This paper summarized the internal and external development of medical metrology, posed its main problem and studied its development trend.
Biometry ; Epidemiologic Measurements

In plastic surgery, patient photography is a vital component of clinical, educational, legal, and research documentation. Optimal acquisition of photographic data requires a dedicated photography studio or a three-dimensional anatomic scanner, both of which are financially impractical for most clinicians. Simplified photo standardization is proposed for use in random clinical settings by using a portable device called the Mirror Stand (MirS). This model device aims to mimic a studio environment by incorporating the basic elements of producing consistent photographs. The pilot MirS is designed for facial photography. Images of 40 random subjects were obtained using the MirS with three different cameras. Real anthropometric measurements of each subject were collected, compared with the photographic measurements, and analyzed. In this study, all three cameras produced equally reliable measurements. Actual facial measurements were comparable to the photogrammetric measurements obtained from photographs taken using the MirS. A constant formula was derived; it allowed the conversion of photographic values into real anthropometric values. The MirS produced consistent photographs with respect to the measurements. The photographs obtained could be translated reliably into their real anthropometric measurements. Therefore, the MirS can be applied in daily practice, providing an efficient alternative for obtaining a standard justifiable photograph.
Anthropometry ; Cephalometry ; Humans ; Photogrammetry ; Photography ; Surgery, Plastic

Pediatric surgery could establish a definitive position in the medical field on the basis of a stable patient population. Neonatal surgery, the core of pediatric surgery, requires highly skilled surgeons. However, recent advancement of prenatal diagnosis followed by intervention and decreased birth rate has resulted in a significant decrease in the neonatal surgical population and the number of surgical operations. The purpose of this study is to examine the outcome of neonatal surgeries and to propose a guide for the future surgeries. A total of 359 neonatal surgical patients operated upon at the Department of Surgery, Ewha Medical Center, during past 21 years were studied. The study period hasbeen divided into two time periods : from 1983 to 1993 and from 1994 to 2004. Analysis was based on the Clinical Classification System and mortality pattern, frequency of disorders, occurrence and cause of death, and other changes. Neonatal surgery was 6.4 % of all pediatric surgery during the total 21 year period, 9.9 % in the first period and 4.8 % in the second. Male to female ratio increased from 2.7 : 1 to 2.1 : 1. The overall mortality was 6.7 %, and there was significant decrease from 7.4 % in the first period to 6.0 % in the second. The clinical classification system (CCS) for death cases included class II 2, III 4, and IV 7 during the first period and class III 3, and IV 8 during the second, respectively. According to the mortality pattern by Hazebroek, there were 6 preventable death cases during the first period, and only one in the second, and 2 non-preventable death cases during the first period and 8 in second, respectively. Although the patients in the second period had more serious diseases, surgical mortality has been decreased in the second period, which may be the result of improved surgery methods for newborns and advanced patient care.
Birth Rate ; Cause of Death ; Classification ; Female ; Humans ; Infant, Newborn* ; Male ; Mortality* ; Patient Care ; Prenatal Diagnosis

OBJECTIVETo study the quantified indices for describing the distributional status of diseases in the spatial point pattern analysis, and provide the a statistic in disease prevention and control.

METHODSG function, F function, J function and K function were summarized based on the inter-case distances from the view of spatial point pattern analysis. Through the introduction of the basic principles, these were used to analyze the data of acute schistosomiasis in the Guichi District, Chizhou City, Anhui province, with the study distances being from 0 to 3000 meters with 50-meter intervals. The findings were also validated by means of spatial moving scan window performed in SaTScan software.

RESULTSA total of 83 cases of acute schistosomiasis identified in Guichi District, and the point map showed that these cases were mainly distributed around the Yangtze and Qiupu rivers. The computational methods and characteristics of the four quantified indices were obtained. These acute schistosomiasis cases were also explored by using these indices, and the results showed that C and K functions were above 95% confidence interval. While, F and J functions were below 95% confidence interval. Ml these four indices showed that spatial clustering existed in the acute cases, which was consistent with the results of spatial moving scan window method. The latter method also found a most likely cluster, the coordinate of the circle center is (30.65 N, 117.44 E), radius is 2.69 km, and relative risk is 12.78 (DIR = 32. 80, P = 0. 0001).

CONCLUSIONThe quantified indices to describe the distributional status of diseases have not only solved the obstacle that spatial point pattern map which could only be analyzed qualitatively, but also supplied a theoretical foundation to deepen spatial clustering analysis.

OBJECTIVETo study the quantified indices for describing the distributional status of

OBJECTIVE: Providing a risk assessment method for the implementation of radiotherapy to identify possible risks in the implementation of the treatment process, and proposing measures to reduce or prevent these risks. METHODS: A multidisciplinary expert evaluation team was developed and the radiotherapy treatment process flow was drawn. Through the expert team, the failure mode analysis is carried out in each step of the flow chart. The results were summarized and the (risk priority ordinal) score was obtained, and the quantitative evaluation results of the whole process risk were obtained. RESULTS: One hundred and six failure modes were obtained, risk assessment of (20%) high risk failure model are 22 and severity (≥ 8) high risk failure model are 27. The reasons for the failures were man-made errors or hardware and software failures. CONCLUSIONS Failure mode and effect analysis can be used to evaluate the risk assessment of radiotherapy, and it provides a new solution for risk control in radiotherapy field.
Healthcare Failure Mode and Effect Analysis ; Risk Assessment

PURPOSE: The survival rate of very low birth weight infants(VLBWI) has improved by virtue of specialized neonatal care. This study was performed to analyze the changes in incidence, survival rate and morbidity of VLBWI who admitted to Chonnam National University Hospital from 1996 to 2001. METHODS: We enrolled 565 VLBWI, and compared the incidence and the survival rate according to the birth weight or gestational weeks between period I(1996 to 1998) and period II(1999 to 2001). The mortality rate according to the postnatal age, cause of death, morbidity and days of hospital stay were also compared. Morbidity is categorized into 'short term' which is curable until discharge, and 'long term' causing any types of sequelae after discharge. RESULTS: Incidence of VLBWI significantly increased in period II over period I(6.0% vs. 11.0%, P<0.001). The survival rate also increased in period II(71.8% vs. 80.1%, P<0.05), especially in 1,000 to 1,249 gm of birth weight(P<0.001) and in 28 to 30 weeks of gestation(P<0.001). The most common cause of death was respiratory distress syndrome in period I; however it was sepsis in period II. Although overall and short term morbidity rate increased, long term morbidity and days of hospital stay didn't increase in period II. CONCLUSION: Although the incidence of VLBWI significantly increased and the survival improved in period II compared to period I, especially in 1,000 to 1,249 gm of birth weight and 28 to 30 weeks of gestation, 'long term' morbidity rate and hospital days didn't increase.
Birth Weight ; Cause of Death ; Humans ; Incidence* ; Infant* ; Infant, Very Low Birth Weight* ; Jeollanam-do ; Length of Stay ; Mortality ; Parturition ; Pregnancy ; Sepsis ; Survival Rate* ; Virtues

PURPOSE: We describe clinical outcomes of NOM on spleen injuries with judicious selection and embolization during the past 10 years. METHODS: From March 2000 to November 2009, 151 patients with splenic injury were included. Eighteen patients were excluded because of incomplete data. Patients' medical records were reviewed to examine admission demographics, laboratory results, radiologic findings as well as transfusion requirement, hospital stay, and ultimate outcomes. RESULTS: Twenty patients were chosen for non-operative management (NOM) after splenic embolization and 1/20 (5%) patient failed. There were 32 patients more than 55 years old (range, 55~87 years). Of these patients, 26 (81%) patients were chosen for NOM and 3 (11.5%) patients failed. According to OIS, 51 patients were grade 3; 26 patients, grade 4; and 6 patients, grade 5. Among grade 3, 49 (96%) were chosen for NOM with or without embolization and 1 (2%) patient failed; grade 4, 19 (73%) with NOM, 2 (7.6%) patients failed. Of all 133 patients with NOM or failed NOM (FNOM), there was 0 mortality in grade 3; 2, in grade 4; 2, in grade 5, excluding other causes of death. The mean ISS was significantly higher in the failed NOM group compared with successful NOM group (P=0.01). The group of failed NOM had a significantly higher mean OIS (P=0.00). CONCLUSION: Aggressive but highly selective NOM on the base of clinicoradiologic parameters with the aid of angioembolization would result in a low failure rate and complication in the management of high grades (grade 3 or 4).
Cause of Death ; Demography ; Humans ; Length of Stay ; Medical Records ; Spleen

OBJECTIVETo explain trend of death in Chinese by quantitative analysis of demographic and non-demographic factors and estimate the proportion of contribution of non-demographic and demographic factors.

METHODSUsing census data and death causes data of National Disease Surveillance Points at 1991 and 2000 to calculate the proportion of contribution of demographic and non-demographic factors and to change on various death causes from 1991 to 2000 by methods of decomposing the differences of death rates.

RESULTSThe death rate showed a rapid decrease during 1950 - 1975, mainly owing to the contribution of non-demographic factors, including economic development, popularization of education and health service, especially the "patriotic hygiene movement". During 1991 - 2000, the death causes of lung cancer, liver cancer, breast cancer, chronic heart disease, stroke, diabetes and traffic accident had been increasing. The increase of deaths caused by these diseases were contributed to the non-demographic factors including 63% of the increase on lung cancer and 88% of increase on death rate of traffic accidents.

CONCLUSIONThe study showed that the risk factors had contributed to the increase of death rates, including behavioral risk factors described in the preceding 5 papers as smoking and passive smoking, unhealthy diet, sedentary life style, violating traffic regulation etc. In order to reduce the death rates on cancer, heart diseases, diabetes, traffic accidents, emphasis should be also laid on the change of unhealthy behaviors.

OBJECTIVES: This multi-institutional study aims to investigate the survival rate of premature infants and the causes of death according to gestational age and birth weight during the past three years. METHODS: This study retrospectively examined medical records of 1,400 premature infants who were born at 23 to 34 weeks gestation and were hospitalized in the neonatal intensive care unit of seven hospitals from 2004 to 2006. Gestational age, birth weight, gender, plurality, survival rate, and cause of death were examined, and the survival rate was measured according to gestational age and birth weight. RESULTS: The average gestational age and the average birth weight of the subjects was 31+/-1.8 weeks and 1,775+/-530 g, respectively. The survival rate showed no difference by gender, plurality and years. The survival rate of very premature babies, low birth weight infants, very low birth weight infants, and extremely low birth weight infants were 87.6%, 93.8%, 83.2%, and 62.7% respectively. Causes of death were the complications of prematurity (83.8%), congenital anomalies (15.2%), birth asphyxia (5.0%) and others (2.5%). The survival rate increased significantly according to the gestational age and also by the birth weight. CONCLUSIONS: Our data do not represent of the survival rate and the causes of death in Korea. However, our data may reflect the common survival rate and the causes of death in Korean NICU, because the 7 hospitals participated in this study were common facilities and manpower in Korea.
Asphyxia ; Birth Weight ; Cause of Death ; Gestational Age ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Korea ; Medical Records ; Parturition ; Pregnancy ; Premature Birth ; Retrospective Studies ; Survival Rate

OBJECTIVEThis study aims to test the accuracy and precision of iWitness photogrammetry for measuring the facial tissues of mannequin head.

METHODSUnder ideal circumstances, the 3D landmark coordinates were repeatedly obtained from a mannequin head using iWitness photogrammetric system with different parameters, to examine the precision of this system. The differences between the 3D data and their true distance values of mannequin head were computed.

RESULTSOperator error of 3D system in non-zoom and zoom status were 0.20 mm and 0.09 mm, and the difference was significant (P 0.05). Image captured error of 3D system was 0.283 mm, and there was no significant difference compared with the same group of images (P>0.05). Error of 3D systen with recalibration was 0.251 mm, and the difference was not statistically significant compared with image captured error (P>0.05). Good congruence was observed between means derived from the 3D photos and direct anthropometry, with difference ranging from -0.4 mm to +0.4 mm.

CONCLUSIONThis study provides further evidence of the high reliability of iWitness photogrammetry for several craniofacial measurements, including landmarks and inter-landmark distances. The evaluated system can be recommended for the evaluation and documentation of the facial surface.