• Title/Summary/Keyword: Wilcoxon signed rank test

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Detecting Peripheral Nerves in the Elbow using Three-Dimensional Diffusion-Weighted PSIF Sequences: a Feasibility Pilot Study

  • Na, Domin;Ryu, Jaeil;Hong, Suk-Joo;Hong, Sun Hwa;Yoon, Min A;Ahn, Kyung-Sik;Kang, Chang Ho;Kim, Baek Hyun
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.2
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    • pp.81-87
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    • 2016
  • Purpose: To analyze the feasibility of three-dimensional (3D) diffusion-weighted (DW) PSIF (reversed FISP [fast imaging with steady-state free precession]) sequence in order to evaluate peripheral nerves in the elbow. Materials and Methods: Ten normal, asymptomatic volunteers were enrolled (6 men, 4 women, mean age 27.9 years). The following sequences of magnetic resonance images (MRI) of the elbow were obtained using a 3.0-T machine: 3D DW PSIF, 3D T2 SPACE (sampling perfection with application optimized contrasts using different flip angle evolution) with SPAIR (spectral adiabatic inversion recovery) and 2D T2 TSE (turbo spin echo) with modified Dixon (m-Dixon) sequence. Two observers used a 5-point grading system to analyze the image quality of the ulnar, median, and radial nerves. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of each nerve were measured. We compared 3D DW PSIF images with other sequences using the Wilcoxon-signed rank test and Friedman test. Inter-observer agreement was measured using intraclass correlation coefficient (ICC) analysis. Results: The mean 5-point scores of radial, median, and ulnar nerves in 3D DW PSIF (3.9/4.2/4.5, respectively) were higher than those in 3D T2 SPACE SPAIR (1.9/2.8/2.8) and 2D T2 TSE m-Dixon (1.7/2.8/2.9) sequences (P < 0.05). The mean SNR in 3D DW PSIF was lower than 3D T2 SPACE SPAIR, but there was no difference between 3D DW PSIF and 2D T2 TSE m-Dixon in all of the three nerves. The mean CNR in 3D DW PSIF was lower than 3D T2 SPACE SPAIR and 2D T2 TSE m-Dixon in the median and ulnar nerves, but no difference among the three sequences in the radial nerve. Conclusion: The three-dimensional DW PSIF sequence may be feasible to evaluate the peripheral nerves around the elbow in MR imaging. However, further optimization of the image quality (SNR, CNR) is required.

Regenerative effect of recombinant human bone morphogenetic protein-2/absorbable collagen sponge (rhBMP-2/ACS) after sequestrectomy of medication-related osteonecrosis of the jaw (MRONJ)

  • Min, Song-Hee;Kang, No-Eul;Song, Seung-Il;Lee, Jeong-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.3
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    • pp.191-196
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    • 2020
  • Objectives: Beyond the original application approved by the U.S. Food and Drug Administration, recombinant human bone morphogenetic protein-2 (rhBMP-2) is used for medication-related osteonecrosis of the jaw (MRONJ) treatment because of its bone remodeling enhancement properties. The purpose of the study was to investigate the bone formation effect of rhBMP-2/absorbable collagen sponge (ACS) in patients with MRONJ. Materials and Methods: In this retrospective cohort study, 26 female patients diagnosed with MRONJ and who underwent mandibular sequestrectomy at Ajou University Dental Hospital from 2010 to 2018 were included. The experimental group was composed of 18 patients who received rhBMP-2/ACS after sequestrectomy, while the control group was composed of 8 patients who did not receive rhBMP-2/ACS after sequestrectomy. A total dose of 0.5 mg of rhBMP-2 was used in the experimental group at a concentration of 0.5 mg/mL. Follow-up panoramic X-rays were taken immediately after the surgery and more than 6 months after the surgery. Using those X-rays, a radiographic index of bone defect area was calculated using the modified Ihan Hren method, which measures radiographic density of the normal bone and the defect site. Results: This study suggests that rhBMP-2 contributes to new bone formation. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the experimental group was 68.4% and 79.8%, respectively. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the control group was 73.4% and 76.7%, respectively (Wilcoxon signed rank test, P>0.05). The mean radiographic index increased 11.4% in the experimental group and 3.27% in the control group (Mann-Whitney U-test, P<0.05). Conclusion: Based on the results, use of rhBMP-2/ACS on bone defect sites after sequestrectomy could be a successful strategy for treatment of MRONJ patients.

Correlation between Fatty Infiltration of Lumbar Paraspinal Muscle and Slip Percentage on 45 Korean Medicinal Treatment Cases of Spondylolisthesis: A Retrospective Study (척추전방전위증 환자 45예의 요추주변근육의 지방침착도와 전위정도의 상관성에 대한 후향적 연구)

  • Kim, Yu-Gon;Kim, Dae-Ho;Jeong, Hyeon-Gyo;Lim, Jin-Woong;Kim, Yong-Hwa;Kang, Deok;Jeong, Hwe-Joon;Shin, Kyung-Moon;Shin, Dong-Hoon;Yang, Jae-Woo;O, Ji-Hoon;Cho, Jae-Seong
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.1
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    • pp.51-62
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    • 2022
  • Objectives Objective of this study is to investigate the role of paraspinal muscles by examining the correlation between slip percentage (SP) of spondylolisthesis and fatty infiltration of lumbar paraspinal muscle. Methods Retrospective analysis was performed on 45 patients diagnosed with spondylolisthesis based on medical records. Using T2-weighted axial magnetic resonance imaging, cross-sectional areas (CSAs) of psoas major (PM), multifidus (MU) and erector spinae (ES) were calculated and divided by CSA of lower level vertebral body (VB). SP was measured using sagittal T2-weighted images. Correlation of SP with muscle relative cross-sectional area (RCSA) and muscle fatty infiltration by Goutallier classification was respectively analyzed using Spearman correlation. Statistic assessment conducted by Wilcoxon signed rank test and paired t-test using program GraphPad prism 5 (GraphPad Software, Inc., San Diego, CA, USA). Results Spondylolisthesis forward slip percentage by Taillard's method was negatively associated with both side MU RCSAs. No significant correlation was found between PM RCSA, ES RCSA and SP. Forward slippage was significantly correlated with fatty infiltration of lumbar paraspinal muscle measured by Goutallier classification. Conclusions This study is to understand the role of paraspinal muscle affecting spinal instability by investigating correlation between statistical deviation of lumbar muscle characters (RCSA, fatty infiltration of lumbar muscle) and SP. We found that spondylolisthesis SP is positively related to fatty infiltration of lumbar paraspinal muscle. and is negatively associated with both side MU RCSAs.

Changes of The Epidemiologic Competences after Introductory Course of The Korea - Field Epidemiologist Training Program(K-FETP) in Epidemiologic Intelligence Servise(EIS) Officers (한국 역학조사관 기본교육(K-FETP) 전후 역량 평가)

  • Kim, Eun-Young;Lee, Moo-Sik;Lee, Tae-Jun;Lee, Kwan;Nam, Hae-Sung;Lee, Ju-Hyoung;Kim, Hong-Bin;Chun, Byung-Chul;Lee, Sang-Won;Lee, Dong-Han;Kim, Hee-Jung;Kwon, Sung-Whe;Yoon, Na-Bi;Shin, Moon-Chul;Lim, Mee-Jee
    • Journal of agricultural medicine and community health
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    • v.47 no.2
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    • pp.78-89
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    • 2022
  • 목적: 이 연구는 2019학년도 역학조사관 입문교육 과정에 참여한 29명의 수습과정생에게 참여형 자기주도 학습 역학조사관 연수 프로그램(FETP)의 효과와 만족도 등 역량 변화를 분석해 그 결과를 향후 과정 개발의 참고 자료로 활용하고자 하였다. 방법: 교육 프로그램의 만족도와 교육 후 모듈에 대한 역량 변화를 평가하는 연구가 수행되었다. 만족도와 역량의 차이 비교는 크루스칼 왈리스 검정(Kruskal-Wallis test)를 실시하였고, 역량의 차이는 윌콕슨 부호순위검정(Wilcoxon signed rank test)에 의해 이루어 졌다. 결과: 2019년 FETP에 참여한 역학조사관 중 여성은 48.3% 였으며, 40세 미만은 9.4% 였다. 역학조사관 입문교육과정 모듈(역학조사, 보건통계 및 정보통계, 감염병 국가 체계, 감염병 질환 감시 체계, 진단 및 실험실 검사, 생물 안전 및 관리, 주요 감염성질환 관리와 조사, 커뮤니케이션, 협동과 리더십, 일반과정)별 만족도는 실무적 도움, 전문성, 기능, 태도 등에서 4점(5점 만점)을 초과하였고, 전체 4.2±0.21(5점 만점)점으로 높은 수준이였다, 모듈의 교육훈련 전후 평균 점수는 2.25±0.91, 3.68±0.63점 등으로 유의한 향상이 있었으며, 모든 모듈 및 하위 주제들도 유의한 향상이 있었다(p<0.001). 그 중에서 현장역학조사 경험이 가장 높은 변화가 있었고, 표본 수집과 실무가 가장 낮은 역량 변화가 있었다. 결론: 2019년 진행된 입문교육 과정은 수료 후 학생들의 역량은 개선되었고, 만족도는 높은 편이었다. 참여형 자기주도학습의 촉진은 역량을 향상시킬 뿐만 아니라 보건 종사자들의 자신감을 높일 수 있었다.

Feasibility of Free-Breathing, Non-ECG-Gated, Black-Blood Cine Magnetic Resonance Images With Multitasking in Measuring Left Ventricular Function Indices

  • Pengfei Peng;Xun Yue;Lu Tang;Xi Wu;Qiao Deng;Tao Wu;Lei Cai;Qi Liu;Jian Xu;Xiaoqi Huang;Yucheng Chen;Kaiyue Diao;Jiayu Sun
    • Korean Journal of Radiology
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    • v.24 no.12
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    • pp.1221-1231
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    • 2023
  • Objective: To clinically validate the feasibility and accuracy of cine images acquired through the multitasking method, with no electrocardiogram gating and free-breathing, in measuring left ventricular (LV) function indices by comparing them with those acquired through the balanced steady-state free precession (bSSFP) method, with multiple breath-holds and electrocardiogram gating. Materials and Methods: Forty-three healthy volunteers (female:male, 30:13; mean age, 23.1 ± 2.3 years) and 36 patients requiring an assessment of LV function for various clinical indications (female:male, 22:14; 57.8 ± 11.3 years) were enrolled in this prospective study. Each participant underwent cardiac magnetic resonance imaging (MRI) using the multiple breath-hold bSSFP method and free-breathing multitasking method. LV function parameters were measured for both MRI methods. Image quality was assessed through subjective image quality scores (1 to 5) and calculation of the contrast-to-noise ratio (CNR) between the myocardium and blood pool. Differences between the two MRI methods were analyzed using the Bland-Altman plot, paired t-test, or Wilcoxon signed-rank test, as appropriate. Results: LV ejection fraction (LVEF) was not significantly different between the two MRI methods (P = 0.222 in healthy volunteers and P = 0.343 in patients). LV end-diastolic mass was slightly overestimated with multitasking in both healthy volunteers (multitasking vs. bSSFP, 60.5 ± 10.7 g vs. 58.0 ± 10.4 g, respectively; P < 0.001) and patients (69.4 ± 18.1 g vs. 66.8 ± 18.0 g, respectively; P = 0.003). Acceptable and comparable image quality was achieved for both MRI methods (multitasking vs. bSSFP, 4.5 ± 0.7 vs. 4.6 ± 0.6, respectively; P = 0.203). The CNR between the myocardium and blood pool showed no significant differences between the two MRI methods (18.89 ± 6.65 vs. 18.19 ± 5.83, respectively; P = 0.480). Conclusion: Multitasking-derived cine images obtained without electrocardiogram gating and breath-holding achieved similar image quality and accurate quantification of LVEF in healthy volunteers and patients.

Evaluation for Effectiveness of Radon Mitigation on Dwellings and Public Buildings in Korea (건축물 유형에 따른 라돈 저감 효과 평가)

  • Lee, DongHyun;Ryu, Seung-Hun;Jo, JungHeum;Seo, SungChul
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.24 no.4
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    • pp.518-527
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    • 2014
  • Objectives: The adverse health effects attributed to exposure to radon have been well known over the world. However, the efforts for prevention and mitigation of radon have not been taken in Korea so far. The purpose of this study was to evaluate the effectiveness of mitigation methods applied for various types of houses and public buildings with high level of radon. Methods: Based on the results of "National Radon Survey" performed by the National Institute of Environmental Research(NIER) in 2010-2012, we selected 30 candidate buildings consisting of 20 houses and 10 public buildings with greater than $148Bq/m^3$ of radon level. We measured the concentration of radon in 30 buildings, using E-PERMs and RAD-7 during January to March of 2013. More than five E-PERMs and one RAD-7 per house were installed for seven days. Ten houses and five public buildings were finally chosen to be mitigated after mainly considering the level of radon and the location of buildings nationwide. Three mitigation methods such as Sealing, two types of Active Ventilation(window-shaped and wall-typed ventilations), and Active Soil Depressurization(ASD) were applied, and the concentrations of radon were measured before and after mitigation, respectively. To evaluate the effectiveness of mitigation methods, reduction rates of radon were calculated and Wilcoxon's signed-rank test was performed. Results: The mean concentration of 15 buildings just before radon mitigation was $297.8Bq/m^3$, and most of the buildings were located in Gangwon, Chungbuk, Chungnam, and Daegu areas(73.3%), and built in 1959-1998. The level of radon decreased from 48% to 90% and kept the below recommendation limit of $148Bq/m^3$ after installation of radon mitigation. Among mitigation methods applied, the reduction rate(58.7-90.4%) of radon attributed to ASD was the greatest than that of other methods, followed by Active Ventilation(48.4-78.4%) and Sealing(<22%). The effectiveness of radon reduction by window-shaped Active Ventilation(63.2-75.2%) was relatively better than that of wall-typed Active Ventilation(48.4-54.3%). Conclusions: The results of this study indicate that ASD could be more effective for radon mitigation. Moreover, our findings would be background information in future for making the strategy for radon mitigation nationwide, as well as for developing Korean-version of mitigation techniques according to types of dwellings in Korea.

The Clinical Study of 29 Cases on Effects of Cervical Hyeopcheok(Jiaji) Point Treatment for Neck Pain (경항통 환자에 대한 경추 협척혈 치료 29례)

  • Ryu, Young-Jin;Sun, Seung-Ho;Lee, Yeon-Hee;Choi, Ga-Young;Lee, Sun-Ju;Lee, Kwang-Ho
    • Journal of Acupuncture Research
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    • v.27 no.4
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    • pp.239-245
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    • 2010
  • Objectives : The aim of this study is to evaluate the effect of cervical Hyeopcheok(Jiaji) point for neck pain. Methods : The twenty-nine patients who feel neck pain, are chosen from chart review, received acupuncture treatment on cervical Hyeopcheok(Jiaji) point. The evaulation of progress was checked by NDI(neck disability index), and VAS(visual analog scale). Data were analyzed by Friedman two way analysis of variance and Wilcoxon matched pairs signed rank test. Results : NDI value(mean${\pm}$SD) was $17.76{\pm}8.26$(n=29) at the first visit, $13.41{\pm}8.04$(n=29) at 3days after treatment, $10.85{\pm}8.46$(n=26) at 5days, $11.00{\pm}7.80$(n=13) at 9days, $7.22{\pm}4.76$(n=9) at 15days, $3.86{\pm}4.06$(n=7) at 20days, and $3.33{\pm}3.78$(n=6) at 30days. VAS value(mean${\pm}$SD) was $4.07{\pm}1.33$(n=29) at the first visit, $12.97{\pm}1.05$(n=29) at 3days after treatment, $2.15{\pm}1.12$(n=26) at 5days, $2.15{\pm}0.99$(n=13) at 9days, $1.56{\pm}0.73$(n=9) at 15days, $1.29{\pm}0.49$(n=7) at 20days, and $0.83{\pm}0.41$(n=6) at 30days. The value of NDI and VAS gradually decreased. Repeated measurement results(the difference between the first visit and each measurement day) and the difference between before and after the interval(except between 5 and 9days, between 20 and 25days) were statistically significant. Conclusions : This result was shown that treatment of cervical Hyeopcheok(Jiaji) acupuncture point for neck pain can be effective. Further systematic research will be needed.

The Effect of the Health Belief and Efficacy Expectation Promoting Program on Osteoporosis Preventive Health Behavior in Women with Rheumatoid Arthritis (건강신념 및 효능기대증진 프로그램이 류마티스 관절염환자의 골다공증 예방행위에 미치는 영향)

  • Lee, Eun-Nam
    • Journal of muscle and joint health
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    • v.5 no.2
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    • pp.174-190
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    • 1998
  • Osteoporosis has been known as a common complication of rheumatoid arthritis and a major preventable health problem. Lots of studios have demonstrated that changes in life style can help delay or prevent osteoporosis. Therefore nursing intervention related osteoporosis prevention have consisted of education programs aimed at changing dietary and exercise habit. However knowledge gained from education haven't always leaded to behavior change. Therefore it is important to consider other psychological variables in effecting behavior change. Numerous research have found self efficacy and health belief to be an important factor in individual decision making behavior. The purpose of the study was to develop health belief and efficacy expectation promoting program based on Health Belief Model & Self Efficacy Model and to investigate its effects in women with rheumatoid arthritis. For this purpose, one group pretest-post design was used. The subject of the study were 16 women with rheumatoid arthritis in Pusan city and data collection was carried out from April, 1997 to May, 1998. The intervention program was consisted of educating on osteoporosis and enhancing and reinforcing self efficacy by verbal persuasion during the period of 4 weeks. The instruments were used to collect data in this study were Osteoporosis Health Belief Scale, Osteoporosis Self Efficacy Scale, and Osteoporosis Preventive Behavior Scale. Data was analyzed by Wilcoxon signed rank test using SPSS $PC^+$ program. The results are as follows : 1) The behavior should be increased after intervention was supported(Z=-3.5162, p=.0004, diet : Z=-3.2942, p=.0010, exercise). 2) The sub-hypothesis that perceived sensitivity should be increased after intervention was supported (Z=-2.3854, p=.0171). 3) The sub-hypothesis that perceived severity should be increased after intervention was rejected(Z=-1.4327, p=.1520). 4) The sub-hypothesis that perceived benefit should be increased after intervention was supported(Z=-2.6410, p=.0083). 5) The sub-hypothesis that perceived barrier should be decreased after intervention was supported (Z=-2.4138, p=.0158). 6) The sub-hypothesis that efficacy expectation should be increased after intervention was supported(Z=-3.5162, p=.0004). As a conclusion, it was found that health belief and self efficacy promoting program was an effective nursing intervention for preventing osteoporosis of rheumatoid arthritis.

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Comparison of Three, Motion-Resistant MR Sequences on Hepatobiliary Phase for Gadoxetic Acid (Gd-EOB-DTPA)-Enhanced MR Imaging of the Liver

  • Kim, Doo Ri;Kim, Bong Soo;Lee, Jeong Sub;Choi, Guk Myung;Kim, Seung Hyoung;Goh, Myeng Ju;Song, Byung-Cheol;Lee, Mu Sook;Lee, Kyung Ryeol;Ko, Su Yeon
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.2
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    • pp.71-81
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    • 2017
  • Purpose: To compare three, motion-resistant, T1-weighted MR sequences on the hepatobiliary phase for gadoxetic acid-enhanced MR imaging of the liver. Materials and Methods: In this retrospective study, 79 patients underwent gadoxetic acid-enhanced, 3T liver MR imaging. Fifty-nine were examined using a standard protocol, and 20 were examined using a motion-resistant protocol. During the hepatocyte-specific phase, three MR sequences were acquired: 1) gradient recalled echo (GRE) with controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA); 2) radial GRE with the interleaved angle-bisection scheme (ILAB); and 3) radial GRE with golden-angle scheme (GA). Two readers independently assessed images with motion artifacts, streaking artifacts, liver-edge sharpness, hepatic vessel clarity, lesion conspicuity, and overall image quality, using a 5-point scale. The images were assessed by measurement of liver signal-to-noise ratio (SNR), and tumor-to-liver contrast-to-noise ratio (CNR). The results were compared, using repeated post-hoc, paired t-tests with Bonferroni correction and the Wilcoxon signed rank test with Bonferroni correction. Results: In the qualitative analysis of cooperative patients, the results for CAIPIRINHA had significantly higher ratings for streak artifacts, liver-edge sharpness, hepatic vessel clarity, and overall image quality as compared to, radial GRE, (P < 0.016). In the imaging of uncooperative patients, higher scores were recorded for ILAB and GA with respect to all of the qualitative assessments, except for streak artifact, compared with CAIPIRINHA (P < 0.016). However, no significant differences were found between ILAB and GA. For quantitative analysis in uncooperative patients, the mean liver SNR and lesion-to-liver CNR with radial GRE were significantly higher than those of CAIPIRINHA (P < 0.016). Conclusion: In uncooperative patients, the use of the radial GRE sequence can improve the image quality compared to GRE imaging with CAIPIRINHA, despite the data acquisition methods used. The GRE imaging with CAIPIRINHA is applicable for patients without breath-holding difficulties.

Accuracy of dental model based on the state-of-the-art manufacturing technique (첨단 제조기술 기반으로 제작된 치과용 모형의 정확도에 관한 연구)

  • Kim, Jae-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.11
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    • pp.693-700
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    • 2020
  • This study compared the accuracy and reliability of definitive casts fabricated from a digital impression and conventional impression technique. A master model with the prepared upper full-arch tooth was used. Samples of ten plaster models and ten polyurethane models were duplicated using a selected standard master model. Six linear measurements were recorded between the landmarks, directly on each of the stone models and the polyurethane models on two occasions by a double examiner. The Wilcoxon signed-rank test, interclass correlation coefficient (ICC), measurement error (MSE), and limit of agreement (LoA) were used for statistical analysis. The ICC ranged from 0.76 to 0.99 when comparing the stone models and polyurethane models. The mean difference between the stone models and polyurethane models ranged from 0.09mm to 0.20mm, suggesting that stone models might be slightly larger than polyurethane models. Based on this study, the accuracy of the polyurethane models in evaluating the performance of an oral scanner and subtractive technology was acceptable. Further studies will be needed on patient subjects under clinical conditions that may involve missing or malpositioned teeth and fixed dental prostheses because this study was limited to use a standard master model and duplicated sample models in a laboratory setting.