의료영상 품질관리의 전망

최준일 대한의사협회 2015 대한의사협회지 Vol.58 No.12

After the enactment of the laws for special medical devices, quality assurance for medical imaging devices such as computed tomography, magnetic resonance imaging, and mammography has been widely performed in Korea and the results of quality assurance tests for these imaging devices also have been markedly improved. However, this is not the end. The ultimate goal of quality assurance for medical imaging might be the overall quality improvement over the whole process of imaging studies in medical fields. From this point of view, quality assurance of medical imaging has a long way to go. In this review, we will look some future perspectives of the quality assurance of medical imaging.

프로토콜 명세의 검증에 관한 연구

최준일 김천대학교 1994 김천대학교 논문집 Vol.15 No.-

The specification written in CSP-based specification language is analyzed and the state transition table that represents the behavior of a specified protocol is prepared. Then refe-rencing this state transition table, user can verify the behavior of a protocol through a user interface, and important features such as deadlock, unreachable state and unspecified input- output are verified. Using the system, detection and correction of a mis-specified protocol are possible at the initial phase of a development cycle.

Efficacy of Alternative Antiandrogen Therapy for Prostate Cancer That Relapsed after Initial Maximum Androgen Blockade

최준일,김윤범,양승옥,이정기,정태영 대한비뇨의학회 2011 Investigative and Clinical Urology Vol.52 No.7

Purpose: We evaluated the effectiveness of second-line maximum androgen blockade (MAB) with an alternative antiandrogen in patients who relapsed after initial MAB. Materials and Methods: We retrospectively analyzed 47 patients with prostate cancer who relapsed after initial MAB, including surgical or medical castration combined with antiandrogens, from January 1998 to December 2009. When the serum prostate-specific antigen (PSA) level was increased on three consecutive occasions, we discontinued the antiandrogen and then administered an alternative antiandrogen. Seven patients were assessed for antiandrogen withdrawal syndrome (AWS). The effect of the second-line MAB was evaluated by the serum PSA level, and response was subdivided into ≥50% and <50% PSA reductions from the baseline PSA at the start of second-line MAB. Results: PSA reduction was observed in 32 patients (68.1%). Among them, 23 (48.9%) achieved ≥50% PSA reductions with a mean response duration of 13.4±5.4 months. Nine (19.2%) patients reached <50% PSA reductions with a mean response duration of 12.2±6.2 months. The time to nadir PSA level after first-line MAB in the ≥50% PSA reduction group, <50% PSA reduction group, and PSA elevation group was 15.6±12.9 months, 11.8±6.0 months, and 8±6.5 months, respectively. That is to say, it was significantly longer in the responder groups (p=0.038). Conclusions: Second-line MAB using an alternative antiandrogen is an effective treatment option before cytotoxic chemotherapy in patients who relapse after initial MAB.

영상의학검사의 정도관리

최준일,나동규,김학희,신용문,안국진,이재영 대한영상의학회 2004 대한영상의학회지 Vol.50 No.5

Medical imaging is the one of the most important diagnostic tools of modern medical science and quality control of the medical imaging is already systemized in the advanced countries. However, in Korea, quality control of medical imaging has not been properly performed until now and low quality examinations have been done without any regulation. The Korean Radiological Society, as society of supervision of medical imaging, has emphasized the importance of quality control and in 2003, the law for the quality control of medical imaging was made. In conformity of the law, the regulation of the quality control of medical imaging will commence, but this is just the beginning and there are still many tasks left for settling down and expanding the range of the quality control of the medical imaging. We reviewed the history of the quality control of medical imaging in Korea and explained the particulars of mammography, fluoroscopy, computed tomography and magnetic resonance imaging. We also looked into future prospect and tasks of the quality control of medical imaging. 현대 의학에서 가장 중요한 진단 도구인 영상의학검사는 정도관리가 체계화된 선진국과는 달리, 우리나라에서는 최근까지 적절한 화질 관리 체계 없이 운용되어, 일부 부적절한 품질의 영상의학검사가 남용되는 부작용이 있었다. 대한영상의학회는 영상의학검사의 주관 학회로서 꾸준히 영상의학검사에 대한 체계적 정도관리의 필요성을 주장하였고, 재정건전화특별법에 근 거한 특수의료장비의설치및운영에관한규칙이 2003년 발효되면서 영상의학검사의 정도관리는 법적 제도 내로 들어오게 되었다. 현재 영상의학검사의 정도관리가 제도적으로 실행되고 있지 만 아직 시작 단계에 불과하고, 발전적으로 정착되기 위해서는 여러 과제들을 해결해야 할 시 점이다. 본 종설에서는 우리나라에서의 정도관리 사업의 진행 과정과 유방촬영용장치, 투시촬 영용장치, 전산화단층촬영장치, 자기공명영상촬영장치 검사의 정도관리 실제 그리고 추후 정도 관리 사업의 전망 및 과제를 알아보고자 한다.

소뇌와 뇌교의 정상 자기공명분광 소견: 같은 장비내 및 다른 장비간의 결과 비교

최준일,장기현,송인찬,도강현,이준우 대한자기공명의과학회 2001 Investigative Magnetic Resonance Imaging Vol.5 No.2

목적 : 정상 성인에셔 소뇌와 뇌교의 MRS의 정상 소견과 대사물질비의 정상값을 구하고, 같은 장비에서 반복 시행한 결과의 차이와 다른 장비간의 결과의 차이가 어느 정도인지를 알아보고자 하였다. 대상 및 방법 : 건강한 9명의 정상 자원자(평균연령 23세)를 대상으로 두 개의 서로 다론 1.5T MR 장비 (A, B 장비)에서 각각 두 번씩 총 4회의 MRS를 양측 소뇌 반구와 뇌교에셔 시행하였 다. 스핀에코 단일화적소기법을 이용하였고 소뇌에서는 $2{\times}2{\times}1.5{\;}em$의 voxel 크기를, 뇌교 에서는 $1.5{\times}1.5{\times}1.5{\;}cm$의 voxel을 적용하였다. TR/TE는 2000/288 msec, Averaging 은 128회로 하였다. 소뇌와 뇌교의 NAA/Cho, NAA/Cr, NAA/(Cho+Cr), Cr/Cho 비를 peak height와 peak area로 각각 구하여, 같은 장비 내 (intra-unit) , 그리고 다론 장비간 (inter-unit)의 정상값에 유의한 차이가 있는지를 알아보았다. 결과 : A 장비에서 첫번째로 시행한 peak height NAA/Cho, NAA/Cr, NAA/(Cho+ Cr), CriCho 비의 평균값(표준편차는 소뇌에서 각각 $1.08{\pm}0.16,{\;}1.44{\pm}0.286,{\;}0.61{\pm}0.09,{\;}0.76{\pm}0.13$ 였고, 두번째 시행한 결과와 비교할 때 장비내 차이는 3-7% 였다. B장비에서 시 행한 2회의 검사 사이에서는 22% 의 차이를 보인 Cr/Cho를 제외하면 1-9% 의 장비내 차이 를 보였다. A, B 두 장비 간 차이는 1-26%였다. 뇌교에서는 A장비 첫번째 peak height 측정 치는 $1.51{\pm}0.35,{\;}3.35{\pm}0.78,{\;}1.02{\pm}0.16,{\;}0.47{\pm}0.14$로서, 소뇌보다 NAA/Cho, NAA/Cr, NAA!(Cho+Cr) 비가 유의하게 높았다. 장비내 차이는 A장비에서 2-21 %였고, B장비에서 4-18%였다. A, B 두 장비간 차이는 1-18% 였다. peak area로 구한 대사산물비의 평균값은 peak height 의 그것에 비해 전반적으로 두 장비에서 높거나 광범위한 변이를 보였다. 결론 : 소뇌의 NAA/Cho과 NAA/Cr의 평균값이 뇌교의 그것보다 유의하게 낮았다. 같은 장비 내에서 반복 시행한 평균값의 차이는 대체적으로 유의한 차이가 없었으나, 다른 장비에서 반복 시행한 장비간의 사이에는 유의한 차이가 있는 경우가 더 많았다. 따라서 , MRS 검사를 소뇌나 뇌교의 어떤 절환에 적용하기 전에 각 장비 마다 정상 기준치를 반드시 얻은 후에 이상여부를 판 정하는 것이 필수적이라고 생각된다. Purpose: The purposes of this study are to evaluate normal MR spectroscopy (MRS) data of the cerebellum and pons, and to evaluate intra-unit and inter-unit differences of the results. Materials and methods: Nine normal volunteers (mean age 23 years) were studied with two 1.5 Tesla MR units (A and B units). A total of four sessions of MRS study were performed with two sessions in ea.ch MR unit in each volunteer. In each session, MRS data were obtained from bilateral cerebellar hemisphere and pons. MRS was performed using spin-echo single voxel technique with repetition time of 2000 ms, echo time of 288ms and 128 averagings. Voxel size was $2{\;}{\times}{\;}2{\;}{\times}{\;}1.5{\;}cm$ in the cerebellum and $1.5{\;}{\times}{\;}1.5{\;}{\times}{\;}1.5{\;}cm$ in the pons. Metabolite ratios of NAA/Cho, NAAcCr, NAAc(Cho+Cr) and Cr/Cho (both peak heights and the peak areas) were compared among the results of four sessions of MRS for evaluation of intra-unit and inter-unit differences. Results: In the cerebellum, mean (SO values of peak height NAA/Cho, NAA/Cr, NAA/(Cho+Cr) and Cr/Cho ratios obtained in the first session of A unit were $1.08{\pm}O.16,{\;}1.44{\pm}O.286,{\;}0.61{\pm}O.09{\;}and{\;}O.76{\pm}0.13$, respectively. Comparing with the results of the second session, intra-unit differences were 3-7%. In B unit intra-unit differences were 1-9%, except for 22% of Cr/Cho ratio. Inter-unit differences between A and B units were 1-26%. In the pons, mean ISD values of peak height NANCho, NANCr, NANICho + Cr) and Cr/Cho ratios obtained in the first session of A unit were $1.51{\pm}O.35,{\;}3.35{\pm}O.78,{\;}1.02{\pm}0.16{\;}and{\;}0.47{\pm}O.14$, respectively. Mean NAAfCho, NANCr and NAAI(Cho+ Cr} ratios of the pons were significantly higher than those of the cerebellum. Intra-unit differences were 2-21 % in A unit and 4-18 % in B unit. Inter-unit differences between A and B units were 1-18%. The mean values obtained by using peak area were generally higher and wider in range than those of peak height in both units. Conclusion: Mean NAAfCho, NAAlCr and NAAf(Cho+Cr) ratios of the cerebellum were significanHy lower than those of the pons. Intra-unit differences of most metabolites ratios were generally not significant, whereas inter-unit differences were greater than intra-unit differences in more metabolite ratios. Therefore, normal MRS data of the cerebellum and the pons should be obtained in every MR unit, before MRS applications in the diseases of the cerebellum and the pons.

재사용 소프트웨어 부품의 추출 및 분류에 관한 연구

최준일 김천대학교 1996 김천대학교 논문집 Vol.17 No.-

To overcome today's software crisis, we should reconsider software reusability in software development. Recently software reusability become a key issue in software engineering. Reusing software com-ponents enhance the productivity and quality of software. In this paper, the identification and classification system devel-oped for the reuse system. While a great deal of research over the past several years has been devoted to the component libraries and reusable software component, the composition issue of how to extract reusable components from existing systems, to classify reusable component has remained relatively unexplored. The identi-fication and classification system for the reusable components will support practical application for the reuse system.

리피오돌 침착을 이용한 간세포암의 CT유도하 고주파 열치료 : 치료효과 및 부작용

최준일,박중원,김창민,이우진,박상재,이광웅,김성훈,한성식,우상명 대한간학회 2008 Clinical and Molecular Hepatology(대한간학회지) Vol.14 No.3(S)

CO₂ electrolysis Ruddlesden-Popper cathode prepared with in situ exsolved Fe nanoparticles in solid oxide electrolysis cell

최준일,박성민,이승준,박민선,김지훈,김원배 한국에너지학회 2021 한국에너지공학회 학술발표회 Vol.2021 No.4

교량슬래브 붕괴 관련 안전 취약공종(가시설)의 점검기준 마련

최준일,Choe, Jun-Il 한국도로학회 2007 도로 : 도로학회지 Vol.9 No.3

프로젝트 산출물 재사용을 위한 데이터베이스의 분석 및 설계에 관한 연구

최준일 김천대학교 1999 김천대학교 논문집 Vol.20 No.-

The technique of Software Reusability have been introduced in order to enhance the development productivity and the quality of the software itself. The currently developed and used Software Reusability with the poor interconnection of the existing Software Development Methodology during the life cycle of the Software Development. In this paper, We will analyze and design a project deliverables database system which can share and reuse project deliverables.