• Title/Summary/Keyword: Incorrect ratio

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The Consideration of the Region of Interest on $^{99m}Tc$-DMSA Renal Scan in Pediatric Hydronephrosis Patients (수신증을 진단 받은 소아 환자의 DMSA 신장 검사에서 정확한 관심영역 설정에 대한 고찰)

  • NamKoong, Hyuk;Lee, Dong-Hyuk;Oh, Shin-Hyun;Cho, Seok-Won;Park, Hoon-Hee;Kim, Jung-Yul;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.1
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    • pp.27-33
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    • 2012
  • Purpose: Most of diagnosis in the pediatric hydronephrosis patients have been performed $^{99m}Tc$-DMSA renal scan. Then the region of interest (ROI) is set for comparative analysis of uptake ratio in left-right kidney after acquiring the image. But if the equipment set an automatic ROI, the ROI could include expanded renal pelvis due to hydronephrosis and the uptake ratio of left-right kidney will be incorrect result. Therefore this study compared both ROIs including expanded renal pelvis and excluding renal pelvis through experiment using normal kidney phantom and expanded renal pelvis phantom and suggested setting method of improved ROI. In addition, this study have been helped by readout doctor for investigate distinction radiopharmaceutical uptake between renal cortex and remained urine by expanded renal pelvis. Materials and Methods: The both of renal phantoms were filled with water and shacked with $^{99m}TcO_4$ 111 MBq. In order to describe the expanded renal pelvis, the five latex balloon were all filled with 10 mL water and each of balloon was mixed with $^{99m}TcO_4$ 18.5, 37, 55.5, 74, 92.5 MBq. And we made phantom with fixed $^{99m}TcO_4$activity of 37 MBq and mixed water 5, 10, 15, 20, 25 mL in each balloon. The left kidney was fixed its shape and the right kidney was modified like as hydronephrosis kidney by attached the latex balloons. And the acquiring counts were 2 million. After acquisition, we compared the image of ROI with Expanded renal pelvis and the image of ROI without renal pelvis for analyzing difference in the uptake ratio of left-right kidney and for reproducibility, set the ROI 5 times in the same images. Patients were injected $^{99m}Tc$-DMSA 1.5~1.9 MBq/kg and scanned 3 to 4 hours after injection. The each of 3 skillful radio technologists performed the comparing estimation by setting ROI. To determine statistical significance between two data, SPSS (ver. 17) Wilcoxon Signed Ranks Test was used. Results: As a result of renal phantom's experiment, we compared with average of counts Background (BKG) ratios in the setting of ROI including expanded renal pelvis and setting of excluding expanded renal pelvis. Therefore, they can obtain changed counts and changed ratios. Patient also can obtain same results. In addition, the radiopharmaceutical uptake in expanded renal pelvis was come out the remained urine that couldn't descend to ureter by the help of readout doctor. Conclusion: As above results, the case of setting ROI including expanded renal pelvis was more abnormally increasing uptake ratio than the case of setting ROI excluding expanded renal pelvis in analysis the uptake ratio in left-right kidney of hydronephrosis. Because of the work convenience and prompted analysis, the automatic ROI is generally used. But in case of the hydronephrosis study, we should set the manual ROI without expanded renal pelvis for an accurate observation of the uptake ratio of left-right kidney since the radiopharmaceutical uptake in expanded renal pelvis is the remained urine.

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A Proposal to Control System and the Problems of the Problems of the Report about Supply and Demand for Medical Technicians and Management Policy ("의료기사인력수급에 관한 보고서"의 문제점과 관리제도의 개선방안)

  • Kim, Sang-Hyun;Lim, Yongmoo
    • Journal of Korean Ophthalmic Optics Society
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    • v.13 no.4
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    • pp.25-30
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    • 2008
  • Purpose: In this paper, we have analyzed the problems of the Oh's report which is used to the basic data for supply and demand of medical technicians and studied a proposal for improvement to control system and supply and demand of korean optometrists. Methods: We have analyzed errors of Oh's report including supply and demand for medical technicians and management policy, expecting number for future optician, inaccurate estimation by limited data (employment rate, retirement rate, mortality rate) and an incorrect method of measurement for future supply and demand. Results: Oh's report showed the 18% error for estimation of supply which exclude the irregular entrance students. The estimation of supply was calculated by graduation rate 62.6% (college and University of Technology are 78.9% and 85.98% respectively), employment rate 65.8% (the average employment between 2002 and 2007 is 73.96%) and retirement rate is 2.3% (the retirement of pharmacists is 1.3%) but it showed the significant differences to objective data. For estimate the suitable ratio of optometrists to the population, the ratio use of medical facilities by an age group was used, and suggested spectacle wearers 1,280 persons (populations 2,928 persons) per optometrist but the different from reference of Germany (4,706 persons), America (1,789 persons) and Korea (1,825 persons/an optometrist) are applied to estimation on supply. This report applied the low employment rate and argued that maintain the present situation, but claimed that utilize unemployment persons. The above result has induced double weighting effect on estimation of supply. Conclusions: To solve the related problems of supply and demand, we have to make a search for exact data and optimum application model, have to take an example of nation similar job category as Germany and the research result of the job satisfaction into consideration. After we get the integrated research result, we must carried out the policy with fairness and balance for the estimation of supply and demand. Therefore exact research is required prior to beginning policy establishment, government and related group have to make a clear long-term plan and permanent organization for medical technician to establish supply and demand of medical technician.

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GnRH Agonist Stimulation Test (GAST) for Prediction of Ovarian Response in Controlled Ovarian Stimulation (COH) (난소기능평가를 위한 Gonadotropin Releasing Hormone Agonist Stimulation Test (GAST)의 효용성에 관한 연구)

  • Kim, Mee-Ran;Song, In-Ok;Yeon, Hye-Jeong;Choi, Bum-Chae;Paik, Eun-Chan;Koong, Mi-Kyoung;Song, Il-Pyo;Lee, Jin-Woo;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.2
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    • pp.163-170
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    • 1999
  • Objectives: The aims of this study are 1) to determine if GAST is a better indicator in predicting ovarian response to COH compared with patient's age or basal FSH level and 2) to evaluate its role in detecting abnormal ovarian response. Design: Prospective study in 118 patients undergoing IVF-ET using GnRH-a short protocol during May-September 1995. Materials and Methods: After blood sampling for basal FSH and estradiol $(E_2)$ on cycle day two, 0.5ml (0.525mg) GnRH agonist ($Suprefact^{(r)}$, Hoechst) was injected subcutaneously. Serum $E_2$ was measured 24 hours later. Initial $E_2$ difference $({\Delta}E_2)$ was defined as the change in $E_2$ on day 3 over the baseline day 2 value. Sixteen patients with ovarian cyst or single ovary or incorrect blood collection time were excluded from the analysis. The patients were divided into three groups by ${\Delta}E_2$; group A (n=30):${\Delta}E_2$<40 pg/ml, group B (n=52): 40 pg/ml${\leq}{\Delta}E_2$<100 pg/ml, group C (n=20): ${\Delta}E_2{\leq}100$ pg/ml. COH was done by GnRH agonist/HMG/hCG and IVF-ET was followed. Ratio of $E_2$ on day of hCG injection over the number of ampules of gonadotropins used ($E_2hCGday$/Amp) was regarded as ovarian responsiveness. Poor ovarian response and overstimulation were defined as $E_2$ hCGday less than 600 pg/ml and greater than 5000 pg/ml, respectively. Results: Mean age $({\pm}SEM)$ in group A, B and C were $33.7{\pm}0.8^*,\;31.5{\pm}0.6\;and\;30.6{\pm}0.5^*$, respectively ($^*$: p<0.05). Mean basal FSH level of group $A(11.1{\pm}1.1mlU/ml)$ was significantly higher than those of $B(7.4{\pm}0.2mIU/ml)$ and C $(6.8{\pm}0.4mIU/ml)$ (p<0.001). Mean $E_2hCGday$ of group A was significantly lower than those of group B or C, i.e., $1402.1{\pm}187.7pg/ml,\;3153.2{\pm}240.0pg/ml,\;4078.8{\pm}306.4pg/ml$ respectively (p<0.0001). The number of ampules of gonadotropins used in group A was significantly greater than those in group B or C: $38.6{\pm}2.3,\;24.2{\pm}1.1\;and\;18.5{\pm}1.0$ (p<0.0001). The number of oocytes retrieved in group A was significantly smaller than those in group B or C: $6.4{\pm}1.1,\;15.5{\pm}1.1\;and\;18.6{\pm}1.6$, respectively (p<0.0001). By stepwise multiple regression, only ${\Delta}E_2$ showed a significant correlation (r=0.68, p<0.0001) with $E_2HCGday$/Amp, while age or basal FSH level were not significant. Likewise, only ${\Delta}E_2$ correlated significantly with the number of oocytes retrieved (r=0.57, p<0.001). All four patients whose COH was canceled due to poor ovarian response belonged to group A only (Fisher's exact test, p<0.01). Whereas none of 30 patients in group A (0%) had overstimulation, 14 patients among 72 patients (19.4%) in group B and C had overstimulation (Fisher's exact test, p<0.01). Conclusions: These data suggest that initial $E_2$ difference after GAST may be a better prognostic indicator of ovarian response to COH than age or basal FSH level. Since initial $E_2$ difference demonstrates significant association with abnormal ovarian response such as poor ovarian response necessitating cycle cancellation or overstimulation, GAST may be helpful in monitoring and consultation of patients during COH in IVF-ET cycle.

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Analysis and the Standardization Plan of the Terms Used by Seafarers on Small Vessel (소형선박 종사자 사용용어 실태 분석 및 표준화 방안)

  • Kang, Suk-Young;Ryu, Won;Bae, Chang-Won;Kim, Jong-Kwan
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.25 no.7
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    • pp.867-873
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    • 2019
  • As of August 2019, there were 3,823 vessels under 30 tons that could be included in the category of small vessels; these account for 42.5 % of the 9,001 registered vessels in Korea. The problem is that many small vessel seafarers face many problems such as an board communication disconnection, difficulties in communication in maritime license interviews, or education related to maritime training using a large number of nonstandard terms, which are derived from foreign languages; this is leading to a decline the job skills of small vessel seafarers. Therefore, in this study, we closely analyzed the terminology of small vessel seafarers and proposed a standardization plan. In the terminology analysis, the preliminary terms of the maritime license interview and the high-frequency terms of the small vessel educational textbook were identified and the corresponding nonstandard terms were examined. Based on a survey, an expert meeting was held and incorrect Japanese notation, English notation, and the standard language for key terms were presented to analyze which questionnaire was most familiar. The ratio of the use of standard words is relatively high in the case of nautical terms, however, the wrong Japanese notation is used more for engine terms; the analysis results by age and tonnage also generally use the Japanese notation and the use frequency of English notation was determined to be low. Based on this, short- and long-term plans for the use of standard words by small vessel seafarers were proposed, including the production of a standard language dictionary for terms used by these seafarers, a promotion of the importance of using standard terms, active education through educational institutions, and the systematic preparation and implementation of Korean-language education for foreign sailors.