• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 4
  • 1
  • 1
  • Tagged with
  • 6
  • 3
  • 2
  • 2
  • 2
  • 2
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Model osiguranja useva od rizika suše / Crop insurance model for managing drought risk

Popović Ljiljana 18 January 2018 (has links)
<p>Predmet ovog istraživanja je suša i model osiguranja useva od rizika suše na teritoriji Vojvodine. Na osnovu detaljnog istraživanja vremenskih klimatoloških uslova na ispitivanom području, cilj ove disertacije je da se identifikuju meteorološki parametari i indikatori pogodni za indeksno osiguranje, potom da se identifikovani indeksi (padavine, SPI i SPEI indeksi suše) testiraju i odredi koji od njih najviše pogoduje osiguranju useva od rizika suše u Vojvodini.</p> / <p>The subject of this research is drought phenomena and crop insurance model for managing drought risk, on the territory of Vojvodina Province. After detailed research of weather and climate conditions of research area, themain purpose of this dissertation is to identify meteorological parameters and indicators suitable for index based insurance. Then,to test them (rainfall, SPI and SPEI drought indices) in order to determine index that is most suitable for crop insurance in Vojvodina.</p>
2

Monitoring nejonizujućeg zračenja, zagađujućih materija i toplotnih indeksa u regionu Vojvodine / Monitoring of the non-ionizing radiation, air pollution and heat indexes in Vojvodina region

Malinović Milićević Slavica 19 November 2012 (has links)
<p>Predmet istraživanja ove disertacije je monitoring i analiza ultraljubičastog zračenja, toplotnih indeksa i zagađujućih materija u vazduhu većih naselja na teritoriji Vojvodine. Cilj istraživanja je da se prostornom i vremenskom analizom posmatranih parametara dođe do &scaron;to optimalnijih saznanja o stanju kvaliteta životne sredine na području Vojvodine kao i stvaranje jedinstvene baze podataka koja će služiti za buduća istraživanja. U radu je ispitan odnos između sunčevog globalnog i UV zračenja, izvedena i verifikovana empirijska jednačina za procenu dnevnih suma UV-B zračenja u osam naselja za period 1981-2008, analizirane koncentracije pet zagađujućih materija u sedam naselja za period 2001-2008. godina i analizirani toplotni indeksi u sedam naselja u periodu od 1992. do 2008. Analiza pokazuje da rekonstruisane vrednosti dnevnih suma UV-B zračenja i srednji godi&scaron;nji toplotni indeksi u svim naseljima pokazuju tendenciju rasta i da dominantan uticaj na kvalitet vazduha u naseljima Vojvodine imaju čestice. Napravljena je jedinstvena baze podataka sa vrednostima koncentracija zagađivača vazduha, toplotnih indeksa, UV i globalnog zračenja.</p> / <p>This study analyzes UV radiation, heat indexes and air pollution in town in Vojvodina region. Objective of the thesis is to provide scientific facts about environmental quality in Vojvodina, as well as, to generate unique data base for the future research. The relationship between UV-B and global radiation has been studied and correlation equation for estimating UV-B from global radiation has been deduced. Equation was used for UV-B radiation calculation in eight towns in Vojvodina region during the period 1981-2008. This study also analyzes concentrations of five air pollutant in during the period 2001-2008, and heat index during the period 1992-2008. in seven towns in Vojvodina. The results from this study show growth UV-B radiation and heat index in all towns, and denote particulate maters as main air pollutants in Vojvodina towns.</p>
3

Signal correlations in biomass combustion – an information theoretic analysis

Ruusunen, M. (Mika) 27 August 2013 (has links)
Abstract Increasing environmental and economic awareness are driving the development of combustion technologies to efficient biomass use and clean burning. To accomplish these goals, quantitative information about combustion variables is needed. However, for small-scale combustion units the existing monitoring methods are often expensive or complex. This study aimed to quantify correlations between flue gas temperatures and combustion variables, namely typical emission components, heat output, and efficiency. For this, data acquired from four small-scale combustion units and a large circulating fluidised bed boiler was studied. The fuel range varied from wood logs, wood chips, and wood pellets to biomass residue. Original signals and a defined set of their mathematical transformations were applied to data analysis. In order to evaluate the strength of the correlations, a multivariate distance measure based on information theory was derived. The analysis further assessed time-varying signal correlations and relative time delays. Ranking of the analysis results was based on the distance measure. The uniformity of the correlations in the different data sets was studied by comparing the 10-quantiles of the measured signal. The method was validated with two benchmark data sets. The flue gas temperatures and the combustion variables measured carried similar information. The strongest correlations were mainly linear with the transformed signal combinations and explicable by the combustion theory. Remarkably, the results showed uniformity of the correlations across the data sets with several signal transformations. This was also indicated by simulations using a linear model with constant structure to monitor carbon dioxide in flue gas. Acceptable performance was observed according to three validation criteria used to quantify modelling error in each data set. In general, the findings demonstrate that the presented signal transformations enable real-time approximation of the studied combustion variables. The potentiality of flue gas temperatures to monitor the quality and efficiency of combustion allows development toward cost effective control systems. Moreover, the uniformity of the presented signal correlations could enable straightforward copies of such systems. This would cumulatively impact the reduction of emissions and fuel consumption in small-scale biomass combustion. / Tiivistelmä Kasvava ympäristö- ja kustannustietoisuus ohjaa polttoteknologioiden kehitystä yhä tehokkaampaan biomassan hyödyntämiseen ja puhtaampaan palamiseen. Näiden tavoitteiden saavuttamiseen tarvitaan mittaustietoa palamismuuttujista. Nykyiset palamisen seurantaan tarkoitetut ratkaisut ovat kuitenkin pienpolttolaitteita ajatellen usein kalliita tai monimutkaisia. Tässä työssä tutkittiin mitattujen savukaasun lämpötilojen riippuvuussuhdetta tyypillisiin kaasukomponentteihin, lämpötehoon ja tehokkuuteen. Tätä varten analysoitiin mittausaineistot neljästä erityyppisestä pienpolttolaitteesta ja suuresta kiertoleijupeti-kattilasta. Puupolttoaineina olivat klapi, hake, pelletti ja hakkuujäte. Analyysi tehtiin alkuperäisillä mittaussignaaleilla ja niistä matemaattisesti muunnetuilla signaaleilla. Riippuvuussuhteiden selvittämiseksi johdettiin informaatioteoriaan perustuva monimuuttuja-etäisyysmitta, jonka lukuarvolla mitataan signaalien samankaltaisuutta. Esitetty analyysimenetelmä sisälsi myös riippuvuuksien ajallisen muutoksen ja suhteellisten aikaviiveiden arvioinnin. Tulosten arvojärjestys perustui etäisyysmitan arvoon. Riippuvuussuhteiden samankaltaisuutta mittausaineistojen välillä vertailtiin 10-kvantiileilla. Analyysimenetelmän toimivuus vahvistettiin kahdella tunnetulla koeaineistolla. Savukaasun lämpötilojen ja palamismuuttujien mittaussignaaleissa oli samankaltainen informaatiosisältö. Vahvimmat riippuvuudet olivat muunnettujen signaalien yhdistelmillä pääosin lineaarisia ja palamisteorian mukaisia. Merkittävää oli, että tietyillä signaalimuunnos- ja palamismuuttujapareilla oli sama riippuvuussuhde kaikissa mittausaineistossa. Tämä todettiin myös simuloinneilla arvioitaessa savukaasujen hiilidioksidipitoisuutta lineaarisella, kiinteällä mallirakenteella. Mallin tarkkuus oli riittävä kolmella erityyppisellä kriteerillä jokaisessa mittausaineistossa. Tulosten perusteella signaalimuunnoksilla voidaan arvioida palamismuuttujia reaaliaikaisesti. Savukaasujen lämpötilojen potentiaali palamisen laadun ja tehokkuuden seurannassa mahdollistaa kustannustehokkaiden säätöratkaisujen kehityksen. Löydettyjä yleistettäviä riippuvuussuhteita hyödyntämällä niiden käyttöönotto lukuisissa polttolaitteissa helpottuisi. Pienpolton päästöjen ja polttoaineen kulutuksen vähentyminen olisi tällöin kumulatiivista.
4

Psykoosityöryhmä vaikeiden mielenterveyshäiriöiden hoidossa Kainuussa vuosina 1992 - 1996

Saari, M. (Mauno) 15 March 2002 (has links)
Abstract The first objective of the study was to describe the changes in the psychic state and functioning of two groups of patients' suffering from severe acute mental disorders. The experimental group (n = 40) was treated in a psychosis team and the control group (a historical control group: n = 40) in conventional psychiatric special care (hospital and non-institutional) before the beginning of the work of the psychosis team. Another objective was to describe the patients' use of services, especially psychiatric hospital treatment during the two-year follow-up. The third objective was to examine the changes in family burden and expressed emotion (EE) and the differences between the experimental group and the control group both on an individual and on a family level. The last objectives were to describe how the functioning of each patients' family was reflected on an individual level and in the use of psychiatric hospital treatment, and how the psychosis team and conventional psychiatric special care differ in structure and contents as regards clinical work in practice. The study was conducted in Kainuu in 1992-1996. On an individual level, there was positive development in both groups between 0-9 months. After that the positive development continued in the experimental group, stopping in the control group. During the follow-up the experimental group used psychiatric hospital treatment less than the control group: between 0-2 years there were 713 days of treatment (17.8 days per person) in the experimental group and 2759 days (68.9 days per person) in the control group. The number of patients using hospital treatment was 12 (30%) in the experimental group and 30 (75%) in the control group. There was no difference between the groups in the number of non-institutional psychiatric special care meetings. During the follow up the expenses caused by psychiatric special care were 1.572.000 marks in the experimental group and 3.175.200 marks in the control group. In both groups the burden of the families sank in the time period of 0-9 months. After that, the positive development continued in the experimental group, stopping in the control group. The number of families with a high EE-index at the beginning of the treatment was 18 (75%) in the experimental group and 13 (72%) in the control group, after two years the figures being 15 (62%) and 10 (56%) respectively. Cases with a high or low family EE-index did not differ from each other in the amount of psychiatric hospital treatment. The positive development in psychic state and functioning was related to the better functioning of the family. During the first month of treatment, therapy meetings were held more often for the experimental group (experimental group: n = 202; control group: n = 147), and family members or other close people participated in the meetings more often in the experimental group (experimental group: n = 370; control group: n = 122). Working in the psychosis team was on an individual level at least as profitable as conventional psychiatric special treatment. Family burden decreased in both groups between 0-9 months and continued to decrease in the experimental group between 9 months-2 years, but stopped in the control group. Treatment in the psychosis team was cheaper than conventional treatment. As a whole, the work of the psychosis team was more profitable and economical than conventional psychiatric special treatment. / Tiivistelmä Tutkimuksen tarkoituksena oli kuvata psykoosityöryhmässä hoidettujen (koeryhmä: n = 40) ja ennen psykoosityöryhmän toiminnan alkamista tavanomaiseen tapaan psykiatrisessa erikoissairaanhoidossa sekä sairaala- että avohoidossa hoidettujen (historiallinen kontrolliryhmä: n = 40) äkillisistä vaikeista mielenterveyshäiriöistä kärsivien potilaiden psyykkisen tilan ja toimintakyvyn muutoksia ja palveluiden, erityisesti psykiatrisen sairaalahoidon käyttöä noin kahden vuoden seuranta-aikana. Tarkoituksena oli myös seurata lähiomaisten kuormittuneisuuden (family burden) ja perheen tunneilmapiirin (expressed emotion; EE) muutoksia ja koe- ja kontrolliryhmien välisiä eroja sekä yksilö- että perhetason ominaisuuksien suhteen. Tarkoituksena oli edelleen kuvata kunkin potilaan perheen toimintakyvyn heijastumista yksilötasolla ja psykiatrisen sairaalahoidon käytössä ja kuvata psykoosityöryhmätyyppisen ja tavanomaisen psykiatrisen erikoissairaanhoidon rakenteellisia ja sisällöllisiä eroja käytännön kliinisessä työssä. Tutkimus toteutui Kainuussa vuosina 1992-1996. Yksilötasolla molemmissa ryhmissä tapahtui myönteistä kehitystä psyykkisessä tilassa ja toimintakyvyssä aikavälillä 0-9 kuukautta. Aikavälillä 9 kuukautta-9 vuotta myönteinen kehitys jatkui koeryhmässä, mutta pysähtyi kontrolliryhmässä. Koeryhmä käytti psykiatrista sairaalahoitoa seuranta-aikana huomattavasti kontrolliryhmää vähemän: hoitopäiviä aikavälillä 0-2 vuotta oli koeryhmässä 713 (17.8 päivää henkilöä kohti) ja kontrolliryhmässä 2759 (68.9 päivää henkilöä kohti). Sairaalahoitoa käyttäneitä potilaita oli koeryhmässä 12 (30 %) ja kontrolliryhmässä 30 (75 %). Psykiatrisen erikoissairaanhoidon avohoitokäyntien määrässä ei ryhmien välillä ollut eroa. Psykiatrisen erikoissairaanhoidon kustannukset seuranta-aikana olivat koeryhmässä 1.572.000 markkaa ja kontrolliryhmässä 3.175.200 markkaa. Lähiomaisten subjektiivinen ja objektiivinen kuormittuneisuus laskivat molemmissa ryhmissä aikavälillä 0-9 kk. Tämän jälkeen myönteinen kehitys jatkui koeryhmässä, mutta pysähtyi kontrolliryhmässä. Korkean EE-indeksin saaneita perheitä oli koeryhmässä hoidon alussa 18 (75 %) ja kontrolliryhmässä 13 (72 %) ja kahden vuoden kuluttua koeryhmässä 15 (62 %) ja kontrolliryhmässä 10 (56 %). Tapaukset, joissa oli mitattu perheen korkea tai matala EE- indeksi eivät eronneet psykiatrisen sairaalahoidon määrän suhteen toisistaan. Psyykkisen tilan ja toimintakyvyn myönteinen kehitys liittyi perheen parempaan toimintakykyyn. Hoitokokousten ja yksilötapaamisten kokonaismäärässä ei ryhmien välillä ollut eroa. Ensimmäisen kuukauden aikana hoitokokouksia järjestettiin koeryhmässä enemmän kuin kontrolliryhmässä (koeryhmä: n = 202; kontrolliryhmä: n = 147) ja omaisten tai läheisten osallistuminen hoitokokouksiin oli koeryhmässä tavallisempaa (koeryhmä: n = 370; kontrolliryhmä: n = 122). Saatujen tulosten perusteella psykoosityöryhmätyöskentely oli vaikeissa mielenterveyshäiriöissä yksilötasolla vähintäänkin yhtä tuloksellista kuin tavanomainen psykiatrinen erikoissairaanhoito. Etenkin aikavälillä 9 kuukautta-2 vuotta psykoositöryhmässä hoidetut selviytyivät tavanomaista hoitoa saaneita paremmin. Perheen kuormittuneisuus laski molemmissa ryhmissä aikavälillä 0-9 kuukautta ja lasku jatkui koeryhmässä aikavälillä 9 kuukautta-2 vuotta, mutta pysähtyi kontrolliryhmässä. Hoito psykoosityöryhmässä oli tavanomaista hoitoa halvempaa. Kokonaisuutena psykoosityöryhmän työskentely oli tavanomaista psykiatrista erikoissairaanhoitoa tuloksellisempaa ja taloudellisempaa.
5

Биоклиматска слика Западне Србије у функцији туризма / Bioklimatska slika Zapadne Srbije u funkciji turizma / Bioclimatic pictures of Western Serbia in the function of tourism

Stojićević Goran 23 September 2016 (has links)
<p>Главну&nbsp; тему&nbsp; рада представља анализа биоклиматских фактора на локалитетима<br />Златибора и Бање Ковиљаче уз помоћ два биоклиматска топлотна индекса PET&nbsp; -Физиолошки еквивалентне температуре и Универзалног топлотног климатског<br />индекса&nbsp; -UTCI. Анализирани су биоклиматски услови Златибора и Бање Ковиљаче<br />и приказани су коришћењем вредности на бази&nbsp; PET&nbsp; и UTCI, у десетодневним<br />интервалима током године. Осим Златибора и Бање Ковиљаче прикупљани су<br />подаци на још 47 тачака у Западној Србији.&nbsp; Прикупљени су сви неопходни<br />климатски подаци за израчунавање&nbsp; UTCI-a&nbsp; и&nbsp; PET-a. Добијени резултати су<br />упоређени са сличним истраживањима која су рађена у свету. Резултати мерења<br />UTCI&nbsp; и&nbsp; PET&nbsp; треба да имају већи значај у развоју туризма&nbsp; на Златибору и у Бањи<br />Ковиљачи односно генерално у Србији,&nbsp; као информација за туристе, али и за<br />туристичке раднике као показатељ у ком правцу треба развијати туристичке<br />дестинације и туристичку приведу.</p> / <p>Glavnu&nbsp; temu&nbsp; rada predstavlja analiza bioklimatskih faktora na lokalitetima<br />Zlatibora i Banje Koviljače uz pomoć dva bioklimatska toplotna indeksa PET&nbsp; -Fiziološki ekvivalentne temperature i Univerzalnog toplotnog klimatskog<br />indeksa&nbsp; -UTCI. Analizirani su bioklimatski uslovi Zlatibora i Banje Koviljače<br />i prikazani su korišćenjem vrednosti na bazi&nbsp; PET&nbsp; i UTCI, u desetodnevnim<br />intervalima tokom godine. Osim Zlatibora i Banje Koviljače prikupljani su<br />podaci na još 47 tačaka u Zapadnoj Srbiji.&nbsp; Prikupljeni su svi neophodni<br />klimatski podaci za izračunavanje&nbsp; UTCI-a&nbsp; i&nbsp; PET-a. Dobijeni rezultati su<br />upoređeni sa sličnim istraživanjima koja su rađena u svetu. Rezultati merenja<br />UTCI&nbsp; i&nbsp; PET&nbsp; treba da imaju veći značaj u razvoju turizma&nbsp; na Zlatiboru i u Banji<br />Koviljači odnosno generalno u Srbiji,&nbsp; kao informacija za turiste, ali i za<br />turističke radnike kao pokazatelj u kom pravcu treba razvijati turističke<br />destinacije i turističku privedu.</p> / <p>he&nbsp; main topic&nbsp; of the paper is the analysis of&nbsp; bioclimatological conditions&nbsp; on&nbsp; Zlatibor Mountain and in Banja Koviljaca with the help of two&nbsp; bioclimatological&nbsp; thermal indexes&nbsp; PET&nbsp; -Physiologically&nbsp; Equivalent&nbsp; Temperature&nbsp; and&nbsp; UTCI&nbsp; -&nbsp;&nbsp; Universal&nbsp; Thermal&nbsp; Climate Index. Bioclimatological conditions of&nbsp; Zlatibor and Banja Koviljaca&nbsp; were analyzed and they were presented by means of values based on PET and UTCI, in ten-day periods during the year. Apart from Zlatibor and Banja Koviljaca, the data were gathered on 47 points in West Serbia. All the climatological data&nbsp; necessary&nbsp; to calculate UTCI and PET were obtained. The results were compared with the similar research conducted around the world. The results of measuring UTCI and PET should have greater significance for the development of tourism on Zlatibor and in Banja Koviljaca, that is to say in Serbia in general, as information for tourists, but also for tourist workers as an indicator of the direction in which tourist destinations and tourist industry should develop.</p>
6

Klinički značaj načina određivanja torakalnih indeksa u dijagnostici i terapijskom tretmanu pektus ekskavatuma kod dece / Clinical significance of the method for thoracic indices assessment in diagnosing and treatment of pectus excavatum in children

Pajić Miloš 19 September 2016 (has links)
<p>Cilj: Proveriti da li je moguće promeniti način CT verifikacije Hallerovog indeksa u okviru preoperativne pripreme pacijenata sa deformitetom grudnog ko&scaron;a po tipu pectus excavatum-a, uz utvrđivanje fiziolo&scaron;kog opsega vrednosti indeksa, njegove zavisnosti od uzrasta i pola, kao i respiratorne faze u kojoj se CT pregled izvodi. Utvrditi značaj vrednosti indeksa korekcije, indeksa asimetrije i indeksa torzije sternuma. Proveriti i mogućnost smanjivanja efektivne doze jonizujućeg zračenja kod primene CT tehnike jednog skena (single slice). Materijal i metod rada: Ispitivanje se sastojalo iz prospektivne studije koja je obuhvatila 30 pacijenata sa pektus ekskavatumom uz CT snimanje (single slice) u respiratornim fazama: ekspirijum i inspirijum. Na dobijenim snimcima su izračunati pored Halerovog indeksa i indeksi asimetrije, korekcije i sternalne torzije. Prema dobijenim rezultatima merenja i izračunavanja, dono&scaron;ena je odluka o načinu terapijskog tretmana. U retrospektivnoj studiji, urađena je analiza 100 CT pregleda grudnog ko&scaron;a kod dece gde nije verifikovan pectus excavatum, uz kalibriranje vrednosti indeksa u odnosu na uzrast i pol pacijenata. Retrospektivno istraživanje je obuhvatilo i analizu dodatnih 30 CT pregleda grudnog ko&scaron;a pacijenata sa deformitetom grudnog ko&scaron;a po tipu pectus excavatum-a, koji su dijagnostikovani i/ili operisani. Kod svih operisanih pacijenata je primenjenja Nusova operativna tehnika. U ovoj grupi pacijenata je izračunata srednja vrednost efektivne doze jonizujućeg zračenja, a dobijene vrednosti su potom komparirane sa efektivnim dozama koje su dobijene niskodoznim CT pregledima grudnog ko&scaron;a uz primenu novog protokola (&quot;single-slice&quot; tehnika u respiratornim fazama inspirijuma i ekspirijuma). Rezultati: Fiziolo&scaron;ki opseg vrednosti Haller-ovog indeksa u populaciji zdravih pacijenata se kretao od 1,47 do 3,17 i u proseku je iznosio 2,23&plusmn;0,32 (znatna pozitivna korelacija uzrasta i vrednosti HI). Na osnovu rezultata Man-Vitnijevog testa nije postojala polna razlika u posmatranoj grupi. Haller-ov indeks u grupi dijagnostikovane/operisane dece je u proseku iznosio 3,39 i kretao se u intervalu od 2,23 do 5,72 (korelacija između uzrasta ovih pacijenata i Haller-ovog indeksa je bila neznatna i negativna). Utvrđena je zavisnost veličine Haller-ovog indeksa od respiratorne faze u kojoj se CT pregled izvodi. Tako su prosečne vrednosti Haller-ovog indeksa u inspirijumu dece sa dijagnostikovanim deformitetom iznosile 2,69&plusmn;0,76. Kod dece ove grupe u ekspirijumu vrednosti Haller-ovog indeksa su iznosile 3,49&plusmn;1,19. U inspirijumu su samo 3/32 (9%) ispitanika imali vrednost HI preko 3,25 (granična vrednost za operativni tretman), dok ih je u ekspirijumu bilo znatno vi&scaron;e 13/32 (41%), &scaron;to je statistički značajna razlika (&chi;2=6,250; df =1; p=0,012). &quot;Single-slice&quot; tehnika CT pregleda u inspirijumu i ekspirijumu 20-25 puta smanjuje efektivnu dozu jonizujućeg zračenja. Zaključak: Vrednost Haller-ovog indeksa raste sa uzrastom deteta, dok nije utvrđena zavisnost Haller-ovog indeksa od pola. Moguće je promeniti načini CT verifikacije Haller-ovog indeksa u preoperativnoj pripremi za Nuss-ovu operaciju primenom &quot;single-slice&quot; tehnike u ekspiratornoj fazi. Osim Hallerovog indeksa, korisno je određivati i indeks korekcije, indeks asimetrije i indeks sternalne rotacije. Predlaže se protokol standardne preoperativne pripreme i lečenja pacijenata dečjeg uzrasta sa deformitetom grudnog ko&scaron;a po tipu pektus ekskavatuma, sa ciljem njegove primene u svakodnevnom radu u institucijama koje se bave ovim problemom, a u cilju pobolj&scaron;anja kvaliteta dijagnostikovanja i krajnjeg ishoda lečenja.</p> / <p>Aim: The aim of this study was to verify whether it is possible to change the way of CT verification of Haller index (HI), as part of preoperative preparation for patients with pectus excavatum, with the determination of the physiological range of the index value, its dependence on the age and sex, as well as the respiratory phase during which the scan is performed. Also, the aim was to determine the significance of correction, asymmetry and sternal torsion indices values. Evaluate the possibility of reduction the effective dose of ionizing radiation using a single slice CT scan technique. Materials and methods: The study consisted of prospective study that included evaluation of CT scans (single slice technique) of 30 patients with pectus excavatum in both respiratory phases: expirium and inspirium. Haller index and indices of asymmetry, correction and sternal torsion were measured. The decision for the treatment was made according to the results of measurements and calculations of these indices. In retrospective study, 100 CT scans of the chest in children without the deformity (pectus excavatum) were analyzed, and the index value was calibrated depending on the age and gender. The retrospective study also included the analysis of another 30 CT scans in patients who were operated or diagnosed with pectus excavatum. Nuss procedure was used in all operated patients. In this group of patients the median value of effective dose of ionizing radiation was calculated, and the values were compared with the effective dose obtained using low-dose CT examinations applied in the new protocol (single-slice technique in inspiratory and expiratory respiratory phases). Results: The physiological range of Haller index value in healthy patients was from 1.47 to 3.17 and average value was 2.23&plusmn;0.32 (significant positive correlation between age and the value of HI). Results of Mann- Whitney test did not demonstrate any difference between gender in the observed group. In the group of patients who were operated/diagnosed with pectus excavatum the average value of Haller index was 3.39 within the range of 2.23 to 5.72 (correlation between the age of these patients and Haller index was negative, but not significant). The dependence of the Haller index value and certain respiratory phase during which the CT scan was performed also was determined. Thus, the average value of Haller index in inspirium in children with diagnosed deformity was up to 2.69&plusmn;0.76. In the same group of patients the value of Haller index in expirium was up to 3.49&plusmn;1.19. Only 3/32 (9%) patients had HI value over 3.25 (a boundary value for surgical treatment) during inspirium, while 13/32 (41%) patients had it in expirium, this data showed statistically significant difference (&chi;2=6.250; df=1; p=0.012). Single-slice CT technique during the inspiratory and expiratory phase reduces 20-25 times the effective dose of ionizing radiation. Conclusion: The value of Haller index increases with the age, but its dependence on the gender was not determined. It is possible to change the way of CT verification of Haller index in preoperative preparation for the Nuss operation using the &quot;single-slice&quot; technique in exspiratory phase. In addition to Haller index it is useful to determine correction index, the index of asymmetry and the index of sternal rotation as well. This protocol is proposed for standard preoperative preparation and treatment of pediatric population with pectus excavatum with the aim of its application in daily work in institutions that deal with this problem, but also to improve the quality of diagnosis and treatment outcomes.</p>

Page generated in 0.0571 seconds