• 대한후두음성언어의학회지
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• 제31권2호
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• pp.71-77
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• 2020

Background and Objectives OperaVOXTM (Oxford Wave Research Ltd.) is a portable voice analysis software package designed for use with iOS devices. As a relatively cheap, portable and easily accessible form of acoustic analysis, OperaVOXTM may be more clinically useful than laboratory-based software in many situations. The aim of this study was to evaluate the agreement between OperaVOXTM and Multi-Dimensional Voice Program (MDVP; Computerized Speech Lab) to assess voice quality before and after laryngeal microsurgery in patient with vocal polyp. Materials and Method Twenty patients who had undergone laryngeal microsurgery for vocal polyp were enrolled in this study. Preoperative and postoperative voices were assessed by acoustic analysis using MDVP and OperaVOXTM. A five-seconds recording of vowel /a/ was used to measure fundamental frequency (F0), jitter, shimmer and noise-to-harmonic ratio (NHR). Results Several acoustic parameters of MDVP and OperaVOXTM related to short-term variability showed significant improvement. While pre-operative value of F0, jitter, shimmer, NHR was 155.75 Hz (male: 125.37 Hz, female: 183.37 Hz), 2.20%, 6.28%, 0.16, post-operative values of these parameter was 164.34 Hz (male: 129.42 Hz, female: 199.26 Hz), 2.15%, 5.18%, 0.14 Hz in MDVP. While pre-operative value of F0, jitter, shimmer, NHR was 168.26 Hz (male: 135.16 Hz, female: 201.37 Hz), 2.27%, 6.95%, 0.26, post-operative values of these parameters was 162.72 Hz (male: 128.267 Hz, female: 197.18 Hz), 1.71%, 5.36%, 0.20 in OperaVOXTM. There was high intersoftware agreement for F0, jitter, shimmer with intraclass correlation coefficient. Conclusion Our results showed that the short-term variability of acoustic parameters in both MDVP and OperaVOXTM were useful for the objective assessment of voice quality in patients who received laryngeal microsurgery. OperaVOXTM is comparable to MDVP and has high intersoftware reliability with MDVP in measuring the F0, jitter, and shimmer

• PNF and Movement
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• 제21권2호
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• pp.171-183
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• 2023

Purpose: The purpose of this study was to compare universal goniometry (UG), which is commonly used in clinical practice to measure the range of motion (ROM) of finger joints with a wearable soft sensor glove, and to analyze the reliability to determine its usefulness. Methods: Ten healthy adults (6 males, 4 females) participated in this study. The metacarpophalangeal joint (MCP), interphalangeal joint (IP), and proximal interphalangeal joint (PIP) of both hands were measured using UG and Mollisen HAND soft sensor gloves during active flexion, according to the American Society for Hand Therapists' measurement criteria. Measurements were taken in triplicate and averaged. The mean and standard deviation of the two methods were calculated, and the 95% limits of agreement (LOA) of the measurements were calculated using the intraclass correlation coefficient (ICC) and Bland-Altman plot to examine the reliability and discrepancies between the measurements. Results: The results of the mean values of the flexion angles for the active range of motion (AROM) of the finger joints showed large angular differences in the finger joints, except for the MCP of the thumb. In the inter-rater reliability analysis according to the measurement method, the ICC (2, 1) value showed a low level close to 0, and the mean difference by the Bland-Altman plot showed a value greater than 0, showing a pattern of discrepancy. The 95% LOA had a wide range of differences. Conclusion: This study is a preliminary study investigating the usefulness of the soft sensor glove, and the reliability analysis showed a low level of reliability and inconsistency. However, if future studies can overcome the limitations of this study and the technical problems of the soft sensor glove in the development stage, it is suggested that the measurement instrument can show more accurate measurement and higher reliability when measuring ROM with UG.

• 보건행정학회지
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• 제32권4호
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• pp.347-355
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• 2022

Background: Since November 2019, long-term care hospitals have been able to provide patients with discharging programs to support the elderly in the community. This study aimed to identify both patient- and hospital-level factors that affect successful community discharge from long-term care hospitals. Methods: A multilevel logistic regression model was performed using hospitals as a clustering unit. The dependent variable was whether a patient stayed in the community for at least 30 days after discharge from a long-term care hospital. As for the patient-level independent variables, an agreement between a patient and the family about discharge, length of hospital stay, patient category, and residence at discharge were included. The number of beds and the ratio of long-stay patients were selected for the hospital-level factors. The sample size was 1,428 patients enrolled in the discharging program from November 2019 to December 2020. Results: The number of patients who were discharged to the community and stayed at least for 30 days was 532 (37.3%). The intraclass correlation coefficient was 22.9%, indicating that hospital-level factors had a significant impact on successful community discharge. The odds ratio (OR) of successful community discharge increased by 1.842 times when the patients and their families agreed on discharge. The ORs also increased by 3.020 or 2.681 times, respectively when the patients planned to discharge to their own house or their child's house compared to those who didn't have a plan for residence at discharge. The ORs increased by 1.922 or 2.250 times when the hospitals were owned by corporate or private property compared to publicly owned hospitals. The ORs decreased by 0.602 or 0.520 times when the hospital was sized over 400 beds or located in small and medium-sized cities compared to less than 200 bedded hospitals or located in metropolitan cities. Conclusion: The results of the study showed that the patients' and their family's willingness for discharge had a great impact on successful community discharge and the hospital-level factors played a significant role in it. Therefore, it is important to acknowledge and support long-term care hospitals to involve active in the patient discharge planning process.

• 한국방사선학회논문지
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• 제17권6호
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• pp.985-991
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• 2023

온열치료의 품질관리를 위해서 조직등가 팬텀이 필요하다. 그러나 이를 위한 팬텀이 없어 한천으로 만든 팬텀이 여러 연구에서 사용되고 있다. 본 연구에서는 한천 팬텀의 조직등가 특성을 조직등가 물질 볼루스와 비교하여 확인하였다. 한천 팬텀과 볼루스의 CT 영상을 획득하고 영상분석과 전산화 치료계획 시스템을 이용한 선량계산으로 조직등가 특성을 확인하였다. 평균 픽셀값은 볼루스에서 96.960 ± 10.999, 3% 한천 팬텀에서는 108.559 ± 8.233, 4% 한천 팬텀에서 111.844 ± 8.651의 값을 보였다. 6 MV 엑스선을 SSD 기법으로 1.5 cm 깊이에 100 cGy를 처방하여 10×10cm²로 조사하여 빔의 중심축에서 깊이에 따른 흡수선량을 계산하였다. 볼루스, 3% 한천 팬텀, 4% 한천 팬텀의 심부선량분포의 급내상관계수는 0.979(p<.001, 95%CI .957-.991)로 나타났다. 흡수선량을 계산한 지점의 밀도(g/cm³)는 볼루스에서 0.990 ± 0.020, 3% 한천 팬텀에서 1.018 ± 0.020, 4% 한천 팬텀에서 1.035 ± 0.024로 나타났다. 본 연구에서 CT영상의 분석과 전산화 방사선치료계획 시스템을 이용해 한천 팬텀의 내부 밀도 분포와 균일도가 조직등가 물질로서 적절함을 확인하였다.

• Korean Journal of Radiology
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• 제22권11호
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• pp.1777-1785
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• 2021

Objective: To investigate the accuracy of the Agatston score obtained with the ultra-high-pitch (UHP) acquisition mode using tin-filter spectral shaping (Sn150 kVp) and a kVp-independent reconstruction algorithm to reduce the radiation dose. Materials and Methods: This prospective study included 114 patients (mean ± standard deviation, 60.3 ± 9.8 years; 74 male) who underwent a standard 120 kVp scan and an additional UHP Sn150 kVp scan for coronary artery calcification scoring (CACS). These two datasets were reconstructed using a standard reconstruction algorithm (120 kVp + Qr36d, protocol A; Sn150 kVp + Qr36d, protocol B). In addition, the Sn150 kVp dataset was reconstructed using a kVp-independent reconstruction algorithm (Sn150 kVp + Sa36d, protocol C). The Agatston scores for protocols A and B, as well as protocols A and C, were compared. The agreement between the scores was assessed using the intraclass correlation coefficient (ICC) and the Bland-Altman plot. The radiation doses for the 120 kVp and UHP Sn150 kVp acquisition modes were also compared. Results: No significant difference was observed in the Agatston score for protocols A (median, 63.05; interquartile range [IQR], 0-232.28) and C (median, 60.25; IQR, 0-195.20) (p = 0.060). The mean difference in the Agatston score for protocols A and C was relatively small (-7.82) and with the limits of agreement from -65.20 to 49.56 (ICC = 0.997). The Agatston score for protocol B (median, 34.85; IQR, 0-120.73) was significantly underestimated compared with that for protocol A (p < 0.001). The UHP Sn150 kVp mode facilitated an effective radiation dose reduction by approximately 30% (0.58 vs. 0.82 mSv, p < 0.001) from that associated with the standard 120 kVp mode. Conclusion: The Agatston scores for CACS with the UHP Sn150 kVp mode with a kVp-independent reconstruction algorithm and the standard 120 kVp demonstrated excellent agreement with a small mean difference and narrow agreement limits. The UHP Sn150 kVp mode allowed a significant reduction in the radiation dose.

• Korean Journal of Radiology
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• 제21권4호
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• pp.431-441
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• 2020

Objective: To compare the diagnostic performance and interobserver variability of strain ratio obtained from one or two regions of interest (ROI) on breast elastography. Materials and Methods: From April to May 2016, 140 breast masses in 140 patients who underwent conventional ultrasonography (US) with strain elastography followed by US-guided biopsy were evaluated. Three experienced breast radiologists reviewed recorded US and elastography images, measured strain ratios, and categorized them according to the American College of Radiology breast imaging reporting and data system lexicon. Strain ratio was obtained using the 1-ROI method (one ROI drawn on the target mass), and the 2-ROI method (one ROI in the target mass and another in reference fat tissue). The diagnostic performance of the three radiologists among datasets and optimal cut-off values for strain ratios were evaluated. Interobserver variability of strain ratio for each ROI method was assessed using intraclass correlation coefficient values, Bland-Altman plots, and coefficients of variation. Results: Compared to US alone, US combined with the strain ratio measured using either ROI method significantly improved specificity, positive predictive value, accuracy, and area under the receiver operating characteristic curve (AUC) (all p values < 0.05). Strain ratio obtained using the 1-ROI method showed higher interobserver agreement between the three radiologists without a significant difference in AUC for differentiating breast cancer when the optimal strain ratio cut-off value was used, compared with the 2-ROI method (AUC: 0.788 vs. 0.783, 0.693 vs. 0.715, and 0.691 vs. 0.686, respectively, all p values > 0.05). Conclusion: Strain ratios obtained using the 1-ROI method showed higher interobserver agreement without a significant difference in AUC, compared to those obtained using the 2-ROI method. Considering that the 1-ROI method can reduce performers' efforts, it could have an important role in improving the diagnostic performance of breast US by enabling consistent management of breast lesions.

• Korean Journal of Radiology
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• 제22권8호
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• pp.1266-1278
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• 2021

Objective: We aimed to compare the aortic valve area (AVA) calculated using fast high-resolution three-dimensional (3D) magnetic resonance (MR) image acquisition with that of the conventional two-dimensional (2D) cine MR technique. Materials and Methods: We included 139 consecutive patients (mean age ± standard deviation [SD], 68.5 ± 9.4 years) with aortic valvular stenosis (AS) and 21 asymptomatic controls (52.3 ± 14.2 years). High-resolution T2-prepared 3D steady-state free precession (SSFP) images (2.0 mm slice thickness, 10 contiguous slices) for 3D planimetry (3DP) were acquired with a single breath hold during mid-systole. 2D SSFP cine MR images (6.0 mm slice thickness) for 2D planimetry (2DP) were also obtained at three aortic valve levels. The calculations for the effective AVA based on the MR images were compared with the transthoracic echocardiographic (TTE) measurements using the continuity equation. Results: The mean AVA ± SD derived by 3DP, 2DP, and TTE in the AS group were 0.81 ± 0.26 cm², 0.82 ± 0.34 cm², and 0.80 ± 0.26 cm², respectively (p = 0.366). The intra-observer agreement was higher for 3DP than 2DP in one observer: intraclass correlation coefficient (ICC) of 0.95 (95% confidence interval [CI], 0.94-0.97) and 0.87 (95% CI, 0.82-0.91), respectively, for observer 1 and 0.97 (95% CI, 0.96-0.98) and 0.98 (95% CI, 0.97-0.99), respectively, for observer 2. Inter-observer agreement was similar between 3DP and 2DP, with the ICC of 0.92 (95% CI, 0.89-0.94) and 0.91 (95% CI, 0.88-0.93), respectively. 3DP-derived AVA showed a slightly higher agreement with AVA measured by TTE than the 2DP-derived AVA, with the ICC of 0.87 (95% CI, 0.82-0.91) vs. 0.85 (95% CI, 0.79-0.89). Conclusion: High-resolution 3D MR image acquisition, with single-breath-hold SSFP sequences, gave AVA measurement with low observer variability that correlated highly with those obtained by TTE.

• 심성연구
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• 제33권1호
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• pp.61-80
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• 2018

본 연구는 그레이-휠라이트 검사의 문항들이 융의 유형론의 개념을 잘 반영하는지 알아보고 그 결과를 바탕으로 개선된 단축형 그레이-휠라이트 검사를 만든 것이다. 총 431명의 사람들이 연구에 참여하여 그레이-휠라이트 검사를 실시하였고 최우도법(Maximum likelihood)과 Varimax 회전법을 이용한 요인분석을 통해 그 결과를 분석하였다. 그레이-휠라이트의 81개 문항들을 요인분석에서 추출한 요인으로 분류하고 분류된 요인들이 융의 유형 척도와 일치하는지를 살펴보았다. 요인들과 일치하지 않거나 주요 요인에 포함되지 않은 문항들을 제외하고 남은 45개의 문항들로 단축형 그레이-휠라이트 검사를 제작하였다. 급내상관계수로 평가한 단축형 그레이-휠라이트 검사의 검사-재검사 신뢰도와 Cronbach's α 계수로 평가한 단축형 그레이-휠라이트 검사의 내적일치도는 원 그레이-휠라이트 검사의 결과와 대등한 수준이었다. 급내상관계수와 Cohen's weighted kappa로 각각 평가한 단축형 검사와 원 검사의 일치도 역시 매우 높았다. 단축형 그레이-휠라이트 검사는 적은 수의 문항으로 검사에 소요되는 시간과 노력을 줄이면서도 융의 유형론에 기반한 성격 유형을 잘 측정하고 있어 향후 임상에서 단축형 그레이-휠라이트 검사의 활용도를 높일 수 있을 것으로 기대한다.

• Korean Journal of Radiology
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• 제23권2호
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• pp.180-188
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• 2022

Objective: To validate the performance of 3T spin-echo echo-planar imaging (SE-EPI) magnetic resonance elastography (MRE) for staging hepatic fibrosis in a large population, using surgical specimens as the reference standard. Materials and Methods: This retrospective study initially included 310 adults (155 undergoing hepatic resection and 155 undergoing donor hepatectomy) with histopathologic results from surgical liver specimens. They underwent 3T SE-EPI MRE ≤ 3 months prior to surgery. Demographic findings, underlying liver disease, and hepatic fibrosis pathologic stage according to METAVIR were recorded. Liver stiffness (LS) was measured by two radiologists, and inter-reader reproducibility was evaluated using the intraclass correlation coefficient (ICC). The mean LS of each fibrosis stage (F0-F4) was calculated in total and for each etiologic subgroup. Comparisons among subgroups were performed using the Kruskal-Wallis test and Conover post-hoc test. The cutoff values for fibrosis staging were estimated using receiver operating characteristic (ROC) curve analysis. Results: Inter-reader reproducibility was excellent (ICC, 0.98; 95% confidence interval, 0.97-0.99). The mean LS values were 1.91, 2.41, 3.24, and 5.41 kPa in F0-F1 (n = 171), F2 (n = 26), F3 (n = 38), and F4 (n = 72), respectively. The discriminating cutoff values for diagnosing ≥ F2, ≥ F3, and F4 were 2.18, 2.71, and 3.15 kPa, respectively, with the ROC curve areas of 0.97-0.98 (sensitivity 91.2%-95.9%, specificity 90.7%-99.0%). The mean LS was significantly higher in patients with cirrhosis (F4) of nonviral causes, such as primary biliary cirrhosis (9.56 kPa) and alcoholic liver disease (7.17 kPa) than in those with hepatitis B or C cirrhosis (4.28 and 4.92 kPa, respectively). There were no statistically significant differences in LS among the different etiologic subgroups in the F0-F3 stages. Conclusion: The 3T SE-EPI MRE demonstrated high interobserver reproducibility, and our criteria for staging hepatic fibrosis showed high diagnostic performance. LS was significantly higher in patients with non-viral cirrhosis than in those with viral cirrhosis.

• Korean Journal of Radiology
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• 제23권1호
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• pp.30-41
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• 2022

Objective: Computed tomography enterography (CTE) and magnetic resonance enterography (MRE) are considered substitutes for each other for evaluating Crohn's disease (CD). However, the adequacy of mixing them for routine periodic follow-up for CD has not been established. This study aimed to compare MRE alone with the mixed use of CTE and MRE for the periodic follow-up of small bowel inflammation in patients with CD. Materials and Methods: We retrospectively compared two non-randomized groups, each comprising 96 patients with CD. One group underwent CTE and MRE (MRE followed by CTE or vice versa) for the follow-up of CD (interval, 13-27 months [median, 22 months]), and the other group underwent MRE alone (interval, 15-26 months [median, 21 months]). However, these two groups were similar in clinical characteristics. Three independent readers from three different institutions determined whether inflammation had decreased, remained unchanged, or increased within the entire small bowel and the terminal ileum based on sequential enterography of the patients after appropriate blinding. We compared the two groups for inter-reader agreement and accuracy (terminal ileum only) using endoscopy as the reference standard for enterographic interpretation. Results: The inter-reader agreement was greater in the MRE alone group for the entire small bowel (intraclass correlation coefficient [ICC]: 0.683 vs. 0.473; p = 0.005) and the terminal ileum (ICC: 0.656 vs. 0.490; p = 0.030). The interpretation accuracy was higher in the MRE alone group without statistical significance (70.9%-74.5% vs. 57.9%-64.9% in individual readers; adjusted odds ratio = 3.21; p = 0.077). Conclusion: The mixed use of CTE and MRE was inferior to MRE alone in terms of inter-reader reliability and could probably be less accurate than MRE alone for routine monitoring of small bowel inflammation in patients with CD. Therefore, the consistent use of MRE is favored for this purpose.