• 제목/요약/키워드: Medical measurement

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A Three-Dimensional Deep Convolutional Neural Network for Automatic Segmentation and Diameter Measurement of Type B Aortic Dissection

  • Yitong Yu;Yang Gao;Jianyong Wei;Fangzhou Liao;Qianjiang Xiao;Jie Zhang;Weihua Yin;Bin Lu
    • Korean Journal of Radiology
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    • 제22권2호
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    • pp.168-178
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    • 2021
  • Objective: To provide an automatic method for segmentation and diameter measurement of type B aortic dissection (TBAD). Materials and Methods: Aortic computed tomography angiographic images from 139 patients with TBAD were consecutively collected. We implemented a deep learning method based on a three-dimensional (3D) deep convolutional neural (CNN) network, which realizes automatic segmentation and measurement of the entire aorta (EA), true lumen (TL), and false lumen (FL). The accuracy, stability, and measurement time were compared between deep learning and manual methods. The intra- and inter-observer reproducibility of the manual method was also evaluated. Results: The mean dice coefficient scores were 0.958, 0.961, and 0.932 for EA, TL, and FL, respectively. There was a linear relationship between the reference standard and measurement by the manual and deep learning method (r = 0.964 and 0.991, respectively). The average measurement error of the deep learning method was less than that of the manual method (EA, 1.64% vs. 4.13%; TL, 2.46% vs. 11.67%; FL, 2.50% vs. 8.02%). Bland-Altman plots revealed that the deviations of the diameters between the deep learning method and the reference standard were -0.042 mm (-3.412 to 3.330 mm), -0.376 mm (-3.328 to 2.577 mm), and 0.026 mm (-3.040 to 3.092 mm) for EA, TL, and FL, respectively. For the manual method, the corresponding deviations were -0.166 mm (-1.419 to 1.086 mm), -0.050 mm (-0.970 to 1.070 mm), and -0.085 mm (-1.010 to 0.084 mm). Intra- and inter-observer differences were found in measurements with the manual method, but not with the deep learning method. The measurement time with the deep learning method was markedly shorter than with the manual method (21.7 ± 1.1 vs. 82.5 ± 16.1 minutes, p < 0.001). Conclusion: The performance of efficient segmentation and diameter measurement of TBADs based on the 3D deep CNN was both accurate and stable. This method is promising for evaluating aortic morphology automatically and alleviating the workload of radiologists in the near future.

피부탄성 측정 문제점 개선을 위한 6시그마 프로젝트 (A Case Study of Six Sigma Project for Improving Measurement Method of Skin Elasticity)

  • 이혜정;강남식;전영주;김근호;김홍기;김종열
    • 한국한의학연구원논문집
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    • 제16권3호
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    • pp.135-140
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    • 2010
  • The usefulness of constitutional diagnoses based on skin measurements has been established in oriental medicine. According to Sasang constitutional medicine, humans can be distinguished based on properties of skin's friction, thickness and elasticity. To quantify and standardize skin diagnosis, the present study designed an equipment for measuring skin elasticity of hand. But there were some noises in measuring skin elasticity such as measurement method, environment, operator and conditions of patient. So we considered a six sigma project for reducing the measurement errors. The project was followed to discipline process of five macro phases: Define, Measure, Analyze, Improve and Control(DMAIC). So, we could find the major factors which should be controled for stabilizing measurement system and we revised the SOP(Standard Operating Procedure) of the skin elasticity measurement.

Uncertainty Assessment: Relative versus Absolute Point Dose Measurement for Patient Specific Quality Assurance in EBRT

  • Mahmood, Talat;Ibrahim, Mounir;Aqeel, Muhammad
    • 한국의학물리학회지:의학물리
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    • 제28권3호
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    • pp.111-121
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    • 2017
  • Verification of dose distribution is an essential part of ensuring the treatment planning system's (TPS) calculated dose will achieve the desired outcome in radiation therapy. Each measurement have uncertainty associated with it. It is desirable to reduce the measurement uncertainty. A best approach is to reduce the uncertainty associated with each step of the process to keep the total uncertainty under acceptable limits. Point dose patient specific quality assurance (QA) is recommended by American Association of Medical Physicists (AAPM) and European Society for Radiotherapy and Oncology (ESTRO) for all the complex radiation therapy treatment techniques. Relative and absolute point dose measurement methods are used to verify the TPS computed dose. Relative and absolute point dose measurement techniques have a number of steps to measure the point dose which includes chamber cross calibration, electrometer reading, chamber calibration coefficient, beam quality correction factor, reference conditions, influences quantities, machine stability, nominal calibration factor (for relative method) and absolute dose calibration of machine. Keeping these parameters in mind, the estimated relative percentage uncertainty associated with the absolute point dose measurement is 2.1% (k=1). On the other hand, the relative percentage uncertainty associated with the relative point dose verification method is estimated to 1.0% (k=1). To compare both point dose measurement methods, 13 head and neck (H&N) IMRT patients were selected. A point dose for each patient was measured with both methods. The average percentage difference between TPS computed dose and measured absolute relative point dose was 1.4% and 1% respectively. The results of this comparative study show that while choosing the relative or absolute point dose measurement technique, both techniques can produce similar results for H&N IMRT treatment plans. There is no statistically significant difference between both point dose verification methods based upon the t-test for comparing two means.

S병원 성과평가지표 개발에 관한 연구 (Development of Performance Measurement Indicators in S Hospital)

  • 이희원;유승흠;이해종;박창일
    • 한국병원경영학회지
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    • 제5권1호
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    • pp.1-23
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    • 2000
  • This study was undertaken to develop performance measurement indicators in S Hospital, which is the largest component of Y Medical Center which implemented the Responsible Management System in 1993. To begin, strategic initiatives for S Hospital were reestablished based on Y Medical Center's goals and objectives. The BSC(Balanced Scorecard) was used to develop performance measurement indicators after validity checks by specialists. The results were that total 16 indicators were developed to measure performance for strategic initiatives. Those included the growth rate of patient revenues, operating profit to gross revenues, reduction rate in administrative expenses from a financial perspective; average medical expenses per adjusted patient, patient satisfaction survey for inpatients and outpatients and emergency room patients, return rate for treatment results from the customer's perspective; reduction rate in average length of hospital stay, expenses for lost cases of medical disputes, rate for contracted employees, the number of published reports per faculty member from an internal perspective; educational expenses for training medical staff and full time employees, adjusted patient per medical staff, and the number of cases implemented which were proposed by employees. Any organization needs to have its own explicit objectives to grow and develop and it is absolutely necessary to measure performance to accomplish them. The performance measurement indicators developed by this study are expected to be used as a tool to attain the objectives of S Hospital.

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골반부와 관련된 국내임상연구동향 고찰 -골반부의 변위를 중심으로- (Analysis of the Research Trends of Pelvic Malposition in Korean Clinical Research)

  • 박재현;남수현;김동후;강준혁;허우영
    • 한방재활의학과학회지
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    • 제25권2호
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    • pp.81-88
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    • 2015
  • Objectives The purpose of this review was to analyze the research trends in clinical research related to pelvic malposition published in Korean medicine journals. Methods We searched articles in Korean databases (OASIS, NDSL, RISS, and KTKP), and sorted the articles by publishing date, pelvic malposition type, field of study, and measurement index. Results 1. 25 original articles and 9 case report articles were reviewed. 2. In recent years, this topic has been studied more frequently, with an increasing number of original articles published. 3. 16 articles analyzed pelvic malposition type. And half of the articles focused on ilium. 4. The original articles have figured out the correlation between pelvic malposition measurement indices and other measurement indices or diseases. 5. Treatment tools, such as chuna therapy, the mckenzie method, devices for correcting malposition, acupuncture were used in the case report articles. 6. 29 measurement indices, such as Ferguson's angle, Ilium shadow measurement, and Iliac height difference were used. Conclusions According to the literature, pelvic malposition is related to other diseases and measurement indices, and manual medicine on pelvic malposition can be effective. However, due to the lack of sufficient empirical evidence from medical articles to support this, further clinical research should be conducted.

필름 및 tissue equivalent 팬톰을 이용한 NEC LINAC 6 MVX 소조사면에 대한 선량분포 측정 (Measurement of Dose Distribution in Small Fields of NEC LINAC 6 MVX Using Films and Tissue Equivalent Phantoms)

  • Suh, Tae-Suk;Park, Dong-Rak;Choe, Bo-Young;Yoon, Sei-Chul;Jang, Hong-Seok;Park, Il-Bong;Kim, Moon-Chan;Bahk, Yong-Whee;Shin, Kyung-Sub
    • 한국의학물리학회지:의학물리
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    • 제4권2호
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    • pp.9-17
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    • 1993
  • 본 논문의 목적의 NEC LINAC 6 MVX 선의 소조사면에 대한 선량분포를 복잡한 물팬톰 및 ion chamber대신 film 및 고체 물팬톰을 이용하여 간단히 측정하고 분석하는 시스템을 개발하는 데 있다. 단일 선속측정을 위하여 필름과 고체 물팬톰이 이용되었으며, 측정된 데이타는 percent depth dose (PDD), off-axis ratio (OAR) 등을 포함하며, 한변이 1, 2, 3cm의 정사각형 소조사면에 대하여 측정이 이루어 졌다. 또한 Output factor측정은 ion chamber로 측정되었으며, 필름에 의하여 측정된 PDD, OAR 등은 ion chamber측정기로 측정된 값과 비교 검토되었다. 필름으로 부터 측정된 PDD값으로 부터 환산식을 이용하여 tissue maximum ratio (TMR) 값을 얻었으며, 본 실험에서 얻어진 TMR, OAR 값들은 같은 에너지를 나타내는 Philips LINAC의 선량 데이타와 유사한 결과를 보여주었다. 고체 물팬톰 및 필름을 이용한 소조사면 측정은 간편하고도 유용한 방법이었으며, 특히, 자체 개발된 필름팬톰은 뇌정위적 방사선 수술을 위한 OAR 선량을 측정하는 데 유용하였다.

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균형성과표를 활용한 전자의무기록시스템의 성과측정 모형개발 (Development of the Performance Measurement Model of Electronic Medical Record System - Focused on Balanced Score Card -)

  • 이경희;김영훈;부유경
    • 한국병원경영학회지
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    • 제21권4호
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    • pp.1-12
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    • 2016
  • The purpose of this study are suggest to performance measurement model of Electronic Medical Record(EMR) and Key Performance Index(KPI). For data collection, 665 questionnaires were distributed to medical record administrators and insurance reviewers at 31 hospitals, and 580 questionnaires were collected(collection rate: 87.2%). Regarding methodology, Critical Success Factor(CSF) and index of the information system were derived based on previous studies, and these were set as performance measurement factors of EMR system. The performance measurement factors were constructed by perspective using BSC, and analysis on causal relationship between factors was conducted. A model of causal relationship was established, and performance measurement model of EMR system was proposed through model validation. Analysis on causal relationship between performance management factors revealed that utility cognition of the learning & growth perspective factor had causal relationship with job efficiency(${\beta}=0.20$) and decision support(${\beta}=0.66$) of the internal process perspective factors, and security had causal relationship with system satisfaction(${\beta}=0.31$) of the customer perspective factor. System quality had causal relationship with job efficiency(${\beta}=0.66$) and decision support(${\beta}=0.76$) of the internal process perspective factors, all of which were statistically significant(P<0.01). Job efficiency of the internal process perspective had causal relationship with system satisfaction(${\beta}=0.43$), and decision support had causal relationship with decision support satisfaction(${\beta}=0.91$) and job satisfaction (${\beta}=0.74$), all of which were statistically significant(P<0.01). System satisfaction of the customer perspective had causal relationship with job satisfaction(${\beta}=0.12$), job satisfaction had causal relationship with cost reduction(${\beta}=0.53$) of the financial perspective, and decision support satisfaction had causal relationship with productivity improvement(${\beta}=0.40$)of the financial perspective(P<0.01). Also, cost reduction of the financial perspective had causal relationship with productivity improvement(${\beta}=0.37$), all which were statistically significant(P<0.05). Suitability index verification of the performance measurement model whose causal relationship was found to be statistically significant revealed that $X^2/df=2.875$, RMR=0.036, GFI=0.831, AGFI=0.810, CFI=0.887, NFI=0.838, IFI=0.888, RMSEA=0.057, PNFI=0.781, and PCFI=0.827, all of which were in suitable levels. In conclusion, the performance measurement indices of EMR system include utility cognition, security, and system quality of the learning & growth perspective, decision support and job efficiency of the internal process perspective, system satisfaction, decision support satisfaction, and job satisfaction of the customer perspective, and productivity improvement and cost reduction of the financial perspective. In this study, it is expected that the performance measurement indices and model of EMR system which are suggested by the author, will be a measurement tool available for system performance measurement of EMR system in medical institutions.

A Measurement System for Rounded Shoulder Posture using a Wearable Stretch Sensor

  • Nguyen, Manh Thang;Dang, Quoc Khanh;Kim, Younghoon;Chee, Youngjoon
    • 대한의용생체공학회:의공학회지
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    • 제39권1호
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    • pp.10-15
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    • 2018
  • In this paper, we present a wearable measurement system for monitoring rounded shoulders. The system contains a shoulder correction band and a stretch sensor that can correct and measure shoulder posture, respectively. The capacitance of the stretch sensor changes linearly according to changes in the shoulders. To verify measurement, a motion analysis system was used as the reference to compare the change in the rounded angles of the shoulders and the change in the stretch sensor's capacitance. The results indicated that there is a high correlation between the two changes and the system can be used as a monitoring device for rounded shoulders.

전자선에서 Virtual Source Distance의 위치 결정 (Determination of the Virtual Focus Position for Electron Beam with Air Scanning)

  • 권경태;윤화룡;박광호;김정만
    • 대한방사선치료학회지
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    • 제6권1호
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    • pp.89-93
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    • 1994
  • Authors have measured virtual source distance of electron beam from CL/1800 medical linear accelerator, with newly designed method. Beam scanning was performed with the direction of beam axis in the air. Compared results between this study and well established in phantom measurement shows good agreement with in experimental error. And we have found that build-up cap plays very important role in air measurement because of charge build up. The method of in-air measurement of virtual source distance is very easy to set-up and generate accurate results.

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측정 횟수 및 방문 횟수에 따른 혈압 변화 (The Change of Blood Pressure according to the Number of Measurements and the Number of Visits)

  • 박지은;이민희;류연희;류연;정희정;홍상훈;이승덕;김남권;최선미
    • 한국한의학연구원논문집
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    • 제18권3호
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    • pp.111-118
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    • 2012
  • Objective : The aim of this study was to investigate the number of measurements and visits for blood pressure measurement. We also analyzed the change of blood pressure based on the measurement method and measurement interval. Methods : Data of three clinical trials evaluating the effect of acupuncture, moxibustion, and qigong for pre and mild essential hypertension were used. Blood pressure was measured 3 times each visit with 1 or 5 minutes interval, and it was checked until $3^{rd}$ visit. Two trials used sphygmomanometer and another one trial used automatic device for blood pressure measurement. Results : The mean difference between $1^{st}$ and $2^{nd}$, and $2^{nd}$ and $3^{rd}$ measurement were significant in systolic (p<0.001) and diastolic blood pressure (p<0.001). However, in automated measurement or measuring with 1 minute interval, the difference between $2^{nd}$ and $3^{rd}$ was not significant. The mean of $1^{st}$ and $2^{nd}$ measurements was also significantly different from the mean of all three measurements in both systolic (p<0.001) and diastolic blood pressure (p<0.001). While the difference between each visit was not significant in diastolic blood pressure, the systolic blood pressure difference was significant between $1^{st}$ and $2^{nd}$ visit in automated and manual measurement. Conclusion : The mean of two measurements and three measurements were significantly different. The change of blood pressure was different according to the method and interval of blood pressure measurement.