• International Journal of Advanced Culture Technology
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• v.11 no.2
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• pp.310-314
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• 2023

In this paper, we show that the limitations of Holter monitoring and Wearable Electrocardiogarphy Devices and their arrhythmia detection. Sudden death caused by cardiovascular disease, often referred to as the "silent killer" due to its unpredictable nature, is a major health concern. Electrocardiography (ECG) is a basic diagnostic tool for detecting heart disease, but its limitations make it difficult to detect arrhythmia, a significant indicator of an irregular heart state. To address this limitation, a long-term continuous ECG recording device has been developed, Holter ECG device and wearable device. A significant number of studies have focused on the differences between Holter monitoring and wearable devices. The Holter tests were useful for detecting regularly occurring arrhythmias, whereas wearable patches were better at detecting random and infrequent arrhythmias. Wearable patches were effective in detecting episodes of arrhythmia and myocardial ischemia. Despite the concern, wearable devices had less signal loss than Holter monitoring and patients also preferred wearable devices over Holter monitoring due to convenience. These results could mean that the wearable devices can perfectly replace the Holter test.

• The Korean Journal of Nuclear Medicine
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• v.9 no.2
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• pp.13-22
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• 1975

The purpose of the present study is to evaluate the diagnostic value of the ETR test as compared to other thyroid function tests in normal persons, patients with thyroid disorders and patients with alterations of thyroxine-binding proteins. The ETR values were obtained from 35 cases as normal control, 63 hyperthyroid patients, 56 euthyroid patients, 23 hypothyroid patients, 10 pregnant women, 5 women taking oral contraceptive medication, 8 liver cirrhosis patients and 4 nephrotic syndrome patients. The results obtained were as follows. 1. The mean value of ETR obtained from the normal controls was $0.99{\pm}0.06$. 2. The mean ETR values of various thyroid states were $1.25{\pm}0.16$ in hyperthyroidism, $0.99{\pm}0.08$ in euthyroidism and $0.82{\pm}0.05$ in hypothyroidism and significant difference was found between these groups. 3. Seven out of 63 hyperthyroid patients(11.1%) and 2 out of 23 hypothyroid patients(8.7%) had ETR values within normal range and among the 56 euthyroid patients 6(10.7%) had ETR values outside normal range, so the diagnostic compatibility of ETR was 89.4% in thyroid diseases. 4. Even though the ETR value was well correlated with $^{131}I$-thyroid uptake rate, serum $T_3$ resin uptake rate and serum $T_4$, a high positive correlation was found (r=0.79) between ETR and $T_7$. 5. The mean ETR values from patients with alteration in TBG binding capacity were $0.99{\pm}0.05$ in pregnant women, $0.98{\pm}0.04$ in women with oral contraceptive medication, $1.04{\pm}0.09$ in liver cirrhosis patients and $0.94{\pm}0.02$ in nephrotic syndrome patients and most of them (85.2%) had ETR values within normal range. Our results, therefore, suggests that the ETR estimation does offer the simplest and most reliable single procedure for the screening and diagnosis of various thyroid diseases as a indirect indicator of serum-free thyroxine concentration without essential influence of changes in the thyroxine-binding proteins in serum.

• Investigative Magnetic Resonance Imaging
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• v.25 no.4
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• pp.313-322
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• 2021

Purpose: To find diagnostic image features, to compare diagnostic performance of multiphase CT versus gadoxetic acid disodium-enhanced MRI (GAD-MRI), and to evaluate the impact of analyzing Liver Imaging Reporting and Data System (LI-RADS) imaging features, for distinguishing combined hepatocellular-cholangiocarcinoma (CHC) from hepatocellular carcinoma (HCC). Materials and Methods: Ninety-six patients with pathologically proven CHC (n = 48) or HCC (n = 48), diagnosed June 2008 to May 2018 were retrospectively analyzed in random order by three radiologists with different experience levels. In the first analysis, the readers independently determined the probability of CHC based on their own knowledge and experiences. In the second analysis, they evaluated imaging features defined in LI-RADS 2018. Area under the curve (AUC) values for CHC diagnosis were compared between CT and MRI, and between the first and second analyses. Interobserver agreement was assessed using Cohen's weighted κ values. Results: Targetoid LR-M image features showed better specificities and positive predictive values (PPV) than the others. Among them, rim arterial phase hyperenhancement had the highest specificity and PPV. Average sensitivity, specificity, and AUC values were higher for MRI than for CT in both the first (P = 0.008, 0.005, 0.002, respectively) and second (P = 0.017, 0.026, 0.036) analyses. Interobserver agreements were higher for MRI in both analyses (κ = 0.307 for CT, κ = 0.332 for MRI in the first analysis; κ = 0.467 for CT, κ = 0.531 for MRI in the second analysis), with greater agreement in the second analysis for both CT (P = 0.001) and MRI (P < 0.001). Conclusion: Rim arterial phase hyperenhancement on GAD-MRI can be a good indicator suggesting CHC more than HCC. GAD-MRI may provide greater accuracy than CT for distinguishing CHC from HCC. Interobserver agreement can be improved for both CT and MRI by analyzing LI-RADS imaging features.

• Korean Journal of Oriental Medicine
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• v.13 no.2 s.20
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• pp.53-58
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• 2007

Background and Purpose : The purpose of this study was to investigate that which symptoms are adequate indicator of the Dampness-Phlegm pattern in the stroke patients. Methods : In the time period Jul. 2005 to Sep. 2006, 136 patients with a first-ever stroke admitted in the department of Internal Medicine of Daejeon University Oriental Medical Hospital in Daejeon city, Wonkwang Oriental Medical Hospital in Iksan, JeonJu city were included. Patients were hospitalized within 3 months after the onset of stroke. Stroke patients had been interviewed by resident who studied standard operation procedures in Fundamental Study for Standardization and Objectification of Differentiation and Pattern Identification of Syndrome of Oriental Medicine for Stroke. Gi-deficiency patients was confirmed by medical specialist diagnosis, resident diagnosis, case report form analysis without a dissenting voice. Results : Dampness-Phlegm group included 37 case, Non Dampness-Phlegm group 45 case out of 136 patients. white tongue coating, slippery purse, yellowish complexion, enlarged tongue, swollen tongue were higher among Dampness-Phlegm group. Dampness-Phlegm and Non Dampness-Phlegm patients do not significantly differ in heavy sensation in the head, voice with sputum, teeth printed tongue, borborygmus, dizziness with nausea. Conclusions : This study was insufficiency because sample size is very small. More data from prospective cohort studies will help to Korean Standard Differentiation of the Symptoms and Signs for the Stroke.

• The korean journal of orthodontics
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• v.28 no.2 s.67
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• pp.203-217
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• 1998

Sella turcica contains pituitary gland that has influence on craniofacial growth. So, if the volume of sella turcica correlate to the function of Pituitary gland, we can assume that the volume of sella turcica in skeletal Class III patients has some difference to that of normal occlusion group. The purpose of this study was to evaluate the difference of shape and volume of sella turcica between normal occlusion group and Class III patients. The shape of sella turcica was Classified by Inaba method and the volume of sella turcica was measured in lateral and P-A cephalograms by Di Chiro method. To find out the possibility of the volume of sella turcica as diagnostic aid to predict Class III growth pattern, the correlation coefficients between the volume of sella and cephalometric variables were calculated. The results were as follows. 1. The volume of sella turcica in Class III patients is larger than that of normal occlusion groups 2. The volume of sella turcica in female was larger than that of male in Class III patients 3. The volume of sella turcica has close correlation with APDI, ANB, SNA, SNB, ODI, gonial angle, post. cranial base length 4. Sella Index (volume of sella / ant. cranial base length) can be a more accurate indicator that represent Class III growth pattern than volume of sella itself. 5. The morphologic pattern of sella turcica had no significant difference between two groups.

• Quality Improvement in Health Care
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• v.27 no.2
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• pp.73-82
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• 2021

Purpose: This study aims to examine the quality of tuberculosis (TB) care after the 1st to 3rd national quality assessment (QA) program for TB healthcare service in Korea was conducted. Methods: We analyzed Health Insurance Review & Assessment Service (HIRA) claims data of new TB patients during the period of January to June from 2018-2020. The new TB patients were defined as TB patients reported to Korea Centers for Disease Control and Prevention Agency (KCDA). The unit of analysis was the patient. Chi-square tests were used to analyze the differences in indicator value according to the types of medical facilities. The QA indicators of TB care were divided into 3 areas consisting of the following 7 quality indicators: 4 indicators of diagnosis test (the rate of acid-fast bacilli smear, the rate of acid-fast bacilli culture, the rate of Mycobacterium tuberculosis-polymerase chain reaction, drug susceptibility test), 1 compliance of treatment guideline, and 2 indicators of care management of TB patients (encounter rate, day of therapy). Results: The QA program for TB care was conducted among 8,246 patients from 534 facilities in 2020. The value of the 7 quality indicators was shown to increase as a result of the QA program. The indicators of the diagnostic test were all higher than 95%, with the exception of the drug susceptibility test which was 84.8%. Both indicators for care management of TB patients were 88.5%. Conclusion: The quality of TB care has been improving with the implementation of the QA program. In order to continue to improve the quality of TB care, it will be necessary to disclose the results of the QA program in medical facilities in the future.

• Journal of the Korean Society of Radiology
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• v.12 no.5
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• pp.593-601
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• 2018

Recently in nuclear medicine, to improve diagnostic value, SUV, semi-quantitative indicator used in PET-CT, is adopted in SPECT-CT. Therefore, this research analyzed correlation of $SUV_{max}$ of two scanners through phantom test, and evaluated possibility of clinical application. Radiopharmaceuticals ($^{18}F$, $^{99m}Tc$) were injected with the ratios of 8:1 and 4:1, considering background radioactivity, into the phantom manufactured with 6 globes of different sizes, and, based on clinical protocol, positive phases were acquired with PET-CT and SPECT-CT scanners, and interesting areas were divided into ROI and VOI, and $SUV_{max}$ of them were measured, and analyzed. Tests found out no statistically significant difference in $SUV_{max}$ measured with two scanners (P>0.05). Thus, $SUV_{max}$ of PET-CT and SPECT-CT had a certain correlation within significant levels, and were evaluated as the same. Accordingly, it seems that $SUV_{max}$ quantitative analysis using SPECT-CT can provide significant diagnostic information as the case of PET-CT.

• Proceedings of the Korean Vacuum Society Conference
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• 2013.08a
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• pp.273-273
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• 2013

Recently, Point-of-care (POC) testing microdevices enable to do the patient monitoring, drug screening, pathogen detection in the outside of hospital. Immunochromatographic strip (ICS) is one of the diagnostic technologies which are widely applied to POC detection. Relatively low cost, simplicity to use, easy interpretations of the diagnostic results and high stability under any circumstances are representative advantages of POC diagnosis. It would provide colorimetric results more conveniently, if the genetic analysis microsystem incorporates the ICS as a detector part. In this work, we develop a reverse transcriptase-polymerase chain reaction (RT-PCR) microfluidic device integrated with a ROSGENE strip for colorimetric influenza H1N1 virus detection. The integrated RT-PCR- ROSGENE device is consist of four functional units which are a pneumatic micropump for sample loading, 2 ${\mu}L$ volume RT-PCR chamber for target gene amplification, a resistance temperature detector (RTD) electrode for temperature control, and a ROSGENE strip for target gene detection. The device was fabricated by combining four layers: First wafer is for RTD microfabrication, the second wafer is for PCR chamber at the bottom and micropump channel on the top, the third is the monolithic PDMS, and the fourth is the manifold for micropump operation. The RT-PCR was performed with subtype specific forward and reverse primers which were labeled with Texas-red, serving as a fluorescent hapten. A biotin-dUTP was used to insert biotin moieties in the PCR amplicons, during the RT-PCR. The RT-PCR amplicons were loaded in the sample application area, and they were conjugated with Au NP-labeled hapten-antibody. The test band embedded with streptavidins captures the biotin labeled amplicons and we can see violet colorimetric signals if the target gene was amplified with the control line. The off-chip RT-PCR amplicons of the influenza H1N1 virus were analyzed with a ROSGENE strip in comparison with an agarose gel electrophoresis. The intensities of test line was proportional to the template quantity and the detection sensitivity of the strip was better than that of the agarose gel. The test band of the ROSGENE strip could be observed with only 10 copies of a RNA template by the naked eyes. For the on-chip RT-PCR-ROSGENE experiments, a RT-PCR cocktail was injected into the chamber from the inlet reservoir to the waste outlet by the micro-pump actuation. After filling without bubbles inside the chamber, a RT-PCR thermal cycling was executed for 2 hours with all the microvalves closed to isolate the PCR chamber. After thermal cycling, the RT-PCR product was delivered to the attached ROSGENE strip through the outlet reservoir. After dropping 40 ${\mu}L$ of an eluant buffer at the end of the strip, the violet test line was detected as a H1N1 virus indicator, while the negative experiment only revealed a control line and while the positive experiment a control and a test line was appeared.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.11
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• pp.600-604
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• 2018

Background and Objectives This study aimed to identify a reliable preoperative predictive factor for the development of thyroid cancer in patients with atypia of undetermined significance (AUS) identified by fine needle aspiration biopsy (FNAB). Subjects and Method This was a retrospective cohort study. Two hundred and ninety-nine patients diagnosed with AUS by preoperative FNAB who underwent curative thyroid surgery at our institution between September 2005 and February 2014 were analyzed. Clinical, radiological and molecular features were investigated as preoperative predictors for postoperative permanent malignant pathology. Results The final pathologic results revealed 36 benign tumors including nodular hyperplasia, follicular adenoma, adenomatous goiter, nontoxic goiter, and lymphocytic thyroiditis, as well as 263 malignant tumors including 1 follicular carcinoma and 1 invasive follicular carcinoma; the rest were papillary thyroid carcinomas. The malignancy rate was 87.9%. The following were identified as risk factors for malignancy by univariate analysis: $BRAF^{V600E}$ gene mutation, specific ultrasonographic findings including smaller nodule size, low echogenicity of the nodule, and irregular or spiculated margin (p<0.05). Multivariate analysis revealed that only $BRAF^{V600E}$ mutation was a statistically significant risk factor for malignancy (p<0.05). When $BRAF^{V600E}$ mutation was positive, 98.5% of enrolled patients developed malignant tumors. In addition, the diagnostic rate of malignancy in these cases was approximately 16-fold higher than BRAF-negative cases. Conclusion Patients with AUS thyroid nodules should undergo $BRAF^{V600E}$ gene mutation analysis to improve diagnostic accuracy and if the mutation is confirmed, surgery is recommended due to the high risk of malignancy.

• Journal of Korean Neurosurgical Society
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• v.62 no.4
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• pp.476-486
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• 2019

Objective : The functional information of $^{11}C$-methionine positron emission tomography (MET-PET) images can be applied for Gamma knife radiosurgery (GKR) and its image quality may affect defining the tumor. This study conducted the phantom-based evaluation for geometric accuracy and functional characteristic of diagnostic MET-PET image co-registered with stereotactic image in Leksell $GammaPlan^{(R)}$ (LGP) and also investigated clinical application of these images in metastatic brain tumors. Methods : Two types of cylindrical acrylic phantoms fabricated in-house were used for this study : the phantom with an array-shaped axial rod insert and the phantom with different sized tube indicators. The phantoms were mounted on the stereotactic frame and scanned using computed tomography (CT), magnetic resonance imaging (MRI), and PET system. Three-dimensional coordinate values on co-registered MET-PET images were compared with those on stereotactic CT image in LGP. MET uptake values of different sized indicators inside phantom were evaluated. We also evaluated the CT and MRI co-registered stereotactic MET-PET images with MR-enhancing volume and PET-metabolic tumor volume (MTV) in 14 metastatic brain tumors. Results : Imaging distortion of MET-PET was maintained stable at less than approximately 3% on mean value. There was no statistical difference in the geometric accuracy according to co-registered reference stereotactic images. In functional characteristic study for MET-PET image, the indicator on the lateral side of the phantom exhibited higher uptake than that on the medial side. This effect decreased as the size of the object increased. In 14 metastatic tumors, the median matching percentage between MR-enhancing volume and PET-MTV was 36.8% on PET/MR fusion images and 39.9% on PET/CT fusion images. Conclusion : The geometric accuracy of the diagnostic MET-PET co-registered with stereotactic MR in LGP is acceptable on phantom-based study. However, the MET-PET images could the limitations in providing exact stereotactic information in clinical study.