• Title/Summary/Keyword: Agreement score

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When Should Familial Hypercholesterolemia Be Suspected?: A Case of Dyslipidemia in Young Patient without Coronary Artery Disease (가족성 고콜레스테롤혈증은 언제 의심해야 할까?: 관상동맥 질환이 없는 젊은 이상지질혈증 환자 증례)

  • In Sun Ryou
    • Archives of Obesity and Metabolism
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    • v.2 no.1
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    • pp.29-35
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    • 2023
  • Familial hypercholesterolemia (FH) is a genetic disease that is not well known or diagnosed in Korea. This disease is associated with persistently high levels of low-density lipoprotein cholesterol (LDL-C), which increase the risk of coronary artery disease at a young age. Therefore, early diagnosis and treatment are important; however, there are no global consensus diagnostic criteria. In Korea, the Dutch Lipid Clinic Network diagnostic criteria, and the Simon Broome diagnostic criteria were used for diagnosis of FH according to the agreement announced at the Korean Society of Lipid and Atherosclerosis (KSoLA) in 2022. Recently, the absence of coronary artery calcification has been considered a good prognostic factor, even among patients with very high LDL-C levels who are considered to be at high risk for atherosclerotic cardiovascular disease. We describe throughout this paper the diagnosis and treatment of FH in a young male without coronary artery calcification.

Reliability and Validity of the Behavioral Observation Method for Assessing Low Back Pain in Patients with Spinal Diseases (척추질환자의 요통사정을 위한 통증행위 관찰법의 신뢰도 및 타당도 검정)

  • Yoon, Ho-Soon;Lee, Eun-Ok
    • Journal of muscle and joint health
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    • v.1 no.1
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    • pp.97-115
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    • 1994
  • The purpose of this study was to examine the reliability and validity of the observed behaviors of subjects who suffered from low back pain with spinal diseases, Thirty two low back pain patients admitted on the neurosurgical unit in an army hospital were compared with 30 normal controls belonged to an army unit, by means of matching the age, hight and weight. Observed pain behaviors were developed by the researcher on the bases of literature and patient observation. This tool consists of 18 behaviors seperated into two major groups : mutually exclusive and concomittent behaviors. The mutually exclusive behaviors included coding cathegories for 6. body motions assumed by the subjects during the observation session. These 6 standardized motions consisted of sitting from standing first, and serially tying down, reclining, sitting again, and then standing, 6 steps walking. Concomittent behaviors consisted of 12 observable patterns that can be observed systematically from the face, grimacing, bracing, rubbing, walking with arms fixed, support with hands on sitting or standing, guarded movement, limping, unbalaced weightbearing, stopped movement from tying position to sitting, sighing and graoning. Subjects were videotrecorded as they performed a 6-standardized sequence of motions, simultanously researcher measured the time spent performing each motion and step length. Patients were asked torate their subjective pain score on the 10 mm graphic rating scale ranging from 'no pain' to 'sever pain'. For scoring of the pain behaviors, two trained nursing officiers independently and simutanously viewwd each videorecording and checked subject 'pain behaviors at the observational item checklist. The result of the study are summarized as follows : 1. Reability of the observational tool was a=.845. 2. Spearman's rho and percentage agreement were p=.97 and 81.7 persent respectively, that indicate adequate interrater reability of this tool. 3. The sensitivity rate of the tool was .875 while specificity rate .866 for differentiating patient from the normal. 4. When difference in the objective pain indices between patient group and control were compared, there was significant difference of all indices, such as pain behavior(t=7.71, p=.0001). spent time performing motion(t=14.2, p=.0001), step length (t=-10.72, p=.0001). 5. There were differences in the objective indices the subjective pain subgroups (low, medium, high). Differences in the mean score of objective pain behavior (F=6.376. p=.005) and spent time for moyion(F=4.631, p=.018). But there were no significant differences in the step length among the subgroups(F=.667, p=.521). 6. Highly correlated pain behavior items wiyh subjective pain score were 'stopped movement from lying position to sitting', 'limping', 'support with hands on sitting or standing', 'bracing', 'guarding' and 'walking with arms fixed'. In summary, although some of rho behavior items such as sighing and groaning in this study could not be observed because of videotaped datd, the reliability and validity of the over all observation method were satifactory. Thus, the results of the present study demonstrate rye potetional utility of the tool in assessing objective pain complementing self-reported pain in low back pain patients.

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Prediction of Obstructive Coronary Artery Disease by Coronary Artery Calcification Finding on Low-dose CT Image for screening of lung diseases: Compared with Calcium Scoring CT (폐질환 선별검사를 위한 저선량 CT영상의 관상동맥 석회화 소견으로부터 폐쇄성 관상동맥질환 예측: 석회화수치 CT검사와 비교)

  • Lee, Won-Jeong
    • The Journal of the Korea Contents Association
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    • v.11 no.10
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    • pp.333-341
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    • 2011
  • To compare between calcium scoring CT (CSCT) and Low-dose CT (LDCT) image finding for coronary artery calcification (CAC) in screening of lung disease by MDCT. A total of 61 subjects who retired-workers exposed to inorganic dust were performed LDCT and CSCT by using a MDCT scanner on the same day, after be approved by the institutional review board, and obtaining the written informed consent from all subjects. LDCT images were read for detecting lung diseases as well as CAC by a experienced chest radiologist, then the subjects were divided either the positive group with CAC or the negative group without it. The CSCT was used to quantify and detect the presence of calcification in the coronary artery, and score of CAC calculated by using a Rapidia software (ver 2.8). In all coronary arteries, calcium score of positive group was higher better than that in negative group, especially in the total calcium (13.7 vs. 582.9, p=0.008) and the left anterior descending artery (3.2 vs. 249.0, p=0.006). CAC findings between CSCT and LDCT image were showed excellent agreement in cut-off point 100(K-value=0.80, 95% CI=0.69-0.91) from total calcium score. CAC findings on LDCT images showed the higher relation with CSCT. Therefore, the obstructive coronary artery disease could be predicted by CAC on LDCT images for screening of lung diseases.

Proficiency testing of cadmium and lead in polypropylene resin (폴리프로필렌 수지 중 카드뮴과 납 측정 숙련도시험)

  • Cho, K.H.;Lim, M.C.;Min, H.S.;Han, M.S.;Song, H.J.;Park, C.J.
    • Analytical Science and Technology
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    • v.20 no.3
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    • pp.183-192
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    • 2007
  • The various environmental regulation directives such as RoHS (restriction of hazardous substances in electrical and electronic products) and WEEE (waste from electrical and electronic equipments) are practically used as the technical barrier in international trade (TBT) of vehicles and electrical and electronic products recently. Regarding such an environmental regulation, Korea Research Institute of Standards Science (KRISS) organized a proficiency testing scheme to establish the reliability of measurement results produced by the relevant research institutes and test laboratories in Korea. Participants were 31 laboratories related to production of the electrical and electronic equipments and mobile vehicles. Two polypropylene samples of pellet type were employed as the proficiency testing materials (PTMs). Cadmium and lead were the analytes chosen among six components regulated in European Union (EU) RoHS directive. The PTMs were sent to the participants by post on September $1^{st}$ 2006, and deadline for results submission were October $10^{th}$ 2006. The results of each laboratory were evaluated in comparison with KRISS reference values using Robustic Z-score and Youden plot methods. The results of the various sample digestion methods were also compared. Most of participants reported good agreement within 10 % range of reference values. However, results from several laboratories showed significant biases from reference values. These laboratories should establish the quality assurance system for improvement of the measurement reliability.

Retrospective Electrocardiography-Gated Real-Time Cardiac Cine MRI at 3T: Comparison with Conventional Segmented Cine MRI

  • Chen Cui;Gang Yin;Minjie Lu;Xiuyu Chen;Sainan Cheng;Lu Li;Weipeng Yan;Yanyan Song;Sanjay Prasad;Yan Zhang;Shihua Zhao
    • Korean Journal of Radiology
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    • v.20 no.1
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    • pp.114-125
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    • 2019
  • Objective: Segmented cardiac cine magnetic resonance imaging (MRI) is the gold standard for cardiac ventricular volumetric assessment. In patients with difficulty in breath-holding or arrhythmia, this technique may generate images with inadequate quality for diagnosis. Real-time cardiac cine MRI has been developed to address this limitation. We aimed to assess the performance of retrospective electrocardiography-gated real-time cine MRI at 3T for left ventricular (LV) volume and mass measurement. Materials and Methods: Fifty-one patients were consecutively enrolled. A series of short-axis cine images covering the entire left ventricle using both segmented and real-time balanced steady-state free precession cardiac cine MRI were obtained. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), and LV mass were measured. The agreement and correlation of the parameters were assessed. Additionally, image quality was evaluated using European CMR Registry (Euro-CMR) score and structure visibility rating. Results: In patients without difficulty in breath-holding or arrhythmia, no significant difference was found in Euro-CMR score between the two techniques (0.3 ± 0.7 vs. 0.3 ± 0.5, p > 0.05). Good agreements and correlations were found between the techniques for measuring EDV, ESV, EF, SV, and LV mass. In patients with difficulty in breath-holding or arrhythmia, segmented cine MRI had a significant higher Euro-CMR score (2.3 ± 1.2 vs. 0.4 ± 0.5, p < 0.001). Conclusion: Real-time cine MRI at 3T allowed the assessment of LV volume with high accuracy and showed a significantly better image quality compared to that of segmented cine MRI in patients with difficulty in breath-holding and arrhythmia.

Needs on Management Development Program for Head Nurse (간호 관리 능력 개발을 위한 교육 연구)

  • Park, Jeong-Sun
    • Journal of Home Health Care Nursing
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    • v.5
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    • pp.84-99
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    • 1998
  • The objectives of this study are to identify the actual educational contents of management for head nurse and to propose the educational subjects according to identity the needs of head, charge, and staff nurses. The subjects were investigated the actual Management Development Programs and educational needs of head nurses and prospective nurse manager(charge nurse, staff nurse with a lot of clinical experiences) in general hospitals. The tools were composed of two questionnaires: One was developed from the literature review for making items to measure actual situation. The other was revised Katz's model for measurement of educational needs. The first respondents of actual situation were 27 general hospitals with over 400 beds in Seoul and the second respondents were 89 head nurses, 67 charge nurses and 136 nurses at 3 hospitals by convenient sampling out of 27 general hospitals. Data were collected by telephone interview, mail questionnaire and visiting from 7th of October through 30th of November in 1997. In data analysis, general characteristics of the respondents and actual status of Management Development Programs were analyzed by frequency and percentage. Educational needs according to general characteristics were analyzed by ANOVA The results were as follows: 1. Actual situation of Management Development Program 1) Seven hospitals(26%) had Management Development Program for prospective managers and 14 hospitals (52%) for head nurses. 2) Education Department existed in 14 hospitals (52%). 3) One hospital(4%) had top level managers took part in the Management Development. 4) Two hospitals selected head nurse, who had finished courses of Management Development. Eight hospitals(30%) assessed educational needs. The assessment tools consisted of making a question via questionnaire(75%), determining at department meeting(12%) and interview(13%). 5) Educational programs had 3 types: 10 lecture type, 7 discussion type and 4 role play type programs. 6) One hospital evaluated the change of learner's attitude. 7) Four hospitals scored educational point, but that was measured only by attending. 8) Actual Management Development Programs were as follows. parenthesis indicates the number of hospitals. (1) Management Development Programs for Prospective manager. Role perception of Middle level Manager (1) . Role reconstruction of Nurse Manager (1). Workshop for Charge Nurse (1). Nursing Delivery System and Nursing Process (1). Communication (1). Motivation (1) (2) Management Development Programs for Head nurse.. Head nurse's Role (5). Administrative Work (7). Service Education (4). Prevention and Countermeasure of Nursing Incidence (3). Appraisal (3) 2. The results of needs on Management Development subject 1) The educational needs of all respondents on 3 skill domains showed positive agreement to strongly positive agreement. 2) High priority(more than 4.5) items were 12 of 24 Human skill items(50%), 1 of 6 Technical skill items(16%), and 2 of 13 Conceptual skill items (15%). 3) Out of high priority items, 8 items were instituted. 4) All respondents showed high needs on 3 skill domains regardless of 3 positions (head nurse, charge nurse, and nurse). Educational needs of Human skill domain, according to position were 108. S, 108.7, 106.8 (mean score = 72) , needs of Technical skill domain were 26.5, 26.6, 26.I(mean score=18), and needs of Conceptual skill domains were 56.9,56.7, 55.1(mean score=39). 5) Needs of 3 skill domains according to clinical career showed significant difference. Out of respondents, nurses with career of over 16years showed lowest degree of needs in Human skill domains(F=4.47, P=.004) and Conceptual skill domain(F=2.93, P=.034). 6) Educational needs according to educational background were not significant difference. But out of respondents, nurses educated at 3-year junior college relatively showed lowest needs in all of the 3 skill domains. With the above-mentioned findings, further study is necessary for generalization of this study at hospitals with different bed size and location. Also it is needed to study about management skill of nurse and charge nurse, and effective educational method.

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Comparison of Computed Diffusion-Weighted Imaging b2000 and Acquired Diffusion-Weighted Imaging b2000 for Detection of Prostate Cancer (전립선암 발견을 위한 계산형 확산강조영상 b2000과 실제 획득한 b2000 영상의 비교)

  • Yeon Jung Kim;Seung Ho Kim;Tae Wook Baek;Hyungin Park;Yun-jung Lim;Hyun Kyung Jung;Joo Yeon Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.1059-1070
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    • 2022
  • Purpose To compare the sensitivity of tumor detection and inter-observer agreement between acquired diffusion-weighted imaging (aDWI) b2000 and computed DWI (cDWI) b2000 in patients with prostate cancer (PCa). Materials and Methods Eighty-eight patients diagnosed with PCa by radical prostatectomy and having undergone pre-operative 3 Tesla-MRI, including DWI (b, 0, 100, 1000, 2000 s/mm2), were included in the study. cDWI b2000 was obtained from aDWI b0, b100, and b1000. Two independent reviewers performed a review of the aDWI b2000 and cDWI b2000 images in random order at 4-week intervals. A region of interest was drawn for the largest tumor on each dataset, and a Prostate Imaging-Reporting and Data System (PI-RADS) score based on PI-RADS v2.1 was recorded. Histologic topographic maps served as the reference standard. Results The study population's Gleason scores were 6 (n = 16), 7 (n = 53), 8 (n = 9), and 9 (n = 10). According to the reviewers, the sensitivities of cDWI b2000 and aDWI b2000 showed no significant differences (for reviewer 1, both 94% [83/88]; for reviewer 2, both 90% [79/88]; p = 1.000, respectively). The kappa values of cDWI b2000 and aDWI b2000 for the PI-RADS score were 0.422 (95% confidence interval [CI], 0.240-0.603) and 0.495 (95% CI, 0.308-0.683), respectively. Conclusion cDWI b2000 showed comparable sensitivity with aDWI b2000, in addition to sustained moderate inter-observer agreement, in the detection of PCa.

Analysis of Clinical Indicators related to Pattern-Identification in Acute Cerebral Infarction Patient (급성기 뇌경색 환자에 있어 변증형별 유의한 임상지표의 분석)

  • Lee, Eun-chan;Hyun, Sang-ho;Kwak, Seung-hyuk;Woo, Su-kyung;Park, Ju-young;Jung, Woo-sang;Moon, Sang-kwan;Cho, Ki-ho;Park, Sung-wook;Ko, Chang-nam
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.13 no.1
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    • pp.33-42
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    • 2012
  • Object : The aim of this study was to assess the clinical indicators related to Pattern-Identification(PI) in acute cerebral infarction patients. Methods : We studied hospitalized patients within 30days after ictus, who admitted at Korean Medicine Center of Kyung-Hee University from January 2010 to October 2012.(n=290) Two Traditional Korean Medicine(TKM) physicians evaluated the patients independently and diagnosed PI. Inter-rater reliability was measured using simple percentage agreement and the Cohen's kappa(κ) coefficient. To assess the clinical indicators closely related to each PI, we analysed average score of each indicator in each group. Results : Simple percentage agreement of PI between raters was 64.83% and Cohen's kappa(κ) coefficient was 0.526(95% CI: 0.451-0.600). Inter-rater reliability level was fair to good. We analysed the clinical indicators in each group. Significant indicators for Fire-Heat Pattern(FHP) were reddened complexion and strong pulse power, and meaningful indicators for FHP were halitosis and thick tongue fur. Significant indicator for Dampness-Phlegm Pattern(DPP) was overweight and there was no meaningful indicator. Significant indicator for Yin-Deficiency Pattern(YDP) was dry tongue fur and meaningful indicator for YDP was thirst. There was no significant indicator for Qi-Deficiency Pattern(QDP) and pale complexion and faint low voice were meaningful indicators for QDP. Conclusions : This study reveals the significant and meaningful clinical indicators related to each Pattern-Identification in acute cerebral infarction patients. It will contribute to standardization of Korean Medical Diagnosis and Treatment in acute cerebral infarction patients.

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Deep Learning-Based Assessment of Functional Liver Capacity Using Gadoxetic Acid-Enhanced Hepatobiliary Phase MRI

  • Hyo Jung Park;Jee Seok Yoon;Seung Soo Lee;Heung-Il Suk;Bumwoo Park;Yu Sub Sung;Seung Baek Hong;Hwaseong Ryu
    • Korean Journal of Radiology
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    • v.23 no.7
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    • pp.720-731
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    • 2022
  • Objective: We aimed to develop and test a deep learning algorithm (DLA) for fully automated measurement of the volume and signal intensity (SI) of the liver and spleen using gadoxetic acid-enhanced hepatobiliary phase (HBP)-magnetic resonance imaging (MRI) and to evaluate the clinical utility of DLA-assisted assessment of functional liver capacity. Materials and Methods: The DLA was developed using HBP-MRI data from 1014 patients. Using an independent test dataset (110 internal and 90 external MRI data), the segmentation performance of the DLA was measured using the Dice similarity score (DSS), and the agreement between the DLA and the ground truth for the volume and SI measurements was assessed with a Bland-Altman 95% limit of agreement (LOA). In 276 separate patients (male:female, 191:85; mean age ± standard deviation, 40 ± 15 years) who underwent hepatic resection, we evaluated the correlations between various DLA-based MRI indices, including liver volume normalized by body surface area (LVBSA), liver-to-spleen SI ratio (LSSR), MRI parameter-adjusted LSSR (aLSSR), LSSR × LVBSA, and aLSSR × LVBSA, and the indocyanine green retention rate at 15 minutes (ICG-R15), and determined the diagnostic performance of the DLA-based MRI indices to detect ICG-R15 ≥ 20%. Results: In the test dataset, the mean DSS was 0.977 for liver segmentation and 0.946 for spleen segmentation. The Bland-Altman 95% LOAs were 0.08% ± 3.70% for the liver volume, 0.20% ± 7.89% for the spleen volume, -0.02% ± 1.28% for the liver SI, and -0.01% ± 1.70% for the spleen SI. Among DLA-based MRI indices, aLSSR × LVBSA showed the strongest correlation with ICG-R15 (r = -0.54, p < 0.001), with area under receiver operating characteristic curve of 0.932 (95% confidence interval, 0.895-0.959) to diagnose ICG-R15 ≥ 20%. Conclusion: Our DLA can accurately measure the volume and SI of the liver and spleen and may be useful for assessing functional liver capacity using gadoxetic acid-enhanced HBP-MRI.

Diagnostic Coincidence of Radiologic Measurement Methods of the Proximal Femur Anterior-posterior Projection for Assessment of Osteoporosis (근위대퇴부 정면 영상을 이용한 골다공증 평가 시 방사선적 계측의 진단일치도)

  • Kang, Yeong-Han;Cho, Kwang-Ho
    • The Journal of the Korea Contents Association
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    • v.12 no.6
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    • pp.353-360
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    • 2012
  • The purpose of this study was to determine whether there are relationships between radiologic parameters for osteoporosis by the proximal femur radiograhps and bone mineral density, as assessed by Dual Energy X-ray Absorptiometry(DEXA). Proximal femur anterior-posterior projection were taken from 112 individuals who undergoing DEXA. Radiographic parameters including canal-to-calcar ratio(CCR) and cortical thickness indices(CTI) were measured and compared with bone mineral density($g/cm^2$), T-score. The intramedullary femoral canal width(FW) and calcar width(CW) at osteoporosis group was significantly larger than that of control group. The CCR were correlated negatively with bone mineral density($g/cm^2$)(r=-0.340, p<0.01), and the CTI were correlated positively(r=0.624). The diagnostic accuracy of CCR for osteoporosis was 63.4%, and kappa value was 0.271. And the accuracy of CTI was 67.0%, and kappa value was the level of fair agreement(${\kappa}$=0.258). The proximal femur with large CCR and small CTI had lower T-scores. When evaluating proximal femur anterior-posterior radiographs, those patients with the thinnest femur diaphyseal cortices should be referred for further osteoporosis investigation.