• Title/Summary/Keyword: Medical Ultrasonography

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A Break-Even Analysis that Helps with Decision Making involving the Introduction of Ultrasonography (초음파기기 도입 시 의사결정 지원을 위한 손익 분석)

  • Yeo, Seong-Hee;Lee, Hae-Jong;Seo, Young-Joon;Kim, Young-Hoon
    • Korea Journal of Hospital Management
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    • v.14 no.3
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    • pp.23-48
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    • 2009
  • The purpose of this study was to provide criteria which help executives to make decisions through the analysis of profitability of ultrasonography conducted in each medical department. In order to achieve such purpose, the study conducted break-even analyses on three medical departments of a university hospital in which has used ultrasonography was largely conducted in diagnosing diseases and performing surgeries. The research was carried out from January to June 2008. The data necessary for calculating cost, were collected using by computerized data. The results of the study were summarized as follows. 1. The Cost structure of each medical department: The Cost of ultrasonography was divided into direct cost and indirect cost through the categorization by cost object. Labor cost accounted for the largest portion of the direct cost with 69.3% in the department of obstetrics and gynecology, 67.4% in the department of radiology and 58.2% in the cardiac ultrasonography center, which followed by the depreciation cost of ultrasonography equipment. The calculation of the average material cost of each ultrasonographic test by medical test found that the cardiac ultrasonography center took first place with 2,355 won, followed by the department of obstetrics and gynecology with 266 won and the department of radiology with 233 won. As for the power cost of ultrasonography equipment, the department of radiology took fist place with 442,000 won. The power cost, however, did not affect much the cost price, because it accounted for only a small portion of the cost. As for indirect cost, the cardiac ultrasonography center ranked first with 7,156,000 won. Building depreciation cost accounted for the largest portion of the indirect cost. 2. Break-even analysis: Under the supposition that cost price can be divided into fixed cost and variable cost, a break-even analysis was conducted using the cost price confirmed through the cost structure of each medical department. As for the average customary charge of ultrasonography test conducted in each medical department, the department of obstetrics and gynecology charged 24,627 won, the department of radiology 53,179 won and the cardiac ultrasonography center 65,174 won. According to these results, the charges of ultrasonography test imposed by the department of radiology and the cardiac ultrasonography center wre enough to surpass break-even levels, but the charge imposed by the department of obstetrics and gynecology was not enough to offset the cost price. In conclusion, labor cost accounted for the largest proportion of cost price of ultrasonography test conducted in diagnosing diseases and performing surgeries in medical departments, followed by the fixed cost of ultrasonographic equipment depreciation cost. In medical department where the current charge of ultrasonography test turned out not to offset cost price through the break-even analysis of ultrasonographic equipment, ways to reduce fixed cost which accounts for the largest proportion of the cost price should be sought. Even medical departments whose current charge of ultrasonography test is enough to surpass break-even level are required to work for efficient management and cost reduction to continuously generate profits.

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Diagnostic Value of Ultrasonography for Acute Tear of Tibiofibular Syndesmosis in Ankle (족관절 원위 경비 인대 결합의 급성 파열에 대한 초음파 검사의 진단적 의의)

  • Lee, Ho-Seung;Park, Soo-Sung;Kim, Ji-Wan;Shin, Myung-Jin;Kim, Sung-Moon;Lee, Sang-Hoon;Lee, Sang-Min
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.1-6
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    • 2004
  • Purpose: We studied the diagnostic value of ultrasonography to confirm the presence of the syndesmosis injuries in the ankle. Materials and Methods: Pre-operative ultrasonography were taken in 42 cases of ankle fractures to determine injury of syndesmosis between February 2000 and August 2003. Tear of syndesmosis was confirmed when they met the following criteria; widening of distal tibiofibular clear space greater than 7 mm on pre-operative AP X-rays, leakage of contrast dye during intra-operative arthrography, and operative findings revealing syndesmosis rupture. We compared these diagnoses with those made by pre-operative ultrasonography. Results: Syndesmosis injuries were confirmed in 23 cases among the total 42 cases. Ultrasonography revealed syndesmosis tear in 25 cases, with 20 cases corresponding with confirmed tear and 5 cases without tear in confirm. Syndesmoses were found to be intact in 17 cases of ultrasonograph, but 3 cases were actually confirmed tear. In ankle ultrasonography, the sensitivity was 90.9%, the specificity was 75.0%. Conclusion: Preoperative ultrasonography is a non-invasive and useful study to determine the syndesmosis injury in ankle fractures.

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Height-Based Formula Predicting Renal Length in Korean Children derived from Technesium-99m Dimercaptosuccinic Acid Scan

  • Cho, Myung Hyun;Yoo, Ha Yeong;Kwak, Byung Ok;Park, Hye Won;Chung, Sochung;Kim, Soo Nyung;Son, Jae Sung;Kim, Kyo sun
    • Childhood Kidney Diseases
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    • v.19 no.2
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    • pp.131-135
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    • 2015
  • Purpose: The aim of this study was to establish a simple formula to predict renal length in children using a Technesium-99m dimercaptosuccinic acid (DMSA) scan data, and to compare it with the formula derived from ultrasonography, which is widely accepted. Methods: Children who underwent a DMSA scan and ultrasonography were reviewed retrospectively, and those who had anatomical urinary tract abnormalities or urinary tract infections were excluded. Results: A total of 230 children (84 males and 146 females; age, 1 month to 16 years; mean age, $16.8{\pm}27.4$ months). Mean renal length measured by DMSA scan was longer than that by ultrasonography ($6.38{\pm}1.16$ vs. $6.02{\pm}1.14cm$; P < 0.001). Renal length was correlated with age, weight, height, and body surface area on the DMSA scan and ultrasonography, and showed the strongest positive correlation with height. The following formulae were established to predict renal length: mean renal length (cm) = 5.433 ${\times}$ height (m) + 2.330 (R2, 0.833) using the DMSA scan data, and mean renal length (cm) = 5.367 ${\times}$ height (m) + 2.027 (R2, 0.853) using ultrasonography data. Conclusion: We propose a simple height-based formula to predict renal length in children using a DMSA scan data, and validate it by comparing with ultrasonography formula.

Prediction of successful caudal epidural injection using color Doppler ultrasonography in the paramedian sagittal oblique view of the lumbosacral spine

  • Yoo, Seon Woo;Ki, Min-Jong;Doo, A Ram;Woo, Cheol Jong;Kim, Ye Sull;Son, Ji-Seon
    • The Korean Journal of Pain
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    • v.34 no.3
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    • pp.339-345
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    • 2021
  • Background: Ultrasound-guided caudal epidural injection (CEI) is limited in that it cannot confirm drug distribution at the target site without fluoroscopy. We hypothesized that visualization of solution flow through the inter-laminar space of the lumbosacral spine using color Doppler ultrasound alone would allow for confirmation of drug distribution. Therefore, we aimed to prospectively evaluate the usefulness of this method by comparing the color Doppler image in the paramedian sagittal oblique view of the lumbosacral spine (LS-PSOV) with the distribution of the contrast medium observed during fluoroscopy. Methods: Sixty-five patients received a 10-mL CEI of solution containing contrast medium under ultrasound guidance. During injection, flow was observed in the LSPSOV using color Doppler ultrasonography, following which it was confirmed using fluoroscopy. The presence of contrast image at L5-S1 on fluoroscopy was defined as "successful CEI." We then calculated prediction accuracy for successful CEI using color Doppler ultrasonography in the LS-PSOV. We also investigated the correlation between the distribution levels measured via color Doppler and fluoroscopy. Results: Prediction accuracy with color Doppler ultrasonography was 96.9%. The sensitivity, specificity, positive predictive value, and negative predictive value were 96.7%, 100%, 100%, and 60.0%, respectively. In 52 of 65 patients (80%), the highest level at which contrast image was observed was the same for both color Doppler ultrasonography and fluoroscopy. Conclusions: Our findings demonstrate that color Doppler ultrasonography in the LS-PSOV is a new method for determining whether a drug solution reaches the lumbosacral region (i.e., the main target level) without the need for fluoroscopy.

Mammography and Ultrasonography Reports Compared with Tissue Diagnosis - An Evidence Based Study in Iran, 2010

  • Akbari, Mohammad Esmaeil;Haghighatkhah, Hamidreza;Shafiee, Mohammad;Akbari, Atieh;Bahmanpoor, Mitra;Khayamzadeh, Maryam
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1907-1910
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    • 2012
  • Background: Breast cancer is the most prevalent cancer and the fifth cause of cancer death in Iranian women. Early detection and treatment are important for appropriate management of this disease. Mammography and ultrasonography are used for screening and evaluation of symptomatic cases and the main diagnostic test for breast cancer is pathological. In this study we evaluated mammography and ultrasonography as diagnostic tools. Methods: In this cross-sectional study 384 mammography and ultrasonography reports for 255 women were assessed, divided into benign and malignant groups. Suspected cases were referred for pathology evaluation. The radiologic and pathologic reports were compared and also comparison was performed based on age groups (more and less than 50 years old), history of breastfeeding and gravidity. Statistical analysis was performed by SPSS. Results: The mean ages of malignant and benign cases were $49{\pm}11.6$ and $43{\pm}11.2$ years, respectively. Sensitivity and specificity for mammography were 73% and 45%, respectively. Sensitivity and specificity for ultrasonography were 69% and 49%, respectively. There were statistical differences between specificity of mammography in patients based on factors such as history of gravidity, breastfeeding and sensitivity in patients equal or more than 50 years old and less. Conclusion: Factors affecting different results in mammography and ultrasonography reports were classified into three groups, consisting of skill, experience and training of medical staff, and setting of instruments. It is recommended that health managers in developing countries pay attention the quality of setting and man power more than current status. Policy-makers and managers must establish guidelines regarding breast imaging in Iran.

Ultrasonography-Combined with Nerve Stimulator Technique for Injection of the Genitofemoral Nerve in a Patient with Chronic Postoperative Inguinal Pain (수술 후 서혜부 만성 통증에서 신경 자극기를 이용한 초음파 유도하 음부대퇴신경 차단술)

  • Oh, Young-Bin;Shin, Hyun Baek;Ko, Myoung-Hwan;Seo, Jeong-Hwan;Kim, Gi-Wook
    • Clinical Pain
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    • v.18 no.1
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    • pp.36-39
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    • 2019
  • Chronic postoperative inguinal pain (CPIP) is a major complication after inguinal herniorrhaphy. We report the treatment of CPIP using ultrasonography-combined with nerve stimulator for injection of the genitofemoral nerve (GFN). A 59-year-old man underwent laparoscopic herniorrhaphy and presented with numbness from the inguinal region to the scrotum after operation. In the pain clinic, ultrasonography-guided GFN block and pharmacological treatments had little effect. Six month after operation, patient was referred to the Department of Physical Medicine and Rehabilitation, and ultrasonography-combined with nerve stimulator for GFN injection underwent to enhance the accuracy of neural approach. The induction of scrotal contraction and paresthesia on the GFN distribution was monitored by nerve stimulator and local anesthetic was injected. After the block, pain relief lasted for 6 months without analgesic use. Ultrasonography-combined with nerve stimulator is an effective approach to treat CPIP as it enhances precise localization and injection of small peripheral nerve like GFN.

A Case Report on 2 Cases of Patients with Uterine Fibroids Observed an Effective Result on Ultrasonography after Korean Traditional Medical Treatment (초음파를 이용하여 관찰한 자궁근종의 한의 치료 경과 고찰 2례 : 증례보고)

  • Gwak, Yu-Jin;Park, Sang-Hee;Jung, Myung-Ju;Park, Sung-Woo;Park, Ung;Jo, Hee-Guen
    • The Journal of Korean Obstetrics and Gynecology
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    • v.28 no.1
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    • pp.147-157
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    • 2015
  • Objectives: We report two cases that have an effective result with Korean traditional medical treatment to two patients who have uterine fibroids, using transabdominal ultrasonography for checking the size of uterine fibroids. Methods: A 44-year-old patient and a 43-year-old patient were treated with an herbal medicine, acupuncture and cupping therapy. We followed up the symptoms and the size of uterine fibroids. Results: The 44-year-old patient was asymptomatic, her size of the uterine fibroid was reduced for 6 months. Also, the 43-year-old patient experienced that the symptoms such as urinary frequency, ovulation pain, heavy bleeding were improved and the size of the uterine fibroid was reduced. Conclusions: This results suggest that Korean traditional medical treatment if effective for both asymptomatic and symptomatic uterine fibroids and ultrasonography is useful for checking the effect of Korean traditional medical treatment. Further case series and studies are warranted.

Tentative diagnosis and monitoring using ultrasound in a cat with pansteatitis: a case report

  • Kang, Hyesun;Noh, Daji;Lee, Sang-Kwon;Lee, Kija
    • Korean Journal of Veterinary Research
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    • v.62 no.1
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    • pp.7.1-7.4
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    • 2022
  • A 7-year-old Scottish Straight cat presented with hypersalivation and generalized hyperesthesia. The cat was provided tuna-based food for 2 to 3 weeks before clinical symptoms appeared. Abdominal ultrasonography showed a heterogeneous, hyperechoic mesentery with hypoechoic foci. Pansteatitis was tentatively diagnosed and the cat was treated with vitamin E, anti-inflammatory drugs, and dietary changes. The clinical signs and changes in mesenteric fat on serial ultrasonography resolved. After feeding tuna-based food again, the same clinical signs and mesenteric changes on ultrasound recurred, which recovered through the same treatment. This study suggests that ultrasonography can be useful for diagnosis and monitoring of feline pansteatitis.

Effects of Age, Breast Density and Volume on Breast Cancer Diagnosis: A Retrospective Comparison of Sensitivity of Mammography and Ultrasonography in China's Rural Areas

  • Wang, Feng-Liang;Chen, Fei;Yin, Hong;Xu, Nan;Wu, Xiao-Xiang;Ma, Jing-Jing;Gao, Shen;Tang, Jin-Hai;Lu, Cheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2277-2282
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    • 2013
  • Purpose: Mammography has been confirmed as the only effective mode to improve the prognosis of patients with breast cancer in Western developed countries, but might not be a good choice in other areas of the world. One of the major challenges in China is to determine an optimal imaging modality for breast cancer screening. This study was designed to clarify the sensitivity of ultrasonography compared with that of mammography in rural China. Methods: We retrospectively studied the sensitivity of mammography and ultrasonography based on 306 breast cancer patients detected by the program of "screening for cervical cancer and breast cancer" performed in Chinese rural areas between January 2009 and December 2011, and analyzed the effects of age, breast density and volume on the sensitivity. Results: Stratified analysis showed that the sensitivity of breast ultrasonography was significantly higher than that of mammography in premenopausal patients (81.4% vs. 61.1%, p=0.02), in women ${\leq}$ 55 years of age (82.2% vs. 63.4%, p<0.01), in the high breast density group (American College of Radiology [ACR] levels 3-4) (85.9% vs. 60.6%, p<0.01) and in the small breast volume group (${\leq}$ 400 ml) (87.1% vs. 66.7%, p<0.01). Age had a significant effect on sensitivity of mammography (breast density and volume-adjusted odds ratio, 6.39; 95% confidence interval, 2.8-14.4 in age group > 55 compared to age group ${\leq}$ 45), but not that of ultrasonography. Neither breast density nor volume had significant effect on sensitivity of mammography or ultrasonography. Conclusions: Ultrasonography is more sensitive than mammography in detecting breast cancer in women under 55 year-old Chinese, especially in those with high-density and relatively small breasts.

An Efficiency of Diagnostic Ultrasonography in Taking Side View of Medical Examination (진사적(診査的) 측면(側面)에서 본 초음파진단(超音波診斷)의 효율성(效率性))

  • Moon, Soo-Hyung;Han, Hye-Jin;Kim, Kang-Sueck
    • The Journal of the Korean life insurance medical association
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    • v.1 no.1
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    • pp.123-132
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    • 1984
  • Among the person who want to insure, there are not only fair persons who want to become the insurance with not realizing that one was not infected with certain disease but also someones on purpose to overcome the disease through the insurance company with be recognized by oneselves. However, it was found that the ultrasonography and exact effects of medical examination with the existing medical equipments of the insurance company could not be expected. We present some several proven examples for the purpose of getting the advanced effects in medical examination by utilizing the ultrasonic device which is not harmful to human body presently as far as known. We could find affirmation through the check of ultrasonography from 907 cases, in our Department of Medical selection that many portion of the cases checked the medical examination have the present condition of illness even though they enjoy social life with good health and finally the conclusions we have learned are as follows; The aged cases show the increase of rate of possessing disease and man shows 2.2 times of possessing disease than woman. Fatty infiltration of liver take portion of 74.7% from the case checked. 12 cases of cholelithiasis are not conscious of symptom at all. Through the check of ultrasonography in obstetrics and gynecology, myoma uteri be showed high rate of 72.2% from the case of possessing disease. In Case of the potential pregnancing woman it made clear to find pregnancy which was undistincted still more also know the existence and nonexistence of fetal death when pregnancy expected.

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