• Title/Summary/Keyword: condition evaluation method

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Recovery of Pulmonary Function according to the Operative Sites after General Anesthesia (전신마취를 이용한 수술에서 수술부위에 따른 폐기능의 회복)

  • Kim, Hyeon-Tae;Lee, Sang-Moo;Uh, Soo-Taek;Chung, Yeon-Tae;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.3
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    • pp.250-258
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    • 1993
  • Background: After general anesthesia, decrease of functional residual capacity and lung compliance, ventilation/perfusion imbalance, and transpulmonary shunting can provoke hypoxemia during postoperative periods. Diaphragmatic dysfunction may be the main cause of these physiological abnormalities. Thus, we evaluated the change of pulmonary function after general anesthesia according to the operative sites, which could suggest clinical course and critical period of respiratory care of postoperative patients. Method: Preoperative portable spirometric evaluation and arterial blood gas analysis were performed at sitting or most-sitting position just previous day of surgery. Pulmonary function tests were also as same condition from postoperative day 1 to day 5. Results: 1) For thoracic surgery, FEV1 and FVC were not recovered at day 5, but FEV1/FVC was not decreased. $PaCO_2$ was slightly elevated at postoperative one day. 2) After upper abdominal surgery, postoperative day 5 did not show the recovery of FEV1 and FVC, but mild hypoxemia was developed at postoperative day 1. 3) Pulmonary function was recovered as preoperative value at postoperative day 5 in lower abdominal operation, but mild hypoxemia was also noted at postoperative day 1. 4) Surgery of peripheral areas did not show significant pulmonary function change and hypoxemia and hypercapnia from postoperative day 1. Conclusion: Surgery involving diaphragm provoke significant postoperative pulmonary function change after day 5. For the operation of peripheral sites adequate respiratory care during operation and postoperative period within 24 hours could prevent patients from respiratory complication.

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Evaluation of the Accuracy for Respiratory-gated RapidArc (RapidArc를 이용한 호흡연동 회전세기조절방사선치료 할 때 전달선량의 정확성 평가)

  • Sung, Jiwon;Yoon, Myonggeun;Chung, Weon Kuu;Bae, Sun Hyun;Shin, Dong Oh;Kim, Dong Wook
    • Progress in Medical Physics
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    • v.24 no.2
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    • pp.127-132
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    • 2013
  • The position of the internal organs can change continually and periodically inside the body due to the respiration. To reduce the respiration induced uncertainty of dose localization, one can use a respiratory gated radiotherapy where a radiation beam is exposed during the specific time of period. The main disadvantage of this method is that it usually requests a long treatment time, the massive effort during the treatment and the limitation of the patient selection. In this sense, the combination of the real-time position management (RPM) system and the volumetric intensity modulated radiotherapy (RapidArc) is promising since it provides a short treatment time compared with the conventional respiratory gated treatments. In this study, we evaluated the accuracy of the respiratory gated RapidArc treatment. Total sic patient cases were used for this study and each case was planned by RapidArc technique using varian ECLIPSE v8.6 planning machine. For the Quality Assurance (QA), a MatriXX detector and I'mRT software were used. The results show that more than 97% of area gives the gamma value less than one with 3% dose and 3 mm distance to agreement condition, which indicates the measured dose is well matched with the treatment plan's dose distribution for the gated RapidArc treatment cases.

Research on the Actual Condition of the radiation Safety Management(RSM) for the Educated Training of the Dental Diagnostics X-ray Generators (교육용 치과 엑스선 발생장치에 대한 방사선 안전 관리 실태 조사)

  • Lee, Mihyeon;Yu, Yunsik;Lee, Jaeseung;Im, Inchul
    • Journal of the Korean Society of Radiology
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    • v.8 no.7
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    • pp.467-477
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    • 2014
  • The purpose of this study is to offer data base for establishment of dental training x-ray generator based safety usage through surveying real radiation safety management state of radiation worker's in plan of operations that have dental training x-ray generators and use it. For it, comprehensive references were surveyed referring reports of current state of regulation technique development and domestic radiation safety evaluation and nuclear related legislation regarding radiation safety management of dental training x-ray generators. On the basis of it, questionnaires were filled in about respondent's general characteristic radiation safety manager's status current state of radiation safety management and the level of knowledge & consciousness. For the study, the survey was conducted to 224 people of radiation safety managers and university graduates training assistants and full-time professors who can treat dental training x-ray generators in education center. through this survey 95 questionnaires were used as analysis materials except the insufficient and omitted responses. As a method of analysis, the frequency and percentage were figured out with the general characteristics and safety manager's status. Chi-square test for frequency and correlation per question analysis and Pearson correlation analysis for crosslevel correlation were done with current state of radiation safety management and knowledge & consciousness level. As a result, running dental training x-ray generators was dealt with by 20's to 40's who have high education level over post undergraduate degree and major in dental hygienic. In addition, female have higher consciousness level for radiation safety management than male. It shows significal linear relation statistically(${\chi}^2$ >5, 0.1${\chi}^2$ >5, 0.3${\chi}^2$ >5, 0.3

Evaluation on Reproducibility of Low-Dose Kidney Scan in Dynamic Kidney Scan (동적신장검사에서 저선량을 사용한 신장검사의 재현성 평가)

  • Lee, Jaesang;Lee, Kyuchan;Lee, Seunghwan;Bae, Seongbok;Park, Jongyeop
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.1
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    • pp.59-65
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    • 2016
  • Purpose Dynamic kidney scan is a typical imaging technique that visualizes kidney function. Reproducibility of dynamic kidney scans has been evaluated by comparing low-dose kidney scans with low-dose radiopharmaceutical and standard dynamic kidney scan. With this comparative study, if reproducibility is superb, the dynamic kidney scan method with reduced radioactivity to patients is to be utilized and radiation exposure to patient is to be reduced. Materials and Methods For gamma camera, Orbiter, SymbiaE (Siemens, Germany) was used. Among patients who had used 370 Mbq (10 mCi) from January of 2013 to February 2014 and other patients who had used 185 Mbq (5 mCi) from March of 2014 to July of 2015 with identical condition, 21 subjects using DTPA and 20 subjects using $MAG_3$, 41 subjects in total, had been selected as subjects for data. From renogram of the result image, frame of the peak point was selected. Then, region of interest of kidney and background had been selected and Kidney to Background Ratio has been calculated for comparison. Results In tests using DTPA, kidney to background ratio when using 370 Mbq was $5.67{\pm}0.8$ at average while it was $5.62{\pm}0.87$ when using 185 Mbq, which didn't show much difference. Also in the tests using $MAG_3$, kidney to background ratio when using 370 Mbq was $14.95{\pm}2.58$ at average and $14.56{\pm}2.02$ in 185 Mbq, which neither showed much difference. In paired sample t-test, p-value was 0.566 in DTPA and 0.363 in $MAG_3$, which confirmed that there was no difference between the groups. Conclusion In identical patients, when dose was decreased from 370 Mbq to 185 Mbq, reproducibility of dynamic kidney scan was proven to be excellent. Low-dose Dynamic kidney scan can achieve results with fine reproducibility without improvement in performance of gamma camera and is expected to reduce radiation exposure to patient.

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Clinical Analysis of Video Assisted Thoracic Surgery for the Treatment of Thoracic Empyema (비디오 흉강경을 이용한 농흉수술의 임상분석)

  • Oh, Sang-Gi;Song, Sang-Yun;Yun, Chi-Hyeong;Na, Kook-Ju;Kong, Kang-Eun;Park, Song-Ran;Kim, Sang-Hyung
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.139-143
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    • 2010
  • Background: Thoracic empyema remains a serious problem despite the availability of modern diagnostic methods and appropriate antibiotics. The condition presents in many different forms and stages that require different therapeutic options. Video-assisted thoracic surgery (VATS) has become increasingly popular for use in the treatment of empyema. Material and Method: From January 2005 to May 2009, VATS was performed in 36 patients with pleural empyema and for whom chest-tube drainage and antibiotic therapy had failed or the CT scan showed multiseptate disease. The perioperative clinical factors were analyzed for all the study patients. Result: All the patients underwent VATS, but it was necessary to convert to thoracotomy in one patient. The mean operation time was $90{\pm}38.5\;min$. For the operative evaluation, 11 patients were compatible with ATS stage III. The duration of chesttube insertion was $11.9{\pm}5.8$ (3~24) days. One patient did not improve and therefore this patient underwent additional open drainage. At discharge, costophrenic angle blunting was observed in 22 patients, pleural thickening was noted in 20 patients, both were noted in 17 patients and neither was noted in 11 patients. However, at follow-up, each of these changes was observed in 9, 7, 4 and 24 patients, respectively. All except one patient showed radiographic improvement. Conclusion: VATS is suitable for the treatment of early and fibrinopurulent thoracic empyema, and even in selected patients with stage III disease.

Determination of Short Term Prognosis Among Chronic Obstructive Lung Disease with Acute Respiratory Failure According to Simplified Acute Physiology Score (만성 폐쇄성 폐질환에서 급성 호흡부전 발생시 Simplifed Acute Physiology Score에 따른 단기예후의 평가)

  • Lee, Sang-Pyo;Sung, Yun-Up;Kim, Sang-Hoon;Kim, Bong-Sik;Kim, Young-Jun;Park, In-Won;Choi, Byung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.532-539
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    • 1993
  • Background: Physician's estimates of patient survival often influence clinical decisions, especially those near the end of life. In addition. clinical decisions frequently reflect trade-offs between morbidity and length of survival. As a result, accurate estimates of survival can be extremely useful in clinical decision. When the episode of acute respiratory failure in chronic obstructive lung disease, evaluation of the severity of the condition and short term prognosis is difficulit based on the available clinical or paraclinical data at the time of admission. Method: In this study, we performed a retrospective study in Chung Ang University Hospital, 74 patients (51 males, 23 females), who were hospitalized with chronic obstructive lung disease with acute respiratory failure from 1980 to 1992. We evaluated these patients to determine lung prognostic factors at time of admission in the Intensive Care Unit (ICU) that predict short term survival, and to determine the possible application of the Simplified Acute Phsiology Score (SAPS) to this population, All patients were treated with similar regimen during the hospitalization. Results: The results were as follows: 1) Hospital mortality was 34%(25/74 patients) and surival rate was 66%(49/74 patients) in COPD with acute respiratory failure. The prognosis of the older age was much poorer than those of the young age. 2) There was no difference in mortality according to the results of basal pulmonary test and arterial blood gas analysis. 3) The SAPS at admission was higher in those patients who expired(10.8) than the survived(6.5), and there was positive correlation between SAPS and mortality (r=0.91, p<0.05). 4) Prognostic factors in acute respiratory failure complicating COPD which were identifiable at time of admission to the ICU were as follows: cachexia, encephalopathy, serum creatinine and phosphate. Conclusion: In conclusion, the SAPS might have a good prognostic value for determination of short term survival among chronic obstructive lung disease with acute respiratory failure.

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Development of Automated Region of Interest for the Evaluation of Renal Scintigraphy : Study on the Inter-operator Variability (신장 핵의학 영상의 정량적 분석을 위한 관심영역 자동설정 기능 개발 및 사용자별 분석결과의 변화도 감소효과 분석)

  • 이형구;송주영;서태석;최보영;신경섭
    • Progress in Medical Physics
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    • v.12 no.1
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    • pp.41-50
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    • 2001
  • The quantification analysis of renal scintigraphy is strongly affected by the location, shape and size of region of interest(ROI). When ROIs are drawn manually, these ROIs are not reproducible due to the operators' subjective point of view, and may lead to inconsistent results even if the same data were analyzed. In this study, the effect of the ROI variation on the analysis of renal scintigraphy when the ROIs are drawn manually was investigated, and in order to obtain more consistent results, methods for automated ROI definition were developed and the results from the application of the developed methods were analyzed. Relative renal function, glomerular filtration rate and mean transit time were selected as clinical parameters for the analysis of the effect of ROI and the analysis tools were designed with the programming language of IDL5.2. To obtain renal scintigraphy, $^{99m}$Tc-DTPA was injected to the 11 adults of normal condition and to study the inter-operator variability, 9 researchers executed the analyses. The calculation of threshold using the gradient value of pixels and border tracing technique were used to define renal ROI and then the background ROI and aorta ROI were defined automatically considering anatomical information and pixel value. The automatic methods to define renal ROI were classified to 4 groups according to the exclusion of operator's subjectiveness. These automatic methods reduced the inter-operator variability remarkably in comparison with manual method and proved the effective tool to obtain reasonable and consistent results in analyzing the renal scintigraphy quantitatively.

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The Contribution of Innovation Activity to the Output Growth of Emerging Economies: The Case of Kazakhstan

  • Smagulova, Sholpan;Mukasheva, Saltanat
    • Journal of Distribution Science
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    • v.10 no.7
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    • pp.33-41
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    • 2012
  • The purpose of this study is to analyse the state of the energy industry and to determine the efficiency of its functioning on the basis of energy conservation principle and application of innovative technologies aimed at improving the ecological modernisation of agricultural sectors of Kazakhstan. The research methodology is based on an integrated approach of financial and economic evaluation of the effectiveness of the investment project, based on calculation of elasticity, total costs and profitability, as well as on comparative, graphical and system analysis. The current stage is characterised by widely spread restructuring processes of electric power industry in many countries through introduction of new technical installations of energy facilities and increased government regulation in order to enhance the competitive advantage of electricity market. Electric power industry features a considerable value of creating areas. For example, by providing scientific and technical progress, it crucially affects not only the development but also the territorial organisation of productive forces, first of all the industry. In modern life, more than 90% of electricity and heat is obtained by Kazakhstan's economy by consuming non-renewable energy resources: different types of coal, oil shale, oil, natural gas and peat. Therefore, it is significant to ensure energy security, as the country faces a rapid fall back to mono-gas structure of fuel and energy balance. However, energy resources in Kazakhstan are spread very unevenly. Its main supplies are concentrated in northern and central parts of the republic, and the majority of consumers of electrical power live in the southern and western areas of the country. However, energy plays an important role in the economy of industrial production and to a large extent determines the level of competitive advantage, which is a promising condition for implementation of energy-saving and environmentally friendly technologies. In these circumstances, issues of modernisation and reforms of this sector in Kazakhstan gain more and more importance, which can be seen in the example of economically sustainable solutions of a large local monopoly company, significant savings in capital investment and efficiency of implementation of an investment project. A major disadvantage of development of electricity distribution companies is the prevalence of very high moral and physical amortisation of equipment, reaching almost 70-80%, which significantly increases the operating costs. For example, while an investment of 12 billion tenge was planned in 2009 in this branch, in 2012 it is planned to invest more than 17 billion. Obviously, despite the absolute increase, the rate of investment is still quite low, as the total demand in this area is at least more than 250 billion tenge. In addition, industrial infrastructure, including the objects of Kazakhstan electric power industry, have a tangible adverse impact on the environment. Thus, since there is a large number of various power projects that are sources of electromagnetic radiation, the environment is deteriorated. Hence, there is a need to optimise the efficiency of the organisation and management of production activities of energy companies, to create and implement new technologies, to ensure safe production and provide solutions to various environmental aspects. These are key strategic factors to ensure success of the modern energy sector of Kazakhstan. The contribution of authors in developing the scope of this subject is explained by the fact that there was not enough research in the energy sector, especially in the view of ecological modernisation. This work differs from similar works in Kazakhstan in the way that the proposed method of investment project calculation takes into account the time factor, which compares the current and future value of profit from the implementation of innovative equipment that helps to bring it to actual practise. The feasibility of writing this article lies in the need of forming a public policy in the industrial sector, including optimising the structure of energy disbursing rate, which complies with the terms of future modernised development of the domestic energy sector.

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The Evaluation of Radiation Therapy and Combined-modality Therapy for Non-small-cell Lung Cancer in Elderly (고령의 비소세포성폐암 환자의 방사선 및 병용치료에 대한 효과 평가)

  • Yoon, Won-Sup;Yang, Dae-Sik;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.101-108
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    • 2007
  • [ $\underline{Purpose}$ ]: To compare radiation therapy alone to combined modality therapy about survival rate and tolerance of elderly patients ($70=or{\geq}$) with non-small-cell lung cancer (NSCLC). $\underline{Materials\;and\;Methods}$: Between 1998 and 2002, 57 patients given radiation therapy due to NSCLC (Stage III) were analysed retrospectively. Radiation therapy alone (RT), concurrent chemoradiation (CRT), and sequential chemoradiation (SCRT) was done to 33, 16 and 8 patients, respectively. Patients' median age was 74 (range $70{\sim}85$). Male and female are 51 patients and 6 patients, respectively. 23 patients were stage IIIa and 34 were stage IIIb. Patients' characteristic distribution of RT and CRT was not significantly different except mass size that RT has a bigger than CRT. The fraction size of radiation therapy was 1.8 Gy in CRT and $1.8{\sim}3\;Gy$ in other groups. Total radiation dose was $51{\sim}63\;Gy$ according to the fraction size. If the prescribed total radiation dose was successfully irradiated, we stated that it was completion of radiation therapy. $\underline{Results}$: 52 patients were dead. Median period of radiation therapy was as follow: RT, 35 days, CRT, 60.5 days and SCRT, 35 days. Overall median survival time (MST) was 10.1 months. The 1 yr- and 2 yr-overall survival rate was 39.8% and 17.6%, respectively. MST of RT, CRT and SCRT was 8.9, 8.2 and 11.7 months, respectively. The 1 yr survival rate of RT, CRT and SCRT was 38.4%, 37.5% and 50% (not significant). Patients given incomplete radiation therapy were 12 (RT, 5 CRT, 6 SCRT, 1). N stage (p=0.081) and the difference of treatment methods (p=0.079) were the factors affecting incompletion of radiation therapy, but it was not significant. In case of combined-agents chemotherapy, 4 of 8 ceased radiation therapy. T stage ($T{\geq}3$), mass size (${\geq}5\;cm$), Karnofsky performance scale (${\leq}70$) and completion of radiation therapy were the prognostic factors in uni- and multi-variate analysis. $\underline{Conclusion}$: In elderly patients with NSCLC, radiation therapy alone was a treatment method with similar survival period compared with other methods. Generally, patients given radiation therapy alone was tolerable to a treatment. Before planning concurrent chemoirradiation in elderly patients with NSCLC, physicians pay attention to a selection of patients and chemotherapy agents considering general condition and toxicity.

Evaluation of Reproductive Growth in a Mature Stand of Korean Pine under Simulated Climatic Condition (국지기후가 잣나무 성숙임분의 생식생장에 미치는 영향분석)

  • 김일현;신만용;김영채;전상근
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.3 no.4
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    • pp.185-198
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    • 2001
  • This study was conducted to reveal the effects of local climatic conditions on reproductive growth in a mature stand of Korean white pine based on climatic estimates. For this, the reproductive growth such as production and characteristics of cone and seed were first measured and summarized for seven years from 1974 to 1980. The local climatic conditions in the study site were also estimated by both a topoclimatological method and a spatial statistical technique. The local climatic conditions were then correlated with and regressed on the growth factors to reveal the relationships between the climatic estimates and the reproductive growth. Average number of conelet formation per tree showed highly negative correlation with some climatic variables related to minimum temperature in the year of flower bud differentiation. Especially, the most significant negative correlation were found between average of the minimum temperature for June and July of flower bud differentiation year and the number of conelet formation. There was no significant correlation between the number of cone production and climatic variables. However, total precipitation from December of the flowering year to February of the cone production year showed the most high correlation (r=0.6036) with the number of cone production. It was found that significant climatic variables affecting the amount of cone drop and cone drop percentage were the sum of cloudy days from June of the flowering year to August of the cone production year. Positive correlation was significantly recognized between the average weight of empty seed per cone and total precipitation from December of the flowering year to February of the cone production year. For the percentage of empty seed, five climatic variables among 19 variables were significantly correlated at 10% level. The average weight of a cone showed negative correlation with total precipitation from June of the flowering year to August of the cone production year. It was also found that average weight of a seed had highly negative correlation with total precipitation from December of the flowering year to February of the cone production year. The average weight of cone coat was negatively correlated with two climatic variables derived from clear days, which are sum of clear days from November of the flowering year to March of the cone production year and sum of clear days from December of the flowering year to February of the cone production year. On the other hand, it showed positive correlation with mean temperature of May in the flowering year. The exactly same results were obtained in correlation analysis for the percentage of cone coat.

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