• 대한심미치과학회지
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• 제30권2호
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• pp.71-90
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• 2021

가상 환자 데이터 세트는 단일 환자로부터 획득한 구강스캔 안면스캔 전신스캔 하악운동경로데이터 등 다양한 소스의 진단 데이터를 하나의 3차원 좌표계로 정렬한 데이터의 집합이다. 치과의사는 가상 환자 데이터 세트를 사용하여 효과적으로 치료 계획을 수립하고 다양한 치료 계획을 가상공간상에서 시뮬레이션 할 수 있으며, 가상 환자 데이터 세트에서 환자의 미소를 디자인 후 그 결과를 시뮬레이션하고 최적의 치료결과를 선택할 수 있다. 가상공간에서 선택된 치료 계획은 3D 프린팅, 밀링, 사출 성형과 같은 제조 기술을 사용하여 환자에게 동일하게 전달될 수 있다. 이러 치료 계획의 전달은 임시 수복물 제작 및 환자의 구강 내에서 목업 확인을 통해 최종 보철물 제작으로 연결할 수 있다. 이와 같이 진단 데이터, 중첩 및 가공의 정확도가 보장된다면 3차원 가상공간 상에서 시뮬레이션된 3D 디지털 스마일 디자인을 실제 환자에게 정확하게 전달할 수 있다. 가상환자데이터세트의 임상적용방법으로 동기능적교합측정 검사를 통해 교합조정치료를 치료계획에서 배제할수 있는 의사결정방법과, 턱관절질환을 가지고 있는 청소년기 특발성 척추측만증 환자의 턱관절 치료전후 전신스캔 비교분석방법, 그리고 전악수복증례인 상하악 총의치환자 진료시 가상환자데이터세트에 기반한 교합평면분석 및 디지털심미분석방법을 제시하였다.

• 임상간호연구
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• 제15권1호
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• pp.19-28
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• 2009

Purpose: The purpose of this study was to examine the effect of position change on discomfort and bleeding in patients undergone coronary angiography with a vascular device and required bed-rest. Method: This study utilized nonequivalent control group non-synchronized design. Data were collected from 118 inpatients after coronary angiography and stayed in general ward at Y hospital in Seoul, from June 5 to August 12, 2008. After coronary angiography, position change was performed to the experimental group who consisted of 59 patients. They stayed in supine position just after angiography and then head-up position with 15 degrees was applied 1 hour later. After that, they could change the position alternatively into lateral position with leg down and supine position. The control group was positioned keeping the affected leg immobile with supine position for 4 hours. Results: The experimental group reported significantly more comfortable than control group after position change. There were no significant differences in the grades of bleeding or hematoma at puncture site between the two groups. Conclusion: The position change in patients undergone angiography could be applied without any harm such as bleeding or hematoma, but effective in reducing back pain and subjective patients' discomforts.

• Korean Journal of Radiology
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• 제22권11호
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• pp.1918-1928
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• 2021

Objective: With the recent development of various MRI-conditional cardiac implantable electronic devices (CIEDs), the accurate identification and characterization of CIEDs have become critical when performing MRI in patients with CIEDs. We aimed to develop and evaluate a deep learning-based algorithm (DLA) that performs the detection and characterization of parameters, including MRI safety, of CIEDs on chest radiograph (CR) in a single step and compare its performance with other related algorithms that were recently developed. Materials and Methods: We developed a DLA (X-ray CIED identification [XCID]) using 9912 CRs of 958 patients with 968 CIEDs comprising 26 model groups from 4 manufacturers obtained between 2014 and 2019 from one hospital. The performance of XCID was tested with an external dataset consisting of 2122 CRs obtained from a different hospital and compared with the performance of two other related algorithms recently reported, including PacemakerID (PID) and Pacemaker identification with neural networks (PPMnn). Results: The overall accuracies of XCID for the manufacturer classification, model group identification, and MRI safety characterization using the internal test dataset were 99.7% (992/995), 97.2% (967/995), and 98.9% (984/995), respectively. These were 95.8% (2033/2122), 85.4% (1813/2122), and 92.2% (1956/2122), respectively, with the external test dataset. In the comparative study, the accuracy for the manufacturer classification was 95.0% (152/160) for XCID and 91.3% for PPMnn (146/160), which was significantly higher than that for PID (80.0%,128/160; p < 0.001 for both). XCID demonstrated a higher accuracy (88.1%; 141/160) than PPMnn (80.0%; 128/160) in identifying model groups (p < 0.001). Conclusion: The remarkable and consistent performance of XCID suggests its applicability for detection, manufacturer and model identification, as well as MRI safety characterization of CIED on CRs. Further studies are warranted to guarantee the safe use of XCID in clinical practice.

• 한국방사선학회논문지
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• 제18권2호
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• pp.153-159
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• 2024

일반 X-선 촬영에서 경험이 없는 비숙련자의 경우, 검사 실패의 경험을 통해 숙련되는 과정을 겪는다. 이것은 불필요한 의료 피폭 가중의 문제를 유발한다. 본 연구에서는 배치 전 비숙련 방사선사가 임상 숙련도를 높일 수 있는 방안으로, 시각적, 공간적 보조 장치를 이용한 두개골 측방향 촬영 실습을 통해, 촬영 보조장치 사용에 따른 정확도와 유용성을 평가하였다. 육안적 관찰과 학습에 의존해서 촬영한 경우 영상 왜곡을 나타내는 회전 이격도 7.85 ± 1.45 mm, 기울임 이격도 4.84 ± 0.5 mm였다. 시각적 보조 장치를 이용해서 실습한 경우 회전 이격도 4.4 ± 0.76 mm, 기울임 이격도 3.01 ± 0.87mm였다. 공간적 보정 기구를 이용해서 실습한 경우 회전과 기울임 이격도는 5.2 ± 0.69 mm, 3.33 ± 0.61 mm로 나타났다. 배치 후 작업 환경과 동일한 조건에서 경험적 촬영 실습에 의한 영상 왜곡은 5.4% 감소하였으나, 기울임에 의한 영상 왜곡은 1.2% 증가하였다. 시각적 보조 장치를 이용해서 실습한 경우, 경험적 촬영 실습보다 회전이격도 40.1% 기울임 이격도 30.7% 감소하였다. 공간적 보정 기구를 사용할 경우, 기존의 경험적 실습 방식보다 회전 이격도 41.7%, 기울임 이격도 23.7% 감소하였다. 따라서 비숙련 방사선사의 배치 전 시각적, 공간적 촬영 보조 기구를 이용한 실습은 배치 후 검사 정확도 향상과 재촬영률 감소에 도움을 줄 수 있을 것으로 사료된다.

• Korean Journal of Radiology
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• 제25권6호
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• pp.565-574
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• 2024

Objective: To evaluate the safety and clinical outcomes of the Passeo-18 Lux drug-coated balloon (DCB) in endovascular revascularization procedures under real-world conditions in a Korean population with atherosclerotic disease of the infrainguinal arteries, including below-the-knee (BTK) arteries. Materials and Methods: Eight institutions in the Republic of Korea participated in this prospective, multicenter, single-arm, post-market surveillance study. Two hundred patients with Rutherford class 2-5 peripheral arterial disease and infrainguinal lesions suitable for endovascular treatment were competitively enrolled. Data were collected at baseline, the time of intervention, discharge, and 1-, 6-, 12-, and 24-month follow-up visits. The primary safety endpoint was freedom from major adverse events (MAE) within 6 months (except when limiting the time frame for procedure- or device-related mortality to within 30 days), and the primary effectiveness endpoint was freedom from clinically driven target lesion revascularization (CD-TLR) within 12 months after the procedure. Results: A total of 197 patients with 332 target lesions were analyzed. Two-thirds of the patients had diabetes mellitus, and 41.6% had chronic limb-threatening ischemia. The median target lesion length was 100 mm (interquartile range: 56-133 mm). Of the target lesions, 35.2% were occlusions, and 14.8% were located in the BTK arteries. Rate of freedom from MAE was 97.9% at 6 months, and the rate of freedom from CD-TLR was 95.0% and 92.2% at 12 and 24 months, respectively. Subgroup analysis of 43 patients and 49 target lesions involving the BTK arteries showed rate of freedom from MAE of 92.8% at 6 months and rates of freedom from CD-TLR of 88.8% and 84.4% at 12 and 24 months, respectively. Conclusion: The results of the present study, including the BTK subgroup analysis, showed outcomes comparable to those of other DCB studies, confirming the safety and effectiveness of Passeo-18 Lux DCB in the Korean population.

• 한국임상수의학회지
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• 제40권6호
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• pp.399-407
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• 2023

Chronic kidney disease (CKD) occurs in more than 15% of the dogs over 10 years of age and causes irreversible renal function deterioration. Therefore, it is important to diagnose CKD early and treat the disease properly. The purpose of this study aimed to to evaluate the clinical utility of urine albumin/creatinine ratio (ACR) using POC (point-of-care) device as an early detection urinary biomarker in CKD dogs and to confirm the correlation between ACR and other known CKD biomarkers. Urine and serum samples were obtained from 50 healthy dogs and 50 dogs with CKD. Serum blood urea nitrogen (BUN), creatinine, and symmetric dimethylarginine (SDMA) concentrations, and urine protein creatinine ratio (UPC) were measured. Urine specific gravity (USG) was evaluated using refractometer, and ACR was measured using an i-SENS A1Care analyzer. The ACR values of dogs with CKD were significantly different from those of healthy dogs (p < 0.001), as with other renal biomarkers. ACR showed significant differences between healthy dogs and dogs with CKD at every IRIS stage (p < 0.005), whereas no significant differences were observed between dogs with CKD IRIS stage I and healthy dogs with UPC. There are significant positive correlation between ACR and BUN (r = 0.611, p < 0.001), creatinine (r = 0.788, p < 0.001), SDMA (r = 0.747, p < 0.001), and UPC (r = 0.784, p < 0.001), and significant negative correlation between ACR and USG (r = -0.700, p < 0.001). In receiver operator characteristic curve analysis, the area under the curve (AUC) was 0.982 (95% CI 0.963-1.000, p < 0.001), with an optimal cut-off value of 64.20 mg/g (94% sensitivity and 94% specificity). Thus, ACR is a useful urinary biomarker for the early diagnosis of proteinuria in CKD and combined use of ACR and other renal biomarkers may be helpful for early diagnosis and prevention of CKD in dogs.

• 대한족부족관절학회지
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• 제28권1호
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• pp.21-26
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• 2024

Purpose: Foot pressure measurement devices are used widely in clinical settings for plantar pressure assessments. Despite the availability of various devices, studies evaluating the inter-device reliability are limited. This study compared plantar pressure measurements obtained from HR Mat (Tekscan Inc.) and EMED-n50 (Novel GmbH). Materials and Methods: The study involved 38 healthy male volunteers. The participants were categorized into two groups based on the Meary's angle in standing foot lateral radiographs: those with normal feet (angles ranging from -4° to 4°) and those with mild flatfeet (angles from -8° to -15°). The static and dynamic plantar pressures of the participants were measured using HR Mat and EMED-n50. The reliability of the contact area and mean force was assessed using the interclass correlation coefficient (ICC). Furthermore, the differences in measurements between the two devices were examined, considering the presence of mild flatfoot. Results: The ICC values for the contact area and mean force ranged from 0.703 to 0.947, indicating good-to-excellent reliability across all areas. EMED-n50 tended to record higher contact areas than HR Mat. The mean force was significantly higher in the forefoot region when measured with EMED-n50, whereas, in the hindfoot region, this difference was observed only during static measurements with HR Mat. Participants with mild flatfeet exhibited significantly higher contact areas in the midfoot region for both devices, with no consistent differences in the other parameters. Conclusion: The contact area and mean force measurements of the HR Mat and EMED-n50 showed high reliability. On the other hand, EMED-n50 tended to record higher contact areas than HR Mat. In cases of mild flatfoot, an increase in contact area within the midfoot region was observed, but no consistent impact on the differences between the two devices was evident.

• 대한영상의학회지
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• 제84권4호
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• pp.879-888
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• 2023

목적 본 연구는 Denali 필터 제거의 결과를 평가하기 위해 설계되었다. 대상과 방법 2015년 9월부터 2020년 4월까지 Denali 필터 삽입을 받은 143명의 환자를 후향적으로 분석하였다. 이 중 필터 제거를 필요로 하는 97명의 환자가 연구에 포함되었다. 표준 방법 또는 심화기술로 필터를 제거하였다. 제거 전후로 정맥조영술을 얻어 성공적인 제거율과 합병증 여부, 필터 삽입에 걸린 시간에 대해 분석하였다. 결과 97명의 환자들이 모두 합병증 없이 필터를 제거하였다. 92명(94.8%)에서는 표준방법으로 제거했고 5명(5.2%)은 심화기술로 제거하였다. 필터 각도가 15도 이상인 예가 2건 있었다. 정맥조영술(venography)로 필터가 하대정맥에 박힌 사례가 17건(17.5%)이 있음을 확인했으나 필터 제거 후 조영제 유출과는 관련이 없었다. 결론 Denali 필터는 합병증 없는 높은 성공적 제거율을 보였다. 본 연구는 기존 연구 및 실험과 같이 사용이 증가하는 Denili 필터는 높은 제거율을 보여주는 신뢰할만하고 안전한 필터임을 보여주었다.

• Journal of Gastric Cancer
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• 제24권3호
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• pp.327-340
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• 2024

Purpose: Results of initial endoscopic biopsy of gastric lesions often differ from those of the final pathological diagnosis. We evaluated whether an artificial intelligence-based gastric lesion detection and diagnostic system, ENdoscopy as AI-powered Device Computer Aided Diagnosis for Gastroscopy (ENAD CAD-G), could reduce this discrepancy. Materials and Methods: We retrospectively collected 24,948 endoscopic images of early gastric cancers (EGCs), dysplasia, and benign lesions from 9,892 patients who underwent esophagogastroduodenoscopy between 2011 and 2021. The diagnostic performance of ENAD CAD-G was evaluated using the following real-world datasets: patients referred from community clinics with initial biopsy results of atypia (n=154), participants who underwent endoscopic resection for neoplasms (Internal video set, n=140), and participants who underwent endoscopy for screening or suspicion of gastric neoplasm referred from community clinics (External video set, n=296). Results: ENAD CAD-G classified the referred gastric lesions of atypia into EGC (accuracy, 82.47%; 95% confidence interval [CI], 76.46%-88.47%), dysplasia (88.31%; 83.24%-93.39%), and benign lesions (83.12%; 77.20%-89.03%). In the Internal video set, ENAD CAD-G identified dysplasia and EGC with diagnostic accuracies of 88.57% (95% CI, 83.30%-93.84%) and 91.43% (86.79%-96.07%), respectively, compared with an accuracy of 60.71% (52.62%-68.80%) for the initial biopsy results (P<0.001). In the External video set, ENAD CAD-G classified EGC, dysplasia, and benign lesions with diagnostic accuracies of 87.50% (83.73%-91.27%), 90.54% (87.21%-93.87%), and 88.85% (85.27%-92.44%), respectively. Conclusions: ENAD CAD-G is superior to initial biopsy for the detection and diagnosis of gastric lesions that require endoscopic resection. ENAD CAD-G can assist community endoscopists in identifying gastric lesions that require endoscopic resection.

• 대한치매학회지
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• 제23권1호
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• pp.22-29
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• 2024

Background and Purpose: Alzheimer's disease (AD) is a neurodegenerative disease characterized by a progressive decline in cognition and performance of daily activities. Recent studies have attempted to establish the relationship between AD and sleep. It is believed that patients with AD pathology show altered sleep characteristics years before clinical symptoms appear. This study evaluated the differences in sleep characteristics between cognitively asymptomatic patients with and without some amyloid burden. Methods: Sleep characteristics of 76 subjects aged 60 years or older who were diagnosed with subjective cognitive decline (SCD) but not mild cognitive impairment (MCI) or AD were measured using Fitbit^® Alta HR, a wristwatch-shaped wearable device. Amyloid deposition was evaluated using brain amyloid plaque load (BAPL) and global standardized uptake value ratio (SUVR) from fluorine-18 florbetaben positron emission tomography. Each component of measured sleep characteristics was analyzed for statistically significant differences between the amyloid-positive group and the amyloid-negative group. Results: Of the 76 subjects included in this study, 49 (64.5%) were female. The average age of the subjects was 70.72±6.09 years when the study started. 15 subjects were classified as amyloid-positive based on BAPL. The average global SUVR was 1.598±0.263 in the amyloid-positive group and 1.187±0.100 in the amyloid-negative group. Time spent in slow-wave sleep (SWS) was significantly lower in the amyloid-positive group (39.4±13.1 minutes) than in the amyloid-negative group (49.5±13.1 minutes) (p=0.009). Conclusions: This study showed that SWS is different between the elderly SCD population with and without amyloid positivity. How SWS affects AD pathology requires further research.