• Title/Summary/Keyword: medical quality improvement

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A Simulation Study on Image Quality of Virtual Monochromatic Image using Dual-energy Method (이중에너지 방법을 이용한 가상 단색 영상의 화질 시뮬레이션 연구)

  • Son, Ki-Hong;Lee, Soo-Yeul;Kim, Dae-Hong;Chung, Myung-Ae
    • Journal of the Korean Society of Radiology
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    • v.16 no.5
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    • pp.553-558
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    • 2022
  • The purpose of this work was a simulation study to evaluate the virtual monochromatic (VM) image quality of blood vessels compared to the monochromatic image. Dual-energy images were obtained based on the linear attenuation coefficients of five materials at 50 keV and 80 keV at low- and high-energies, respectively. A weighting factor is required to synthesize the VM image, and the liver and bone were used as basis materials to obtain the weighting factor. VM images were synthesized at energies ranging from 30 keV to 100 keV. Image quality was evaluated by Contrast to noise ratio (CNR) and noise by setting calcium and contrast medium as signals and blood as background. According to the results, the energies with the maximum CNR were 50 keV and 60 keV for calcium and contrast medium, respectively. The energies showing the minimum noise were 70 keV, 70 keV, and 60 keV in calcium, iodine contrast medium, and blood, respectively. The VM image can contribute to the improvement of diagnostic performance in CT examination because it can implement an image at the optimal energy that minimize noise and maximize CNR.

The Utilization Pattern of a Rural Health Subcenter among Suburban Farmhouse Members (일 도시근교 농가구원의 보건지소 이용양상)

  • Sohn, Seok-Joon;Kwon, Sun-Seok;Kim, Sang-Won;Byun, Ju-Nam;Nam, Hae-Sung;Son, Myung-Ho
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.65-77
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    • 1999
  • In order to estimate the utilization pattern of a rural health subcenter, and to identify the recognition for it among the farmhouse members in a suburban area, a questionnaire survey was carried out for objects of 696 population. The results observed were as follows: The annual utilization rate of rural health subcenter for a basic health service unit was 25.0 per 100 persons, and annual mean visiting times was 0.22 times. And the most frequent disease by annual health subcenter utilization illness was musculoskeletal disease(30.6%), and the next was respiratory disease(14.1%), gastrointestinal disease(13.9%) by order. Favorite reason for community health subcenter utilization were near distance from living place(49.6%), lower disease severity(18.9%) and lower medical cost(18.1%) by order. But disfavoring reasons for it were absence of specialist(20.2%), non effective treatment(19.2%) and insufficient equipment(14.7%) by order. And insufficient items about community health subcenter utilization were restriction of treatment limit(40.7%), lower reliance(22.5%) and difficulty in traffic(13.4%) by order. The results of logistic regression analysis suggested that statistically significant factors in health subcenter utilization was educational level. The desirable works for the health subcenter in a suburban area were disease control of elderly and disease preventing service. These results suggested that to increase the utilization of rural health subcenter in a suburban area and to promote the accessibility of rural residents to primary health care, there must be considered public relation about health subcenter, improvement of medical quality and change of priority about health subcenter's works.

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A Study on the Level of Air Pollution and Noise in Pusan Area (부산의 지역별 대기오염과 소음정도에 관한 조사연구)

  • Cho, G.I.;Moon, D.H.;Lee, J.T.;Sin, H.R.;Kim, Y.W.;Park, H.J.;Pae, K.T.;Lee, C.U.
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.4 s.32
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    • pp.391-403
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    • 1990
  • In order to assess the degree of atmospheric pollution and noise and to contribute the health improvement of residents in Pusan, the author measured the levels of CO, $SO_2,\;NO_2$, TSP, HCHO and noise in 8 areas (industrial, residential and park areas) from January to March in 1990. The results were as follows : 1. Sasang industrial area was significantly higher($2.85{\pm}0.84ppm$) in the average concentration of CO than other areas. However, there no areas to affect the human body in terms of CO concentration. 2. In general, industrial area was significantly higher ($0.134{\pm}0.084ppm$) in the average concentration of $SO_2$ than other areas, and it was the lowest ($0.009{\pm}0.005ppm$) in the Namchon-dong area. 3. Industrial ($0.033{\pm}0.009ppm$) and residential area ($0.029{\pm}0.004ppm$) were significantly higher in the average concentration of $NO_2$ than Park area ($0.009{\pm}0.001ppm$). However, there were no areas to affect the human body in terms of $NO_2$ concentration. 4. Sasang industrial area was the highest ($580.4{\pm}415.26{\mu}g/m^3$) at the average concentration of TSP and Hae-Un Dae area was the lowest ($97.22{\pm}37.86{\mu}g/m^3$). But TSP concentration showed the level to affect the human body in most areas. 5. Industrial area was significantly higher ($2.25{\pm}1.15ppb$) in the average concentration of HCHO than residential ($1.13{\pm}0.25ppb$) and park area ($1.33{\pm}0.20ppb$). 6. Industrial area was significantly higher ($77.28{\pm}6.92dB(A)$) in the level of noise than residential ($65.77{\pm}3.76dB(A)$) and park area ($64.65{\pm}5.25dB(A)$). In comparison with regional Standard Noise Level, howeverm the average noise level of residential and park area was higher than that of the Standard. In general, the level of pollution of industrial complex areas was relatively higher than those of residential and park areas. Among the industrial areas, sasang area was worst in most items. Both $SO_2$ and TSP showed the level to affect the human body in most of studied areas. It is necessary to install a new Air Quality Standard for HCHO to screen our environmental pollution.

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Quality Characteristics of Pettitoes(Jokbal) added with Coffee Meal (커피박 첨가 돈족(豚足)의 품질특성)

  • Choi, Seok-Bong;An, Sang-Ran;Lee, Myung-Ho
    • Culinary science and hospitality research
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    • v.22 no.2
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    • pp.115-124
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    • 2016
  • The purpose of this paper is to verify improvement of the basic quality of food resources and make the pork legs as the more advanced food products after taking special processing steps with the mixture of traditional medical herbs and hot water extracted coffee meal. The pH level of the pettitoes(Jokbal) showed the highest rate among the control group but it showed no statistical differences in the moisture content between the control and the pettitoes(Jokbal) processed with coffee waste extract as an additional component. In addition, the levels of crude fat and crude ash showed slight increases as the addition of the amount increase. In case of the proteins, however, tendency of slight was decreased but it was not significantly difference as the amount increases. The sodium rate in the pettitoes(Jokbal) was higher in the additional group than in the control group. Texture analysis showed a tendency of wide decrease in the hardness and chewiness depending on amount of the added coffee waste extract. On the other hand, as for the cohesiveness and springiness, there was no significant difference with the control group. In case of the lightness value, as the amount of added coffee waste extract is increased from 10% to 20% and 30%, the 'L' value was reduced significantly compared to that of the control. And the 'a' value was not significantly different compared to the coffee waste extract foil impregnated furniture control. But the 'b' values were significantly increased in accordance with the result of increasing the amount of control is at the lowest level. The result may come from the influence of coffee waste extract, which affects the color of the pettitoes(Jokbal). According to the sensory evaluation, the pork part with 10% of coffee waste extract showed the highest score in looking, chewiness, smell and preference, resulting in the improvement in quality of the pettitoes(Jokbal).

Change of Dose Exposure and Improvement of Image Quality by Additional Filtration in Mammography (유방촬영용장치 부가필터에 따른 선량변화 및 화질개선)

  • Cho, Woo Il;Kim, Young Kuen;Lee, Gil Dong
    • Journal of Radiation Protection and Research
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    • v.38 no.2
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    • pp.78-90
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    • 2013
  • Recently, the interest on exposure to radiation is rising. The radiation exposure of mammography is higher in absorbed dose than of X-ray, therefore unnecessary exposure needs to be reduced, and higher image quality is needed. Generally, ray quality of the radiation imaging is an important factor that determines image quality and the amount of ray exposure, and they are affected by tube voltage and added filter. The X-ray energy that is exposed from mammography device is generally a continuous spectrum, which includes low energy that has minute influence on the image quality, and high energy that hinders contrast on image. Currently, molybdenum (Mo) and rhodium (Rh) are the most used added filters for mammography device, and they are used differently according to the energy region of X-ray. This study aims to find out the degree of reduction in exposure dose according to the thickness of aluminum (Al), and to study the changes in image quality and dose when the added filter plates that are made with niobium (Nb) or zirconium (Zr) are used, other than molybdenum (Mo) and rhodium (Rh), the two most used added filters that have similar atomic number and K-absorption regions as Nb and Zr. In this study, single-added filters of molybdenum (Mo), niobium (Nb), and zirconium (Zr) are used, and in some cases, Aluminum (Al) is combined with the single filters. In this case, image quality is considered to be improved depending on the type of added filters, and by using Aluminum (Al) filter together with the others, unnecessary X-ray of low energy would be absorbed, therefore the dose is expected to decrease without any influence when the concentration level becomes identical.

Using CR System at the Department of Radiation Oncology PACS Evaluation (방사선 종양학과에서 CR System을 이용한 PACS 유용성 평가)

  • Hong, Seung-Il;Kim, Young-Jae
    • Journal of the Korean Society of Radiology
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    • v.6 no.2
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    • pp.143-149
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    • 2012
  • Today each hospital is trend that change rapidly by up to date, digitization and introducing newest medical treatment equipment. So, we introduce new CR system and supplement film system's shortcoming and PACS, EMR, RTP system's network that is using in hospital harmoniously and accomplish quality improvement of medical treatment and service elevation about business efficiency enlargement and patient Accordingly, we wish to introduce our case that integrate reflex that happen with radiation oncology here upon to PACS using CR system and estimate the availability. We measured that is Gantry, Collimator Star Shot, Light vs. Radiation, HDR QA(Dwell position accuracy) with Medical LINAC(MEVATRON-MX) Then, PACS was implemented on the digital images on the monitor that can be confirmed through the QA. Also, for cooperation with OCS system that is using from present source and impose code that need in treatment in each treatment, did so that Order that connect to network, input to CR may appear, did so that can solve support data mistake (active Pinacle's case supports DICOM3 file from present source but PACS does not support DICOM3 files.) of Pinacle and PACS that is Planning System and look at Planning premier in PACS. All image and data constructed integration to PACS as can refer and conduct premier in Hospital anywhere using CR system. Use Dosimetry IP in Filmless environment and QA's trial such as Light/Radition field size correspondence, gantry rotation axis' accuracy, collimator rotation axis' accuracy, brachy therapy's Dwell position check is available. Business efficiency by decrease and so on of unnecessary human strength consumption was augmented accordingly with session shortening as that integrate premier that is neted with radiation oncology using CR system to PACS. and for the future patient information security is essential.

An Optimization Method of Measuring Heart Position in Dynamic Myocardial Perfusion SPECT with a CZT-based camera (동적 심근관류 SPECT에서 심장의 위치 측정방법에 대한 고찰)

  • Seong, Ji Hye;Lee, Dong Hun;Kim, Eun Hye;Jung, Woo Young
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.1
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    • pp.75-79
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    • 2019
  • Purpose Cadmium-zinc-telluride (CZT) camera with semiconductor detector is capable of dynamic myocardial perfusion SPECT for coronary flow reserve (CFR). Image acquisition with the heart positioned within 2 cm in the center of the quality field of view (QFOV) is recommended because the CZT detector based on focused multi-pinhole collimators and is stationary gantry without rotation. The aim of this study was to investigate the optimal method for measuring position of the heart within the center of the QFOV when performing dynamic myocardial perfusion SPECT with the Discovery NM 530c camera. Materials and Methods From June to September 2018, 45 patients were subject to dynamic myocardial perfusion SPECT with D530c. For accurate heart positioning, the patient's heart was scanned with a mobile ultrasound and marked at the top of the probe where the mitral valve (MV) was visible in the parasternal long-axis view (PLAX). And, the marked point on the patient's body matched with the reference point indicated CZT detector in dynamic stress. The heart was positioned to be in the center of the QFOV in rest. The coordinates of dynamic stress and rest were compared statistically. Results The coordinates of the dynamic stress using mobile ultrasound and those taken of the rest were recorded for comparative analysis with regard to the position of the couch and analyzed. There were no statistically significant differences in the coordinates of Table in & out, Table up & down, and Detector in & out (P > 0.05). The difference in distance between the 2 groups was measured at $0.25{\pm}1.00$, $0.24{\pm}0.96$ and $0.25{\pm}0.82cm$ respectively, with no difference greater than 2 cm in all categories. Conclusion The position of the heart taken using mobile ultrasound did not differ significantly from that of the center of the QFOV. Therefore, The use of mobile ultrasound in dynamic stress will help to select the correct position of the heart, which will be effective in clinical diagnosis by minimizing the image quality improvement and the patient's exposure to radiation.

A Study on the Outlook of Dental Hygiene Students on the Possible Countermeasure of Domestic Hospitals for the Opening of the Medical Market (의료시장 개방에 따른 국내병원 대응에 대한 치위생과 학생들의 견해에 관한 연구)

  • Yoon, Hyun-Seo;Kim, Dong-Yeol
    • Journal of dental hygiene science
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    • v.9 no.4
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    • pp.443-451
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    • 2009
  • The purpose of this study was to examine the views of dental hygiene students about the possible countermeasure of domestic hospitals for the opening of the medical market. The subjects in this study were 269 dental hygiene sophomores, juniors and seniors at two different colleges in the region of Busan. The findings of the study were as follows: The opening of the medical market and views of possible countermove, whether they agreed to that or not made a statistically significant difference to their opinions on the necessity of customer-oriented marketing strategy(p=0.023), analysis of foreign medical markets/attempt to make inroads into the markets(p<0.000) and the improvement of the quality of medical services/the diversification of the services(p=0.025). As to an intention of going to a foreign hospital, they had a statistically significantly different intention about whether to go to a foreign hospital regardless of medical bills(p<0.000), whether to consult a doctor in a foreign hospital after going to a domestic hospital first (p<0.000), whether to consider the distance between their houses and a foreign hospital(p=0.05) and whether to take considerations on the assistance of an interpreter(p=0.023). In regard to preference for foreign hospitals, American hospitals ranked first(41.9), followed by Australian hospitals(19.9) and Canadian ones(14.2).

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The Learning Curve of Laparoscopy-assisted Distal Gastrectomy (LADG) for Cancer (학습곡선을 기준으로 한 복강경 보조 원위절제술에 대한 결과)

  • Kim, Kab-Choong;Yook, Jeong-Hwan;Choi, Ji-Eun;Cheong, Oh;Lim, Jeong-Taek;Oh, Sung-Tae;Kim, Byung-Sik
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.232-236
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    • 2008
  • Purpose: Laparoscopic surgery for gastric cancer was introduced in the past decade because it was considered less invasive than open surgery, and this results in less postoperative pain, faster recovery and an improved quality of life. Several studies have demonstrated the safety and feasibility of this procedure. We examined the outcome of performing laparoscopic surgery for gastric cancer over the last two year. Materials and Methods: From April 2004 to December 2006, 329 patients with gastric adenocarcinoma underwent a laparoscopy-assisted distal gastrectomy with lymph node dissection. The data was retrospectively reviewed in terms of the clinicopathologic findings, the perioperative outcomes and the complications. Results: The total patient group was comprised 196 men (59.6%) and 133 women (40.4%). The mean BMI was 23.6 and the mean tumor size was 2.7 cm. The mean number of harvested lymph node was 22.7, and this was 18.6 before 30 cases and 23.1 after 30 cases, and the difference was significant (P=0.02). The mean operation time was 180.9 min, and this was than 287.9 min before 30 cases and 170.2 min after 30 cases. After 30 cases, there was a significant improvement of the operation time (P<0.01). The mean incision length after 30 cases was shorter than that before 30 cases (P<0.01). Postoperative complications occurred in 24 (7.3%) of 329 patients and there was no conversion to open surgery. Conclusion: Even though the LADG was accompanied by a difficult learning curve, we successfully performed 329 LADG procedures over the past 2 years and we believe that LADG is a safe, feasible operation for treating most early gastric cancers (EGC).

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Building the Process for Reducing Whole Body Bone Scan Errors and its Effect (전신 뼈 스캔의 오류 감소를 위한 프로세스 구축과 적용 효과)

  • Kim, Dong Seok;Park, Jang Won;Choi, Jae Min;Shim, Dong Oh;Kim, Ho Seong;Lee, Yeong Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.76-82
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    • 2017
  • Purpose Whole body bone scan is one of the most frequently performed in nuclear medicine. Basically, both the anterior and posterior views are acquired simultaneously. Occasionally, it is difficult to distinguish the lesion by only the anterior view and the posterior view. In this case, accurate location of the lesion through SPECT / CT or additional static scan images are important. Therefore, in this study, various improvement activities have been carried out in order to enhance the work capacity of technologists. In this study, we investigate the effect of technologist training and standardized work process processes on bone scan error reduction. Materials and Methods Several systems have been introduced in sequence for the application of new processes. The first is the implementation of education and testing with physicians, the second is the classification of patients who are expected to undergo further scanning, introducing a pre-filtration system that allows technologists to check in advance, and finally, The communication system called NMQA is applied. From January, 2014 to December, 2016, we examined the whole body bone scan patients who visited the Department of Nuclear Medicine, Asan Medical Center, Seoul, Korea Results We investigated errors based on the Bone Scan NMQA sent from January 2014 to December 2016. The number of tests in which NMQA was transmitted over the entire bone scan during the survey period was calculated as a percentage. The annual output is 141 cases in 2014, 88 cases in 2015, and 86 cases in 2016. The rate of NMQA has decreased to 0.88% in 2014, 0.53% in 2015 and 0.45% in 2016. Conclusion The incidence of NMQA has decreased since 2014 when the new process was applied. However, we believe that it will be necessary to accumulate data continuously in the future because of insufficient data until statistically confirming its usefulness. This study confirmed the necessity of standardized work and education to improve the quality of Bone Scan image, and it is thought that update is needed for continuous research and interest in the future.

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