1.Overnight Preliminary Interpretations of CT and MR Images by Radiology Residents in ER: How Accurate Are They?.
Kwang Nam JIN ; Hwan Jun JAE ; Cheong Il SHIN ; Ji Won CHAI ; Su Ryung CHUN ; Sang Do SHIN ; Young Joon KANG ; Dong Kyu NA
Journal of the Korean Society of Emergency Medicine 2008;19(2):205-210
PURPOSE: At many institutes in Korea, preliminary interpretations of after-hours CT and MR images are performed by radiology residents, with the attending radiologist's reviewing the interpretations the next day. The purpose of this study was to assess the rate of discrepancy between residents' interpretations and the final interpretations performed by attending radiologists. METHODS: We reviewed the interpretations of 1381 CT and 404 MRI scans that were obtained at the emergency department of our institute over three months. Any discrepancies between the preliminary and final interpretations were categorized as either major or minor discrepancies with a major discrepancy defined as one resulting in a change in diagnosis and treatment plans. We conducted patient follow-up via a retrospective review of the medical records to evaluate the clinical outcomes of the discrepancies. RESULTS: The rate of major discrepancies was 2.5%, and the rate of minor discrepancies was 11.4%. Major discrepancies led to a change in diagnosis or patient treatment plans, but did not lead to any increase in patient morbidity. CONCLUSION: The discrepancy rate at our institution was relatively insignificant, and patient care at the emergency department was not adversely affected by having radiology residents interpret CT and MRI scans after-hours and the attending radiologist review the interpretations the next morning. Still, further efforts are needed in order to reduce the frequency of major discrepancies.
Academies and Institutes
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Emergencies
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Emergency Medicine
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Follow-Up Studies
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Humans
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Internship and Residency
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Korea
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Magnetic Resonance Imaging
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Medical Records
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Patient Care
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Retrospective Studies
2.Vitamin D deficiency in children aged 6 to 12 years: single center's experience in Busan.
Young Eun ROH ; Bo Ryung KIM ; Won Bok CHOI ; Young Mi KIM ; Min Jung CHO ; Hye Young KIM ; Kyung Hee PARK ; Kwang Hoon KIM ; Peter CHUN ; Su Young KIM ; Min Jung KWAK
Annals of Pediatric Endocrinology & Metabolism 2016;21(3):149-154
PURPOSE: This study investigated the prevalence and risk factors associated with vitamin D deficiency in children. METHODS: We analyzed the medical records of 330 patients from the age of 6 to 12, who visited the endocrinology clinic of the Department of Pediatrics at Pusan National University Hospital, from September, 2013 to May, 2014. According to their serum 25-hydroxyvitamin D (25(OH)D) levels, the patients were grouped into either the deficiency group (25(OH)D<20 ng/mL), or the sufficiency group (25(OH)D≥20 ng/mL). The differences between the 2 groups were compared. RESULTS: There were 195 patients (59.1%) who had vitamin D deficiency. Their mean serum 25(OH)D level was 14.86±3.20 ng/mL. The differences in sex, age, and pubertal status between the 2 groups were not statistically significant. Weight standard deviation score (SDS), and body mass index SDS, were significantly higher in the vitamin D deficiency group (P=0.002 for each), compared to the sufficiency group. Compared with Autumn, both Spring (odds ratio [OR], 9.7; 95% confidence interval [CI], 4.3–22.0), and Winter (OR, 5.9; 95% CI, 3.5–10.0), were risk factors for vitamin D deficiency. In multiple logistic regression analysis, only seasonal differences have been confirmed to have an effect on vitamin D deficiency. CONCLUSION: Vitamin D deficiency in children aged 6 to 12 years is very common. Spring and Winter are the most important risk factors for vitamin D deficiency. We suggest that it is necessary to supplement the guideline for the vitamin D intake according to our situation.
Body Mass Index
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Busan*
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Child*
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Endocrinology
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Humans
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Logistic Models
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Medical Records
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Pediatrics
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Prevalence
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Risk Factors
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Seasons
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Vitamin D Deficiency*
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Vitamin D*
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Vitamins*
3.Vitamin D deficiency in children aged 6 to 12 years: single center's experience in Busan.
Young Eun ROH ; Bo Ryung KIM ; Won Bok CHOI ; Young Mi KIM ; Min Jung CHO ; Hye Young KIM ; Kyung Hee PARK ; Kwang Hoon KIM ; Peter CHUN ; Su Young KIM ; Min Jung KWAK
Annals of Pediatric Endocrinology & Metabolism 2016;21(3):149-154
PURPOSE: This study investigated the prevalence and risk factors associated with vitamin D deficiency in children. METHODS: We analyzed the medical records of 330 patients from the age of 6 to 12, who visited the endocrinology clinic of the Department of Pediatrics at Pusan National University Hospital, from September, 2013 to May, 2014. According to their serum 25-hydroxyvitamin D (25(OH)D) levels, the patients were grouped into either the deficiency group (25(OH)D<20 ng/mL), or the sufficiency group (25(OH)D≥20 ng/mL). The differences between the 2 groups were compared. RESULTS: There were 195 patients (59.1%) who had vitamin D deficiency. Their mean serum 25(OH)D level was 14.86±3.20 ng/mL. The differences in sex, age, and pubertal status between the 2 groups were not statistically significant. Weight standard deviation score (SDS), and body mass index SDS, were significantly higher in the vitamin D deficiency group (P=0.002 for each), compared to the sufficiency group. Compared with Autumn, both Spring (odds ratio [OR], 9.7; 95% confidence interval [CI], 4.3–22.0), and Winter (OR, 5.9; 95% CI, 3.5–10.0), were risk factors for vitamin D deficiency. In multiple logistic regression analysis, only seasonal differences have been confirmed to have an effect on vitamin D deficiency. CONCLUSION: Vitamin D deficiency in children aged 6 to 12 years is very common. Spring and Winter are the most important risk factors for vitamin D deficiency. We suggest that it is necessary to supplement the guideline for the vitamin D intake according to our situation.
Body Mass Index
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Busan*
;
Child*
;
Endocrinology
;
Humans
;
Logistic Models
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Medical Records
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Pediatrics
;
Prevalence
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Risk Factors
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Seasons
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Vitamin D Deficiency*
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Vitamin D*
;
Vitamins*
4.Response Prediction of Altered Thyroglobulin Levels After Radioactive Iodine Therapy Aided by Recombinant Human Thyrotropin in Patients with Differentiated Thyroid Cancer
Minchul SONG ; Subin JEON ; Sae Ryung KANG ; Zeenat JABIN ; Su Woong YOO ; Jung Joon MIN ; Hee Seung BOM ; Sang Geon CHO ; Jahae KIM ; Ho Chun SONG ; Seong Young KWON
Korean Journal of Nuclear Medicine 2018;52(4):287-292
PURPOSE: Thyroglobulin (Tg) may be released from damaged residual thyroid tissues after radioactive iodine (RAI) therapy in patients with differentiated thyroid carcinoma (DTC). We investigated whether altered levels of serum Tg after recombinant human thyrotropin (rhTSH)-aided RAI therapy could be a prognostic marker in patients with DTC.METHODS: We evaluated 68 patients who underwent RAI therapy after total thyroidectomy. Serum Tg levels were measured just before RAI administration (D0Tg) and 7 days after RAI therapy (D7Tg). Patients with a D0Tg level greater than 2.0 ng/mL were excluded to more precisely evaluate the injury effect of RAI in small remnant tissues. The ratioTg was defined as the D7Tg level divided by that on D0Tg. The therapeutic responses were classified as acceptable or non-acceptable. Finally, we investigated which clinicopathologic parameters were associated with therapeutic response.RESULTS: At the follow-up examination, an acceptable response was observed in 50 patients (73.5%). Univariate analysis revealed significant differences in N stage (P = 0.003) and ratioTg (acceptable vs. non-acceptable responses, 21.9 ± 33.6 vs. 3.8 ± 6.5; P = 0.006). In multivariate analysis, only ratioTg significantly predicted an acceptable response (odds ratio 1.104; 95% confidence interval 1.005–1.213; P = 0.040). A ratioTg above 3.5 predicted an acceptable response with a sensitivity of 66.0%, specificity of 83.3%, and accuracy of 70.6% (area under the curve = 0.718; P = 0.006).CONCLUSIONS: Altered levels of serum Tg after RAI therapy, calculated as the ratioTg (D7Tg/D0Tg), significantly predicted an acceptable response in patients with DTC.
Follow-Up Studies
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Humans
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Iodine
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Multivariate Analysis
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Sensitivity and Specificity
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Thyroglobulin
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Thyroid Gland
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Thyroid Neoplasms
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Thyroidectomy
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Thyrotropin
5.Response Prediction of Altered Thyroglobulin Levels After Radioactive Iodine Therapy Aided by Recombinant Human Thyrotropin in Patients with Differentiated Thyroid Cancer
Minchul SONG ; Subin JEON ; Sae Ryung KANG ; Zeenat JABIN ; Su Woong YOO ; Jung Joon MIN ; Hee Seung BOM ; Sang Geon CHO ; Jahae KIM ; Ho Chun SONG ; Seong Young KWON
Korean Journal of Nuclear Medicine 2018;52(4):287-292
PURPOSE:
Thyroglobulin (Tg) may be released from damaged residual thyroid tissues after radioactive iodine (RAI) therapy in patients with differentiated thyroid carcinoma (DTC). We investigated whether altered levels of serum Tg after recombinant human thyrotropin (rhTSH)-aided RAI therapy could be a prognostic marker in patients with DTC.
METHODS:
We evaluated 68 patients who underwent RAI therapy after total thyroidectomy. Serum Tg levels were measured just before RAI administration (D0Tg) and 7 days after RAI therapy (D7Tg). Patients with a D0Tg level greater than 2.0 ng/mL were excluded to more precisely evaluate the injury effect of RAI in small remnant tissues. The ratioTg was defined as the D7Tg level divided by that on D0Tg. The therapeutic responses were classified as acceptable or non-acceptable. Finally, we investigated which clinicopathologic parameters were associated with therapeutic response.
RESULTS:
At the follow-up examination, an acceptable response was observed in 50 patients (73.5%). Univariate analysis revealed significant differences in N stage (P = 0.003) and ratioTg (acceptable vs. non-acceptable responses, 21.9 ± 33.6 vs. 3.8 ± 6.5; P = 0.006). In multivariate analysis, only ratioTg significantly predicted an acceptable response (odds ratio 1.104; 95% confidence interval 1.005–1.213; P = 0.040). A ratioTg above 3.5 predicted an acceptable response with a sensitivity of 66.0%, specificity of 83.3%, and accuracy of 70.6% (area under the curve = 0.718; P = 0.006).
CONCLUSIONS
Altered levels of serum Tg after RAI therapy, calculated as the ratioTg (D7Tg/D0Tg), significantly predicted an acceptable response in patients with DTC.
6.Clinical Impact of F-18 FDG PET-CT on Biopsy Site Selection in Patients with Suspected Bone Metastasis of Unknown Primary Site
Su Woong YOO ; Md. Sunny Anam CHOWDHURY ; Subin JEON ; Sae-Ryung KANG ; Changho LEE ; Zeenat JABIN ; Jahae KIM ; Sang-Geon CHO ; Ho-Chun SONG ; Hee-Seung BOM ; Jung-Joon MIN ; Seong Young KWON
Korean Journal of Nuclear Medicine 2020;54(4):192-198
Purpose:
We investigated the clinical role of F-18 fluorodeoxyglucose (FDG) positron emission tomography-computed tomography(PET-CT) in the identification of the primary site and the selection of the optimal biopsy site in patients with suspectedbone metastasis of unknown primary site.
Methods:
The patients with suspected bone metastasis who underwent PET-CT for evaluation of primary site were enrolled inthis study. The primary sites were identified by the histopathologic or imaging studies and were classified according to the FDGuptake positivity of the primary site. To evaluate the guiding capability of PET-CT in biopsy site selection, we statisticallyanalyzed whether the biopsy site could be affected according to the presence of extra-skeletal FDG uptake.
Results:
Among 74 enrolled patients, 51 patients had a metastatic bone disease. The primary site was identified in 48 of 51patients (94.1%). Forty-six patients were eligible to test the association of clinical choice of biopsy site with PET positivity ofextra-skeletal lesion. The extra-skeletal biopsies were done in 42 out of 43 patients with positive extra-skeletal uptake lesions.Bone biopsies were inevitably performed in the other three patients without extra-skeletal uptake lesions. The association cameout to be significant (Fisher’s exact test, P< 0.001).
Conclusion
F-18 FDG PET-CT significantly contributed not only to identify the primary site but also to suggest optimal biopsysites in patients with suspected bone metastasis.
7.Change of Therapeutic Response Classification According to Recombinant Human Thyrotropin‑Stimulated Thyroglobulin Measured at Different Time Points in Papillary Thyroid Carcinoma
Jang Bae MOON ; Subin JEON ; Ki Seong PARK ; Su Woong YOO ; Sae‑Ryung KANG ; Sang‑Geon CHO ; Jahae KIM ; Changho LEE ; Ho‑Chun SONG ; Jung‑Joon MIN ; Hee‑Seung BOM ; Seong Young KWON
Korean Journal of Nuclear Medicine 2021;55(3):116-122
Purpose:
We investigated whether response classification after total thyroidectomy and radioactive iodine (RAI) therapy could be affected by serum levels of recombinant human thyrotropin (rhTSH)-stimulated thyroglobulin (Tg) measured at different time points in a follow-up of patients with papillary thyroid carcinoma (PTC).
Methods:
A total of 147 PTC patients underwent serum Tg measurement for response assessment 6 to 24 months after the first RAI therapy. Serum Tg levels were measured at 24 h (D1Tg) and 48–72 h (D2-3Tg) after the 2nd injection of rhTSH. Responses were classified into three categories based on serum Tg corresponding to the excellent response (ER-Tg), indeterminate response (IR-Tg), and biochemical incomplete response (BIR-Tg). The distribution pattern of response classification based on serum Tg at different time points (D1Tg vs. D2-3Tg) was compared.
Results:
Serum D2-3Tg level was higher than D1Tg level (0.339 ng/mL vs. 0.239 ng/mL, P < 0.001). The distribution of response categories was not significantly different between D1Tg-based and D2-3Tg-based classification. However, 8 of 103 (7.8%) patients and 3 of 40 (7.5%) patients initially categorized as ER-Tg and IR-Tg based on D1Tg, respectively, were reclassified to IR-Tg and BIR-Tg based on D2-3Tg, respectively. The optimal cutoff values of D1Tg for the change of response categories were 0.557 ng/mL (from ER-Tg to IR-Tg) and 6.845 ng/mL (from IR-Tg to BIR-Tg).
Conclusion
D1Tg measurement was sufficient to assess the therapeutic response in most patients with low level of D1Tg. Nevertheless, D2-3Tg measurement was still necessary in the patients with D1Tg higher than a certain level as response classification based on D2-3Tg could change.
8.The Results of Nation-Wide Registry of Age-related Macular Degeneration in Korea.
Kyu Hyung PARK ; Su Jeong SONG ; Won Ki LEE ; Hee Sung YOON ; Hyoung Jun KOH ; Chul Gu KIM ; Yun Young KIM ; Se Woong KANG ; Ha Kyoung KIM ; Byung Ro LEE ; Dong Heun NAM ; Pill Young LEE ; Hyoung Su KIM ; Hyeoung Chan KIM ; Si Yeol KIM ; In Young KIM ; Gwang Su KIM ; Kuhl HUH ; Jae Ryung OH ; Shin Dong KIM ; Sang Jun LEE ; Young Duk KIM ; Soon Hyun KIM ; Tae Gon LEE ; Sung Won JOE ; Dong Cho LEE ; Mu Hwan CHANG ; Si Dong KIM ; Young Wok JOE ; Sun Ryang BAE ; Ju Eun LEE ; Boo Sup OUM ; Ill Han YOON ; Soon Ill KWON ; Jae Hoon KANG ; Jong In KIM ; Sang Woong MOON ; Hyeong Gon YU ; Young Hee YOON ; Gwang Yul CHANG ; Sung Chul LEE ; Sung Jin LEE ; Tae Kwan PARK ; Young Hun OHN ; Oh Woong KWON ; Woo Hyok CHANG ; Yeon Sik YANG ; Suk Jun LEE ; Su Young LEE ; Chang Ryong KIM ; Jung Hee LEE ; Yeon Sung MOON ; Jae Kyoun AHN ; Nam Chun JOE ; Gwang Ju CHOI ; Young Joon JOE ; Sang Kook KIM ; Sung Pyo PARK ; Woo Hoo NAM ; Hee Yoon JOE ; Jun Hyun KIM ; Hum CHUNG
Journal of the Korean Ophthalmological Society 2010;51(4):516-523
PURPOSE: To evaluate the incidence and clinical features of age-related macular degeneration (AMD) in Korea. METHODS: Web-based (www.armd-nova.or.kr) registration was conducted for AMD patients aged 50 or more who were newly diagnosed by retinal specialists in Korea from August 20, 2005 to August 20, 2006. Patient data including ophthalmologic examination, fundus photography, fluorescein angiogram and/or indocyanin green angiogram (ICG), past medical history, behavioral habit, combined systemic diseases were up-loaded. RESULTS: Among finally enrolled 1,141 newly diagnosed AMD patients, 690 patients (60.5%) were male and 451 patients (39.5%) were female. The average age of AMD patients was 69.7+/-8.0. Early AMD was observed in 190 patients and 951 patients had late AMD. Classic choroidal neovascular membrane (CNVM) was observed in 18.6% of exudative AMD patients and 63.4 % had occult CNVM. Subfoveal CNVM was observed in 80.4% of the patients with CNVM. Among the 580 exudative AMD eyes that performed indocyanin green angiography (ICG), 184 eyes (31.7%) had polypoidal choroidal vasculopathy (PCV) and 36 eyes (6.2%) showed retinal angiomatous proliferation (RAP). Age, male gender, smoking, diabetes and hypertension significantly increased the risk of the AMD among Koreans. CONCLUSIONS: Because of the low rate of participation by retinal specialists, definite incidence of AMD was not obtainable. However, the estimated 1-year AMD incidence in the Pusan area of Korea is at least 0.4%. In contrast to Western people, 31.7% of exudative AMD cases were revealed to be PCV and 6.2% were revealed to be RAP. This discrepancy between ethnic groups should be considered in the diagnosis and treatment modality selection of Korean AMD patients.
Aged
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Angiography
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Choroid
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Ethnic Groups
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Eye
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Female
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Fluorescein
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Humans
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Hypertension
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Incidence
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Korea
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Macular Degeneration
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Male
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Membranes
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Photography
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Retinaldehyde
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Smoke
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Smoking
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Specialization