The Role of Core Needle Biopsy for the Evaluation of Thyroid Nodules with Suspicious Ultrasound Features

정새롬,백정환,Young Jun Choi,Tae-Yon Sung,Dong Eun Song,김태용,이정현 대한영상의학회 2019 Korean Journal of Radiology Vol.20 No.1

Objective: Recent studies demonstrated that core needle biopsy (CNB) can effectively reduce the possibility of inconclusive results and prevent unnecessary diagnostic surgery. However, the effectiveness of CNB in patients with suspicious thyroid nodules has not been fully evaluated. This prospective study aimed to determine the potential of CNB to assess thyroid nodules with suspicious ultrasound (US) features. Materials and Methods: Patients undergoing CNB for thyroid nodules with suspicious features on US were enrolled between May and August 2016. Diagnostic performance and the incidence of non-diagnostic results, inconclusive results, conclusive results, malignancy, unnecessary surgery, and complications were analyzed. Subgroup analysis according to nodule size was performed. The risk factors associated with inconclusive results were evaluated using multivariate logistic regression analysis. Results: A total of 93 patients (102 thyroid nodules) were evaluated. All samples obtained from CNB were adequate for diagnosis. Inconclusive results were seen in 12.7% of cases. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for diagnosis of malignancy were 93.8%, 100%, 100%, 78.9%, and 95%, respectively. None of the patients underwent unnecessary surgery. The diagnostic performance was not significantly different according to nodule size. On multivariate logistic regression analysis, larger nodule size and shorter needle length were independent risk factors associated with inconclusive results. Conclusion: Samples obtained by CNB were sufficient for diagnosis in all cases and resulted in high diagnostic values and conclusive results in the evaluation of suspicious thyroid nodules. These findings indicated that CNB is a promising diagnostic tool for suspicious thyroid nodules.

Computer-Aided Diagnosis System for the Evaluation of Thyroid Nodules on Ultrasonography: Prospective Non-Inferiority Study according to the Experience Level of Radiologists

정새롬,백정환,이민경,안유라,Young Jun Choi,성태연,송동은,김태용,이정현 대한영상의학회 2020 Korean Journal of Radiology Vol.21 No.3

Objective: To determine whether a computer-aided diagnosis (CAD) system for the evaluation of thyroid nodules is non-inferior to radiologists with different levels of experience. Materials and Methods: Patients with thyroid nodules with a decisive diagnosis of benign or malignant nodule were consecutively enrolled from November 2017 to September 2018. Three radiologists with different levels of experience (1 month, 4 years, and 7 years) in thyroid ultrasound (US) reviewed the thyroid US with and without using the CAD system. Statistical analyses included non-inferiority testing of the diagnostic accuracy for malignant thyroid nodules between the CAD system and the three radiologists with a non-inferiority margin of 10%, comparison of the diagnostic performance, and the added value of the CAD system to the radiologists. Results: Altogether, 197 patients were included in the study cohort. The diagnostic accuracy of the CAD system (88.5%, 95% confidence interval [CI] = 82.7–92.5) was non-inferior to that of the radiologists with less experience (1 month and 4 year) of thyroid US (83.0%, 95% CI = 76.5–88.0; p < 0.001), whereas it was inferior to that of the experienced radiologist (7 years) (95.8%, 95% CI = 91.4–98.0; p = 0.138). The sensitivity and negative predictive value of the CAD system were significantly higher than those of the less-experienced radiologists were, whereas no significant difference was found with those of the experienced radiologist. A combination of US and the CAD system significantly improved sensitivity and negative predictive value, although the specificity and positive predictive value deteriorated for the less-experienced radiologists. Conclusion: The CAD system may offer support for decision-making in the diagnosis of malignant thyroid nodules for operators who have less experience with thyroid US.

UV를 이용한 폐기물의 안정화도 평가방법에 관한 연구

정새롬,김경,윤석표,이병선,이남훈 한국폐기물자원순환학회(구 한국폐기물학회) 2011 한국폐기물자원순환학회 추계학술발표논문집 Vol.2011 No.-

[유기성 폐기물 처리 / 자원화] 폐기물매립지의 생물학적 안정화도 평가기준에 관한 연구

정새롬,이경미,김혜진,이남훈 한국폐기물자원순환학회 2010 한국폐기물자원순환학회 학술대회 Vol.2010 No.1

매립가스 중에 함유된 실록산 농도의 특성

정새롬,박정극,허광범,이채영,이남훈 한국폐기물자원순환학회 2010 한국폐기물자원순환학회지 Vol.27 No.4

초등학교 수학에서 속력 지도 방안 연구

정새롬,조영미 공주교육대학교초등교육연구원 2011 敎育論叢 Vol.48 No.1

이 논문에서는 초등학교 수학에서 속력 지도를 위한 교수학습 과정안을 마련하는데 목적을 두었다. 이를 위해 속력 개념을 분석하였으며, 속력 지도 방안을 마련하고 영재교육을 받고 있는 초등학교 4학년생들에게 수업을 하여 그 결과를 살펴보았다. 학생들은 속력에 관한 여러 가지 개념을 익히고, 그것을 활용하여 속력 관련 문제를 해결할 수 있었다. 한편 학생들이 속력을 배우는 과정에서 비 개념, 즉 두 가지 변수를 관계적으로 이해해야 한다는 점에서 어려움을 나타내었다. 또한 속력이 실제로는 '평균 속력'임을 이해하는데 있어 어려움을 겪는 학생들이 있었다. In this thesis we aimed to produce a scheme of the instruction of speed for elementary school mathematics. The speed was not taught during the 7th curriculum in South Korea. But in the new curriculum of 2007 it must be taught for students in elementary school mathematics. So the scheme of the instruction of speed should be developed. For this purpose, we examined the concept of speed. And we also looked around the mathematics textbooks from 1st to 5th. The curriculum of science also was examined for it cotained the contents of speed. Finally we produced the sheets of activities for teaching the speed to students in elementary school. And we taught 4th grade students with them. We found that the students liked to learn the concept of speed and apply it to the mathematics problems. But they felt difficulties in some aspects, so we referred about them.

일반연제(포스터) : P-22 ; 2년 9개월간 AFB Culture 양성률 중 NTM 비율의 증가

정새롬 대한임상병리사협회 2010 임상미생물검사학회 발표자료집 Vol.2010 No.-

배경: 결핵균은 M. tuberculosis complex와 nontuberculous mycobacteria로 나눌 수 있다. 보통결핵균이라 하면 거의 병원성 세균인 M. tuberculosis가 많이 검출 되었지만, 최근 들어서는nontuberculous mycobateria 검출률이 증가하고 있는 추세이다. 본원에서는 AFB culture에서MTB 양성률과 증가하고 있는 NTM 양성률을 비교해 보았다. 방법: ① 객담 내에는 많은 잡균들이 존재하고 있으므로 이들을 제거하고 점액질인 객담을 액화시키도록 NALC - NaOH를 사용하여 전처리 한다. ② 검체 1 ml에 NALC - NaOH 시약을 검체와 동량으로 넣은 후 15분 방치 후 검체가 풀릴때까지 vortexing 한다. ③ 4℃, 3600 rpm, 30분간 원심 후 상층액을 제거한다. ④ 침사에 동량의 Acid plus를 넣고 10분 방치 후 vortexing 하여 침사를 배지에 접종한다. 결과: 2년 9개월간 배양검사에서의 양성은 총 의뢰건수 98,188 건중 4,468 건이 배양검사 양성으로 4.55%의 양성률을 나타냈으며 연도별 MTB, NTM 비율은 2008년 1,557건 양성률 중MTB 88.4%, NTM 10.9%, 2009년 1,632건 양성률 중 MTB 86.7%, NTM 12.8%, 2010년 9월30일까지 1,259 건 양성률 중 MTB 81.1%, NTM 18.5%로 NTM의 비율이 증가하고 있다는 걸볼 수 있다. 고찰: 예전에는 NTM이 중요하게 생각되지 않았으나, 최근에 이것에 의한 발병이 증가하여 중요성이 증가하였고, 특히 HIV 환자에게는 문제가 된다. NTM은 강이나 하천, 습한 땅에서 발견되고 임상증상이 없는 환자의 피부, 비뇨생식기 검체에 분리될 수 있다. 또한 병원감염이나 병원 기구 오염과 관련이 있으므로 우리는 검사를 할 때 기구가 오염 되지 않았는지 시약, 기구 등을 제대로 멸균해서 사용하고 있는지 확인해 볼 필요가 있다고 본다.

Better를 이끌어내는 Worse 캠페인 사용 설명서

정새롬 한국마케팅연구원 2013 마케팅 Vol.47 No.12

Fungal Keratitis Caused by Corynespora cassiicola, a Plant Pathogen

정새롬,이혜수,유인천 대한의진균학회 2018 대한의진균학회지 Vol.23 No.1

A 74-year-old man presented with pain and progressively worsening vision from 20 days ago in the left eye. His ophthalmological history was significant for cataract extraction, scleromalacia, and three surgeries for pterygium removal in the left eye. Slit-lamp examination was remarkable for a 4.5×4.0 mm sized epithelial defect, with corneal stromal infiltration and melting and a surrounding feathery margin. Corneal scraping was performed, and culture of specimen demonstrated mold that grew on Sabouraud dextrose agar. The isolate was finally identified as Corynespora cassiicola based on DNA sequencing analysis of internal transcribed spacer (ITS) with maximum identity of 100%. The patient was treated successfully with intracameral amphotericin B injection and topical voriconazole and amphotericin B. To the best of our knowledge, this is the first reported case of mycotic keratitis caused by a plant pathogen, Corynespora cassiicola, in Korea.

Diffusion-weighted Magnetic Resonance Imaging for Predicting Response to Chemoradiation Therapy for Head and Neck Squamous Cell Carcinoma: A Systematic Review

정새롬,Young Jun Choi,Chong Hyun Suh,Jeong Hyun Lee,Jung Hwan Baek 대한영상의학회 2019 Korean Journal of Radiology Vol.20 No.4

Objective: To systematically review the evaluation of the diagnostic accuracy of pre-treatment apparent diffusion coefficient (ADC) and change in ADC during the intra- or post-treatment period, for the prediction of locoregional failure in patients with head and neck squamous cell carcinoma (HNSCC). Materials and Methods: Ovid-MEDLINE and Embase databases were searched up to September 8, 2018, for studies on the use of diffusion-weighted magnetic resonance imaging for the prediction of locoregional treatment response in patients with HNSCC treated with chemoradiation or radiation therapy. Risk of bias was assessed by using the Quality Assessment Tool for Diagnostic Accuracy Studies-2. Results: Twelve studies were included in the systematic review, and diagnostic accuracy assessment was performed using seven studies. High pre-treatment ADC showed inconsistent results with the tendency for locoregional failure, whereas all studies evaluating changes in ADC showed consistent results of a lower rise in ADC in patients with locoregional failure compared to those with locoregional control. The sensitivities and specificities of pre-treatment ADC and change in ADC for predicting locoregional failure were relatively high (range: 50–100% and 79–96%, 75–100% and 69–95%, respectively). Metaanalytic pooling was not performed due to the apparent heterogeneity in these values. Conclusion: High pre-treatment ADC and low rise in early intra-treatment or post-treatment ADC with chemoradiation, could be indicators of locoregional failure in patients with HNSCC. However, as the studies are few, heterogeneous, and at high risk for bias, the sensitivity and specificity of these parameters for predicting the treatment response are yet to be determined.