• 대한임상독성학회지
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• 제12권1호
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• pp.14-21
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• 2014

Purpose: The objective of this study was to develop a new scoring tool that is comprehensively applicable and predicts fatality within 24 h of intoxication. Methods: This was a cohort study conducted in two emergency medical centers from 2011 to 2012. We identified factors associated with severe/fatality. Through a discriminant analysis, we devised the aBIG (age, Base deficit, Infection, and Glasgow coma scale) score. To compare the ability of aBIG to predict intoxication severity with that of previous scoring systems such as APACHE II, MODS, SAPS IIe, and SOFA, we determined the receiver operating characteristic curves of each variable in predicting severe-to-fatal toxicity. Results: Compared with the mild/moderate toxicity group (n=211), the severe/fatal group (n=143) had higher incidences of metabolic acidosis, infection, serious mental change, QTc prolongation and hepato-renal failure. Age, base deficit, infection-WBC count, and Glasgow Coma Scale were independently associated with severe/fatal poisoning. These variables were combined into the poisoning "aBIG" score [$0.28{\times}$Age group+$0.38{\times}WBC$ count/$10^3+0.52{\times}$Base deficit+$0.64{\times}$(15-GCS)], which were each calculated to have an area under the curve of 0.904 (95% confidence interval: 0.868-0.933). The aBIG poisoning score had an equivalent level of severity predictability as APACHE II and a superior than MODS, SOFA, and SAPS IIe. Conclusion: We developed a simplified scoring system using the four variables of age, base deficit, infected leukocytosis, and GCS. The poisoning aBIG score was a simple method that could be performed rapidly on admission to evaluate severity of illness and predict fatal severity in patients with acute intoxications.

• The Korean journal of internal medicine
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• 제39권2호
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• pp.338-346
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• 2024

Background/Aims: Systemic lupus erythematosus (SLE) responder index (SRI)-4 response has been achieved with belimumab treatment in patients with moderate disease activity in cornerstone clinical trials and following studies. However, most studies involved patients treated with a mean prednisolone-equivalent dose of approximately 10 mg/d and focused on the steroid-sparing effect of belimumab. We aimed to identify the effect of belimumab in patients with mild-to-moderate SLE who were treated with low-dose or no corticosteroids. Methods: We retrospectively reviewed the electronic medical records of patients treated with belimumab for at least 6 months between May 2021 and June 2022. The primary endpoint was SRI-4 response at 6 months. Results: Thirty-one patients were included (13 low dose- and 18 steroid non-users). The mean age was 39.2 ± 11.4 years, and 90.3% of patients were female. The baseline Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) score was 6.0 (4.0-9.0). The primary endpoint was achieved in 32.3% (10/31) of patients. Significant improvements in anemia, C4 levels, and SELENA-SLEDAI score were observed during treatment. Univariate analysis showed that the baseline SELENA-SLEDAI and arthritis were significantly associated with SRI-4 response at 6 months, and only the SELENA-SLEDAI remained significant (p = 0.014) in multivariate analysis. Conclusions: This cohort study is the first to report the efficacy of belimumab after minimizing the effect of corticosteroids. Belimumab showed efficacy in improving the SELENA-SLEDAI score, anemia, and low C4 in patients who did not receive corticosteroids or received only low doses.

• 한국정보통신학회논문지
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• 제22권6호
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• pp.835-841
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• 2018

본 연구에서 공개 의료 빅데이터 분석을 지역사회건강조사 2012~2014년 자료를 이용해 개인의 건강관련 삶의 질 차이와 삶의 질에 영향을 미치는 요인을 분석하였다. 제안논문에서는 공개의료 빅데이터 분석을 위해 Hadoop 기반의 Spack을 이용해 병렬처리 지원을 위한 클라우드 메니저를 구성하고 개인의 삶의 질에 영향을 미치는 요인을 하드웨어의 제약없이 빠르게 분석하였다. 건강관련 삶의 질에 미치는 영향을 개인적 특성과 지역사회 특성으로 구분하여 단계별 다수준 회귀분석(ANOVA, t-test)을 실시하였다. 연구결과 개인별 삶의 질에 영향을 미치는 요인으로는 남자 평균 73.8점, 여자 평균 70.0점으로 남자가 여자보다 건강관련 삶의 질이 높은 것으로 나타났다.

• Perspectives in Nursing Science
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• 제6권1호
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• pp.67-76
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• 2009

Recently, small and medium-sized hospitals which are located in rural areas have many difficulties in securing high quality nurses. That is because working environments for nurses in small and medium-sized hospitals in rural areas are poor compared with those of big hospitals in urban. As a result, the migration of nurses from small and medium-sized hospitals in rural areas to big hospitals in urban is continuously happening. In general, big hospitals provide nurses with high level of salary and fringe benefits. To prevent the migration of nurses, chief executive officers of small & medium hospitals in rural areas have been interested in improving nurses' working conditions including wages. Also, they have raised nurses' salary and improved working conditions. But, basically these individualized efforts have some limit. In connection with this, medical interest groups have produced various voices in terms of interpretation and solutions for these issues. However, from the future perspectives, it seems evident that two approaches for both manpower supply and demand plans of nurses are necessary. They should contain not only accurate estimation of the supply-demand of nursing manpower but also the improvement of working conditions and wages of nurses. Estimation of nursing manpower supply-demand depends on the standards and criteria being used. Supply and demand may be met or not in accordance with the points emphasized on the decision. In the articles, issues regarding nursing manpower, levels of salary, other working conditions and social support system for child care are discussed. According to Joe's report (2005), most health institutions did not meet the guidelines of nurse staffing in Medical Law. The wages of nurse vary on every hospital and there is a big difference in wages' range. The average starting salary for a nurse is 22 million won a year. In case of tertiary hospitals, it reaches up to 30 million won a year. Nurse as a profession should have a strong responsibility and should take care of the patients for 24 hours with three working shifts. Also, most of them are female who have the burden of child rearing. Therefore, it is suggested to increase the salary, to provide comfortable working conditions, and to have social support system for nurses with household affairs.

• 한국의학물리학회지:의학물리
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• 제28권3호
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• pp.106-110
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• 2017

The variable density phantom fabricated with varying the infill values of 3D printer to provide more accurate dose verification of radiation treatments. A total of 20 samples of rectangular shape were fabricated by using the $Finebot^{TM}$ (AnyWorks; Korea) Z420 model ($width{\times}length{\times}height=50mm{\times}50mm{\times}10mm$) varying the infill value from 5% to 100%. The samples were scanned with 1-mm thickness using a Philips Big Bore Brilliance CT Scanner (Philips Medical, Eindhoven, Netherlands). The average Hounsfield Unit (HU) measured by the region of interest (ROI) on the transversal CT images. The average HU and the infill values of the 3D printer measured through the 2D area profile measurement method exhibited a strong linear relationship (adjusted R-square=0.99563) in which the average HU changed from -926.8 to 36.7, while the infill values varied from 5% to 100%. This study showed the feasibility fabricating variable density phantoms using the 3D printer with FDM (Fused Deposition Modeling)-type and PLA (Poly Lactic Acid) materials.

• 대한디지털의료영상학회논문지
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• 제10권2호
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• pp.11-16
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• 2008

Images of medical treatment on PACS environment are digitized and they make saving and transmission of patient's information easy with CD format causing increase of patients transfer rate between hospital and data transmission as well. Figuring out the configuration of confining status of copied images of medical treatment with CD format and present the appropriate way of identification for personal information. 20 general hospital over 500 beds which are utilizing PACS currently. Questionnaire investigation focusing on PACS operation center and it's management people. In accordance with the law of securing personal information of public organizations, it says "Anyone who wants to see his or her information via representative he or she needs to make a letter of attorney and turn in this to the president of it's possessing facility" in the article 16. Based on the investigation of general hospital for CD copy issue status near metropolitan area, 8 out of 20, were issuing CD copy through personal identification process(the person oneself and representative) and 10 general hospital were doing by getting signature of receiptor only without identification of the person oneself and 2 general hospital confirmation process is not at all. By the law of securing personal information of public organization, article 16, confirmation process is supposed to mandate lawfully with a letter of attorney when there is any request of reading and/or copies of one's information. But in reality, there were no consistent rules on reading, the process and coverage of copy issue, rejection coverage of copy issue of CD copy in each general hospital PACS operation center. Therefore there is a big need for consolidated format which is applicable by law when the representative requests to issue of CD copy that is storing medical treatment images. By issue through this consolidated format, securing medical information of individual and systemic operation and management will be valid and effective.

• Korean Journal of Radiology
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• 제23권12호
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• pp.1269-1280
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• 2022

Objective: This study aimed to evaluate the usefulness of quantitative indices obtained from deep learning analysis of gadoxetic acid-enhanced hepatobiliary phase (HBP) MRI and their longitudinal changes in predicting decompensation and death in patients with advanced chronic liver disease (ACLD). Materials and Methods: We included patients who underwent baseline and 1-year follow-up MRI from a prospective cohort that underwent gadoxetic acid-enhanced MRI for hepatocellular carcinoma surveillance between November 2011 and August 2012 at a tertiary medical center. Baseline liver condition was categorized as non-ACLD, compensated ACLD, and decompensated ACLD. The liver-to-spleen signal intensity ratio (LS-SIR) and liver-to-spleen volume ratio (LS-VR) were automatically measured on the HBP images using a deep learning algorithm, and their percentage changes at the 1-year follow-up (ΔLS-SIR and ΔLS-VR) were calculated. The associations of the MRI indices with hepatic decompensation and a composite endpoint of liver-related death or transplantation were evaluated using a competing risk analysis with multivariable Fine and Gray regression models, including baseline parameters alone and both baseline and follow-up parameters. Results: Our study included 280 patients (153 male; mean age ± standard deviation, 57 ± 7.95 years) with non-ACLD, compensated ACLD, and decompensated ACLD in 32, 186, and 62 patients, respectively. Patients were followed for 11-117 months (median, 104 months). In patients with compensated ACLD, baseline LS-SIR (sub-distribution hazard ratio [sHR], 0.81; p = 0.034) and LS-VR (sHR, 0.71; p = 0.01) were independently associated with hepatic decompensation. The ΔLS-VR (sHR, 0.54; p = 0.002) was predictive of hepatic decompensation after adjusting for baseline variables. ΔLS-VR was an independent predictor of liver-related death or transplantation in patients with compensated ACLD (sHR, 0.46; p = 0.026) and decompensated ACLD (sHR, 0.61; p = 0.023). Conclusion: MRI indices automatically derived from the deep learning analysis of gadoxetic acid-enhanced HBP MRI can be used as prognostic markers in patients with ACLD.

• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10683-10690
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• 2015

The big gap between efficacy of population level prevention and expectations due to heterogeneity and complexity of cancer etiologic factors calls for selective yet personalized interventions based on effective risk assessment. This paper documents our research protocol aimed at refining and validating a two-stage and web-based cancer risk assessment tool, from a tentative one in use by an ongoing project, capable of identifying individuals at elevated risk for one or more types of the 80% leading cancers in rural China with adequate sensitivity and specificity and featuring low cost, easy application and cultural and technical sensitivity for farmers and village doctors. The protocol adopted a modified population-based case control design using 72, 000 non-patients as controls, 2, 200 cancer patients as cases, and another 600 patients as cases for external validation. Factors taken into account comprised 8 domains including diet and nutrition, risk behaviors, family history, precancerous diseases, related medical procedures, exposure to environment hazards, mood and feelings, physical activities and anthropologic and biologic factors. Modeling stresses explored various methodologies like empirical analysis, logistic regression, neuro-network analysis, decision theory and both internal and external validation using concordance statistics, predictive values, etc..

• 한국직업건강간호학회지
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• 제12권2호
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• pp.156-163
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• 2003

The 5 year follow up study was conducted to assess the positive seroprevalence of HbsAg and magnitude of new cases in a steel manufacturing big scale workpalce. About 2,000 serum samples collected from 1998 to 2002 for hepatititis B surface antigen(HBsAg), antibody to HBsAg(anti-HBs), sAST, sALT, r-GTP, total cholesterol, and triglyceride were tested. The commercially available enzyme-linked immunosorbent assay was utilized in serologic test of hepatititis B surface antigen (HBsAg), and antibody to HBsAg(anti-HBs). The preceived seroprevalence rates in the study were ranged 6.3~6.9%. The seroprevalences of HbsAg were 4.3~4.9% among the age of thirties, a significantly decreased seroprevalence compared with those among other age groups(in forties, 7.1~8.2%, and in fifties 7.1~7.6%). The positive seroprevalence of anti-HBs were 71.0~77.9%. A new case was not detected in the group.

• 한국전자통신학회논문지
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• 제13권1호
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• pp.221-228
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• 2018

빅데이터(Big data)는 제4차 산업혁명 시대를 맞이하여 과학, 기술, 산업, 사회분야에서 사물인터넷(IoT), 인공지능(AI), 클라우드(Cloud)와 더불어 공공분야와 민간분야를 아우르는 곳에서 중요한 키워드가 되고 있다. 빅데이터 기반의 서비스는 교통, 기상, 의료, 마케팅 등의 다양한 분야에서 제공되고 있다. 특히 스포츠 분야에서는 병원이나 재활센터가 아닌 훈련이나 일상 생활에서 생체 신호(Vital sign)를 측정할 수 있는 웨어러블 장치(Wearable device)의 등장으로 여러 형태의 생체 신호를 수집, 관리할 수 있게 되었다. 하지만 아직까지 스포츠분야, 즉 야구선수의 훈련(training)과 재활(rehabilitation)을 위한 웨어러블 장치에서 추출된 생체 신호를 가지는 빅데이터에 대한 연구가 활성화되지 못하고 있다. 따라서 본 논문에서는 야구선수에 대한 훈련, 특히 내야와 외야 수비선수에 대한 운동량 측정 생체신호를 빅데이터 기반으로 저장하고 분석할 수 있는 시스템에 대한 연구를 제안한다.