• Title/Summary/Keyword: Confidence Evaluation

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Evaluation of Error Factors in Quantitative Analysis of Lymphoscintigraphy (Lymphoscintigraphy의 정량분석 시 오류 요인에 관한 평가)

  • Yeon, Joon-Ho;Kim, Soo-Yung;Choi, Sung-Ook;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.76-82
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    • 2011
  • Purpose: Lymphoscintigraphy is absolutely being used standard examination in lymphatic diagnosis, evaluation after treatment, and it is useful for lymphedema to plan therapy. In case of lymphoscintigraphy of lower-extremity lymphedema, it had an effect on results if patients had not pose same position on the examination of 1 min, 1 hour and 2 hours after injection. So we'll study the methods to improve confidence with minimized quantitative analysis errors by influence factors. Materials and Methods: Being used the Infinia of GE Co. we injected $^{99m}Tc$-phytate 37 MBq (1.0 mCi) 4 sylinges into 40 people's feet hypodermically from June to August 2010 in Samsung Medical Center. After we acquired images of fixed and unfixed condition, we confirmed the count values change by attenuation of soft tissue and bone according to different feet position. And we estimated 5 times increasing 2 cm of distance between $^{99m}Tc$ point source and detector each time to check counts difference according to distance change by different feet position. Finally, we compared 1 and 6 min lymphoscintigraphy images with same position to check the effect of quantitative analysis results owing to difference of amounts of movement of the $^{99m}Tc$-phytate in the lymphatic duct. Results: Percentage difference regarding error values showed minimum 2.7% and maximum 25.8% when comparing fixed and unfixed feet position of lymphoscintigraphy examination at 1 min after injection. And count values according to distance were 173,661 (2 cm), 172,095 (4 cm), 170,996 (6 cm), 167,677 (8 cm), 169,208 counts (10 cm) which distance was increased interval of 2 cm and basal value was mean 176,587 counts, and percentage difference values were not over 2.5% such as 1.27, 1.79, 2.04, 2.42, 2.35%. Also, Assessment results about amounts of movement in lymphatic duct within 6 min until scanning after injection showed minimum 0.15%, and maximum 2.3% which were amounts of movement. We can recognize that error values represent over 20% due to only attenuation of soft tissue and bone except for distance difference (2.42%) and amounts of movement in lymphatic duct (2.3%). Conclusion: It was show that if same patients posed different feet position on the examination of 1 min, 1 hour and 2 hours after injection in the lymphoscintigraphy which is evaluating lymphatic flow of patients with lymphedema and analyzing amount of intake by lymphatic system, maximum error value represented 25.8% due to attenuation of soft tissue and bone, and PASW (Predictive Analytics Software) showed that fixed and unfixed feet position was different each other. And difference of distance between detector and feet and change of count values by difference of examination beginning time after injection influence on quantitative analysis results partially. Therefore, we'll make an effort to fix feet position and make the most of fixing board in lymphoscintigraphy with quantitative analysis.

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Health Management and Services of School-Nurse in Special Schools (특수학교의 보건관리)

  • Lee, Kyung Hee;Park, Jae Yong
    • Journal of the Korean Society of School Health
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    • v.4 no.2
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    • pp.176-192
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    • 1991
  • School nurses, in service of 102 special schools in Korea, were urveyed by mail questionnaires from February to March, 1991 and 77 of hem responded. Collected data were analyzed to establish the direction of health management in special school and to provide basic reference data for improving the quality of the management of school-nurses' services. The major findings are as follows: Out of special schools surveyed, 67.5% is private school and 83.2% is located in city. The average number of classes, students, and educational personnels per special school is 17.2, 194, and 28 respectively. The average age of school-nurses surveyed is 32.7. The proportion of graduates from the junior college and upward was 97.4%, the proportion of the married was 71.4%. Out of respondents, 71.4% has religion : 79.2% has past career in the fields of clinics or public health: 62.3% accompanishes independent services: 77.9% belongs to primary school. About 69% of nursing room in special schools surveyed is located at the first floor. Out of special school surveyed, 90.9% has no organization for school health programms: Only 18.2% entrusted everyone of school doctor, school dentist, and school pharmacists with school health. 46.8% of respondents didn't know about the annual budget for school health programmes. The average annual expenditure for school health programme per special school was 317,000F26. won and the purchase cost for medical supplies accounted for the larger part of them. The monthly average number of students utilizing school nursing room was 71 per school, annual utilization times of school nursing room was 4.4 per student and utilization due to injury was prevalent by 26.6% and there is some differences in using the school nursing room according to disabled area. Rate of referral to medical facilities was 1.4%. The leading reason of referral to medical facilities was high fever among those who have visual handicaps, fracture among those who have emotional disturbance, injury by trauma among others. Nine hundred fifty six students of students in special school surveyed have sufferd from epilepsy and prevalence rate of epilepsy was 6.4%. Only 22.6% of respondents replied that they had physical examination more than 2 times per year. Out of respnodents, 98.7% answered that they had health education and 67.1% of them ansered that they educated in a classroom, 98.7% of respondents emphasized need of sex education. Respondents put the most emphasis on the personal hygiene when they performed health education and they used broadcasting education in the area of visual handicaps, OHP or VTR in hearing handicaps, home correspondence or OHP VTR in other area importantly. About 47% of repondents answered that health education was the most difficult and they emphasized that definite guide on health management was requested. Respondents had self-confidence and high perfomance rate in most of school-nurses' services completely, but so they was not in area of evaluation of school health programmes, an examination of physical strength, evaluation of health education, management of school purification area, suture of wounds. In consideration of above findings, we may conclude that special education for school-nurse in special schools as well as improvement of definite guiding principles are requested to establish direction for health management in special schools and to improve the degree of quality for school-nurses' sevices in special schools.

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Evaluation of Reference Intervals of Some Selected Chemistry Parameters using Bootstrap Technique in Dogs (Bootstrap 기법을 이용한 개의 혈청검사 일부 항목의 참고범위 평가)

  • Kim, Eu-Tteum;Pak, Son-Il
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.509-513
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    • 2007
  • Parametric and nonparametric coupled with bootstrap simulation technique were used to reevaluate previously defined reference intervals of serum chemistry parameters. A population-based study was performed in 100 clinically healthy dogs that were retrieved from the medical records of Kangwon National University Animal Hospital during 2005-2006. Data were from 52 males and 48 females(1 to 8 years old, 2.2-5.8 kg of body weight). Chemistry parameters examined were blood urea nitrogen(BUN)(mg/dl), cholesterol(mg/dl), calcium(mg/dl), aspartate aminotransferase(AST)(U/L), alanine aminotransferase(ALT)(U/L), alkaline phosphatase(ALP)(U/L), and total protein(g/dl), and were measured by Ektachem DT 60 analyzer(Johnson & Johnson). All but calcium were highly skewed distributions. Outliers were commonly identified particularly in enzyme parameters, ranging 5-9% of the samples and the remaining were only 1-2%. Regardless of distribution type of each analyte, nonparametric methods showed better estimates for use in clinical chemistry compare to parametric methods. The mean and reference intervals estimated by nonparametric bootstrap methods of BUN, cholesterol, calcium, AST, ALT, ALP, and total protein were 14.7(7.0-24.2), 227.3(120.7-480.8), 10.9(8.1-12.5), 25.4(11.8-66.6), 25.5(11.7-68.9), 87.7(31.1-240.8), and 6.8(5.6-8.2), respectively. This study indicates that bootstrap methods could be a useful statistical method to establish population-based reference intervals of serum chemistry parameters, as it is often the case that many laboratory values do not confirm to a normal distribution. In addition, the results emphasize on the confidence intervals of the analytical parameters showing distribution-related variations.

The Evaluation of Clinical Usefulness on Application of Myocardial Extract in Quantitative Perfusion SPECT (QPS 프로그램에서 Myocardial extract 적용에 따른 임상적 유용성 평가)

  • Yun, Jong-Jun;Lim, Yeong-Hyeon;Lee, Mu-Seok;Song, Hyeon-Seok;Jeong, Ji-Uk;Park, Se-Yun;Kim, Jae-Hwan;Kim, Jeong-Uk
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.88-93
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    • 2011
  • Purpose: As to analytical method of data, the AutoQUANT software in which it is used quantitative rating of the myocardial perfusion SPECT are reported that there is a difference. Therefore the measured value error of the mutual program is expected to be generated even if the quantitative analysis is made data of the same patient. The purpose of this study is to offer the comparative analysis of myocardial extract method in Quantitative Perfusion SPECT. Materials and methods: We analyzed the 51 patients who were examined by Tc-99m MIBI gated myocardial SPECT in nuclear medicine department of Pusan National University Hospital from June to December 2010(34 men, 17 women, mean age $66.5{\pm}9.9$). We acquired the extracted image in myocardial extract protocol. QPS program that uses the AutoQUANT software measured TID(Transient Ischemic Dilation), ESD(Extent of Stress Defect), SSS(Summed Stress Score). Then analyzed the results. Results: The correlation of appyling myocardial extract is TID(r=0.98), ESD(r=0.99), SSS(r=0.99). In the 95% confidence limit, there was no satistically significant difference(TID p=0.78, ESD p=0.31, SSS p=0.19). After blinding test with a physician for making a qualitative analysis, there was no difference. Conclusion: Quantitative indices in QPS program showed good correlation and the results showed no statistically signigicant difference. The variance between method was small. therefore, the functional parameters by each method can be used interchangeably. Also, we expect patient's satisfaction.

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The Knowledge and Attitude on Breast Feeding of Female University Students (모유수유에 대한 여대생의 지식 및 태도)

  • Kim, Sung-Hee;Choi, Euy-Soon
    • Women's Health Nursing
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    • v.7 no.1
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    • pp.93-106
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    • 2001
  • The purpose of this study is to provide the basic data in order to develop of some educational programs for increasing breast feeding by studying the female university student's knowledge and attitude on breast feeding, who will become a mother in future. The respondents of this research were selected at random for 462 female students at the university in Seoul and Kyongki area, and it was the period collected the data from Oct 28, 2000 to Nov 8, 2000. The method of study distributed the measuring tools of knowledge with 33 items and the tools of measurement with 20 items on the attitude of breast feeding to the respondents directly, and collected them. The data were analyzed to use SPSS program. Unpaired t-test, ANOVA, Pearson correlation coefficient and Multiple regression analysis were used for the calculation of difference between groups and the results were as follows ; 1. The breast feeding was 50.6% in the period of lactation for the respondents and the nuclear families were 81.7% in family constituent unit. In the future the wisher of breast feeding was 91.5%, the medical personnel was a major informer who enjoyed their best confidence, Besides the respond-ents responded that the proper period for education of the breast feeding was in a high school. 2. The level of Knowledge on breast feeding. The respondents's knowledge on breast feeding was average $16.40{\pm}4.59$ points on the basis of 33 points and On the merits and demerits ratio of breast feeding has shown highest but there was low in the field of such a concrete and practical plan as the estimate of breast feeding and the method and mindfulness for breast feeding. The higher grader, the college of the natural science showed significantly the higher points in the knowledge degree by respondents's characters and in such cases the persons of breast feeding or the informed of breast feeding by a medical personnel or the women of strong will for breast feeding action in the future. 3. The Attitude on breast feeding. There was relatively shown a positive attitude of the total average $60.50{\pm}7.59$ points and the average evaluation $3.04{\pm}.36$ points in the attitude on breast feeding. The attitude by each factors has the highest points in the practical action aspect but the lowest in the emotional aspect. The attitude on breast feeding by respondents's characters significantly showed a positive attitude in such cases the persons of breast feeding or the informed of breast feeding or the women of strong will for breast feeding action in the future. 4. Relation to knowledge and attitude on breast feeding. There was shown a correlation of definition in the relation to knowledge and attitude on breast feeding, 5.Factors which have an effect on knowledge and attitude on breast feeding. The factors which have an effect on knowledge of breast feeding were attitudes on breast feeding, graders, the college of natural science and the informed of breast feeding. Also the factors which have an effect on attitude on breast feeding were on will and knowledge on breast feeding, a large family, the informed of breast feeding. In conclusion, it will have to enforce a systematic education on the method of a practical breast feeding enlarged by a medical personnel and professional early enough as the information provision on breast feeding enables one to increase knowledge and attitude on it, besides it has relations with their practical will.

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A Study of School Nursing Activity Performed by School Nurses and Teachers Holding Additional School Health (부산지역 중등학교 양호교사 및 양호겸직교사의 학교보건업무 활동 양상)

  • Park Jung Za;Jung Moon Sook
    • Journal of Korean Public Health Nursing
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    • v.9 no.1
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    • pp.17-32
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    • 1995
  • The purpose of this study was to improve upon school health by understanding the present status of school health and escpecially to investigate the performance rate of regular health instruction. 261 schools, including middle and high schools enrolled in the Busan Educational Association, were sent Questionnaires. Data was collected from the 25th of January to the 10th of April, 1994. 229 subjects who responded to the Questionnaires were finally analyzed as samples. Among them, 127 were school nurses and 102 were teachers acting in a school health capacity. The results of this study are summerized as follows: Of the teachers holding additional school health responsibilities, $85.6\%$ worked in private schools. Many of them $(74.5\%)$ were formally dissatisfied with their ability to provide care because $85.3\%$ of them had never studied any school health. Some of them$(30.4\%)$ didn't know about the annual school nursing budget and $23.5\%$ of them hadn't taught any health education to students. In spite of this fact, they were placed in charge of a school health activity against their own will. There were statistically significant differences in the performance of school health affairs between nurses and teachers holding additional school health (p<0.001) as follows: annual school nursing budget, Health Program Planning and Evaluation, annual purchase price for medicines, average students cared for per day, average students who held at least one consultation per month and extra. Surely, the self-confidence of school nurses was higher than that of teachers with school health as an assigned responsibility. This was demonstrated by a significant statistical difference (p<0.01) in the responses by the two groups. $88.2\%$ of the school nurses and $73.5\%$ of teachers for school health thought that regular health instruction was necessary. But regular health education had been performed only by $32.8\%$ of respondents. Among them, 84% were school nurses and $16\%$ were teachers holding additional school health. Of the persons who performed regular health education, $69.3\%$ used less than $60\%$ of the health content of the athletic textbook. And $64\%$ of them said teaching materials were insufficient. Most of them $(69.4\%)$used home made lesson plans. which they compiled from various sources. There was a significant difference in the formality of the health lesson according to the concern of the school principal (p<0.01) and there was a significant difference in performing health education between school nurses and teachers holding additional school health (p<0.001) It appears that there are a lot of problems with providing school health care using people who are untrained. In a word, school health nurses with professional training are needed in order to perform the qualitative management for the health of the students. These days, regular health education is an indispensable part in making students improve their self-care abilities. Therefore a more effective and better defined program should be prepared for regular systematic health education. To resolve these problems, present laws and regulations related to school health should be revised considering the specialist's request for the improvement of school health. In addition, the concern and financial support of the government are essential.

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Determinants of IPO Failure Risk and Price Response in Kosdaq (코스닥 상장 시 실패위험 결정요인과 주가반응에 관한 연구)

  • Oh, Sung-Bae;Nam, Sam-Hyun;Yi, Hwa-Deuk
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.5 no.4
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    • pp.1-34
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    • 2010
  • Recently, failure rates of Kosdaq IPO firms are increasing and their survival rates tend to be very low, and when these firms do fail, often times backed by a number of governmental financial supports, they may inflict severe financial damage to investors, let alone economy as a whole. To ensure investors' confidence in Kosdaq and foster promising and healthy businesses, it is necessary to precisely assess their intrinsic values and survivability. This study investigates what contributed to the failure of IPO firms and analyzed how these elements are factored into corresponding firms' stock returns. Failure risks are assessed at the time of IPO. This paper considers factors reflecting IPO characteristics, a firm's underwriter prestige, auditor's quality, IPO offer price, firm's age, and IPO proceeds. The study further went on to examine how, if at all, these failure risks involved during IPO led to post-IPO stock prices. Sample firms used in this study include 98 Kosdaq firms that have failed and 569 healthy firms that are classified into the same business categories, and Logit models are used in estimate the probability of failure. Empirical results indicate that auditor's quality, IPO offer price, firm's age, and IPO proceeds shown significant relevance to failure risks at the time of IPO. Of other variables, firm's size and ROA, previously deemed significantly related to failure risks, in fact do not show significant relevance to those risks, whereas financial leverage does. This illustrates the efficacy of a model that appropriately reflects the attributes of IPO firms. Also, even though R&D expenditures were believed to be value relevant by previous studies, this study reveals that R&D is not a significant factor related to failure risks. In examing the relation between failure risks and stock prices, this study finds that failure risks are negatively related to 1 or 2 year size-adjusted abnormal returns after IPO. The results of this study may provide useful knowledge for government regulatory officials in contemplating pertinent policy and for credit analysts in their proper evaluation of a firm's credit standing.

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The Accuracy Evaluation according to Dose Delivery Interruption and Restart for Volumetric Modulated Arc Therapy (용적변조회전 방사선치료에서 선량전달의 중단 및 재시작에 따른 정확성 평가)

  • Lee, Dong Hyung;Bae, Sun Myung;Kwak, Jung Won;Kang, Tae Young;Back, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.1
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    • pp.77-85
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    • 2013
  • Purpose: The accurate movement of gantry rotation, collimator and correct application of dose rate are very important to approach the successful performance of Volumetric Modulated Arc Therapy (VMAT), because it is tightly interlocked with a complex treatment plan. The interruption and restart of dose delivery, however, are able to occur on treatment by various factors of a treatment machine and treatment plan. If unexpected problems of a treat machine or a patient interrupt the VMAT, the movement of treatment machine for delivering the remaining dose will be restarted at the start point. In this investigation, We would like to know the effect of interruptions and restart regarding dose delivery at VMAT. Materials and Methods: Treatment plans of 10 patients who had been treated at our center were used to measure and compare the dose distribution of each VMAT after converting to a form of digital image and communications in Medicine (DICOM) with treatment planning system (Eclipse V 10.0, Varian, USA). We selected the 6 MV photon energy of Trilogy (Varian, USA) and used OmniPro I'mRT system (V 1.7b, IBA dosimetry, Germany) to analyze the data that were acquired through this measurement with two types of interruptions four times for each case. The door interlock and the beam-off were used to stop and then to restart the dose delivery of VMAT. The gamma index in OmniPro I'mRT system and T-test in Microsoft Excel 2007 were used to evaluate the result of this investigation. Results: The deviations of average gamma index in cases with door interlock, beam-off and without interruption on VMAT are 0.141, 0.128 and 0.1. The standard deviations of acquired gamma values are 0.099, 0.091, 0.071 and The maximum gamma value in each case is 0.413, 0.379, 0.286, respectively. This analysis has a 95-percent confidence level and the P-value of T-test is under 0.05. Gamma pass rate (3%, 3 mm) is acceptable in all of measurements. Conclusion: As a result, We could make sure that the interruption of this investgation are not enough to seriously affect dose delivery of VMAT by analyzing the measured data. But this investigation did not reflect all cases about interruptions and errors regarding the movement of a gantry rotation, collimator and patient So, We should continuously maintain a treatment machine and program to deliver the accurate dose when we perform the VMAT for the many kinds of cancer patients.

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Evaluation of Characteristics in the Reference Gamma Radiation Fields for testing of Personnel Dosimetry Performance (개인선량 평가의 성능검증을 위한 기준급 감마선장의 특성 평가)

  • Oh, Jang-Jin;Cho, Dae-Hyung;Han, Seung-Jae;Na, Seong-Ho;Lee, Dew-Hey;Lee, Byung-Soo;Jun, Jae-Shik;Chai, Ha-Seok;Yi, Chul-Young
    • Journal of Radiation Protection and Research
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    • v.23 no.4
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    • pp.229-236
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    • 1998
  • In order to establish a testing system for personnel dosimetry performance, the radiation fields from photons, beta particles and neutrons are required, in recent, Korea Institute of Nuclear Safety(KINS) established the reference radation fields except neutrons and tested a variety of their properties. As a result of the test, the reference beams were shown to meet satisfactorily not only the standards of the International Organization for Standardization(ISO), but also the standard levels of the developed countries which are intercomparable with the international traceability. This paper describes the reference beam of gamma radiation. The self-designed and established reference radiation fields were investigated and analyzed by ISO and other international standards. The secondary photon contribution and the beam uniformity of the gamma radiation field were measured and evaluated to fulfill those requirements suggested by the ISO-4037. The measured air kerma rate for the $^{137}$Cs and $^{60}$Co gamma fields was 0.1891 $\sim$ 23.4967 $\mu$Gy/s sand 0.5844 $\sim$ 15.9954 $\mu$Gy/s respectively. The uncertainty with 95 % confidence level of the measured air kerma rate was determined to be less than 2.5 % which is comparable to the international reference gamma radiation fields. It was found that the evaluated air kerma calibration factors of Exradin ionization chamber were in good agreement within 0.9 % and 0.03 % with those given by PTB and NIST, respectively. The gamma radiation fields installed at KINS can maintain traceability systems in Korea, Germany and United State.

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Quality Evaluation of Domestic and Foreign Extruded Pellets and Moist Pellet Based on Biochemical Analyses for Juvenile Olive Flounder, Parazichthys Olivaceus (시판용 넙치(치어)사료의 성분 비교분석을 통한 품질평가)

  • 최세민;한경민;왕소길;이승형;배승철
    • Journal of Aquaculture
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    • v.17 no.2
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    • pp.144-150
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    • 2004
  • This experiment was conducted to evaluate the parameters such as nutrient requirements, POY, AnV, Totox, VBN, total plate count, dietary fatty acids and amino acids composition, that are not included in the registered standard composition items required by the Ministry of Agriculture and Forestry, of a moist pellet (MP), three domestic extruded pellets (DEP-1, DEP-2, DEP-3), and two foreign extruded pellets (FEP-1, FEP-2) that are utilized by domestic flounder farms at present. The crude protein was added in excess of the dietary protein requirement in 6 kinds of feeds. When considering the proper PH ratio, it is obvious that protein was added in excess, especially in MP and FEP-2. Crude fat was also added in excess, especially in FEP-1. MP contained a higher dietary phosphorus content than formulated feeds, surpassing the dietary phosphorus requirement and greatly increasing the possibility for causing water pollution. The oxidation of fatty acid and decomposition of protein in MP were higher than in formulated feeds, and may also cause problems on fish farms. Also, it is difficult to store and manage MP, Among the fatty acids, EPA and DHA contents in MP were higher than those in formulated feeds. It is necessary to conduct further studies of EPA and DHA contents in formulated feeds. Lysine content in MP and FEP-2 could meet the dietary lysine requirement of flounder, however, the possibility of insufficient lysine content in the other formulated feeds was high and we considered that extra supplementation was necessary. Therefore, it is necessary to set up quality control standards according to fish species and sizes while considering the specific character of aquatic formulated feeds to restore the confidence of feed companies and aquaculturists to these feeds. This may be an opportunity to make an earlier change from MP to formulated feeds.