Usefulness of Urinary Trypsinogen-2 Dipstick Test for Diagnosis of Acute Pancreatitis

Background/Aims: The clinical usefulness of urinary trypsinogen-2 dipstick test is still in controversy. We evaluated the usefulness of urinary trypsinogen-2 dipstick test in patients with acute pancreatitis. Methods: Urinary trypsinogen-2 dipstick test was prospectively performed in 50 patients with acute pancreatitis, 50 patients with non-pancreatic abdominal pain, and 50 healthy controls. Results: On admission, urinary trypsinogen-2 dipstick test was positive in 36 of 50 patients with acute pancreatitis (sensitivity, 72%) and in 4 of 50 patients with non-pancreatic abdominal pain (specificity, 92%). On the other hand, it was all negative in controls. The sensitivity and specificity of serum lipase were 78% and 94%, respectively. At 24 hours after admission, the positive rate of urinary trypsinogen-2 dipstick test rose from 72% to 94% (p＝0.02). The results of urinary trypsinogen-2 dipstick test was positive in 14 of 15 patients with severe pancreatitis and 22 of 35 patients with mild pancreatitis according to the criteria by Atlanta International Symposium, 1992. Conclusions: Urinary trypsinogen-2 dipstick test is comparable to serum lipase in diagnosing acute pancreatitis. Delayed measurement and severe pancreatitis are more likely to yield positive results with urinary trypsinogen-2 dipstick test. Thus, we suggest that the cut-off value of urinary trypsinogen-2 dipstick test should be lowered to increase its sensitivity.ope

Clinical evaluation of pulse oximetry in emergency patients

의학과/석사[한글] 맥박산소측정기는 비관혈적으로 혈액의 산소포화도를 측정하여 심폐기능의 저하가 임상중상으로 발현하기 전에 조기발견이 가능하므로 그 가치를 인정받아 여러 분야에서 기본장비로 사용되고 있으나 산소포화도가 낮은 환자에게는 정확도가 부족한 것으로 판단되고 있다. 본 연구는 산소포화도가 낮을 것으로 예상되는 호흡곤란을 주소로 내원한 응급환자군에서 맥박산소측정기에서의 산소포화도(SpO2)를 동맥혈기체분압검사(ABG)의 산소포화도(SaO2)와 비교 분석하여 그 정확성을 평가해 보았다. SpO2와 SaO2를 호흡곤란 증세로 인하여 내원하는 응급환자에게서 전향적이며 단면적으로 측정을 하였다. 측정은 1994년 5월부터 1995년 9월까지 국내 2개 대학병원 응급실에서 이루어졌다- 수지감자를 가지고 있는 서로 기종이 다른 두 종류의 맥박산소측정기를 사용하여 9B명의 호흡곤란 환자들에게서 SpO2를 측정하였고 SaO2는 ABGf를 실시하여 계측하였다. 대부분의 환자들이 심폐질환 환자들이었다(89.8%). 두 종류의 맥박산소측정기로 측정된 SpO2(88.1±11.4, 88.2±10.0)와 SaO2(88.7±11.4) 사이에는 통계적으로 의미있는 차이를 보이지 않았으나 밀접한 상관관계가 있는 것으로 나타났다(r=.71, r=.80). 산소포화도가 90%이하로 떨어질 때에도 맥박산소측정기와 ABG의 산소포화도 사이에 차이가 없이 밀접한 상관관계를 유지하였다. 맥박산소측정기는 급성 호흡곤란을 주소로 내원하는 응급환자에서 정확성이 인정된다. 맥박산소측정기의 가치는 쉽게 빠르게 저산소혈증의 존재와 지속적으로 산소 포화도의 변화를 나타내므로 응급조치를 가능하게 하는데 있다. 그러나 저산소혈증의 정도나 호흡곤란의 정도를 판단하는데는 제한점이 있으므로 ABG로 폭 넓은 자료를 구해야 한다. 즉 호흡곤란 응급환자에게서는 응급조치를 하는데 맥박산소측정기가 임상적 판단에 응용될 수는 있으나 결정적인 판단은 환자의 병력과 이학적 소견 등이 참고되는 것이 필요한 것으로 확인되었다. [영문] Pulse oximetry is a noninvasive method of measuring blood oxygen saturation even before changes 13 the cardiopulmonary functions become apparent clinically. Therefore it has been widely excepted in many discipline as a standard patient monitoring equipment. But its accuracy has been argued at low oxygen saturation levels. To determine the accuracy of the pulse oximetry in the emergency department where the patients presenting with respiratory difficulty are expected to have low oxygen saturation levels. Prospective, cross-sectional, paired measurements of oxygen saturation by two different pulse oximeters(SpO2) against oxygen saturation of Marterial blood gas analysis(SaO2) was performed from May 1994 to September 1995 at two different university hospitals. Two Pulse oximeters each with its digital probe were applied to the patient for the measurement of SpO2 simultaneously and arterial blond gas was drawn for analysis(ABGA) at the same time to measure SaO2 98 Patients who met the criteria mostly consisted of cardiopulmonary patients. There were no significant differences between mean SpO2(88.1±11.4, 88.2±10.0) of the two pulse oximeters and mean SaG2(88.7±11.4) from the arterial blood gas analysis(p=NS). Strong correlations were found(r=.70, r=.80). But the regression declined as SaO2 decreased especially SaO2 < 90%. The pulse oximetry is potentially useful in patients with clinical signs of acute hypoxemia and patients receiving interventions that may produce acute hypoxemia, because of their ability to continuously monitor the oxygen saturation. But pulse oximetry along cannot identify the degree of hypoxemia or severity of distress. Therefore patients complaining of respiratory difficulty in an emergency department history and physical examination must be performed with pulse oximeter as a guide while backing it up with ABGA.restrictio

Statistic evaluation of compression ratio using JPEG2000 for Mobile Medical Image viewer

의용공학과/석사[한글]현재 PACS가 구축 되어진 대형 병원에서는 의료영상 및 data들를 무선상에서 전송하는 system 을 구축하려는 움직임이 보이고 있다. 기존의 LAN system에서 뿐만 아니라 Wireless data transfer system 에서는 보다 효과적으로 data를 전송 할 수 있는 압축 &#12539;재구성 방법이 절실히 요구되어 지고 있다. 이러한 요구에 부흥하기위해 현재 새로운 DICOM 표준으로의 작업이 진행 되어지고 있는 JPEG2000 압축 방법을 이용하여 의료 영상의 압축 비율별 PSNR값과 Mobile 장치에서 진단에 적합한 영상의 압축 비율을 알아보았다. 의료영상의 압축은 Aware J2k SDK를 이용하여 5:1에서 100:1까지의 비율로 압축을 하여 압축 비율별 PSNR을 측정하여 압축 Image의 정량적 quality를 비교 하여보았고, 압축된 Image를 저장하기 위해 PantiumIV PC를 사용하여 server를 구축하였다. Image를 전송받아 볼 수 있는 Client system으로는 Compaq iPAQ 3850 PDA를 사용 하였으며 server와 Client를 연결하는 무선 통신 system 으로는 Wireless LAN 모듈과 CDMA 1X 모듈를 사용하여 Data 전송의 효율을 비교하여 보았다. 이 결과 이동성에서는 CDMA1X 모듈의 성능이 월등하였으나, Data 전송 효율면 에서는 Wireless LAN 모듈이 우수함을 알 수 있었다. 평가가 이루어진 영상들은 CT-system에서 얻어진 두 개부 이미지로서 PSNR 측정결과5:1~ 100:1까지 압축비율에서 각각 40dB까지 비교적 높은 PSNR값을 보여주어 높은 압축률에서도 비교적 영상의 질이 우수함을 나타내었고 영상의 주관적인 평가를 하기위해 진단방사선과 판독의에 의해서 실시되어진 t-Test 결과에서는 신뢰도95%에서 20:1의 영상이 Original 영상과 유의 한 차이가 있음을 나타내었다. 본 논문의 목적은 JPEG2000 알고리즘을 이용하여 의료영상을 압축하여 압축비율별로 PSNR값과 t-Test를 사용하여 평가하고자 하였다. 본 연구를 위하여 두 가지의 modality(CT, CR)에서 획득되어진 디지털 영상을 JPEG2000 압축 알고리즘을 이용하여 압축하였다. 각각 적용된 압축률은 : 5:1, 10:1, 15:1, 20:1 ~ 100:1까지 적용하였고 t-Test를 위해 2명의 진단 방사선과 전문의가 각각 압축률에 따른 이미지들을 평가하였다. t-Test 결과 JPEG2000을 사용하여 각 압축률 별로 압축하였을 때 각 Modality (CT, CR)에 따른 적정 압축비율을 20:1, 15:1 로 제시 해주고 있다. [영문]Medical images, such as computed radiography(CR), and computed tomography(CT) will require large storage facilities and long transmission times for picture archiving and communications system (PACS) implementation. American College of Radiology and National Equipment Manufacturers Association (ACR/NEMA) group is planning to adopt a JPEG2000 compression algorithm in digital imaging and communications in medicine (DICOM) standard to better utilize medical images. The purpose of this study was to evaluate the compression ratios of JPEG2000 for computed radiography computed tomography images using peak signal-to-noise ratio (PSNR), and the student t-test at the mobile viewer. The compression ratio applied for the studies were 5:1, 10:1, 15:1, 20:1, 25:1, 30:1, 35:1, 40:1, 45:1, 50:1, 55:1, 60:1, 65:1, 70:1, 75:1, 80:1, 85:1, 90:1, 95:1 and 100:1. The original and reconstructed images were displayed in compression ratio order ,10 seconds per images, on viewing PDA and evaluated those images with t-Test analysis by 2 radiologist. The traditional statistical quality measures such as PSNR, which is a commonly used measure for the evaluation of reconstructed images, measures how the reconstructed image differs from the original by making pixel-by-pixel comparisons. The t-test can be used to evaluate the subjective image quality of reconstructed images. The results of the t-test suggested that the possible compression ratios using JPEG2000 for computed radiography and computed tomography images may be as much as 15 : 1 without visual loss or with preserving significant medical information at a confidence level of 99%, although PSNR analyses suggest as much as 50 : 1 compression ratio can be achieved without affecting clinical diagnostic performance at mobile PDA image viewer.ope

잡음 상호상관 분석을 이용한 한반도의 지각구조

Thesis(doctor`s) --서울대학교 대학원 :지구환경과학부,2006.Docto

A New Dynamic Routing Algorithm for Multiple AGV System : Nonsotp Preferential Detour Algorithm

We present a new dynamic routing scheme for multiple autonomous guided vehicles (AGVs) systems. There have been so many results concerned with scheduling and routing of multiple AGV systems; however, most of them are only applicable to systems with a small number of AGVs under a low degree of concurrency. With an increased number of AGVs in recent applications, these AGV systems are faced with another problem that has never been occurred in a system with a small number AGVs. This is the stop propagation problem. That is, if a leading AGV stops then all the following AGVs must stop to avoid any collision. In order to resolve this problem, we propose a nonstop preferential detour (NPD) algorithm which is a new dynamic routing scheme employing an election algorithm. For real time computation, we introduce two stage control scheme and propose a new path searching scheme, k-via shortest path scheme for an efficient dynamic routing algorithm. Finally, the proposed new dynamic routing scheme is illustrated by an example

Systematic Design of Programmable Logic Controller Based on Efficient Code Conversion Algorithm

The ladder diagram (LD) for programmable logic controllers (PLCs) ar responsible for much important roles in advance industrial automation. As automated systems become more complex the design procedures of the system become more difficult as well. Hence. the design automation issues based on discrete event models(DEMs) are receiving more attention. One of the popular ways of tackling these problems is employing Petri nets. In this paper, we use the modified automation Petri net(MAPN) to model the manufacturing system and the modified token passing logic (MTPL) method conversion (ECC) algorithm based on the MAPN and the MTPL Finally, an example of the manufacturing system is provided to illustrate the proposed ECC algorith

간접투자기구의 공시제도에 관한 연구 : 우리나라의 투자설명서와 미국의 form N-1A를 중심으로

학위논문(석사) --서울대학교 대학원 :법학과,2007.Maste