• Title/Summary/Keyword: Classification, Disease

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Evaluation of the Effectiveness of Surveillance on Improving the Detection of Healthcare Associated Infections (의료관련감염에서 감시 개선을 위한 평가)

  • Park, Chang-Eun
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.1
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    • pp.15-25
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    • 2019
  • The development of reliable and objective definitions as well as automated processes for the detection of health care-associated infections (HAIs) is crucial; however, transformation to an automated surveillance system remains a challenge. Early outbreak identification usually requires clinicians who can recognize abnormal events as well as ongoing disease surveillance to determine the baseline rate of cases. The system screens the laboratory information system (LIS) data daily to detect candidates for health care-associated bloodstream infection (HABSI) according to well-defined detection rules. The system detects and reserves professional autonomy by requiring further confirmation. In addition, web-based HABSI surveillance and classification systems use discrete data elements obtained from the LIS, and the LIS-provided data correlates strongly with the conventional infection-control personnel surveillance system. The system was timely, acceptable, useful, and sensitive according to the prevention guidelines. The surveillance system is useful because it can help health care professionals better understand when and where the transmission of a wide range of potential pathogens may be occurring in a hospital. A national plan is needed to strengthen the main structures in HAI prevention, Healthcare Associated Prevention and Control Committee (HAIPCC), sterilization service (SS), microbiology laboratories, and hand hygiene resources, considering their impact on HAI prevention.

Evaluation of the Degenerative Changes of the Distal Intervertebral Discs after Internal Fixation Surgery in Adolescent Idiopathic Scoliosis

  • Dehnokhalaji, Morteza;Golbakhsh, Mohammad Reza;Siavashi, Babak;Talebian, Parham;Javidmehr, Sina;Bozorgmanesh, Mohammadreza
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1060-1068
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    • 2018
  • Study Design: Retrospective study. Purpose: Lumbar intervertebral disc degeneration is an important cause of low back pain. Overview of Literature: Spinal fusion is often reported to have a good course for adolescent idiopathic scoliosis (AIS). However, many studies have reported that adjacent segment degeneration is accelerated after lumbar spinal fusion. Radiography is a simple method used to evaluate the orientation of the vertebral column. magnetic resonance imaging (MRI) is the method most often used to specifically evaluate intervertebral disc degeneration. The Pfirrmann classification is a well-known method used to evaluate degenerative lumbar disease. After spinal fusion, an increase in stress, excess mobility, increased intra-disc pressure, and posterior displacement of the axis of motion have been observed in the adjacent segments. Methods: we retrospectively secured and analyzed the data of 15 patients (four boys and 11 girls) with AIS who underwent a spinal fusion surgery. We studied the full-length view of the spine (anterior-posterior and lateral) from the X-ray and MRI obtained from all patients before surgery. Postoperatively, another full-length spine X-ray and lumbosacral MRI were obtained from all participants. Then, pelvic tilt, sacral slope, curve correction, and fused and free segments before and after surgery were calculated based on X-ray studies. MRI images were used to estimate the degree to which intervertebral discs were degenerated using Pfirrmann grading system. Pfirrmann grade before and after surgery were compared with Wilcoxon signed rank test. While analyzing the contribution of potential risk factors for the post-spinal fusion Pfirrmann grade of disc degeneration, we used generalized linear models with robust standard error estimates to account for intraclass correlation that may have been present between discs of the same patient. Results: The mean age of the participant was 14 years, and the mean curvature before and after surgery were 67.8 and 23.8, respectively (p<0.05). During the median follow-up of 5 years, the mean degree of the disc degeneration significantly increased in all patients after surgery (p<0.05) with a Pfirrmann grade of 1 and 2.8 in the L2-L3 before and after surgery, respectively. The corresponding figures at L3-L4, L4-L5, and L5-S1 levels were 1.28 and 2.43, 1.07 and 2.35, and 1 and 2.33, respectively. The lower was the number of free discs below the fusion level, the higher was the Pfirrmann grade of degeneration (p<0.001). Conversely, the higher was the number of the discs fused together, the higher was the Pfirrmann grade. Conclusions: we observed that the disc degeneration aggravated after spinal fusion for scoliosis. While the degree of degeneration as measured by Pfirrmann grade was directly correlated by the number of fused segments, it was negatively correlated with the number of discs that remained free below the lowermost level of the fusion.

Neuroimaging Findings of First-Visit Headache Patients (두통 초진 환자에서 신경영상검사 소견)

  • Kim, Byung-Su;Kim, Soo-Kyoung;Kim, Jae-Moon;Moon, Heui-Soo;Park, Kwang-Yeol;Park, Jeong Wook;Sohn, Jong-Hee;Song, Tae-Jin;Chu, Min Kyung;Cha, Myoung-Jin;Kim, Byung-Kun;Cho, Soo-Jin
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.294-301
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    • 2018
  • Background: Neuroimaging can play a crucial role in discovering potential abnormalities to cause secondary headache. There has been a progress in the fields of headache diagnosis and neuroimaging in the past two decades. We sought to investigate neuroimaging findings according to headache disorders, age, sex, and imaging modalities in first-visit headache patients. Methods: We used data of consecutive first-visit headache patients from 9 university and 2 general referral hospitals. The International Classification of Headache Disorders, third edition, beta version was used in headache diagnosis. We finally enrolled 1,080 patients undertook neuroimaging in this study. Results: Among 1,080 patients (mean age: $47.7{\pm}14.3$, female: 60.8%), proportions of headache diagnosis were as follows: primary headaches, n=926 (85.7%); secondary headaches, n=110 (10.2%); and cranial neuropathies and other headaches, n=43 (4.1%). Of them, 591 patients (54.7%) received magnetic resonance imaging (MRI). Neuroimaging abnormalities were found in 232 patients (21.5%), and their proportions were higher in older age groups and male sex. Chronic cerebral ischemia was the most common finding (n=88, 8.1%), whereas 76 patients (7.0%) were found to have clinically significant abnormalities such as primary brain tumor, cancer metastasis, and headache-relevant cerebrovascular disease. Patients underwent MRI were four times more likely to have neuroimaging abnormalities than those underwent computed tomography (33.3% vs. 7.2%, p<0.001). Conclusions: In this study, the findings of neuroimaging differed according to headache disorders, age, sex, and imaging modalities. MRI can be a preferable neuroimaging modality to identify potential causes of headache.

Analyzing Cancer Incidence among Korean Workers and Public Officials Using Big Data from National Health Insurance Service (건강보험 빅데이터를 통한 전체 근로자 및 공무원 근로자의 암 발생률 분석)

  • Baek, Seong-Uk;Lee, Wanhyung;Yoo, Ki-Bong;Lee, Woo-Ri;Lee, Won-Tae;Kim, Min-Seok;Lim, Sung-Shil;Kim, Jihyun;Choi, Jun-Hyeok;Lee, Kyung-Eun;Yoon, Jin-Ha
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.32 no.3
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    • pp.268-278
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    • 2022
  • Objectives: This study aimed to establish a control group based on the big data from National Health Insurance Service. We also presented presented the number of incidences for each cancer, and analyzed the cancer incidence rate among Korean workers. Methods: The cohort definition was separated by 'baseline cohort', 'dynamic cohort', and 'fixed- industry cohort' according to the definition. Cancer incidence was calculated based on the Korean Standard Classification of Disease code. Incidence rate was calculated among the group of all workers and public officials. Based on the study subjects and each cohort definition, the number of observations, incidences, and the incidence rate according to sex and age groups was calculated. The incidence rate was estimated based on the incidence per 100,000 person-year, and 95% confidence intervals calculated according to the Poisson distribution. Results: The result shows that the number of cancer cases in the all-worker group decreases after the age of 55, but the incidence rate tends to increase, which is attributed to the retirement of workers over 55 years old. Despite the specific characteristics of the workers, the trend and figures of cancer incidence revealed in this study are similar to those reported in previous studies of the overall South Korean population. When comparing the incidence rates of all workers and the control group of public officials, the incidence rate of public officials is generally observed to be higher in the age group under the age of 55. On the other hand, for workers aged 60 or older, the incidence rates were 1,065.4 per 100,000 person-year for all workers and 1,023.7 per 100,000 person-year for civil servants. Conclusions: This study analyzed through health insurance data including all workers in Korea, and analyzed the incidence of cancer of workers by sex and age. In addition, further in-depth researches are needed to determine the incidence of cancer by industry.

Analysis of the Use of Insured Herbal Extracts and Korean Medicinal Treatments in Patients with Allergic Rhinitis : Data from Health Insurance Review and Assessment Service (알레르기 비염 환자의 보험 한약 제제 및 한의 처치 이용 현황 : 건강보험심사평가원 자료 분석)

  • Kim, Jeong-Hun;Ryu, Ji-In;Kang, Chae-Yeong;Hwang, Jin-Seub;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.2
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    • pp.38-52
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    • 2021
  • Objectives : The purpose of this study is to analyze the use of insured herbal extracts and Korean medicinal treatments, which are mainly used to treat allergic rhinitis in Korean medicine. Methods : Among all HIRA(Health Insurance Review and Assessment Service) claims data in 2016, we included all statements that included J30(vasomotor and allergic rhinitis) or a subcategory of J30(J30.0, J30.1, J30.2, J30.3, or J30.4) as the main disease, using the Korean Standard Classification of Diseases(KCD-7). This study analyzed the most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis in Korean medicine. We performed a frequency analysis on subgroups based on treatment type(inpatient or outpatient), sex, age, insurance type, and medical institution type. Results : The result shows the 10 most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis. The total number of insured herbal extracts prescriptions was 82,533, and the most commonly prescribed insured herbal extracts was socheongryong-tang(35,131 prescriptions), followed by hyeonggaeyeongyo-tang(18,157 prescriptions), samsoeum(6,257 prescriptions), and galgeun-tang(4,465 prescriptions). The total number of Korean medicinal treatments prescriptions was 1,878,541, of which the most common Korean medicinal treatments was acupuncture(922,977 prescriptions), followed by moxibustion(372,120 prescriptions), cupping(242,094 prescriptions), and segmental acupuncture(161,553 prescriptions). Conclusions : It is expected that the results of this study can be used as a basis for establishing the priorities of evidence-based clinical research topics in the field of Korean medicine and making health care policy decisions to strengthen coverage in the future.

The Origins, Changes, and Compositive Principles of Hyungbangjihwang-tang (형방지황탕(荊防地黃湯)의 기원(基源), 변천과정(變遷過程) 및 구성원리(構成原理))

  • So-Hyeon, Ryu;Su-Hyeon, Lee;Seong-Wook, Park;Seung-Won, Shin;Eui-Ju, Lee
    • Journal of Sasang Constitutional Medicine
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    • v.34 no.4
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    • pp.1-12
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    • 2022
  • Objectives This paper investigates the origins, changes, and the constructive principles of Hyungbangjihwang-tang(荊防地黃湯). Methods Hyungbangjihwang-tang and other related prescriptions were analyzed in terms of their pathological indications, based on previous literature including 『Gogeumuigam(古今醫鑑)』, 『Sanghannon(傷寒論)』, 『Uihagjeongjeon(醫學正傳)』, 『Donguisusebowon·Sasangchobongwon(東醫壽世保元·四象草本卷)』, 『Donguisusebowon·Gabobon(東醫壽世保元·甲午本)』, 『Donguisusebowon·Sinchukbon(東醫壽世保元·辛丑本)』. Results and Conclusions The origins of Hyungbangjihwang-tang can be seen in three sections depending on the classification of medicinal herbs. Schizonepeta tenuifolia Briq.(荊芥), Saposhnikovia divaricata Schischk.(防風), Notopterygium incisum Ting(羌活), Aralia cordata Thunb.(獨活), and Plantago asiatica L.(車前子) originated from Hyungbangpaedok-san(荊防敗毒散) included in 『Gogeumuigam』. Poria cocos Wolf.(茯苓) and Alisma canaliculatum(澤瀉) originated from Ohryoung-san(五苓散) included in 『Sanghannon』. Rehmannia glutinosa for hueichingensis(熟地黃) and Cornus officinalis S. et Z.(⼭茱萸) originated from Yukmijihwang-tang(六味地黃湯) included in 『Uihagjeongjeon』. Hyungbangpaedok-san was transformed into "Paedok-san" in 『Chobongwon(草本卷)』, Hyungbangpaedok-san in the 『Gabobon(甲午本)』 and 『Sinchukbon(辛丑本)』. Yukmijihwang-tang was mentioned as a Soyangin medicine in the 『Chobongwon』 and was later transformed into a Suhwagije-tang(水火旣濟湯) in 『Gabobon』. The meaning of Yukmijihwang-tang inherited in 『Sinchukbon』 as Dokhwaljihwang-tang and Hyungbangjihwang-tang. The medicinal herbs in Hyungbangjihwang-tang can be categorized in three sections by their functions, Schizonepeta tenuifolia Briq., Saposhnikovia divaricata Schischk., Notopterygium incisum Ting, Aralia cordata Thunb., and Plantago asiatica L. scatter the Pyohan(表寒) and make the Pyoeum(表陰) drop. Poria cocos Wolf.(茯苓) and Alisma canaliculatum(澤瀉) make the Pyoeum(表陰) drop through Lee-su(利水). Rehmannia glutinosa for hueichingensis(熟地黃) and Cornus officinalis S. et Z.(⼭茱萸) tonify Shin-won(腎元). The each principles of medicinal herbs corresponds to the stage of the "Cold-related Diarrhea in Soyangin Spleen Cold-based Exterior Cold disease(少陽人 脾受寒表寒病 亡陰病 身寒腹痛亡陰證)".

Prognostic Indicators of Extremity Liposarcoma (사지에 발생하는 지방육종의 예후 인자에 대한 분석)

  • Park, Kee Young;Kim, Jeung Il;Lee, In Sook;Song, You Seon;Choi, Kyung Un
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.331-337
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    • 2020
  • Purpose: The aim of this retrospective study was to define the prognostic factors for liposarcoma to aid in the selection of effective treatments. Materials and Methods: This study analyzed 41 cases out of 45 cases diagnosed with and treated for liposarcoma 2002 to 2015; 4 cases of well-differentiated liposarcoma were excluded. The effects of sex, age, site, stage, and histological classification on survival were analyzed retrospectively. For 28 cases diagnosed with myxoid liposarcoma, additional analysis was performed after the inclusion of round cell components. Results: The mean age at diagnosis was 52.05 years (range 25-82 years) and the average follow-up period was 63.7 months. The disease-free survival rate was 43.2%. Most factors, including sex and age, were not significantly associated with the survival rate. On the other hand, the stage (Musculoskeletal Tumor Society stage) was significantly associated with the survival rate. The survival rate of patients with myxoid liposarcoma was 69% and the local recurrence and metastasis results varied according to the presence of round cells. Conclusion: The stage of liposarcoma and the sex of the patient were found to be effective factors for prognosis. When planning the treatment for liposarcoma, the treatment outcome for liposarcoma differs according to several prognostic factors.

Network Analysis Using the Established Database (K-herb Network) on Herbal Medicines Used in Clinical Research on Heart Failure (심부전의 한약 임상연구에 활용된 한약재에 대한 기구축 DB(K-HERB NETWORK)를 활용한 네트워크 분석)

  • Subin Park;Ye-ji Kim;Gi-Sang Bae;Cheol-Hyun Kim;Inae Youn;Jungtae Leem;Hongmin Chu
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.313-353
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    • 2023
  • Objectives: Heart failure is a chronic disease with increasing prevalence rates despite advancements in medical technology. Korean medicine utilizes herbal prescriptions to treat heart failure, but little is known about the specific herbal medicines comprising the network of herbal prescriptions for heart failure. This study proposes a novel methodology that can efficiently develop prescriptions and facilitate experimental research on heart failure by utilizing existing databases. Methods: Herbal medicine prescriptions for heart failure were identified through a PubMed search and compiled into a Google Sheet database. NetMiner 4 was used for network analysis, and the individual networks were classified according to the herbal medicine classification system to identify trends. K-HERB NETWORK was utilized to derive related prescriptions. Results: Network analysis of heart failure prescriptions and herbal medicines using NetMiner 4 produced 16 individual networks. Uhwangcheongsim-won (牛黃淸心元), Gamiondam-tang (加味溫膽湯), Bangpungtongseong-san (防風通聖散), and Bunsimgi-eum (分心氣飮) were identified as prescriptions with high similarity in the entire network. A total of 16 individual networks utilized K-HERB NETWORK to present prescriptions that were most similar to existing prescriptions. The results provide 1) an indication of existing prescriptions with potential for use to treat heart failure and 2) a basis for developing new prescriptions for heart failure treatment. Conclusion: The proposed methodology presents an efficient approach to developing new heart failure prescriptions and facilitating experimental research. This study highlights the potential of network pharmacology methodology and its possible applications in other diseases. Further studies on network pharmacology methodology are recommended.

Analysis of Research Trends Related to drug Repositioning Based on Machine Learning (머신러닝 기반의 신약 재창출 관련 연구 동향 분석)

  • So Yeon Yoo;Gyoo Gun Lim
    • Information Systems Review
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    • v.24 no.1
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    • pp.21-37
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    • 2022
  • Drug repositioning, one of the methods of developing new drugs, is a useful way to discover new indications by allowing drugs that have already been approved for use in people to be used for other purposes. Recently, with the development of machine learning technology, the case of analyzing vast amounts of biological information and using it to develop new drugs is increasing. The use of machine learning technology to drug repositioning will help quickly find effective treatments. Currently, the world is having a difficult time due to a new disease caused by coronavirus (COVID-19), a severe acute respiratory syndrome. Drug repositioning that repurposes drugsthat have already been clinically approved could be an alternative to therapeutics to treat COVID-19 patients. This study intends to examine research trends in the field of drug repositioning using machine learning techniques. In Pub Med, a total of 4,821 papers were collected with the keyword 'Drug Repositioning'using the web scraping technique. After data preprocessing, frequency analysis, LDA-based topic modeling, random forest classification analysis, and prediction performance evaluation were performed on 4,419 papers. Associated words were analyzed based on the Word2vec model, and after reducing the PCA dimension, K-Means clustered to generate labels, and then the structured organization of the literature was visualized using the t-SNE algorithm. Hierarchical clustering was applied to the LDA results and visualized as a heat map. This study identified the research topics related to drug repositioning, and presented a method to derive and visualize meaningful topics from a large amount of literature using a machine learning algorithm. It is expected that it will help to be used as basic data for establishing research or development strategies in the field of drug repositioning in the future.

Fully Automatic Coronary Calcium Score Software Empowered by Artificial Intelligence Technology: Validation Study Using Three CT Cohorts

  • June-Goo Lee;HeeSoo Kim;Heejun Kang;Hyun Jung Koo;Joon-Won Kang;Young-Hak Kim;Dong Hyun Yang
    • Korean Journal of Radiology
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    • v.22 no.11
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    • pp.1764-1776
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    • 2021
  • Objective: This study aimed to validate a deep learning-based fully automatic calcium scoring (coronary artery calcium [CAC]_auto) system using previously published cardiac computed tomography (CT) cohort data with the manually segmented coronary calcium scoring (CAC_hand) system as the reference standard. Materials and Methods: We developed the CAC_auto system using 100 co-registered, non-enhanced and contrast-enhanced CT scans. For the validation of the CAC_auto system, three previously published CT cohorts (n = 2985) were chosen to represent different clinical scenarios (i.e., 2647 asymptomatic, 220 symptomatic, 118 valve disease) and four CT models. The performance of the CAC_auto system in detecting coronary calcium was determined. The reliability of the system in measuring the Agatston score as compared with CAC_hand was also evaluated per vessel and per patient using intraclass correlation coefficients (ICCs) and Bland-Altman analysis. The agreement between CAC_auto and CAC_hand based on the cardiovascular risk stratification categories (Agatston score: 0, 1-10, 11-100, 101-400, > 400) was evaluated. Results: In 2985 patients, 6218 coronary calcium lesions were identified using CAC_hand. The per-lesion sensitivity and false-positive rate of the CAC_auto system in detecting coronary calcium were 93.3% (5800 of 6218) and 0.11 false-positive lesions per patient, respectively. The CAC_auto system, in measuring the Agatston score, yielded ICCs of 0.99 for all the vessels (left main 0.91, left anterior descending 0.99, left circumflex 0.96, right coronary 0.99). The limits of agreement between CAC_auto and CAC_hand were 1.6 ± 52.2. The linearly weighted kappa value for the Agatston score categorization was 0.94. The main causes of false-positive results were image noise (29.1%, 97/333 lesions), aortic wall calcification (25.5%, 85/333 lesions), and pericardial calcification (24.3%, 81/333 lesions). Conclusion: The atlas-based CAC_auto empowered by deep learning provided accurate calcium score measurement as compared with manual method and risk category classification, which could potentially streamline CAC imaging workflows.