• Title/Summary/Keyword: Classification of Diseases

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Proposed Application Design for Community-Based Rehabilitation Services Access in Community Care System: Occupation and Activity Based (커뮤니티케어 제도 내 지역사회중심재활 서비스 접근을 위한 애플리케이션 디자인의 제안 : 작업과 활동 중심으로)

  • Bae, Seong-Hwan;Jang, Yeon-Sig;Baek, Ji-Young
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.4
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    • pp.325-335
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    • 2021
  • Chronic diseases have been increasing recently as the average life expectancy of humans has been extended, and this trend has caused problems such as the widespread demand for health and rehabilitation services and rising medical costs. In order to solve this problem, the community-based rehabilitation has been developed and strengthened in Korea and gradually promoted since 2019. It is important to secure access to clients who want to use services to revitalize community-based rehabilitation. So in this study, as part of the community-based rehabilitation, intends to devise smartphone applications designs and develop a prototype to secure access to community-based occupational therapy services based on occupation and activities. For Occupational Therapy Practice Framework (OTPF), International Classification of Functioning, Disability and Health (ICF), and Allen Diagnostic Module-2 (ADM-2) were used to devise and categorize occupation and activity based application content, and link OTPF, ICF, and ADM-2 through prior research analysis and expert meetings. The derived content was visualized through literature review and activity analysis, and was implemented to enable direct playback within the application using the YouTube API, and finally developed a prototype application. The Android Studio 3.5.2 for Windows 64-bit was used to build the application prototype. In further research, converging various digital technologies for user convenience and additionally researching community-based occupational therapy service providers opinions and service user satisfaction will improve accessibility to community-based occupational therapy services for clients who have difficulty occupational performance in the community.

VRIFA: A Prediction and Nonlinear SVM Visualization Tool using LRBF kernel and Nomogram (VRIFA: LRBF 커널과 Nomogram을 이용한 예측 및 비선형 SVM 시각화도구)

  • Kim, Sung-Chul;Yu, Hwan-Jo
    • Journal of Korea Multimedia Society
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    • v.13 no.5
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    • pp.722-729
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    • 2010
  • Prediction problems are widely used in medical domains. For example, computer aided diagnosis or prognosis is a key component in a CDSS (Clinical Decision Support System). SVMs with nonlinear kernels like RBF kernels, have shown superior accuracy in prediction problems. However, they are not preferred by physicians for medical prediction problems because nonlinear SVMs are difficult to visualize, thus it is hard to provide intuitive interpretation of prediction results to physicians. Nomogram was proposed to visualize SVM classification models. However, it cannot visualize nonlinear SVM models. Localized Radial Basis Function (LRBF) was proposed which shows comparable accuracy as the RBF kernel while the LRBF kernel is easier to interpret since it can be linearly decomposed. This paper presents a new tool named VRIFA, which integrates the nomogram and LRBF kernel to provide users with an interactive visualization of nonlinear SVM models, VRIFA visualizes the internal structure of nonlinear SVM models showing the effect of each feature, the magnitude of the effect, and the change at the prediction output. VRIFA also performs nomogram-based feature selection while training a model in order to remove noise or redundant features and improve the prediction accuracy. The area under the ROC curve (AUC) can be used to evaluate the prediction result when the data set is highly imbalanced. The tool can be used by biomedical researchers for computer-aided diagnosis and risk factor analysis for diseases.

Clinical Investigation of Childhood Epilepsy (소아간질의 임상적 관찰)

  • Moon, Han-Ku;Park, Yong-Hoon
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.103-111
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    • 1985
  • Childhood epilepsy which has high prevalence rate and inception rate is one of the commonest problem encountered in pediatrician. In contrast with epilepsy of adult, in childhood epilepsy, more variable and varying manifestations are found because the factors of age, growth and development exert their influences in the manifestations and the courses of childhood epilepsy. Moreover epileptic children have associated problems such as physical and mental handicaps, psychologicaldisorders and learning disability. For these reasons pediatrician who deals with epileptic children experiences difficulties in making diagnosis and managing them. In order to improve understanding and management of childhood epilepsy, authors reviewed 103 cases of epileptic patients seen at pediatric department of Yeungnam University Hospital retrospectively. The patients were classified according to the type of epileptic seizure. Suspected causes of epilepsy, associated conditions of epileptic patients, age incidence and the findings of brain CT were reviewed. Large numbers of epileptic patients (61.2%) developed their first seizures under the age of 5. The most frequent type of epileptic seizure was generalized ionic-clonic, tonic, clonic seizure (49.5%), followed by simple partial seizure with secondary generalization (17.5%), simple partial seizure (7.8%), a typical absence (5.8%) and unclassified seizure (5.8%). In 83.5% of patients, we could not find specific cause of it, but in 16.5% of cases, history of neonatal hypoxia (4.9%), meningitis (3.9%), prematurity (1.9%), small for gestational age (1.0%), CO poisoning (1.0%), encephalopathy (1.0%), DPT vaccination (1.0%), cerebrovascular accident (1.0%) and neonatal jaundice (1.0%) were found, 30 cases of patients had associated diseases such as mental retardation, hyperactivity, delayed motor milestones or their combinations. The major abnormal findings of brain CT performed in 42 cases were cortical atrophy, cerebral infarction, hydrocephalus and brain swelling. This review stressed better designed classification of epilepsy is needed and with promotion of medical care, prevention of epilepsy is possible in some cases. Also it is stressed that childhood epilepsy requires multidisplinary therapy and brain CT is helpful in the evaluation of epilepsy with limitation in therapeutic aspects.

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Study for Clinical Indicators of Prediction for Histological Finding of IgA Nephropathy (IgA 신병증의 조직소견을 예측할 수 있는 임상지표에 관한 연구)

  • Han Byong-Mu;Cho Jin-Youl;Chuon Ko-Woon;NamGoong Mee-Kyung
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.150-156
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    • 2003
  • Purpose : Efforts to predict the clinicopathological outcome of IgA nephropathy have been made but have yielded conflicting results and have not helped in deciding the appropriate timing of the renal biopsy. In this study, we reviewed the predictive factors of clinicopathological outcome for finding out the criteria of renal biopsy timing of IgA nephropathy. Methods : Forty children diagnosed with biopsy proven IgA nephropathy at Wonju Christian Hospital were studied retrospectively, based on medical records. Results : Among 39 patients, 2 children progressed to higher serum creatinine level. One of them reached to the end stage renal disease within 2 year 7 months. According to WHO histopathological classification, there were 15 cases of class I, 14 cases of class II, 7 cases of class III, and 3 cases of class IV. In the mild histological classes(class I, II), gross hematuria was shown in 23 out of 29 children(P=0.02). In the severe histological classes(class III, IV), gross hematuria was noted in 4 out of 10(P>0.05). The tubulointerstitial changes were grade 1 in 24 cases, grade 2 in 4 cases, grade 3 in 8 cases, and grade 4 in 3 cases. With an increase in the tubulointerstitial grade, the 24 hour urine protein/albumin ratio increased. Serum creatinine less than 0.79 mg/dL could predict the lower grade(grade 1 and 2) of tubulointerstitial changes. But serum creatinine greater than 1.13 mg/dL could predict the higher grade(grade 3 and 4) of tubulointerstitial changes. In children with gross hematuria(n=27), serum creatinine was lower(0.78 vs 1.09 mg/dL, P=0.027), serum IgA was higher(316.3 vs 198.8 mg/dL), and the cases of lower WHO classification(I and II) were more common(23 vs 4, P=0.029) than the children with microscopic hematuria. Conclusion : Serum creatinine less than 0.79 mg/dL, macroscopic hematuria, and higher 24 hour urine protein/albumin ratio would predict the lower grade glomerulo tubulointerstitial lesion in IgA nephropathy and could be used as the criteria delaying the renal biopsy.

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Clinicopathological Analysis of Glomerulonephritis in Children (소아 사구체신염의 임상 및 병리학적 분석)

  • Park Gwang-Yong;Yoon Hye-Kyoung;Chung Woo-Yeong
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.4-12
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    • 1997
  • Purpose: To evaluate the prevalence and clinical manifestations of various glomerulonephritis (GN) in children, a clinicopathological anlysis of 310 biopsied cases were performed. Method: We conducted retrospective study with review of histopathologic findings and clinical manifestations of the 310 cases diagnosed as glomerulonephritis by percutaneous renal biopsy which were done between January 1986 and December 1996 at department of pediatrics, Pusan Paik hospital. Results: 1) Male to female ratio was 1.54:1 and the range of age was from 13 months to 15 years 10 months. 2) Among these, 217 (70.0%) patients were belong to primary GN and 93 (30.0%) patients were belong to secondary GN. As a whole, the most common pathologic diagnosis was minimal change lesion (MC, 32.6%), which was followed by IgA nephropathy (IgAN, 15.8%), $Henoch-Sch\"{o}nlein$ purpura nephritis (HSPN, 13.5%), Poststreptococcal glomerulonephritis (PSAGN, 8.1%). 3) Clinical manifestations of patients were asymptomatic urinary abnormality (43.2%), nephrotic syndrome (41.0%), acute glomerulonephritis (14.2%), chronic glomerulonephritis (1.0%), rapidly progressive glomerulonephritis (0.6%). 4) In primary GN, the most common pathologic diagnosis was MC (46.5%), IgAN (22.6%), thin glomerular basement membrane (GBM) disease (7.8%), membranoproliferative glomerulonephritis (MPGN, 5.5%), mesangial proliferative glomerulonephritis (MesPGN,4.6%), focal segmental glomerulosclerosis (FSGS, 4.6%), membranous nephropathy (MN, 0.9%), sclerosing glomerulonephritis (SCGN, 0.9%), crescentic glomerulonephritis (CreGN, 0.5%) and non-specific glomerulonephritis (NonspGN, 6.0%). 5) Major causes of secondary GN were HSPN (45.2%), PSAGN (26.9%), hepatitis B associated glomerulonephritis (HBGN, 17.2%), lupus nephritis (LN, 6.5%), Alport syndrome (2.2%), hemolytic uremic syndrome (1.0%), fibrillary glomerulonephritis (1.0%) in descending order. Conclusions: There are some differences of the results of clinicopathological stuidies of glomerulonephritis in children because of its different indications of renal biopsy, pathologic classification of renal disease and methods of analysis among investigators. In order to establish more reliable data of incidence and classification of childhood glomerulonephritis in Korea, multicenter cooperative study were necessary.

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Non-radiologic Methods for Predicting Vesicoureteral Reflux in Childhood Urinary Tract Infection (요로감염 환아에서 비방사선학적 방법에 의한 방광요관역류의 조기 예측에 관한 연구)

  • Jeon Seong-Hoi;Lee K.C.;Yoo Kee-Hwan
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.38-45
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    • 1997
  • Purpose : Vesicoureteral reflux(VUR) in childhood may be the primary cause of recurrent urinary tract infection and renal scarring. Renal ultrasonography, DMSA, and voiding cystourethrogram are the standard clinical methods for detection of vesicoureteral reflux. But these methods have many disadvantages such as invasiveness and high cost. So, we studied to observe the significance of urine ${\beta}_2$-microglobulin in association with other non-radiologic methods for predictng vesicoureteral reflux. Methods : We evaluated 40 patients with urinary tract infection who were admitted to Korea university Hospital from July 1993 to June 1994. Among them, 24 patients revealed urinary tract infection and vesicoureteral reflux(group A), 16 patients revealed only urinary tract infection(group B). Both groups were compared by presence of fever, hematuria, and proteinuria, positivity of CRP, and level of BUN, Cr, GFR by 99mTc-DTPA, urine ${\beta}_2$-microglobulin, 24 hours urine albumin. Results : 1) Among 24 patients who had vesicoureteral reflux, 14 had unilateral VUR, 10 had bilateral VUR, three kidneys with grade I, nine with grade II, eleven with grade III, eleven with grade IV by classification of International Reflux Study Committee. Among them, 14 patients had renal scar, five with type A, five with type B, four with type C, none with type D by Smellie's classification. 2) The mean of GFR, BUN, Cr, 24hrs urine albumin and the presence of hematuria and proteinuria showed no significant difference between group A and group B. The mean of urine ${\beta}_2$ microglobulin in group A and group B were $283.6{\pm}195.8{\mu}g/l$ and $78.7{\pm}48.5{\mu}g/l$ respectively, showing that group A had a higher value than group B (p<0.01). In case of ${\beta}_2$ microglobulin > $120{\mu}g/l$ and CRP(+), the sensitivity was 93.3% and the specificity is 77.8% for detecting of VUR. In case of ${\beta}_2$-microglobulin>$120{\mu}g/l$ and fever(+), the sensitivity was 92.2%, and the specificity was 62.5% for detecting of VUR Conclusions : If the level of urinary ${\beta}_2$-microglobulin is more than 120ug/l in children with urinary tract infection in association with fever(+) or CRP(+), it can predict VUR. So we can use it for early detection of VUR.

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Comparative Research on the Health Information Manager(HIM) Duties of One Malaysian Hospital and Similar Scale Korean hospitals (말레이시아 1개 병원과 병상규모가 유사한 한국의 병원 간 보건정보관리자 직무 비교연구)

  • Kim, Hey-Kyung;Lee, Hyun-Ju
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.10
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    • pp.6158-6167
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    • 2014
  • The aim of this study was to perform comparative analysis of the duties of 7 new roles of HIMs in Malaysian and Korean hospitals of a similar scale. A Malaysian general hospital with a scale of 272 hospital beds was chosen. The researcher visited a Malaysian hospital in person and interviewed the staff in charge over a 2 week period from July 22nd 2013 to August 2nd 2013. For domestic hospitals, 13 general hospitals with 270 hospital beds, similar to the Malaysian general hospital, were chosen. Phone interviews with the department recorded the duty recording work. Regarding 7 new roles of Health Information Manager (HIM), although the role as a Health information manager and Security Officer in Malaysian general hospital was not defined, 30.8% performed their role in Korean general hospitals. The classification of disease & procedure within the role of Clinical data specialist was performed by both countries, and while the tumor registry was done in a Malaysian general hospital, only 15.4% of Korean general hospitals were operating. The statistics of the discharged patients were not measured in the Malaysian general hospital but 76.9% of Korean general hospitals recorded these statistics. Although 22.1% of Korean general hospitals operated registration work of special disease, Malaysian general hospital not only had a total legal contagious disease registration, but also took charge of information registration of hospital births and deceased ones. Other than these, the Patient Information Coordinator, Data Quality Manager, Document and Repository Manager, Research and Decision Support Analyst roles were not done by either country. The new role of HIM is operated in a low percentage in Korean middle and small hospitals. Therefore, to clearly establish the role of HIM in Korea, and have middle and small hospitals to operate such a role, it is essential for the related association to give continuous education and provide support to clarify the role within the hospital working environment. It is desirable to benchmark Malaysian general hospital's registration work on special diseases and others, and expand the work to improve overall.

Correlation Analysis Between 3D Kidneys Measurements and Abdominal Obesity Level in Computed Tomography (전산화단층영상에서 콩팥 3차원 영상 계측치와 복부 비만도 간의 상관관계 분석)

  • Ji-Yeong Kim;Youl-Hun Seoung
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.315-325
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    • 2023
  • The purpose of this study was to predict abdominal obesity with 3-Dimensional computed tomography (3D CT) measurements of kidneys by analyzing the correlation between kidney sizes and abdominal obesity level. The subjects were 178 healthy adults without underlying diseases who had a comprehensive health examination at the Health Medical Center of Jesus Hospital in Jeonju. Abdominal obesity was measured by CT cross-sectional image at the level of the umbilicus and divided into visceral fat area, subcutaneous fat area, visceral fat/total fat ratio. The average comparison of kidney sizes classified according to abdominal obesity were performed through one-way analysis of variance (ANOVA) and Scheffe test. Pearson correlation analysis was performed to correlate all measurement values. The results of kidney size ANOVA analysis according to abdominal obesity were as follows. The means of kidney measurements according to visceral fat classification were significantly different in all kidney measurements (p<0.05). And in case of subcutaneous fat classification, the means of kidney measurements by 3D CT of the severe obesity group were significantly different in the right kidney width (p<0.05). In case of visceral fat area/total fat area ratio, the means of kidney measurements by 3D CT of the severe obesity group were significantly different in both kidneys width (p<0.05). Pearson correlation between kidneys measurements and CT abdominal obesity showed that visceral fat area had the highest correlation with the left kidney width measured by 3D CT (r=0.467) and subcutaneous fat area had correlation with the right kidney width measured by 3D CT (r=0.249). The visceral fat area/total fat area ratio had correlation with the left kidney width measured by 3D CT (r=0.291).

Prognostic Value of Fibroblastic Foci in Patients with Usual Interstitial Pneumonia (통상성 간질성 폐렴 환자 예후인자로서의 섬유모세포병소(fibroblastic foci)의 유용성)

  • Park, Yong-Bum;Kang, Gil-Hyun;Shim, Mae-Sun;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Won-Dong;Kitaichi, Masanori;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.3
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    • pp.309-318
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    • 2002
  • Background : Usual interstitial pneumonia (UIP) is a fatal progressive fibrotic disorder of the lung with unknown etiology and characterized by a poor response to conventional immunosuppressive therapy. The histologic hallmark of UIP is parchy distribution of subpleural fibrosis and fibroblastic foci(FBF) with interposed normal appearing lung. Because FBF is a collection of actively proliferating myofibroblasts, it can be a marker of activity and prognosis of UIP. However, there were contradictory reports about the correlation between the degree of FBF and survival. Therefore we performed this study to investigate the value of FBF as prognostic marker of UIP. Methods : This was a retrospective study on the 46 patients(M:F=33:13, mean age:$59{\pm}12$ years) with UIP diagnosed by the surgical lung biopsy at the Asan Medical Center, Seoul, Korea between 1990 and 2000 and had follow-up of more than a year. All the biopsy specimens were reevaluated and diagnosed as UIP according to the ATS/ERS classification. Semiquantitative grading of FBF(absent, 0; mild 1; moderate 2; marked 3) by the experienced pathologists who did not know the clinical findings were compared to the clinical data and the follow up course. Results : Thirteen patients(28.2%) died of UIP progression during the study period. The median survival time of all the subjects was 26 months after the biopsy. At the univariate analysis, FVC, $D_Lco$, smoking history and the grade of FBF were significantly related to the survial. The survival was longer in subjects with lesser degrees of FBF, higher DLco, higher FVC and history of smoking. However the multivariate analysis with Cox regression test showed the extent of FBF was the only independent prognostic marker of UIP. Conclusion : These data suggested that the extent of FBF on the surgical lung biopsy can be used as a prognostic marker of UIP.

Accuracy of the Registered Cause of Death in a County and its Related Factors (일개 군 사망신고자료에 기재된 사인의 정확성과 관련요인)

  • Shin, Hee-Young;Shin, Jun-Ho;Nam, Hae-Sung;Ryu, So-Yeon;Im, Jeong-Soo;Rhee, Jung-Ae;Chung, Eun-Kyung
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.2
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    • pp.153-159
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    • 2002
  • Objectives : To evaluate the accuracy of the registered cause of death in a county and its related factors. Methods : The data used in this study was based on 504 cases, in a county of Chonnam province, registered between January and December 1998. Study subjects consisted of 388 of the 504 cases, and their causes of death were established by an interview survey of the next of kin or neighbor and medical record surveys. We compared the registered cause of death with the confirmed cause of death, determined by surveys and medical records, and evaluated the factors associated with the accuracy of the registered cause of death. Results : 62.6% of the deaths were concordant with 19 Chapters classification of cause of death. external causes of mortality, endocrine, nutritional and metabolic diseases, neoplasms and diseases of the circulatory system showed the good agreement between the registered cause of death and the confirmed cause of death. The factors relating to the accuracy of the registered cause of death were the doctors' diagnosis for the cause of death (adjusted Odds Ratio: 2.67, 95% Confidence Interval: 1.21-5.89) and the grade of the public officials in charge of the death registry (adjusted Odds Ratio: 0.30, 95% CI=0.12-0.78). Conclusions : The accuracy of the registered cause of death was not high. It could be improved by using the doctors' diagnosis for death and improving the job specification for public officials who deal with death registration.