• Title/Summary/Keyword: Medical statistics

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Computer Simulations of Hoffman Brain Phantom:Sensitivity Measurements and Optimization of Data Analysis of 〔Tc-99m〕ECD SPECT Before and After Acftazolamide Administraton (Acetazolamide 사용전후 〔Tc-99m〕 EDC SPECT 데이타 분석 방법의 최적화 및 민감도 측정)

  • Kim, Hee-Joung;Lee, Hee-Kyung
    • Progress in Medical Physics
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    • v.6 no.2
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    • pp.71-81
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    • 1995
  • Consecutive brain 〔Tc-99m〕ECD SPECT studies before and after acetazolamide (Diamox) administration have been performed with patients for the evaluation of cerebrovascular hemodynamic reserve. However, the quantitaitve potential of SPECT Diamox imaging is limited as a result of degrading fractors such as finite detector resolution, attenuation, scatter, poor counting statistics, and methods of data analysis. Making physical measurements in phantoms filled with known amounts of radioactivity can help characterize and potentially quantify the sensitivities. However, it is often very difficult to make a realistic phantom simulating patients in clinical situations. By computer simulation, we studied the sensitivities of ECD SPECT before and after Diamox administration. The sensitivity is defined as ($\Delta$N/N)/($\Delta$S/S)$\times$100%, where $\Delta$N denotes the differences in mean counts between post-and pre-Diamox in the measured data, N denotes the mean counts before Diamox in the measure data, $\Delta$S denotes the differences in mean counts between post-and pre-Diamox in the model, and S denotes the mean counts before Diamox in the model. In clinical Diamox studies, the percentage changes of radioactivity could be determined to measure changes in radioactivity concentration by Diamox after subtracting pre-from post-Diamox data. However, the optimal amount of subtraction for 100% sensitivity is not known since this requires a thorough sensitivity analysis by computer simulation. For consecutive brain SPECT imaging model before and after Diamox, when 30% increased radioactivity concentrations were assingned for Diamox effect in model, the sensitivities were measured as 51.03, 73.4, 94.00, 130.74% for 0, 100, 150, 200% subtraction, respectively. Sensitivity analysis indicated that the partial voluming effects due to finite detector resolution and statistical noise result in a significant underestimation of radioactivity measurements and the amount of underestimation depends on the. % increase of radioactivity concentration and % subtraction of pre-from post-Diamox data. The 150% subtraction appears to be optimal in clinical situations where we expect approximately 30% changes in radioactivity concentration. The computer simulation may be a powerful technique to study sensitivities of ECD SPECT before and after Diamox administration.

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The Clinical Study on Correlation between Knee Osteoarthritis and Obesity (퇴행성 슬관절염과 비만과의 상관성에 관한 임상 연구)

  • Kang, Jung-Won;Ryu, Seong-Ryong;Seo, Byung-Kwan;Cho, Mi-Ran;Cho, Ryo-Won;Woo, Hyun-Su;Lee, Sang-Hoon;Choi, Do-Young;Kim, Keon-Sik;Lee, Doo-Ik;Lee, Yun-Ho;Lee, Jae-Dong
    • Journal of Acupuncture Research
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    • v.22 no.6
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    • pp.17-26
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    • 2005
  • Objectives : The purpose of this study is to investigate the correlation between assessment measurements of knee osteoarthritis and obesity. Methods : Data on assessment measurements of knee osteoarthritis and obesity were obtained from 63 patients suffering from knee osteoarthritis from February to April, 2005. The assessment measurements consisted of BMI (body mass index), WHR (waist-hip ratio), two disease-specific questionnaires (Western Ontario and McMaster Universities (WOMAC) index and Lequesne's Functional Severity Index (LFI)), one generic instrument (Korean Health Assessment Questionnaire (KHAQ)), and VAS (Visual Analogue Scale). Statistical correlations among assessment measurements were evaluated by examining the Pearson's correlation coefficients. Results : 1. The sexual ratio in this study was 1: 5.3 (male: female= 10: 53). The average age of all patients was $59.1{\pm}6.6$ (male: $58.3{\pm}7.1$, female: $59.2{\pm}6.5$), and the group of 60-69 (34 patients, 54%) was biggest in the age distribution. 2. The average BMI of all patients was $25.4{\pm}3.1\;kg/m^2$ (male: female= $23.6{\pm}2.6\;kg/m^2:\;25.8{\pm}3.0\;kg/m^2$), and the group of $20-25\;kg/m^2$ was biggest in the BMI distribution. According to clinical definition of obesity by WHO (1997), 52.4% of all patients was within normal weight, 42.9% was overweight, and 4.8% was obese. 3. The average WHR of all patients was $0.91{\pm}0.06$ (male: female= $0.90{\pm}0.05:\;0.92{\pm}0.06$). According to definition of abdominal obesity, 73.0% of all patients (46 patients were all female) was in the state of abdominal obesity. 4. There were no significant correlations in statistics among assessment measurements except between BMI and WHR. Conclusion : Though there is significant correlation between knee osteoarthritis and obesity according to many clinical and experimental researches, there is no assessment measurement reflecting knee osteoarthritis and obesity simultaneously. For this, further studies on correlation between knee osteoarthritis and obesity and development of assessment measurement or questionnaire on this are needed.

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The Study of Influence on Reducing Exposure Dose According to the Applied Flat-panel CT in Extremity Bone SPECT/CT (상·하지 뼈 SEPCT/CT 검사에서 평판형 CT의 피폭저감 영향에 관한 고찰)

  • Kim, Ji-Hyeon;Park, Hoon-Hee;Lee, Juyoung;Nam-Kung, Sik;Son, Hyeon-Soo;Park, Sang-Ryoon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.15-24
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    • 2013
  • Purpose: With the demand of SPECT/CT increasing, the interest in complex diagnostic information of CT is rising along with the expansion of various studies on potential performance value. But the study on reduction of exposure dose generated by CT is not being conducted enough. Therefore, in this study, the goal is to identify how much dose reduction exists when performing the extremity bone SPECT/CT using the flat-panel CT. Materials and Methods: The extremity bone SPECT/CT was performed with two equipments -BrightView XCT (Philips Healthcare, Cleveland, USA) and Brilliance 16 CT (Philips Healthcare, Cleveland, USA)-to identify the exposed dose and image quality resulted by changing scan parameter (mAs) applying for both equipment respectively. The noise value of image and spatial resolution were measured with AAPM CT phantom. Tube voltage (kVp) was fixed to 120 kVp, tube current (mAs) calculated at different mA (20, 30, 40, 50, 60, 70, 80) was applied to both equipments respectively. DLP (dose length product) were calculated at the same distance at respective mAs. Also, we acquired images and % contrast with NEMA IEC body phantom to confirm the effect on image. The output of statistics was analyzed by SPSS ver.18. Results: Regarding AAPM phantom, the noise decreased as the tube current (mAs) increased and flat-panel had less noise than Helical CT. This difference increased at lower dose exposure. As to the evaluation of spatial resolution, we can differentiate the space up to 0.75 mm with both equipments. With scan parameter (mA) growing, the value of DLP increased up to 54-216 mGy cm at flat-panel CT and up to 177-709 mGy cm at Helical CT. Regarding NEMA IEC body phantom, same sphere with varied parameter (mA) shows that similar results. Conclusion: There is no significant differences of image quality in both flat-panel and Helical CT when the scan parameter (mA) is changed respectively. Moreover, we can identify the reduction of exposure dose and confirm %contrast analysis value with maintaining image quality. Therefore, at the extremity bone SPECT/CT requiring high spital resolution without the wide ROI, the flat-panel CT is considered to be more useful and it expected to result in the similar image quality with lower exposure dose compared to Helical CT. Additionally, through this study, we expect to help the reduction of the unnecessary exposure dose.

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Factors Related to Serum Vitamin C Level in Terminally Ill Cancer Patients (말기암환자에서 혈청 비타민 C 농도와 연관된 인자들)

  • Kim, Hyung Jun;Hwang, In Cheol;Yeom, Chang Hwan;Ahn, Hong Yup;Choi, Youn Seon;Lee, Jae Jun;Lim, Su Hyuk
    • Journal of Hospice and Palliative Care
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    • v.17 no.4
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    • pp.241-247
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    • 2014
  • Purpose: Serum vitamin C is one of the indicators for antioxidant levels in the body and it is lower in cancer patients compared with the healthy population. However, there have been few studies on the levels of serum vitamin C in terminally ill cancer patients and related factors. Methods: We followed 65 terminal cancer patients who were hospitalized in two palliative care units. We collected data of age, sex, cancer type, functional status, clinical symptoms, history of cancer therapy, and various laboratory findings including serum vitamin C level. Patients were categorized into two groups according to the quartile of serum vitamin C level (Q1-3 vs. Q4), which were compared each other. Stepwise multiple logistic regression analysis was used to identify factors related to serum vitamin C levels. Results: The mean serum vitamin C level was $0.44{\mu}g/mL$, and all patients fell into the category of vitamin C deficiency. Univariate analysis showed that The serum vitamin C level was lower in non-lung cancer patients (P=0.041) and febrile patients (P=0.034). Multivariate analysis adjusted for potential confounders such as lung cancer, fever, dysphagia, dyspnea, C reactive protein, and history of chemotherapy demonstrated that odds for low serum vitamin C level was 3.7 for patients receiving chemotherapy (P=0.046) and 7.22 for febrile patients (P=0.02). Conclusion: Vitamin C deficiency was very severe in terminally ill cancer patients, and it was associated with history of chemotherapy and fever.

A Study on the Oral Health Behavior of High School Students in Jeolla-bukdo (전북지역 일부 고등학생의 구강보건형태에 관한 연구)

  • Yu, Mi-Sun;Goo, Kyong-Mi;Kim, Jeong-Suk
    • Journal of dental hygiene science
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    • v.9 no.2
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    • pp.225-230
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    • 2009
  • This study executed questionnaire 388 high school boy students in Jeolla-bukdo Namwon from June 9, 2008 to 20th prepares basic data about boy student's oral health behavior, and examines closely the connection factor and plans oral health promotion. Questionnaire distributed getting classroom teacher's cooperation and reclaimed through classroom teacher after make questionnaire by students. The collected data executed Chi-square test and descriptive statistics using SPSS program and the result is as following. 1. Response that responded that students of 61.1% are 2 times in toothbrushing number of times on 1 day, and appeared by thing which 69.1% does toothbrushing most much after way in the morning, and cleans up and down by toothbrushing method was the most by 36.6%. A student of only 8.5% was using auxiliary oral hygiene devices. 2. The oral medical examination and treatment engine use experience rate was 93.6%, and students of 82.9% do treatment as reason by last oral medical examination and treatment use purpose and did coming to help. The 1 year within use experience rate was 47.7%, and students of 77.1% were satisfied for medical examination and treatment. 3. Toothbrushing frequency of smoked students appeared low compared to students woo do not smoke, and students, who do drinking, was expose toothbrushing number by 3 limes compared to students who do not. 4. The activity limitation experience rate by oral disease was 16.0%, and the year absence experience rate was 5.2%, and the studies achievement hindrance experience rate appeared by 13. 1%. As a result, is considered to strengthen on-time oral medical examination and oral health education, and need prevention and policy of early treatment putting first.

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Relationship between Knee Function at 1 Year Postoperation and Gap Difference (90° Flexion Gap-Extension Gap) in Total Knee Replacement (간격 차이(90° 굴곡 간격-신전 간격)와 슬관절 전 치환술 1년 후의 무릎 기능과의 관계)

  • Cho, Myung-Rae;Do, Jung-Suk;Kim, Kyung-Tae;Choi, Won-Kee
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.254-260
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    • 2019
  • Purpose: To evaluate the relationship between the knee function at 1 year postoperation and the gap difference (90° flexion gap-extension gap) in total knee replacement. Materials and Methods: Eighty-two consecutive osteoarthritis knees that underwent primary total knee replacement using navigation from March 2017 June 2017 were evaluated prospectively. The gap was measured using navigation after reducing the patella with towel clips. After checking the average values of the medial and lateral gaps at extension and 90° flexion knee, the gap difference (90° flexion gap-extension gap) was calculated. The knees were divided into three groups according to the gap difference (gap difference<0 mm, 0 mm≤gap difference<2 mm, 2 mm≤gap difference). The Knee Society score (KSS) and maximal knee flexion were compared at 1 year postoperation among three groups. Results: The numbers of knees according to groups were 37, 29, and 16 knees in regular order. The average of the KSS knee, KSS function, and maximal knee flexion at the 1-year follow-up were 81.21±8.31, 71.34±9.84, and 126.48°±7.28°, respectively. No statistically significant difference in KSS was observed among the 3 groups. The third group (2 mm≤gap difference) showed a larger maximal knee flexion than the other groups in the Mann-Whitney test. Conclusion: The group of total knee replacement (2 mm≤90° flexion gap-extension gap) showed larger maximal knee flexion than the other groups at the 1-year follow-up in statistics.

Survey of Operation and Status of the Human Research Protection Program (HRPP) in Korea (2019) (임상시험 및 대상자보호프로그램의 운영과 현황에 대한 설문조사 연구(2019))

  • Maeng, Chi Hoon;Lee, Sun Ju;Cho, Sung Ran;Kim, Jin Seok;Rha, Sun Young;Kim, Yong Jin;Chung, Jong Woo;Kim, Seung Min
    • The Journal of KAIRB
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    • v.2 no.2
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    • pp.37-48
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    • 2020
  • Purpose: The purpose of this study is to assess the operational status and level of understanding among IRB and HRPP staffs at a hospital or a research institute to the HRPP guideline set by the Ministry of Food and Drug Safety (MFDS) and to provide recommendations. Methods: Online survey was distributed among members of Korean Association of IRB (KAIRB) through each IRB office. The result was separated according to topic and descriptive statistics was used for analysis. Result: Survey notification was sent out to 176 institutions and 65 (37.1%) institutions answered the survey by online. Of 65 institutions that answered the survey; 83.1% was hospital, 12.3% was university, 3.1% was medical college, 1.5% was research institution. 23 institutions (25.4%) established independent HRPP offices and 39 institutions (60.0%) did not. 12 institutions (18.5%) had separate IRB and HRPP heads, 21 (32.3%) institutions separated business reporting procedure and person in charge, 12 institutions separated the responsibility of IRB and HRPP among staff, and 45 institutions (69.2%) had audit & non-compliance managers. When asked about the most important basic task for HRPP, 23% answered self-audit. And according to 43.52%, self-audit was also the most by both institutions that operated HRPP and institutions that did not. When basic task performance status was analyzed, on average, the institutions that operated HRPP was 14% higher than institutions that only operated IRB. 9 (13.8%) institutions were evaluated and obtained HRPP accreditation from MFDS and the most common reason for obtaining the accreditation was to be selected as Institution for the education of persons conducting clinical trial (6 institutions). The most common reason for not obtaining HRPP accreditation was because of insufficient staff and limited capacity of the institution (28%). Institutions with and without a plan to be HRPP accredited by MFDS were 20 (37.7%) each. 34 institutions (52.3%) answered HRPP evaluation method and accreditation by MFDS was appropriate while 31 institutions (47.7%) answered otherwise. 36 institutions answered that HRPP evaluation and accreditation by MFDS was credible while 29 institutions (44.5%) answered that HRPP evaluation method and accreditation by MFDS was not credible. Conclusion: 1. MFDS's HRPP accreditation program can facilitate the main objective of HRPP and MFDS's HRPP accreditation program should be encouraged to non-tertiary hospitals by taking small staff size into consideration and issuing accreditation by segregating accreditation. 2. While issuing Institution for the education of persons conducting clinical trial status as a benefit of MFDS's HRPP accreditation program, it can also hinder access to MFDS's HRPP accreditation program. It should also be considered that the non-contact culture during COVID-19 pandemic eliminated time and space limitation for education. 3. For clinical research conducted internally by an institution, internal audit is the most effective and sole method of protecting safety and right of the test subjects and integrity for research in Korea. For this reason, regardless of the size of the institution, an internal audit should be enforced. 4. It is necessary for KAIRB and MFDSto improve HRPP awareness by advocating and educating the concept and necessity of HRPP in clinical research. 5. A new HRPP accreditation system should be setup for all clinical research with human subjects, including Investigational New Drug (IND) application in near future.

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A Study on the Clinical Statistics of Oriental Medicine Service in the Health Center (보건소내(保健所內) 한방의료(漢方醫療)에 대(對)한 임상통계연구(臨床統計硏究) (전주시(全州市) 완산구(完山區) 보건소(保健所) 중심으로))

  • Song, Beom-Yong;Yuk, Tae-Han
    • The Journal of Korean Medicine
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    • v.18 no.1
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    • pp.40-57
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    • 1997
  • The Background and Purpose It is done the study on the public health care of oriental medicine and improvement of its system recently, I think that these effect a good health care for a people through the public health care of oriental medicine. Since Woosuk university and Chonju-Wansan health center had taken upon the oriental medicine service in the health center in 1995, we have public favor from the local population. So in other to a study on the clinical statistics of oriental medicine service in the health center, I investigated general character, style of diseases, effect of treatments and the like for a paitents received oriental medicine treatments in there. Objective and Methods This study researched into clinical statistics for paitents received oriental medicine treatments in the Chonju-Wansan health center during one year period from January 4 1996 to December 26 1996. The number of object was 238 case of 234 persons. Results and Conclusions Analyzing these 234 persons, the proportion of males to females was 1 to 6.8. As for the distribution of age, the ages of 61 to 70 occupied 34.62 per cent in the ages of 51 to 90 occupied 88.89 per cent in the whole paitons. Therefor female was very highly more than male and paitents were for the most part, old ages(51years old and over). Musculoskeletal system and connective tissue disease of 238 case occupied 82.77 per cent. were the greatest proportion. At the duration of disease, 1 year to 5 years occupied 32.35 per cent, was the highest The grade Ⅲ was the most of the sign of paitents at first visit, it occupied 55.88 per cent. The good(++) and over effect of treatments occupied 62.18 per cent, the fair(+) and over effect of treatments occupied 78.99 per cent. As for the duration of treatment, the case of 2 times to 5 times visit occupied 34.03 per cent, was the highest. And the case of 2 times to 10 times visit was 4 times as good effect as the case of only one visit. By medication of treatment, O-Juk-San(五積散) occupied 32.21 per cent, was the greatest proportion, and Pal-Mj-Hoan(八味丸) occupied the second greatest proportion. Therefor the most of paitents had the chronic diseases and was diagnosed Sin-Yang-He(腎陽虛). The average 22.58 persons received acupuctural treatment a day, the average 0.58 persons received the moxibustion a day, the average 2.28 persons received venesection (bloodletting) a day. And others treatment performed physical therapy and the like. The case received treatment of the oriental and western medicine at the same time. marked 21 persons among 30 persons and had a good effect by 70 per cent. The average 26.95 persons received treatment of oriental medicine a day, the average 3.9 persons received the first medical examination a day.

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Analysis on Relevant Factors in Practice of Prevention for Infections in Dental Clinics - (Focusing on Dental Hygienists) (치과 진료실 감염예방 실천도의 관련요인 분석 (치과위생사를 중심으로))

  • Nam, Young-Shin
    • Journal of dental hygiene science
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    • v.8 no.3
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    • pp.189-198
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    • 2008
  • Objective: The study aimed to provide basic data for enhancing dental hygienists' practice of prevention for infections of dental hygienists by examining what factors there were in their preventing the infections in dental clinics. Method: The subjects of study were 168 dental hygienists who participated in continuing medical education of Incheon & Gyeonggi-do association and Seoul city association in October and November 2005. For the data analysis, an SPSS WIN 13.0 program was used and its significance level was 0.05. In terms of analysis methods, frequency analysis and technical statistics analysis were performed for general characteristics, ANOVA was performed for general traits, practice, medical environments for knowledge and practice analysis, correlation analysis was performed for the relation between knowledge & organization-related factors and practice, Chi-Square Tests were performed for the relation between general traits and educational experiences, T-test was performed for practice and knowledge according to the educational experiences for preventing infections and multiple regression analysis was performed for the factors that affect the practice for preventing infections. Result: knowledge showed statistically significant differences by age (F=4.895, p=0.003) and those with the education experiences in preventing infections had higher scores in practice of prevention for infections than those without them (t=3.315, p=0.001). The correlation between knowledge and practice was significant statistically (p<0.05), the factors related to organization showed significant correlation (p<0.01) and the higher the factors related to organizations, knowledge, education experiences, service career, the higher the practice for prevention of infections was ($R^2=0.32$). Conclusions: In order to enhance the dental hygienists' practice for the prevention of infections, it would be necessary to treat the contents of the infection prevention in educational curriculum at schools and enhance dental hygiene students' knowledge on the prevention of infection and to develop the programs, with which continuous education and PRS could be conducted through in-house education and continuing medical education of the hospital after school graduation and it has been believed that it would be the most important for dental hygienists to make efforts and interest in organizations actively so as to build up safe working environments.

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The Structure of Korean Radiation Oncology in 1997 (국내 병원 별 방사선치료의 진료 구조 현황(1997년 현황을 중심으로 한 선진국과의 비교 구))

  • Kim Mi Sook;Yoo Seoung Yul;Cho Chul Koo;Yoo Hyung Jun;Yang Kwang Mo;Je Young Hoon;Lee Dong Hun;Lee Dong Han;Kim Do Jun
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.172-178
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    • 1999
  • Purpose : To measure the basic structural characteristics of radiation oncology facilities in Korea during 1997 and to compare personnel, equipments and patient loads between Korea and developed countries. Methods and Materials : Mail serveys we conducted in 1998 and data on treatment machines, personnel and peformed new patients were collected. Responses were obtained from the 100 percent of facilities. The consensus data of the whole country were summarized using Microsoft Excel program. Results: In Korea during 1997, 42 facilities delivered megavoltage radiation theraphy with 71 treatment machines, 100 radiation oncologists, 26 medical physicist, 205 technologists and 19,773 new patients. Eighty nine percent of facilities in Korea had linear accelators at least 6 MeV maximum photon energy. Ninety five percent of facilities had simulators while five percent of facilities had no simulator, Ninety one percent of facilities had computer planning systems and eighty three percent of facilities reported that they had a written quality assurance program. Thirty six percent of facilities had only one radiation oncologist and thirty eight percent of facilities had no medical physicists. The median of the distribution of annual patients load of a facility, patients load per a machine, patients load per a radiation oncologist, patients load per a therapist and therapists per a machine in Korea were 348 patients per a year, 263 patients per a machine, 171 patients per a radiation oncologist, 81 patients per a therapist, and 3 therapists per a machine respectively. Conclusions : The whole scale of the radiation oncology departments in Korea was smaller than Japan and USA in population ratio regard. In case of hardware level like linear accelerators, simulators and computer planning systems, there was no big differences between Korea and USA. The patients loads of radiation oncologists and therapists had no significant differences as compared with USA. However, it was desirable to consider the part time system in USA because there were a lot of hospitals which did not employ medical physicists.

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