• Title/Summary/Keyword: Mann-Whitney test.

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Comparison of Monoexponential, Biexponential, Stretched-Exponential, and Kurtosis Models of Diffusion-Weighted Imaging in Differentiation of Renal Solid Masses

  • Jianjian Zhang;Shiteng Suo;Guiqin Liu;Shan Zhang;Zizhou Zhao;Jianrong Xu;Guangyu Wu
    • Korean Journal of Radiology
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    • v.20 no.5
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    • pp.791-800
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    • 2019
  • Objective: To compare various models of diffusion-weighted imaging including monoexponential apparent diffusion coefficient (ADC), biexponential (fast diffusion coefficient [Df], slow diffusion coefficient [Ds], and fraction of fast diffusion), stretched-exponential (distributed diffusion coefficient and anomalous exponent term [α]), and kurtosis (mean diffusivity and mean kurtosis [MK]) models in the differentiation of renal solid masses. Materials and Methods: A total of 81 patients (56 men and 25 women; mean age, 57 years; age range, 30-69 years) with 18 benign and 63 malignant lesions were imaged using 3T diffusion-weighted MRI. Diffusion model selection was investigated in each lesion using the Akaike information criteria. Mann-Whitney U test and receiver operating characteristic (ROC) analysis were used for statistical evaluations. Results: Goodness-of-fit analysis showed that the stretched-exponential model had the highest voxel percentages in benign and malignant lesions (90.7% and 51.4%, respectively). ADC, Ds, and MK showed significant differences between benign and malignant lesions (p < 0.05) and between low- and high-grade clear cell renal cell carcinoma (ccRCC) (p < 0.05). α was significantly lower in the benign group than in the malignant group (p < 0.05). All diffusion measures showed significant differences between ccRCC and non-ccRCC (p < 0.05) except Df and α (p = 0.143 and 0.112, respectively). α showed the highest diagnostic accuracy in differentiating benign and malignant lesions with an area under the ROC curve of 0.923, but none of the parameters from these advanced models revealed significantly better performance over ADC in discriminating subtypes or grades of renal cell carcinoma (RCC) (p > 0.05). Conclusion: Compared with conventional diffusion parameters, α may provide additional information for differentiating benign and malignant renal masses, while ADC remains the most valuable parameter for differentiation of RCC subtypes and for ccRCC grading.

Multivariate Analysis of Predictive Factors for the Severity in Stable Patients with Severe Injury Mechanism (중증 손상 기전의 안정된 환자에서 중증도 예측 인자들에 대한 다변량 분석)

  • Lee, Jae Young;Lee, Chang Jae;Lee, Hyoung Ju;Chung, Tae Nyoung;Kim, Eui Chung;Choi, Sung Wook;Kim, Ok Jun;Cho, Yun Kyung
    • Journal of Trauma and Injury
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    • v.25 no.2
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    • pp.49-56
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    • 2012
  • Purpose: For determining the prognosis of critically injured patients, transporting patients to medical facilities capable of providing proper assessment and management, running rapid assessment and making rapid decisions, and providing aggressive resuscitation is vital. Considering the high mortality and morbidity rates in critically injured patients, various studies have been conducted in efforts to reduce those rates. However, studies related to diagnostic factors for predicting severity in critically injured patients are still lacking. Furthermore, patients showing stable vital signs and alert mental status, who are injured via a severe trauma mechanism, may be at a risk of not receiving rapid assessment and management. Thus, this study investigates diagnostic factors, including physical examination and laboratory results, that may help predict severity in trauma patients injured via a severe trauma mechanism, but showing stable vital signs. Methods: From March 2010 to December 2011, all trauma patients who fit into a diagnostic category that activated a major trauma team in CHA Bundang Medical Center were analyzed retrospectively. The retrospective analysis was based on prospective medical records completed at the time of arrival in the emergency department and on sequential laboratory test results. PASW statistics 18(SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. Patients with relatively stable vital signs and alert mental status were selected based on a revised trauma score of more than 7 points. The final diagnosis of major trauma was made based on an injury severity score of greater than 16 points. Diagnostic variables include systolic blood pressure and respiratory rate, glasgow coma scale, initial result from focused abdominal sonography for trauma, and laboratory results from blood tests and urine analyses. To confirm the true significance of the measured values, we applied the Kolmogorov-Smirnov one sample test and the Shapiro-Wilk test. When significance was confirmed, the Student's t-test was used for comparison; when significance was not confirmed, the Mann-Whitney u-test was used. The results of focused abdominal sonography for trauma (FAST) and factors of urine analysis were analyzed using the Chi-square test or Fisher's exact test. Variables with statistical significance were selected as prognostics factors, and they were analyzed using a multivariate logistics regression model. Results: A total of 269 patients activated the major trauma team. Excluding 91 patients who scored a revised trauma score of less than 7 points, 178 patients were subdivided by injury severity score to determine the final major trauma patients. Twenty-one(21) patients from 106 major trauma patients and 9 patients from 72 minor trauma patients were also excluded due to missing medical records or untested blood and urine analysis. The investigated variables with p-values less than 0.05 include the glasgow coma scale, respiratory rate, white blood cell count (WBC), serum AST and ALT, serum creatinine, blood in spot urine, and protein in spot urine. These variables could, thus, be prognostic factors in major trauma patients. A multivariate logistics regression analysis on those 8 variables showed the respiratory rate (p=0.034), WBC (p=0.005) and blood in spot urine (p=0.041) to be independent prognostic factors for predicting the clinical course of major trauma patients. Conclusion: In trauma patients injured via a severe trauma mechanism, but showing stable vital signs and alert mental status, the respiratory rate, WBC count and blood in the urine can be used as predictable factors for severity. Using those laboratory results, rapid assessment of major trauma patients may shorten the time to diagnosis and the time for management.

A Comparative Study on Closed vs. Open Endotracheal Suctioning on the Newborn Infants Treated with Ventilator (인공호흡기 사용 신생아의 폐쇄형과 개방형 기관흡인에 관한 연구)

  • Park, Jeong-Won;Park, Yeong-Ae
    • 아동간호학회:학술대회논문집
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    • 1997.11a
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    • pp.61-74
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    • 1997
  • Endotracheal suctioning is a routine procedure used for clearing secretions from the airway of the intubated infant. This procedure is not without complications. Endotracheal suctioning has been associated with decreases in $PaO_2$, decreases in systemic venous oxygenation, alterations in mean arterial Pressure, disturbances in cardiac rhythm and development of nosocomial pneumonia. So several endotracheal suctioning techniques have been developed to prevent these blown complications. Another method of Endotracheal suctioning eliminates the risk associated with disconnecting the infant from the ventilatior to perform the suctioning procedure. Studies examining closed endotracheal suctioning methods reported that the closed method results in less arterial oxygen saturation, and less systemic venous oxygen desaturation. However those studies have focused on adult patients, and there have been no published studies for newborn infants. The specific purpose of this study is to investigate the two methods and to make a comparison in terms of (1)variations in $SaO_2$, heart rate, and respiration rate appeared before and after the endotracheal suctioning; (2)difference in occurrence of nosocomial infection; (3)difference in recovery time to arrive at pre-suction baseline after suctioning and in nursing time taken for the suctioning. The present study is based on the data obtained from two groups of newborn infants : one group comprises 8 infants with closed suctioning (a total of 304 suctions) among 17 infants treated with ventilator and the other group 9 infants with open method (a total of 629 suctions). The data were analyzed using the SPSS statistical program package. As the distribution test on dependent variables with the Skewnesser Shapiro Wilk test showed an asymmetric distribution, the Wilcoxon Matched-pairs Singled- Ranks test was used for the test of variations in $SaO_2$, heart rate, and respiration rate appeared before and after the endotracheal suctioning. The difference in $SaO_2$ recovery time and nursing time was analyzed with the Mann-Whitney U-Test. The difference in physiologic consequences and occurrence of nosocomial infection between the two groups was analyzed with the Fisher's Exact Test. The results of the study are summarized as follows. For the hypothesis 1 (There would be a difference in $SaO_2$, heart rate, and respiration rate before and after suctioning between the two suctioning methods), the difference in $SaO_2$ turns out to be statistically significant (P=0.015), but heart rate and respiration rate do not procedure a notable difference (P=0.630). The hypothesis 2 (There would be a difference in rates at which a complication arises after suctioning between the two groups) does not prove to be statistically valid (P=0.246). For the hypothesis 3(There would be a difference in $SaO_2$ recovery time and nursing time between the two groups), the average $SaO_2$ recovery time after suctioning turned out to have somewhat significant difference (P=0.064), however the difference in nursing time taken for the suctioning was not statistically significant (P=0.610). The analyses indicate that the closed endotracheal suctioning is more efficient as compared with the open method, in maintaining pre-suction baseline $SaO_2$ and a rapid recovery of newborn infants. Based on these results we suggust to apply the closed method to newborn infants in the ventilation treatment. We also suggest to extend the investigation to include the comparison of suction cost taking into account the case in which a complication arises after endotracheal suctioning between the two groups.

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Effect of the Ayres Sensory Integration Intervention on the Motor Skills and Occupation Participation of Preschool Children with Attention-Deficit/Hyperactivity Disorder (Ayres의 감각통합중재가 학령전기 주의력결핍 과잉행동장애(ADHD) 성향 아동의 운동기능 및 작업참여에 미치는 영향)

  • Jung, Yun-Jin;Kang, Je-wook;Chang, Moon-young;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.22 no.1
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    • pp.1-14
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    • 2024
  • Objective : This study aimed to investigate the impact of Ayres' sensory integration (ASI) intervention on motor skills and occupational participation of preschool children with attention-deficit/hyperactivity disorder (ADHD). Method : Children with ADHD aged between 4 and 6 years who met the inclusion and exclusion criteria were randomly recruited through screening tests. The subjects were divided into an experimental group (10 subjects) and a control group (8 subjects). The instruments used were the Bruininks-Oseretsky test of motor proficiency-2 (BOT-2), Pediatric Evaluation of Disability Inventory (PEDI), and Goal Attainment Scale (GAS) to evaluate occupational participation. The subjects in the experimental group underwent individual sensory integration therapy according to the ASI principles for 40 minutes twice a week in a total of 16 sessions over eight weeks. The control group did not receive the ASI intervention. Data analysis was performed using the Mann-Whitney U test, chi-squared test, Wilcoxon signed-rank test, and Cohen's d test in SPSS 20.0. Results : The ASI experimental group had significantly higher scores in total motor composite, manual coordination, body coordination, strength, and agility in motor function than the control group (p<.05). The two groups did not differ significantly in terms of occupational participation (PEDI), but GAS scores for individual target activities were significantly higher in the experimental group than in the control group (p<.05). Conclusion : This study shows that the ASI intervention has positive effects on motor skills and occupation participation among preschool children with ADHD.

Implant stability evaluation according to the bone condition, fixture diameter and shape in the osseointegration simulated resin model (골유착 재현 레진 모델에서 골 상태 및 임플란트 형태에 따른 임플란트 안정성에 관한 연구)

  • Kwon, Taek-Ka;Yeo, In-Sung;Kim, Sung-Hun;Han, Jung-Suk;Lee, Jai-Bong;Yang, Jae-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.49 no.2
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    • pp.128-137
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    • 2011
  • Purpose: Resonance frequency analysis, Periotest, and removal torque (RT) test were known as the methods to assess implant stability. The results of these methods are affected by the bone condition, implant diameter and shape. The purpose of this study is to access the meaning and the correlationship of the resonance frequency analysis, Periotest and RT test in osseointegration simulated acrylic resin when the engaged bone thickness and peri-implant bone defect are changed. Materials and methods: To simulate osseointegration, the fixture was fixed to an aluminum mold with a screw. Acrylic resin powder and liquid were poured into the mold for polymerization. The engaged resin thickness with implant was controlled. Simulated cortical bone thicknesses were 1, 3, 5 and 10 mm. Additional 1, 3 and 5 mm peri-implant bone defects were simulated. Three types of implants were used; 4 mm diameter implants of straight shape, 4 mm diameter implants of tapered shape and 5 mm diameter implants of tapered shape. Five fixtures per each type were tested in respective bone condition. Resonance frequency analysis and Periotest were evaluated in all bone conditions. Peak removal torque was measured at simulated cortical bone thicknesses of 1 and 3 mm. The statistical analysis was performed with the Kruskal-Wallis test, Mann-Whitney U test, and Spearman test using a 95% level of confidence. Results: With increasing engaged bone depth, the Implant Stability Quotient (ISQ) values increased and the Periotest values (PTVs) decreased (P<.001, P<.001). With increasing peri-implant bone defect, ISQ values decreased and PTVs increased (P<.001). When the diameter of implant increased, ISQ values increased and Periotest values (PTV) decreased (P<.001). There was a strong correlation between ISQ values and PTVs (r = -0.99, P<.001). Furthermore, the peak removal torque values had weak correlations with both ISQ values and PTVs (r = 0.52, P<.001 ; r = -0.52, P<.001). Conclusion: This study confirmed favorable implant stability with increasing engaged bone depth and implant diameter and decreasing peri-implant bone defect. ISQ values and PTVs showed strong correlation with each other and not with the peak removal torque values.

Myelin Content in Mild Traumatic Brain Injury Patients with Post-Concussion Syndrome: Quantitative Assessment with a Multidynamic Multiecho Sequence

  • Roh-Eul Yoo;Seung Hong Choi;Sung-Won Youn;Moonjung Hwang;Eunkyung Kim;Byung-Mo Oh;Ji Ye Lee;Inpyeong Hwang;Koung Mi Kang;Tae Jin Yun;Ji-hoon Kim;Chul-Ho Sohn
    • Korean Journal of Radiology
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    • v.23 no.2
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    • pp.226-236
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    • 2022
  • Objective: This study aimed to explore the myelin volume change in patients with mild traumatic brain injury (mTBI) with post-concussion syndrome (PCS) using a multidynamic multiecho (MDME) sequence and automatic whole-brain segmentation. Materials and Methods: Forty-one consecutive mTBI patients with PCS and 29 controls, who had undergone MRI including the MDME sequence between October 2016 and April 2018, were included. Myelin volume fraction (MVF) maps were derived from the MDME sequence. After three dimensional T1-based brain segmentation, the average MVF was analyzed at the bilateral cerebral white matter (WM), bilateral cerebral gray matter (GM), corpus callosum, and brainstem. The Mann-Whitney U-test was performed to compare MVF and myelin volume between patients with mTBI and controls. Myelin volume was correlated with neuropsychological test scores using the Spearman rank correlation test. Results: The average MVF at the bilateral cerebral WM was lower in mTBI patients with PCS (median [interquartile range], 25.2% [22.6%-26.4%]) than that in controls (26.8% [25.6%-27.8%]) (p = 0.004). The region-of-interest myelin volume was lower in mTBI patients with PCS than that in controls at the corpus callosum (1.87 cm3 [1.70-2.05 cm3] vs. 2.21 cm3 [1.86-3.46 cm3]; p = 0.003) and brainstem (9.98 cm3 [9.45-11.00 cm3] vs. 11.05 cm3 [10.10-11.53 cm3]; p = 0.015). The total myelin volume was lower in mTBI patients with PCS than that in controls at the corpus callosum (0.45 cm3 [0.39-0.48 cm3] vs. 0.48 cm3 [0.45-0.54 cm3]; p = 0.004) and brainstem (1.45 cm3 [1.28-1.59 cm3] vs. 1.54 cm3 [1.42-1.67 cm3]; p = 0.042). No significant correlation was observed between myelin volume parameters and neuropsychological test scores, except for the total myelin volume at the bilateral cerebral WM and verbal learning test (delayed recall) (r = 0.425; p = 0.048). Conclusion: MVF quantified from the MDME sequence was decreased at the bilateral cerebral WM in mTBI patients with PCS. The total myelin volumes at the corpus callosum and brainstem were decreased in mTBI patients with PCS due to atrophic changes.

Proposal of Localization Policy Based on the Status of Chinese's Research Facilities and Equipment Construction in Korean Basic and Analytical Science Field (국내 기초·분석과학 분야 내 중국산 연구시설·장비 구축 현황에 따른 국산화 정책 제언)

  • Kim, Chang-Yong;Chung, Taewon;Kong, Jaehyun;Park, Chan-Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.6
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    • pp.460-471
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    • 2019
  • The aim of this study was to examine the scale and market share of Chinese's research facility & equipment in the domestic research equipment market of basic and analytical science field for analyzing the difference of the number and amount of construction by year of acquisition, national research facility equipment standard classification code, and type of institution based on the information of the research equipment invested by the Korean government for the past 14 years. In addition, we analyzed the correlation among the year of acquisition, equipment standard classification code, and type of institution variables. As of January 1 2019, from 2005 to 2018, 50 Chinese's research facilities & equipments (main equipment with a construction cost of 30 million won or more) built in the basic and analytical science fields were selected for this study and their number of construction, amount of construction, year of acquisition, type of institution, and standard classification code were analyzed. Differences of the number and amount of construction with-in and by year of acquisition, standard classification code, and type of institution were tested using a single sample Chi-square test, Mann-Whitney U test, and Kruskal-wallis test. The correlation among the three variables was analyzed by using the Chi-square test of cross-tabulation analysis. And there was a statistically significant correlation among the year of acquisition, standard classification code, and type of institution (p<.05). Compared to the 2000s, in the 2010s, high-priced Optical Electronics/Video Equipment was installed at private universities, private enterprises, and government-affiliated research institute. Therefore, the domestic construction status of Chinese's research facility & equipment in the basic science and analytical science field is less than that of the domestic ones, but the number and the amount of construction are increasing statistically. So it is necessary for the government to be able to recognize the possibility that the Chinese's research facility and equipment can encroach on the domestic research industry market and to prepare related provision.

Comparison of Tension Type Headache Associated with Pericranial Tenderness and Headache Attributed to Temporomandibular Joint Disorder Using RDC/TMD Axis II (두개주변압통과 관련된 긴장성 두통과 측두하악장애에 기인한 두통과의 RDC/TMD Axis II에 따른 비교)

  • Park, Hyung-Yun;Bae, Sung-Jae;Yoo, Sang-Hoon;Chun, Yang-Hyun;Hong, Jung-Pyo;Auh, Q-Schick
    • Journal of Oral Medicine and Pain
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    • v.35 no.2
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    • pp.123-133
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    • 2010
  • The purpose of this study is to investigate Tension-type headache associated with pericranial tenderness and Headache attributed to temporomandibular joint disorder among Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score using RDC/TMD Axis II. Eighty five patients who visited the Kyung Hee University Dental Hospital were diagnosed as Tension-type headache associated with pericranial tenderness(n=48) and Headache attributed to temporomandibular joint disorder(n=37) by the International Classification of Headache Disorders, 2nd Edition, and were administered the Korean versions of the RDC/TMD Axis II- Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score. Then it was analyzed statistically by SPSS(ver. 10.0). T-test, The Wilcoxon-signed rank test and Mann-Whitney U test (p<0.05) were used. There were no significant differences in Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score between two groups. Tension type headache associated with pericranial tenderness and Headache attributed to temporomandibular joint disorder showed similar Axis II feature. Tension-type headache associated with pericranial tenderness may be related to Headache attributed to temporomandibular joint disorder.

Needs and Satisfaction of Cancer Patients on the Medical Services in Jeju Special Self-Governing Province (제주지역 암환자의 의료서비스 요구도 및 만족도 분석)

  • Kim, Woo-Jeong;Kim, Min-Young;Chang, Weon-Young;Choi, Jae-Hyuck
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.153-160
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    • 2010
  • Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

Emotional State and Personality Characteristics in Patients with Vitiligo (백반증 환자의 정서상태와 성격특성)

  • Lee, Kyung-Kyu;Lee, Jong-Hyun;Kim, Hyun-Woo;Paik, Ki-Chung;Kim, You-Chan
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.1
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    • pp.88-97
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    • 2000
  • Objectives : This study was aimed to investigate the emotional state and personality factors of patients with vitiligo, and the impacts of clinical characteristics. Methods : Twenty one patients with vitiligo and 20 normal controls were studied. Beck Depression Inventory(BDI), Spielberg's State and Trait Anxiety Inventory(STAI) and Cattell's 16 Personality Factors Questionnaire(16-PF) were used for assessment. Statistically, t-test, Oneway ANOVA, Mann-Whitney U test and Pearson's correlation test were used. Results : The Results were as follows. 1) The comparison of total score of BDI, state anxiety and trait anxiety between the patients with vitiligo and normal controls were not significantly different. 2) In first-stratum source traits of 16-PF, normal control group was significantly higher than the patients with vitiligo in H-factor(Boldness) and I-factor(Tender-mindedness). In second-stratum source traits of 16-PF, there was no significant difference between the patients with vitiligo and normal control in all factors. 3) According to sex, the comparison of total scores of BDI, STAI between male and female patients with vitiligo were not significantly different. In the comparison of 16-PF, female patients were higher than male patients in I-factor only. 4) As according to age(under and over 30 years of age), the comparison of total scores of BDI, STAI between patients over 30 years of age and under 30 years of age were not significantly different. In the comparison of 16-PF, patients over 30 years of age were higher than patients under 30 years of age in E-, G-, L-, M-, Q2-, Q3-, IND-, SUP-, and CRE-factor. 5) As according to the presence of progression of vitiligo and the presence of visible lesion, the comparison of total scores of BDI, STAI and 16-PF were not significantly different. 6) There were no significant correlation between the duration of the vitiligo and BDI, STAI-S, STAI-T, and 16-PF. Conclusions : There were no significant difference between patients with vitiligo and normal controls on the emotional state and personality characteristics. But patients with vitiligo were more bolder and tender-minded than normal controls on 16-PF. The author propose that methods of treatment to resolve problems of the interpersonal relations will be helpful.

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