% resistance to INH, 72.2% to RMP, 81.5% to EMB, 92.6% to PZA. The average resistance rate to 2nd-line antituberculous drugs was 66.1%. Among twenty-one patients(77.8%) who received drug therapy over 6 months, 11 subjects were improved and 10 subjects were aggravated. Of six subjects(22.2%) without therapy, 5 patients were aggravated. Presence of cavity and less than 3 sensitive drugs in the regimen were indicators for adverse outcome. Conclusion : The nontuberculous mycobacterial pulmonary diseases in our hospital developed predominantly in older patients with preexistent pulmonary disease. The results of antituberculous drug therapy has been frustrating and disappointing. To improve treatment response, different susceptibility tests and drug regimens for different species of NTM should be performed. Also, diagnostic and therapeutic guidelines of Korea should be made in the recent future.

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Efficacy of ISO 9001 : 2000 Quality Management System in Human Assisted Reproductive Technology Center (보조생식술 센터에서 ISO 9001 : 2000 품질경영시스템의 도입 및 시행의 효용성)

  • Jun, Jin-Hyun;Park, Yong-Seog;Lee, Hyoung-Song;Kim, Soon-Duk;Hwang, Son-Hee;Han, Su-Kyoung;Kim, Jae-Ho;Song, In-Ok;Kang, Inn-Soo;Koong, Mi-Kyoung
    • Clinical and Experimental Reproductive Medicine
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    • v.34 no.2
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    • pp.107-115
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    • 2007
  • Objective: A quality management system of international standardization organization (ISO) 9001:2000 has been proposed to properly evaluate and improve the quality of productions and services. The purpose of this article was to describe on successful introduction and application of the ISO system to human assisted reproductive technology (ART) center. Methods: Center for reproductive medicine and infertility of Cheil General Hospital started the action for ISO 9001:2000 certification at January-2004. The ISO system of our center was monitored by measuring the customer satisfaction index and periodical internal and external audit. Reports of non-conformity described corrective and preventive actions for problems and occurrences that were not consistent with the standard process and operation of our center. Continuous management and improvement were performed on the project of customer dissatisfaction. Results: Our center has got the certification of ISO 9001:2000 for "Research and development of IVF-ET program for infertility treatment" from Korean Foundation for Quality at June-2004. The policy of ISO was "To establish the best center of reproductive medicine and infertility" and "To establish the best quality management system". We found 140 cases and 7 cases of non-conformity in internal and external audit for three years, respectively, and performed corrective action. Conclusion: Improvement of customer satisfaction, systemic documentation and transparency and efficacy of working procedure were achieved by application and operation of the ISO system to our center. This ISO system could be used as a basic institutional management system for the national guideline to the human ART center.