• 제목/요약/키워드: variation in diagnosis

검색결과 387건 처리시간 0.03초

하악 제2대구치에서 치근의 이개도에 따른 치조골의 면적에 관한 연구 (A Study of the Alveolar Bone Surface following Root Separation Angle in the Mandibular Second Molar)

  • 임동진;임성빈;정진형;홍기석
    • Journal of Periodontal and Implant Science
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    • 제34권3호
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    • pp.523-533
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    • 2004
  • The purpose of this study was to evaluate the alveolar bone surface following root separation angle in the mandibular second molars. The fifty mandibular second molars(which were extracted) were selected, and the alveolar bone surface following root separation angle of the selected teeth were evaluated. The results were obtained as follows; 1. The root separation angle of fifty mandibular second molars were divided into three groups. The first $group(10-20^{\circ})$ was made up of ten teeth, the second $group(20-30^{\circ})$ was made up of fifteen teeth, and the third group(30-40$^{\circ}$) was made up of twenty-five teeth. 2. The mean root separation angle was $28.1^{\circ}$. The mean alveolar bone rate on the mesial surface of the mesial root was 44.27%, on the distal surface of the mesial root was 36.52%, on the mesial surface of the distal root was 33.45%, and on the distal surface of the distal root was 25.28%. 3. The mean alveolar bone rate on the distal surface of the mesial root, which composed the root separation area, was 32.95% in the first group, 36.06% in the second group, and 38.22% in the third group. The mean alveolar bone rate in the mesial surface of the distal root was 31.40% in the first group, 31.93% in the second group, and 35.18% in the third group. 4. The positive correlation was found between the root separation angle and the alveolar bone rate in the root separation area.(P<0.05) Although the mandibular second molar is a very important tooth in the oral cavity, its treatment and diagnosis is very difficult due to the variation of its root form. When periodontal disease involves the mandibular second molar, the result of this study assists in its treatment and diagnosis.

급성 아킬레스건 파열의 치료 동향: 대한족부족관절학회 회원 설문조사 분석 (Current Trends in the Treatment of Acute Achilles Tendon Rupture: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey)

  • 조재호;조병기;정형진;배서영;2021 대한족부족관절학회 학술위원회
    • 대한족부족관절학회지
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    • 제26권2호
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    • pp.88-94
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    • 2022
  • Purpose: This study was based on the Korean Foot and Ankle Society (KFAS) member survey and aimed to report the current trends in the epidemiology, diagnosis, and management of acute Achilles tendon rupture (AATR) over the past few decades. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in October 2021. The questions were mainly related to the clinical experience and preferred management of patients with AATR. Answers with a prevalence ≥50% of the respondents were considered a tendency. Results: Seventy-one (12.9%) of the 550 members responded to the survey. The male sex ratio in AATR was answered mean 78%, and the most common age groups were 30~40 years (n=49; 69.0%), and 40~50 years (n=37; 52.1%), in that order. The most common seasons for the occurrence of AATR were spring (37 cases; 52.1%) and autumn (27 cases; 38.0%). Also, sports-related rupture had an average occurrence of 76.2%. The most important clinical factor to determine the type of treatment was the history of previous injuries, and 75.9% of respondents started conservative treatment in the 2010s. The most preferred protocol of conservative treatment was an orthosis capable of ankle range of motion after casting (68.5%), and 53.7% 'satisfied' and 1.9% 'very satisfied' with conservative treatment. The most preferred surgical method was open repair (80.3%), and the Krackow method (60.6%), and 49.3% of treated patients responded 'satisfied' and 45.1% 'very satisfied' with this treatment. Conclusion: This study gives updated information concerning the current trend of epidemiology, diagnosis, and treatment of AATR in Korea. Both consensus and variation in the approach to AATR were identified using this survey study. This study may raise the awareness of various possible approaches toward AATR and should be used to further establish a standard protocol for the management of this injury.

컴퓨터 단층촬영의 조직간 밀도차이에 대한 노이즈 영향 (Effect of Noise on Density Differences of Tissue in Computed Tomography)

  • 양원석;손정민;천권수
    • 한국방사선학회논문지
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    • 제12권3호
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    • pp.403-407
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    • 2018
  • 현재 우리나라의 암 사망률 중 가장 높은 암은 폐암이며 조기발견이 어려운 대표적인 암이다. 조기 발견을 위하여 저선량 흉부 CT를 활용하고 있으며 이는 일반 흉부 X선 사진에 비해 약 3배 정도 폐암 진단율이 높다. 그러나 저선량 흉부 CT는 영상 해상도가 크게 저하될 뿐 아니라 신호가 약해 잡음에 민감한 단점이 있다. 또한 공기로 채워져 있는 폐는 밀도가 낮은 장기로 잡음의 유무가 암의 조기 진단에 영향을 크게 줄 수 있다. 본 연구는 Visual C++을 이용하여 2.0밀도를 가진 큰 원 내부에 물의 밀도인 1.0을 값을 갖는 원을 설정하고 그 안에 각각 밀도가 다른 작은 5개의 원을 수학적 팬텀화하고 가우시안 노이즈를 1%, 2%, 3%, 4% 각각 발생시켜 밀도차에 의한 노이즈의 영향을 평균 값과 표준편차 값, 신호대잡음비(SNR)로 확인하였다. 1% 노이즈 발생 시 큰 원과 작은 원의 밀도차가 가장 큰 영역의 SNR은 4.669로 노이즈의 영향이 작게 나타났으며 밀도차가 가장 낮은 영역의 SNR은 1.183으로 노이즈의 영향이 크게 나타났다. 또한 음의 밀도차에서도 같은 결과 값을 얻었으며 양의 밀도와 음의 밀도 모두 큰 원과 작은 원의 밀도차이가 높은 경우에 SNR 값이 높은 것을 확인 할 수 있다. 화질 또한 밀도차가 크게 나타났을 때 확연하게 육안으로 확인할 수 있었으며 노이즈레벨이 증가하는 경우에는 SNR이 감소하여 잡음의 영향이 크게 나타났다. 이는 밀도차가 적은 장기 또는 암과의 밀도가 비슷한 영역의 장기는 노이즈 영향이 크게 나타날 것이며 노이즈의 발생 확률에 따른 밀도차이의 영향이 진단에 영향을 끼칠 것으로 사료된다.

상악동 중격;임플란트 수술 계획시 파노라마와 치과용 전산화 단충촬영 분석 (Maxillary sinus septum;panoramic radiographic and dental computed tomographic analyses in the planning of implant surgery)

  • 소현자;정동근;권진희;유소현;김형섭
    • Journal of Periodontal and Implant Science
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    • 제36권1호
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    • pp.147-154
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    • 2006
  • Surgical intervention in the posterior maxillary region requires detailed knowledge of maxillary sinus anatomy and the possible anatomical variations. This study evaluated the incidence, location of maxillary sinus septa by using radiographic (panoramic radiography and computed tomography) findings and comparison of panoramic radography with CT in antral anatomical variation. This study was based on data from 70 sinuses in partial dentate maxilla. The sample consisted of 61 patients(25 women and 36 men, with ages ranging between 19 and 77 years and a mean age of $49.4{\pm}11.3$ years) who were being treatment-planned to receive implant-supported restorations. First, the panoramic images were examined for the presence of antral septa by radiologist and examiner who don't know about CT findings. And incidence of antral septa was evaluated using an axial plane of CT image. The incidence of septa was compared between panoramic radiography and CT. The accuracy of the incidence was compared between radiologists and dentists. A total of 20 septa were found in 70 sinuses on CT image and the prevalence of one or more septa per sinus was found to be 28.6%. The assumed incidence of septa on panoramic radiography was $27.6%{\pm}2.2%$ in radiologist and $31.9%{\pm}5.8%$ in dentists. Erroneous diagnosis rate was 11.42% in radiologist and 15.96% in dentists. 40% of antral septa were located in the anterior(premolar) region, 30% of septa were located in the middle(first molar) and posterior(second molar) region separately. Prior to implant placement, it seems appropriate to consider panoramic radiography as a standard radiographic examination and periapical radiographs may be used to complete the findings in regions not sharply depicted in the panoramic radiograph. And cross-sectional imaging should be used in sites with severe bone loss and close proximity of the maxillary sinus.

초음파영상에서 주파수와 파라미터를 이용한 정량적 영상평가 (Evaluation of Quantitative Image Quality using Frequency and Parameters in the Ultrasound Image)

  • 김창수;강세식;김정훈
    • 한국방사선학회논문지
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    • 제10권4호
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    • pp.247-253
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    • 2016
  • 초음파 장비는 여러 질환을 진단하는 장비로서 널리 사용되고 있으나, 초음파영상 품질의 평가방법에서는 정량적 표준이 없는 실정이다. 따라서 본 연구에서는 ATS-539 다목적 팬텀 내 8 mm 표적의 파라미터로서 주파수, Dynamic range, 초점수를 변화하여 예민도의 SNR과 영상의 히스토그램을 분석하고 왜곡도를 측정하여 표적별 적합한 주파수 및 파라미터를 도출하여 초음파영상의 병변 진단율을 향상 하고자 한다. 실험재료는 초음파 장비, ATS-539 다목적 팬텀을 사용하며, 실험방법은 영상 평가 팬텀의 8 mm를 주파수(2, 3, 4 MHz, 하모닉 3, 4, 4.5 MHz), Dynamic range(58, 68, 78, 88, 98), Focus(2, 4, 6개)를 변화시키면서 85장의 영상을 획득한다. 8 mm 영상의 예민도를 Image J 프로그램에서 각 표적별 SNR을 측정하고, 왜곡도는 신호의 히스토그램에서 백그라운드 값을 뺄셈하여 측정한다. 측정 결과 값에서 상위 40% 결과에서 파라미터 변화에 따라 예민도의 SNR, 왜곡도의 변화양상의 데이터 값을 산출하여 초음파 장비에서 적절한 영상의 품질을 나타내는 파라미터를 도출하였다. 결과는 초점수가 증가하면 SNR이 높고 왜곡도가 감소하며, 주파수 4 MHz에서 SNR값이 높고 왜곡도가 감소하였다. 그리고 Dynamic range 88, 98에서 최적의 영상을 나타내었으며, 실험 결과값을 기초로 초음파영상의 품질을 평가한다면 보다 정확한 초음파 진단이 가능할 것으로 사료된다.

고혈압 의료비 지역 간 변이 및 변이 요인 분석 (Analysis on geographic variations and variational factors in expenditures for hypertension)

  • 최순호;용왕식;김유미
    • 디지털융복합연구
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    • 제13권10호
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    • pp.425-436
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    • 2015
  • 본 연구는 우리나라의 고혈압 의료비의 지역별 변이와 지역의 사회학적, 의료공급, 건강행태 등의 변이 요인을 규명함으로써 이를 기반으로 지역별 고혈압 관리 사업 방안 마련에 기초자료를 제시하는 것이다. 이를 위해 전국 시 군 구 247개 지역을 대상으로, 2012년 지역별 의료이용 통계자료(국민건강보험공단), 지역사회건강조사(질병관리본부) 및 국토해양부 자료를 이용 분석하였다. 연구결과 전국 247개 시 군 구의 고혈압 건강보험진료비는 평균 6만2천원이었고 변동계수는 30.0으로 지역 간 높은 고혈압 의료비 변이를 보였다. 주요 변이 요인으로는 인구밀도, 유배우자율, 평균가구원수입, 인구십만명당병원수, 관외의료비비율, 월간음주율, 중증도이상신체활동실천율, 평생의사진단율 등으로 나타났다. 의사결정나무를 이용한 분석 결과 평생의사진단율, 평균가구원수입, 유배우자율, 인구십만명당병원수, 비만율, 월간음주율에서 유의한 차이가 있었다. 본 연구의 결과 고혈압 의료비의 지역 간 변이요인으로는 의료공급이나 인구사회학적 특성뿐만 아니라 건강행태에 있음을 확인하였고 이는 고혈압의료비 절감을 위한 지역보건사업 정책 결정에 참고가 될 수 있을 것이다.

Variation of Hospital Costs and Product Heterogeneity

  • Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • 제11권1호
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    • pp.123-127
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    • 1978
  • The major objective of this research is to identify those hospital characteristics that best explain cost variation among hospitals and to formulate linear models that can predict hospital costs. Specific emphasis is placed on hospital output, that is, the identification of diagnosis related patient groups (DRGs) which are medically meaningful and demonstrate similar patterns of hospital resource consumption. A casemix index is developed based on the DRGs identified. Considering the common problems encountered in previous hospital cost research, the following study requirements are estab-lished for fulfilling the objectives of this research: 1. Selection of hospitals that exercise similar medical and fiscal practices. 2. Identification of an appropriate data collection mechanism in which demographic and medical characteristics of individual patients as well as accurate and comparable cost information can be derived. 3. Development of a patient classification system in which all the patients treated in hospitals are able to be split into mutually exclusive categories with consistent and stable patterns of resource consumption. 4. Development of a cost finding mechanism through which patient groups' costs can be made comparable across hospitals. A data set of Medicare patients prepared by the Social Security Administration was selected for the study analysis. The data set contained 27,229 record abstracts of Medicare patients discharged from all but one short-term general hospital in Connecticut during the period from January 1, 1971, to December 31, 1972. Each record abstract contained demographic and diagnostic information, as well as charges for specific medical services received. The 'AUT-OGRP System' was used to generate 198 DRGs in which the entire range of Medicare patients were split into mutually exclusive categories, each of which shows a consistent and stable pattern of resource consumption. The 'Departmental Method' was used to generate cost information for the groups of Medicare patients that would be comparable across hospitals. To fulfill the study objectives, an extensive analysis was conducted in the following areas: 1. Analysis of DRGs: in which the level of resource use of each DRG was determined, the length of stay or death rate of each DRG in relation to resource use was characterized, and underlying patterns of the relationships among DRG costs were explained. 2. Exploration of resource use profiles of hospitals; in which the magnitude of differences in the resource uses or death rates incurred in the treatment of Medicare patients among the study hospitals was explored. 3. Casemix analysis; in which four types of casemix-related indices were generated, and the significance of these indices in the explanation of hospital costs was examined. 4. Formulation of linear models to predict hospital costs of Medicare patients; in which nine independent variables (i. e., casemix index, hospital size, complexity of service, teaching activity, location, casemix-adjusted death. rate index, occupancy rate, and casemix-adjusted length of stay index) were used for determining factors in hospital costs. Results from the study analysis indicated that: 1. The system of 198 DRGs for Medicare patient classification was demonstrated not only as a strong tool for determining the pattern of hospital resource utilization of Medicare patients, but also for categorizing patients by their severity of illness. 2. The wei틴fed mean total case cost (TOTC) of the study hospitals for Medicare patients during the study years was $11,27.02 with a standard deviation of $117.20. The hospital with the highest average TOTC ($1538.15) was 2.08 times more expensive than the hospital with the lowest average TOTC ($743.45). The weighted mean per diem total cost (DTOC) of the study hospitals for Medicare patients during the sutdy years was $107.98 with a standard deviation of $15.18. The hospital with the highest average DTOC ($147.23) was 1.87 times more expensive than the hospital with the lowest average DTOC ($78.49). 3. The linear models for each of the six types of hospital costs were formulated using the casemix index and the eight other hospital variables as the determinants. These models explained variance to the extent of 68.7 percent of total case cost (TOTC), 63.5 percent of room and board cost (RMC), 66.2 percent of total ancillary service cost (TANC), 66.3 percent of per diem total cost (DTOC), 56.9 percent of per diem room and board cost (DRMC), and 65.5 percent of per diem ancillary service cost (DTANC). The casemix index alone explained approximately one half of interhospital cost variation: 59.1 percent for TOTC and 44.3 percent for DTOC. Thsee results demonstrate that the casemix index is the most importand determinant of interhospital cost variation Future research and policy implications in regard to the results of this study is envisioned in the following three areas: 1. Utilization of casemix related indices in the Medicare data systems. 2. Refinement of data for hospital cost evaluation. 3. Development of a system for reimbursement and cost control in hospitals.

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한국 양돈장의 porcine cytomegalovirus 감염양상 및 바이러스학적 유병률 (Virological Prevalence and Infection Patterns of Porcine Cytomegalovirus in Selected Pig Farms in Korea)

  • 박최규;최은진
    • 생명과학회지
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    • 제19권10호
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    • pp.1451-1455
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    • 2009
  • Porcine cytomegalovirus (PCMV) is a betaherpesvirus which causes reproductive failure in breeding sows and generalized infection in newborn piglets. It has worldwide distribution including Korea. Serological survey on this virus has been reported in 76.3% of pigs, but virological survey and epidemiological analysis on PCMV distribution have been reported in only a few papers in Korea. In this study, we investigated the virological prevalence and infection status of PCMV on a farm level in selected swine farms with respiratory diseases. A total of 1,938 blood samples taken from groups of pigs of different ages were collected from 31 farms distributed nationwide in 2006 and 2007 and tested by PCR to detect the presence of PCMV. Virological prevalence at farm level and pig level were 96.8% and 17.5%, respectively, suggesting that PCMV has endemically infected Korean pig herds. The prevalence at farm level in gilts, sows and suckling piglet groups were 16.7%, 36.7% and 56.7%, indicating that vertical infections frequently occurred in conception or newborn stage. Thereafter, detection rates of PCMV were slightly increased in pig groups aged 40 and 70 days (70.0% and 73.3%), and then gradually decreased as they aged - 33.3% in 100, 26.7% in 130 and 16.7% in 160 day old pig groups. The prevalence at pig level has similar patterns to that at farm level. With the passage of time, the variation of infection patterns of PCMV was investigated in four PCMV-positive farms. Three blood samples were collected at intervals of 6 months in each farm, and examined for presence of PCMV using PCR. The results revealed that once PCMV was introduced to the pig farms, it continuously circulated between and within groups of sows and piglets in those farms. Taken together, it can be concluded that PCMV has endemically infected Korean pig farms and has the potential risk for emerging pathogen in combination with the known endemic pathogens including porcine reproductive, respiratory syndrome virus and porcine circovirus type 2. Therefore, more research is needed on diagnosis, epidemiology and control strategy for PCMV on the field.

Association between C16orf47 Gene and Serum Liver Enzyme Levels in the Korean Population

  • Ahn, Hyo-Jun;Eom, Yong-Bin
    • 대한의생명과학회지
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    • 제19권3호
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    • pp.239-244
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    • 2013
  • Serum liver enzyme levels are widely used in the clinical diagnosis of liver diseases and the assessment of liver status. They also have epidemiological significance to be prospective risk factors for type 2 diabetes, cardiovascular disease. In the previous study, single nucleotide polymorphisms (SNPs) in several genes have been reported to be associated with serum liver enzyme levels in American population. We aimed to confirm whether the genetic variation of C16orf47 (chromosome 16 open reading frame 47) gene also influence the serum liver enzyme levels in Korean population. We genotyped variants in or near C16orf47 in a population-based sample including 994 unrelated Korean adult. Here, we performed association analysis to elucidate the possible relations of genetic polymorphisms in C16orf47 gene with serum liver enzyme levels. By examining genotype data of a total of 944 subjects in 5 hospital health promotion center, we discovered the C16orf47 gene polymorphisms are associated with serum liver enzyme levels. The common and highest significant polymorphism was rs7203412 (${\beta}$=3.68, P=3.66E-06) with glutamic oxaloacetic transferase (GOT) and rs7203412 (${\beta}$=6.2, P=7.06E-05) with glutamic pyruvate transaminase (GPT) in all group. Furthermore, the SNP rs7203412 was consistently associated with GOT (${\beta}$=6.41, P=6.78E-08) and GPT (${\beta}$=11.53, P=2.81E-06) in men group. Consequently, we found statistically significant SNP in C16orf47 gene that are associated with serum levels of GOT and GPT. In addition, these results suggest that the individuals with the minor alleles of the SNP in the C16orf47 gene may be more elevated serum liver enzyme levels in the Korean population.

The Genetic Variations of RETNLB Gene are Associated with Serum Levels of Alkaline Phosphatase in the Korean Population

  • Ahn, Hyo-Jun;Eom, Yong-Bin
    • 대한의생명과학회지
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    • 제19권4호
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    • pp.338-343
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    • 2013
  • Serum levels of alkaline phosphatase (ALP) are widely used in the clinical diagnosis of hepatic diseases and the assessment of liver status. They also have epidemiological significance to be prospective risk factors for bone diseases, such as osteitis deformans, rickets, osteomalacia, hyperparathyroidism, healing fractures, and osteoblastic bone tumors. In the previous study, single nucleotide polymorphisms (SNPs) in several genes have been reported to be associated with serum levels of liver enzyme in American population. We aimed to confirm whether the genetic variation of RETNLB (resistin like beta) gene also influence the serum levels of liver enzyme in Korean population. We genotyped variants in or near RETNLB in a population-based sample including 994 Korean adults. Here, we performed association analysis to elucidate the possible relations of genetic polymorphisms in RETNLB gene with serum levels of liver enzyme. By examining genotype data of a total of 944 subjects in 5 hospital health promotion centers, we discovered the RETNLB gene polymorphisms are associated with serum levels of ALP. The common and highest significant polymorphism was rs736327 (${\beta}$=8.66, P=2.37E-05), rs7639070 (${\beta}$=8.56, P=3.24E-05) with ALP in all groups. Furthermore, the ALP was consistently associated with rs736327 (${\beta}$=10.40, P=5.23E-05), rs7639070 (${\beta}$=10.32, P=6.74E-05) in the male population. Consequently, we found statistically significant SNPs in RETNLB gene that are associated with serum levels of ALP. In addition, these results suggest that the individuals with the minor alleles of the SNP in the RETNLB gene may have elevated serum levels of ALP in the Korean population.