• Title/Summary/Keyword: Diagnostic standard

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Relationship between Ambulatory 24-hour Double Probe pH Monitoring and Reflux Finding Score in Patients with LPR (인후두 역류환자에서 이동성 24시간 이중 탐침 산도 검사와 인후두 역류 소견 점수와의 상관관계)

  • Park, Young-Dae;Kang, Dae-Woon;Lee, Jin-Choon;Lee, Byung-Joo;Wang, Soo-Geun;Kim, Gwang-Ha
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.19 no.2
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    • pp.136-141
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    • 2008
  • Background and Objectives: Laryngopharyngeal reflux (LPR) is a very common disease among outpatients of department of otorhinolaryngology. Although there are several diagnostic tools for LPR disease and ambulatory 24-hour double-probe pH monitoring is gold standard method, empirical diagnosis by reflux symptom index and reflux finding score (RFS) are mainly used. So we analyzed the relationship between ambulatory 24-hour double-probe pH monitoring and RFS in patients with LPR. Subjective and Method: Fifty patients with LPR symptoms and abnormal RFS and ambulatory 24-hour double probe monitoring were enrolled. Each items and sum of laryngeal reflux score were compared the results of ambulatory 24-hour double-probe pH monitoring in upper (UES) and lower (LES) esophageal sphincter. Results: There were no significant correlation between the results of ambulatory 24-hour double-probe pH monitoring in UES (pH<4 and pH<5) and each item and sum of RFS. However, supine time and reflux number of UES (pH<5) were showed the partial correlations with diffuse laryngeal edema and thick endolaryngeal mucus (p=0.03, p=0.01). Although there were no relationship between the results of ambulatory 24-hour double-probe pH monitoring in LES and sum of RFS, the significant correlations presented between granuloma and total time (p=0.008), upright time (p=0.008, reflux number (p=0.049) of LES. Conclusion: Although granuloma among items of RFS showed significantly correlation with the results of ambulatory 24-hour double-probe pH monitoring in LES, there were no significant correlation between the results of ambulatory 24-hour double-probe pH monitoring in UES and LES and items and sum of RFS.

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Study on image quality improvement using Non-Linear Look-Up Table (비선형 Look-Up Table을 통한 영상 화질 개선에 관한 연구)

  • Kim, Sun-Chil;Lee, Jun-Il
    • Korean Journal of Digital Imaging in Medicine
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    • v.5 no.1
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    • pp.32-44
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    • 2002
  • The role of radiology department has been greatly increased in the past few years as the technology in the medical imaging devices improved and the introduction of PACS (Picture Archiving and Communications System) to the conventional film-based diagnostic structure is a truly remarkable factor to the medical history. In addition, the value of using digital information in medical imaging is highly expected to grow as the technology over the computer and the network improves. However, the current medical practice, using PACS is somewhat limited compared to the film-based conventional one due to a poor image quality. The image quality is the most important and inevitable factor in the PACS environment and it is one of the most necessary steps to more wide practice of digital imaging. The existing image quality control tools are limited in controlling images produced from the medical modalities, because they cannot display the real image changing status. Thus, the image quality is distorted and the ability to diagnosis becomes hindered compared to the one of the film-based practice. In addition, the workflow of the radiologist greatly increases; as every doctor has to perform his or her own image quality control every time they view images produced from the medical modalities. To resolve these kinds of problems and enhance current medical practice under the PACS environment, we have developed a program to display a better image quality by using the ROI optical density of the existing gray level values. When the LUT is used properly, small detailed regions, which cannot be seen by using the existing image quality controls are easily displayed and thus, greatly improves digital medical practice. The purpose of this study is to provide an easier medical practice to physicians, by applying the technology of converting the H-D curves of the analog film screen to the digital imaging technology and to preset image quality control values to each exposed body part, modality and group of physicians for a better and easier medical practice. We have asked to 5 well known professional physicians to compare image quality of the same set of exam by using the two different methods: existing image quality control and the LUT technology. As the result, the LUT technology was enormously favored over the existing image quality control method. All the physicians have pointed out the far more superiority of the LUT over the existing image quality control method and highly praised its ability to display small detailed regions, which cannot be displayed by existing image quality control tools. Two physicians expressed the necessity of presetting the LUT values for each exposed body part. Overall, the LUT technology yielded a great interest among the physicians and highly praised for its ability to overcome currently embedded problems of PACS. We strongly believe that the LUT technology can enhance the current medical practice and open a new beginning in the future medical imaging.

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A Study on Patients Dose and Image Quality according to Source to Image receptor Distance in Abdomen Radiography: comparison of ESD measured and DRLs in other countries (복부일반촬영시 선원과 검출기간의 거리변화에 따른 영상 화질 및 피폭선량에 관한 연구)

  • Jang, Ji-Sung;Choi, Weon-Keun;Jung, Jae-Yon;Lee, Kwan-Sub;Ha, Dong-Yoon
    • Korean Journal of Digital Imaging in Medicine
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    • v.14 no.2
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    • pp.39-46
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    • 2012
  • Purpose : The purpose of this study was to reduce Entrance Surface Dose and maintain image quality by changing Source to Image receptor Distance. And we'd like to compare ESD on this study to DRLs in other contries. Materials and Methods : We used indirect DR system(Definium 8000, General Electric, USA)and phantom(ART-200X, Flukebiomedical, USA),glass dosimeters(GD-352M, Asahi Techno Glass, Japan)for this study. The imagies were obtained throuh 80kVp fixed, and different tube currents using AEC mode in $16{\times}16$(inch) field size and changing Source to Image receptor Distance from 100 cm to 130 cm per 10 cm unit. The phantom with attaching 5 glass dosimeters on abdomonal skin was set at supine and erect position as a anterioposterial projection on detector For measuring Entrance Surface Dose. Image analysis was conducted by histograms of Image J(1.46r) which was given from National Institutes of Health(NIH). Results : Due to inverse square law of distance, the tube currents were increasing 42.6 % in supine position and 32.6 % in erect position according to the change of Source to Image receptor Distance. While Entrance Surface Doses were rapidly decreasing 14.2 % in supine position and 29.4 % in erect position according to the change of Source to Image receptor Distance. As the results of histogram using Image J, pixel mean values from 100 cm to 110 cm, 120 cm and 130 cm were decreasing each 1.4%, 2.5%, 2.7%, 4.5%, 2.2 %, 5.8 % in supine, erect position. While standard deviations from 100 cm to 110 cm, 120 cm and 130 cm were increasing each 1.4 %, 2.5 %, 2.5 %, 4.0 %, 2.0 %, 4.9 % Consequently, there are no significant differences in abdomen images taken. Conclusion: As the results described above, we strongly recommend using long Sourceto Image receptor Distance than 100cm that we have been using. So, we should deliver less Entrance Surface Dose to the patients while maintaining image quality in abdomen radiography.

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A Study on Virtual Reality Management of 3D Image Information using High-Speed Information Network (초고속 정보통신망을 통한 3차원 영상 정보의 가상현실 관리에 관한 연구)

  • Kim, Jin-Ho;Kim, Jee-In;Chang, Chun-Hyon;Song, Sang-Hoon
    • The Transactions of the Korea Information Processing Society
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    • v.5 no.12
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    • pp.3275-3284
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    • 1998
  • In this paper, we deseribe a Medical Image Information System. Our system stores and manages 5 dimensional medical image data and provides the 3 dimensional medical data via the Internet. The Internet standard VR format. VRML(Virtual Reality Modeling Language) is used to represent the 3I) medical image data. The 3D images are reconstructed from medical image data which are enerated by medical imaging systems such ans CT(Computerized Tomography). MRI(Magnetic Resonance Imaging). PET(Positron Emission Tomograph), SPECT(Single Photon Emission Compated Tomography). We implemented the medical image information system shich rses a surface-based rendering method for the econstruction of 3D images from 2D medical image data. In order to reduce the size of image files to be transfered via the Internet. The system can reduce more than 50% for the triangles which represent the surfaces of the generated 3D medical images. When we compress the 3D image file, the size of the file can be redued more than 80%. The users can promptly retrieve 3D medical image data through the Internet and view the 3D medical images without a graphical acceleration card, because the images are represented in VRML. The image data are generated by various types of medical imaging systems such as CT, MRI, PET, and SPECT. Our system can display those different types of medical images in the 2D and the 3D formats. The patient information and the diagnostic information are also provided by the system. The system can be used to implement the "Tele medicaine" systems.

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Clinical Test on Application of ShiHo-GuizhiTang (시호계지탕(柴胡桂枝湯)의 임상치험(臨床治驗)에 관(關)한 소고(小考))

  • Lee, Min-seop;Kim, Dong-hee;Shin, Soon-shik
    • Journal of Haehwa Medicine
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    • v.9 no.1
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    • pp.201-214
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    • 2000
  • Precise and detailed clinical research and evaluation based on objective standards are imperative factors in securing reliability of a clinical test. Built on this principle, this clinical test has been conducted during the period between March 1999 and March 2000 dealing with 31 outpatients treated with ShiHo-GuizhiTang or ShiHo-GuizhiTang modify and ShiHo-GuizhiTang mixed prescriptions at the Sung-bo ORIENTAL MEDICAL CLINIC. A variety of information relating to those patients has been collected and analyzed under such criteria as precise diagnoses and their clinical effectiveness. The analysis was duly based on "The theory of cold syndrome". Then, the 31 patients' individual clinical information was compared one another by breaking down the results into sub-categories including gender, age, disease, main symptom, blood pressure, pulse beats, syndrome of abdomen, treatment period, modify and mixed prescription, and evaluation. The result of this clinical test can be summarized as follows: First, ShiHo-GuizhiTang appears to be more frequently prescribed in the case of female patients than in the case of male patients despite the fact that it does not necessarily need to be applied only to female. In addition, the numbers of prescriptions of ShiHo-GuizhiTang in the two age groups consisting of elementary school children and economically active adults respectively were the highest among other age groups. Second, ShiHo-GuizhiTang proved to be most effective in treatment for respiratory ailments and arthritis. Third, ShiHo-GuizhiTang brought down blood pressure of hypertension patients and at the same time benefited patients with normal or lower-than-normal blood pressure who were vulnerable to diseases due to low disease-resistance. Fourth, ShiHo-GuizhiTang was effective in the case of frequent pulse(rapid pulse) and thereby indicating the fact it carries Taiyang superficies syndrome. 지맥 arises from suppressed immune responses owing to adrenocortical hormones. ShiHo-GuizhiTang controls and revitalizes those suppressed immune systems which stem from slow pulse and, as a consequence of that process, helps them return to normal condition of pulse. Fifth, from the standpoint of syndrome of abdomen, feeling of obstruction in the epigastrium serves as an important standard in the process of diagnosing diseases and evaluating effectiveness of treatments. Sixth, according to the results of the clinical test with the 31 patients, a total of 81 percent of test subjects benefited from the treatment. The figure is the sum of 52 percent of I-class (both main symptom and accompanying symptoms had been eliminated) and 29 percent of II-class (part of main symptom and accompanying symptoms had been eliminated) respectively. All told it is safe to say that ShiHo-GuizhiTang can elect to be a viable clinical treatment. In conclusion, it is estimated that this clinical study has drawn up guidelines for objective diagnostic standards and evaluation on specific treatments' effectiveness. This will lead to more general application of ShiHo-GuizhiTang. On top of that, this study could also provide an opportunity to stress the significance of ShiHo-GuizhiTang and ShiHo-GuizhiTang modify and ShiHo-GuizhiTang mixed prescriptions as an alternative treatment for collagen disease which comes from environmental degradation and pollution.

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Ex vivo High-resolution Optical Coherence Tomography (OCT) Imaging of Pleural Reaction after Pleurodesis Using Talc

  • Ahn, Yeh-Chan;Oak, Chulho;Park, Jung-Eun;Jung, Min-Jung;Kim, Jae-Hun;Lee, Hae-Young;Kim, Sung Won;Park, Eun-Kee;Jung, Maan Hong
    • Journal of the Optical Society of Korea
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    • v.20 no.5
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    • pp.607-613
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    • 2016
  • The pleura is known as an end target organ of exposure to toxic environmental materials such as fine particulate matter and asbestos. Moreover, long-term exposure to hazardous materials can eventually lead to fatal lung disease such as diffuse pleural fibrosis or mesothelioma. Chest computed tomography (CT) and ultrasound are gold standard imaging modalities for detection of advanced pleural disease. However, a diagnostic tool for early detection of pleural reaction has not been developed yet due to difficulties in imaging ultra-fine structure of the pleura. Optical coherence tomography (OCT), which provides cross-sectional images of micro tissue structures at a resolution of 2-10 μm, can image the mesothelium with a thickness of ~100 μm and therefore enables investigation of the early pleural reaction. In this study, we induced the early pleural reaction according to a time sequence after pleurodesis using talc, which has been widely used in the clinical field. The pleural reaction in talc grouped according to the time sequence (1st, 2nd, 4th weeks) showed a significant thickening (average thickness: 45 ± 7.5 μm, 80 ± 10.7 μm, 90 ± 12.5 μm), while the pleural reaction in sham and normal groups showed pleural change from normal to minimal thickening (average thickness: 16 ± 5.5 μm, 17 ± 4.5 μm, 15 ± 6.5 μm, and 12 ± 7.5 μm, 13 ± 2.5 μm, 12 ± 3.5 μm). The measurement of pleural reaction by pathologic examinations was well-matched with the measurement by OCT images. This is the first study for measuring the thickness of pleural reactions using a biophotonic modality such as OCT. Our results showed that OCT can be useful for evaluating the early pleural reaction.

Comparison of Diagnostic Validity between Laser Fluorescence Devices in Proximal Caries (레이저 형광 원리를 이용한 우식 진단 기기의 구치부 인접면 우식 진단 능력 비교)

  • Lee, Changkeun;Lee, Daewoo;Kim, Jaegon;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.4
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    • pp.426-435
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    • 2018
  • The aim of this study was to evaluate the proximal caries detecting ability and identify the optimal cut-off values of two types of laser fluorescence (LF) devices; classic type (DD) and pen type (DDpen). The number of proximal surfaces participated in this study were 164 surfaces in primary dentition and 438 surfaces in permanent dentition. Each tooth surface was sequentially assessed by two types of LF devices, and bitewing radiograph. The radiographs were classified into 3 groups in primary dentition ($pR_0$, $pR_1$, $pR_2$), and 4 groups in permanent dentition ($PR_0$, $PR_1$, $PR_2$, $PR_3$) according to the depth of caries, and used as gold standard. In primary dentition, the area under the curve (AUC) values of DD were 0.851 and 0.890, and those of DDpen were 0.883 and 0.917, respectively in enamel caries and dentin caries. In permanent dentition, the AUC values of DD were 0.762 and 0.886, and those of DDpen were 0.828 and 0.958, respectively in enamel caries and dentin caries. When detecting proximal caries in posterior teeth with LF devices, DDpen is more useful than DD in both primary and permanent dentition. However, in primary dentition, DD can also be useful to detect proximal caries.

Comparison between domestic and foreign Clinical guidelines and previous researches on Korean medicine for psoriasis to develop the clinical trial guideline of psoriasis using Korean medicine (건선 한약제제 임상시험 가이드라인 개발을 위한 관련 국내외 가이드라인과 기존 건선치료 한약제제 연구와의 비교)

  • Kang, Se Hyun;Moon, Young-Kyun;Jeong, Woo-Yeol;Nam, Hae-Jung;Kim, Yoon-Bum;Lee, Jun-Hee;Kim, Kyuseok
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.29 no.2
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    • pp.12-32
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    • 2016
  • Objectives : The objective of this study is to develop the strategies of the psoriasis clinical trials guideline on Korean medicine by comparison between Clinical guidelines and domestic and foreign clinical trials papers of psoriasis on Korean medicine. Methods : This study is based on analysis of papers on Clinical trials guidelines, Clinical practice guideline and clinical trials about Korean medicine. The papers were searched from Pubmed, Medline, Oasis(Oriental Medicine Advanced Searching Integrated System), Korean Traditional Knowledge Portal and Google portal database. Results : A total 8 Clinical practice guidelines and 2 Clinical trials guidelines were found. Moreover, there were 15 foreign papers about clinical trials and 29 internal articles about case studies. They suggested the diagnostic strategy, classification, effective outcome measure, severity measure, precaution of combination therapy, precaution and treatment period of clinical trials, safety evaluation, patterns of Korean Medicine, clinical specific features on psoriasis.Conclusions : The criteria of every item to provide the clinical trials guideline using Korean medicine on psoriasis were developed by apply the results. If we accumulate the more clinical articles on Korean medicine, it will be great help to develop the reliable standard of that guideline.

Method Development for the Profiling Analysis of Urine Globotriaosylceramide (Gb3) for the Screening of Fabry Disease by Tandem Mass Spectrometry (ESI-MS/MS를 이용한 소변 중 Globotriaosylceramide(Gb3)의 정량 및 임상 응용; 패브리병(Fabry) 진단)

  • Yoon, Hye-Ran;Cho, Kyung-Hee;Kang, Seung-Woo;Kwon, Young-Joo;Jeong, Choon-Sik;Lee, Yong-Soo
    • YAKHAK HOEJI
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    • v.51 no.2
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    • pp.96-102
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    • 2007
  • Measurement of globotriaosylceramide (Gb3, ceramide trihexoside) in urine has clinical importance for monitoring after enzyme replacement therapy in Fabry disease patients. The disease is an X-linked lipid storage disorder that results from a deficiency of the enzyme ${\alpha}$-galactosidase A (${\alpha}$-Gal A). The lack of ${\alpha}$-Gal A causes an intracellular accumulation of glycosphingolipids, mainly Gb3. A simple, rapid, and highly sensitive analytical method for Gb3 in urine was developed without labor-extensive pre-treatment by electrospray ionization MS/MS (ESI-MS/MS). Only simple 5-fold dilution of urine is necessary for the extraction and isolation of Gb3 in urine. Gb3 in diluted urine was dissolved in dioxane containing C17:0 Gb3 as an internal standard. After centrifugation it was directly injected and analyzed through guard column by in combination with multiple reaction monitoring mode of ESI-MS/MS. Eight isoforms of Gb3 were completely resolved from urine matrix. C24:0 Gb3 occupied 50% of total Gb3 as a major component in urine. Linear relationship for Gb3 isoforms was found in the range of 0.005${\sim}$5.0 ${\mu}$g/ml. The limit of detection (S/N=5) was 0.005 ${\mu}$g/ml and limit of quantification was 0.05 ${\mu}$g/ml for C24:0 Gb3 with acceptable precision and accuracy. Correlation coefficient of calibration curves for 8 Gb3 isoforms ranged from 0.9598 to 0.9975. This method could be useful for rapid and sensitive 1st line Fabry disease screening, monitoring and/or diagnostic tool for Fabry disease.

An Integration of Legacy Nuclear Simulation Code into HLA Federation using Shared Memory (공유메모리를 사용한 레거시 원자력 시뮬레이션 코드의 HLA 패더레이션으로의 통합)

  • Park Geun-Ok;Han Kwan-Ho;Lim Jong-Tae
    • The KIPS Transactions:PartD
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    • v.12D no.5 s.101
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    • pp.797-806
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    • 2005
  • The objective of the In-h(High Level Architecture) have recommended by DoD(Department of Defense) is to facilitate interoperability among simulations and to promote reuse of their components. There are many legacy simulation softwares developed before the HLA becomes simulation standard. The integration of legacy simulations into federations using the HLA is an important research topic in M&S(Modeling and Simulation) area. Legacy simulation softwares of the mission critical industry such as nuclear and aerospace are generally use Fortran language. However, the reuse of those is not easy because the HLA is not support Fortran language. This paper suggests a integration method which minimizes the modification of legacy simulation software and migrates the legacy simulation software to HLA federation. Each federate participating in federation have the separated executables that communicate via a shared memory created at run-time. Two types of shared memory blocks are used for publication and subscription. Declaration block for global variables used in legacy simulation software is separated for publication and subscription and then mapped as classes of objects and interactions for the HLA FOM design. To validate the suggested method, we approached the HLA integration of legacy nuclear simulation code being used in plant design and to observe the integration results, we used the FMT(Federation Management Tool). The diagnostic information which the FTM displays showed that our method can be successfully and effectively used for a HLA federation.