• Title/Summary/Keyword: Medical measurement

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CT Measurement of Diameter and Dimension of the Trachea in Normal Korean Adults (흥부 전산화단층촬영을 이용한 한국성인의 기관내경과 단면적의 측정)

  • Han, Jae-Youl;Kim, Kwang-Ho;Lee, Gun;Kim, Hyung-Jin;Cho, Soon-Koo;Sun, Kyung
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.534-538
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    • 2001
  • Background: Knowledge of size and morphology of the normal trachea is important for airway management and tracheal reconstruction. Conventional radiography is a simple method used to measure the tracheal diameter, but it is not accurate because of the artifacts related to image magnification and overlapping by the shoulder. The purpose of this study was to provide the normal values of the tracheal size and anatomy in Korean adults using Computerized Topography. Material and Method: There were 43 men and 34 women included in this study. They were divided into three age groups(group 1, 20-39 years ; group 2, 40-59 yeas , groups 3, $\geq$60 years). The anteroposterior and transverse diameters and cross - sectional areas of the trachea were measured at the level of the thoracic inlet(Level 1) and the aortic arch(Level 2). These values obtained at each level were compared between age groups and sexes. Result: In 43 men, the anteroposterior / transverse diameters(mean SD in millimeters) of the trachea at levels 1 and 2 were 19.95$\pm$2.99 / 17.72$\pm$2.13 and 19.77$\pm$2.57 / 18.02$\pm$2.19, respectively. In 34 women, those values at levels 1 and 2 were 15.56$\pm$2.12 / 14.18$\pm$2.07 and 15.35$\pm$1.82 / 15.00$\pm$1.60, respectively. At both levels, the anteroposterior and transverse diameters were significantly greater in men than in women (p<0.05). The cross-sectional area of the trachea at levels 1 and 2 were 279.14$\pm$61.37 / 281.93$\pm$63.97 $\textrm{mm}^2$ in men and 173.29$\pm$35.81 / 181.88$\pm$34.74 in women, respectively. They also showed significantly greater values in men than in women(P<0.05). There was no significant difference in diameters and cross-sectional areas of the trachea between age groups. Conclusion: There are significant differences in the internal diameter and cross- sectional area of the trachea between men and women in normal Korean adults, while the age difference was insignificant. We believed CT is a relatively accurate and safe way to measure the internal diameter and cross-sectional areas of the trachea.

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Change of Regional Myocardial Blood Flow After Transmyocardial Laser Revascularization in Porcine Model of Chronic Myocardial Ischemia (돼지 만성 심근허혈 모델에서 경심근레이저혈류재건술 후 국소 심근 혈류량의 변화)

  • Park, Kay-Hyun;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.662-671
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    • 2001
  • Background: This study was aimed to assess improvement in myocardial perfusion after TMR by measuring regional myocardial blood flow(RMBF) in porcine model of chronic myocardial ischemia. Material and Method: Ameroid ring was placed around the proximal left circumflex coronary artery in fourteen pigs. After 4 weeks, the control group(7 pigs) underwent rethoracotomy only, and the TMR group(7 pigs) underwent Ho:YAG laser TMR at the circumflex territory. After another 4 weeks, the animals were sacrificed for the measurement of RMBF using colored microspheres. The ratio of RMBF between the circumflex territory and the interventricular septum was calculated and compared. Result: At 4 weeks after ameroid constriction, RMBF of the circumflex territory decreased to 46∼89% of RMBF of the interventricular septum. In five of six animals in the TMR group, RMBF of the circumflex territory at 8 weeks after ameroid constriction was higher compared with RMBF at 4 weeks after ameroid constriction. However, the improvement was statistically significant only in two animals. In three of the four animals in the control group, RMBF of the circumflex territory also increased at 8 weeks compared with RMBF at 4 weeks. The degree of increase in RMBF was not different between the control and the TMR groups. Conclusion: In porcine model of chronic myocardial ischemia, the degree of increase in RMBF of the ischemic area after Ho:YAG TMR was not different from the increase by development of native collateral circulation. Perfusion of ischemic myocardium after TMR is not thought to improve to the degree that can be demonstrated by currently available method of assessment such as radioisotope myocardial scintigraphy.

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A Study on Hypertension Management of Community Health Practitioner Posts (보건진료소 고혈압 관리사업의 실태)

  • Kwon, Myung-Soon
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.155-169
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    • 2003
  • Objectives: The purpose of this study is to provide data for the improvement of hypertension management of community health practitioner posts through the study on hypertension management in community health practitioner posts. Methods: A questionnaire was mailed to 700 community health practitioners and 205 of them responded during the period from March 13, 2003 to May 13. The survey results were analyzed using SPSS program, version 11. Results: The results are as follows; 1. There are two major activities in a hypertension prevention project for community: health education and early detection. About 57% of community health care practitioners perform a health education for community people four times a year. The 64.5% of them used the materials for health education provided from a community health center and 22.1% of them performed a post-evaluation. The main method of early detection of hypertension was measurement of blood pressure of person to visit, which was 96.1%. Other methods included home visiting(89.3%), a referral from community hospitals and other resources(49.1%), health promotion events(39.5%), and a review of medical records(35.7%). 2. For the registration and management of patients with hypertension, about 36% of community health centers used a special form and more than 50% of them have registered patients who were managed by other health care institutions in the community. A computerized program was used for the management of patients with hypertension in 68.5% of them. More than 60% of them responded that it was used for report, treatment, and follow-up of patients with hypertension.

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Estimation of Glomerular Filtration Rate(GFR) Using $^{99m}Tc$-DTPA Renal Scan and the Parameters for Renal Function ($^{99m}Tc$-DTPA를 이용한 신장스캔에서 사구체 여과율의 측정방법과 영상분석에서 구한 지표들에 의한 신장기능의 평가)

  • Cho, Ihn-Ho;Yoon, Hyun-Dae;Won, Kyu-Chang;Lee, Chan-Woo;Lee, Hyoung-Woo;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.101-108
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    • 1994
  • Many previously described nuclear medicine procedures to assess glomerular filtration rate have some problems because numerous blood sample is to be taken and they don't measure each separate renal function. Gates described isotopic method for the measurement of global and unilateral GFR based on the fractional renal uptake of $^{99m}Tc$-DTPA 2 to 3 minutes after its intravenous injection. We evaluated GFR using $^{99m}Tc$-DTPA in 57 people according to Gates method and compared with creatinine clearance. A good correlation was observed between creatinine clearance and GFR calculated by Gates' formula with an r value of 0.9(P<0.05). And also the relationship between parameters of $^{99m}Tc$-DTPA renal scan images and GFR was taken. They were significantly correlated with GFR calculated by Gates' formula : r value 0.66 between relative intensity of peak renal to peak aortic activity(pK/pA) and GFR, -0.42 between time between aortic and kidney peak(A-K) and GFR and -0.48 between parenchymal renal activity at 25 min compared to peak kidney activity(25K/pK) and GFR. In conclusion, the determination of GFR according to the Gates' formula shows good and reproducible of GFR with rapidity and simplicity. And the parameters from the renal scan images can use to estimate the renal function.

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The Survey for Improvement in Clinical Practice Curriculum of Physiotherapy (물리치료 임상실습 교과내용 개선을 위한 조사연구)

  • Jang, Su-Gyeong
    • Journal of Korean Physical Therapy Science
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    • v.5 no.3
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    • pp.659-674
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    • 1998
  • This Study was to investigate elaborated research themes and direction through specifying the problems of clinical practice education and looking for the direction of improvement. It was in the basis of the viewpoint of the educators that professors and therapists who were the subjects of this study. Perform this study, the 15 colleges' professors and the 55 hospitals' therapists was made up questionnaire, and the data was analysing by Chi-square test and percentage. The results were as follow : ${\cdot}$ In a personal history among the general qualities, professors have little clinical practice history(l-5 years, 53.3%), and therapists have little lecture career(1-5 years, 43.6%, have no 49.0%), ${\cdot}$ The 78.6% subjects were unsatisfied of clinical practice systems. ${\cdot}$ The correlation between clinical history, school career and lecture career and the satisfaction level of clinical practice systems has no(P<.005), ${\cdot}$ The subjects were agreed to that clinical practice curriculum should be changed(67.1%), reinforced(82.9%), and specified(90.0%). ${\cdot}$ The clinical practice credits are 11 points averagely. ${\cdot}$ In the clinical practice curriculum, it made no difference in the practicum of diseases, modality, and the therapeutic techniques between professors and therapists. ${\cdot}$ The 100% professors said that the practicum of the patients' assessment is necessary, and the 63.6% therapists were training for that. ${\cdot}$ The 66.7% professors said that the practicum of the clinical psychology is necessary, and only the 20.0% therapists were training for that. ${\cdot}$ The 93.3% professors said that the practicum of the patients' management is necessary, and the 50.9% therapists were training for that. ${\cdot}$ The 66.7% professors said that the practicum of the medical ethics is necessary, and the 34.5% therapists were training for that. ${\cdot}$ The 46.7% professors said that the practicum of the hospital administration is necessary, but the 54.5% therapists have not training. ${\cdot}$ The 33.3% professors said that the practicum of the pharmacology is necessary, but the 81.8% therapists have not training. ${\cdot}$ The 86.7% professors said that the practicum of the patient's education is necessary, and the 43.6% therapists have training. ${\cdot}$ The 66.7% professors said that the practicum of the prosthesis and brace is necessary, but the 14.5% therapists have not training. ${\cdot}$ The 60.0% professors said that the practicum of the exercise prescription is necessary, but the 25.5% therapists have not training. ${\cdot}$ The 53.5% professors said that the practicum of the emergency treatment is necessary, but the 52.7% therapists have not training. ${\cdot}$ Drawing up the plan about the curriculum of clinical practice, the professors (46.7%) were agreed to national master plan framing by an expert advisor, but the therapists (58.2%) said that the plan that make the most of hospitals' characteristics should be specified. ${\cdot}$ It was found that a clinical special therapists(54.5%) was good as a person in charge of clinical practice education, in that each therapist's own good time (34.5%) was. ${\cdot}$ It made use of the form framing by college(40.0%) as the clinical practice textbook, the form framing by hospital (42.9%) and each therapist(22.9%) as the plan, and the form framing by college (74.3%) as the measurement. ${\cdot}$ The most difficult point in clinical practice education was the lacks of the theory-praciticum linkage(78.2%). ${\cdot}$ It was found that the period of clinical practice was in the second semester-third grade (40.0%) and the desirable period was in the first semester-third grade(50.0%). ${\cdot}$ Professors (53.3%) were agreed that the desirable clinical practice duration was from four months to six months(60.0%), and the therapists (60.0%) were agreed that from one month to three months. ${\cdot}$ This study presented the lacks of rearing the experts, the lacks of cultural education, and the lacks of the theory-clinical practice linkage. There were need to develop the systematic programs, clinical practice textbooks, the measurements and the special hospital for clinical practice. And it was need to reduce the gab between of the hospitals for clinical practice, to cut down the costs. and to improve the labour conditions of leaders. In view of this findings, it takes notice of that both professor and therapist were dissatisfied at the present clinical practice systems. These results point out the problems of clinical practice systems, and do not make expect to us the successive and positive clinical practice. The general, specific and intensive plan about the problems and the direction of improvement that establishing the level of hospital for clinical practice and physiotherapy can be elaborated.

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Comparative Analysis of Signal Intensity and Apparent Diffusion Coefficient at Varying b-values in the Brain : Diffusion Weighted-Echo Planar Image ($T_2^*$ and FLAIR) Sequence (뇌의 확산강조 영상에서 b-value의 변화에 따른 신호강도, 현성확산계수에 관한 비교 분석 : 확산강조 에코평면영상($T_2^*$ 및 FLAIR)기법 중심으로)

  • Oh, Jong-Kap;Im, Jung-Yeol
    • Journal of radiological science and technology
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    • v.32 no.3
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    • pp.313-323
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    • 2009
  • Diffusion-weighted imaging (DWI) has been demonstrated to be a practical method for the diagnosis of various brain diseases such as acute infarction, brain tumor, and white matter disease. In this study, we used two techniques to examine the average signal intensity (SI) and apparent diffusion coefficient (ADC) of the brains of patients who ranged in age from 10 to 60 years. Our results indicated that the average SI was the highest in amygdala (as derived from DWI), whereas that in the cerebrospinal fluid was the lowest. The average ADC was the highest in the cerebrospinal fluid, whereas the lowest measurement was derived from the pons. The average SI and ADC were higher in $T_2^*$-DW-EPI than in FLAIR-DW-EPI. The higher the b-value, the smaller the average difference in both imaging techniques; the lower the b-value, the greater the average difference. Also, comparative analysis of the brains of patients who had experienced cerebral infarction showed no distinct lesion in the general MR image over time. However, there was a high SI in apparent weighted images. Analysis of other brain diseases (e.g., bleeding, acute, subacute, chronic infarction) indicated SI variance in accordance with characteristics of the two techniques. The higher the SI, the lower the ADC. Taken together, the value of SI and ADC in accordance with frequently occurring areas and various brain disease varies based on the b-value and imaging technique. Because they provide additional useful information in the diagnosis and treatment of patients with various brain diseases through signal recognition, the proper imaging technique and b-value are important for the detection and interpretation of subacute stroke and other brain diseases.

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The Clinical Aspects of Regional Lymphadenitis following BCG Vaccination (BCG 접종 후 국소 림프절염의 임상양상)

  • Bae, Sun Young;Park, Yang Joon;Kim, Jong-Hyun;Oh, Jin Hee;Koh, Dae Kyun;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.137-146
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    • 2006
  • Purpose : A regional lymphadenitis is the most frequent adverse reaction of BCG. In order to find out developmental factors and establish a strategy of management, we investigated the clinical courses of children with lymphadenitis following BCG on the aspect of BCG strains, suppurative rates according to the sizes of lymph node and the clinical difference with or without treatment. Methods : From January 1997 to June 2004, 52 children less than 24 month-age-old diagnosed as BCG lymphadenitis in Department of Pediatrics, St. Vincent's Hospital, The Catholic University of Korea were enrolled. The type of BCG strain, place of vaccination, location and size of lymphadenitis were assessed with medical records, retrospectively. Finally, we analysed the correlations between BCG strains or the sizes of lymph node and natural remission or suppuration. Results : The first detected mean age of BCG lymphadenitis was 5.5 month-age. The larger of the measurement was at the first visiting, the younger of age that was first presented. The most frequent location was the same sided axillary region of BCG injection. Among 52 subjects, 46 cases(88.5%) were vaccinated with intradermal Pastuer strain, and only 5 cases(9.6%) were done with percutaneous multipunctured Tokyo strain. Twenty eight cases(53.8%) were regressed naturally, otherwise 24 cases(46.2%) were suppurated. The larger those were sized, the higher freqeuncies those were suppurated on, significantly. Treatment with medications could not prevent the suppuration and could not shorten the healing periods. Conclusion : We predict that there are differences between the occurrent rate of BCG lymphadenitis and BCG strains or methods. Treatment with medication is not recommended owing to its ineffectiveness. Especially, in case of non-suppurative lymphadenitis should be onlyless influence on the tuberculin skin test, cause less adverse reactions, and is inexpensive. observed without treatment, because it could be regressed naturally. An ideal BCG makes a scar, We should make an effort to choose the best BCG strain that can fulfill such requirements.

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The Effectiveness of CT and MRI Contrast Agent for SUV in 18F-FDG PET/CT Scanning (18F-FDG PET/CT 검사에서 정량분석에 관한 CT와 MRI 조영제의 효과)

  • Cha, Sangyoung;Cho, Yonggwi;Lee, Yongki;Song, Jongnam;Choi, Namgil
    • Journal of the Korean Society of Radiology
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    • v.10 no.4
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    • pp.255-261
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    • 2016
  • In this study, among various factors having influence on SUV, we intended to compare and analyze the change of SUV using CT(4 type) and MRI(3 type) contrast agents which are commercialized now. We used Discovery 690 PET/CT(GE) and NEMA NU2 - 1994 PET phantom as experimental equipment. We have conducted a study as follows; first, we filled distilled water to phantom about two-thirds and injected radioisotope(18F-FDG 37 MBq), contrast agent. Second, we mixed CT contrast agent with distilled water and MRI contrast agent with that water separately. And then, we stirred the fluid and filled distilled water fully not to make air bubble. In emission scan, we had 15minutes scanning time after 40 minutes mixing contrast agent with distilled water. In transmission scan, we used CT scanning and its measurement conditions were tube voltage 120 kVp, tube current 40 mA, rotation time 0.5 sec, slice thickness 3.27 mm, DFOV 30 cm. Analyzing results, we set up some ROIs in 10th, 15th, 20th, 25th, 30th slice and measured SUVmean, SUVmax. Consequently, all images mixed 3 types of MRI contrast agent with distilled water have high SUVmean as compared with pure FDG image but there was no statistical significance. In SUVmax, they have high score and there was statistical significance. And other 4 images mixed 4 types of CT contrast agent with distilled water have significance in both SUVmean and SUVmax. Attenuation correction in PET/CT has been executed through various methods to make high quality image. But we figured out that using CT and MRI contrast agents before PET/CT scanning could make distortion of image and decrease diagnostic value. In that reason, we have to sort out the priority of examination in hospital not to disturb other examination's results. Through this process, we will be able to give superior medical service to our customers.

Quality of Life Changes in Patients Admitted to the Hospice Unit (호스피스 병동 입원 환자의 삶의 질 변화)

  • Park, Theresia;Song, Hae-Hiang;Seo, In-Ok;Cho, Young-Yee;Park, Myung-Hee;Heo, Jeong-Hee;Kim, Eun-Kyung;Park, Sun-Ju;Ra, Jeong-Ran
    • Journal of Hospice and Palliative Care
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    • v.3 no.1
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    • pp.18-27
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    • 2000
  • Purpose : This study aims to find out the quality of life of patients admitted to the hospice unit at Kangnam St. Mary's Hospital, at admission and after weeks hospice service and to assess the effects of hospice service on the quality of life of terminal cancer patients. Methods : This study subjects were 100 patients admitted to the hospice unit at Kangnam St. Mary's Hospital, Catholic University between October 1999 and March 2000, and their primary caregivers. Quality of life data were collected using a questionnaire revised by the authors and were analyzed by means of repeated measures ANOVA. Results : 1) Patient's quality of life as perceived by the primary caregiver was significantly improved and the mean score was 3.31, 3.68, 3.56, 3.73, 3.75 at admission and week 1, 2, 3, 4. With the detailed item analysis, the following items were shown to be significantly improved: "clean bodies"(F=6.50, P=0.0001) "pain control"(F=18.01, P=0.0001) constipate"(F=2.96, P=0.0237) "sleep"(F=3.99, P=0.0048) "nausea/vomiting"(F=4.50, P=0.0022) "medical team's comfortable care" (F=3.95, P=0.0051) "family's care"(F=2.76, P=0.0317) "anxiety" (F=3.14, P=0.0177) "comfort"(F=3.63, P=0.0085) "treat with dignity"(F=3.32, P=0.0136). The item of "death is not the end of life rather the beginning" was significantly decreased(F=2.54, P=0.0450). 2) Patient's quality of life as perceived by the patient showed an improvement but statistically insignificant and the mean score was 3.63 and 3.83 at admission and week 1. With the detailed item analysis, the item of "pain control" was shown to be significantly improved(F=9.19, P=0.0251). 3) The quality of score in the last week of life of patient were 3.48, 3.51, 3.44, 3.46, 3.50, respectively, from 5 week prior to 1 week prior to death and these changes were insignificant. Conclusion : The findings of this study showed a positive effect of hospice service on quality of life of the terminal cancer patients admitted to the hospice unit. To improve the quality of life, we need first of all to develop hospice interventions with a particular emphasis on the spiritual aspect of patient. Secondly, measurement instruments need to be developed to collect the quality of life of the hospice patients who become weakened especially in the last weeks of their life and with this effort more representative data of hospice patients may be collected.

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Computer Aided Diagnosis System for Evaluation of Mechanical Artificial Valve (기계식 인공판막 상태 평가를 위한 컴퓨터 보조진단 시스템)

  • 이혁수
    • Journal of Biomedical Engineering Research
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    • v.25 no.5
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    • pp.421-430
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    • 2004
  • Clinically, it is almost impossible for a physician to distinguish subtle changes of frequency spectrum by using a stethoscope alone especially in the early stage of thrombus formation. Considering that reliability of mechanical valve is paramount because the failure might end up with patient death, early detection of valve thrombus using noninvasive technique is important. Thus the study was designed to provide a tool for early noninvasive detection of valve thrombus by observing shift of frequency spectrum of acoustic signals with computer aid diagnosis system. A thrombus model was constructed on commercialized mechanical valves using polyurethane or silicon. Polyurethane coating was made on the valve surface, and silicon coating on the sewing ring of the valve. To simulate pannus formation, which is fibrous tissue overgrowth obstructing the valve orifice, the degree of silicone coating on the sewing ring varied from 20%, 40%, 60% of orifice obstruction. In experiment system, acoustic signals from the valve were measured using microphone and amplifier. The microphone was attached to a coupler to remove environmental noise. Acoustic signals were sampled by an AID converter, frequency spectrum was obtained by the algorithm of spectral analysis. To quantitatively distinguish the frequency peak of the normal valve from that of the thrombosed valves, analysis using a neural network was employed. A return map was applied to evaluate continuous monitoring of valve motion cycle. The in-vivo data also obtained from animals with mechanical valves in circulatory devices as well as patients with mechanical valve replacement for 1 year or longer before. Each spectrum wave showed a primary and secondary peak. The secondary peak showed changes according to the thrombus model. In the mock as well as the animal study, both spectral analysis and 3-layer neural network could differentiate the normal valves from thrombosed valves. In the human study, one of 10 patients showed shift of frequency spectrum, however the presence of valve thrombus was yet to be determined. Conclusively, acoustic signal measurement can be of suggestive as a noninvasive diagnostic tool in early detection of mechanical valve thrombosis.