Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제43권6호
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pp.388-394
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2017
Objectives: The objective of this study was to investigate the presence of oral lesions in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients in a descriptive cross-sectional study, and to establish their presence according to levels of CD4+ cells (including the CD4+/CD8+ cell ratio). Materials and Methods: A total of 75 patients infected with HIV were included. Oral lesions were observed and classified using World Health Organization classification guidelines. Potential correlations between the presence and severity of oral lesions and CD4+ cells, including the CD4+/CD8+ cell ratio, were studied. Results: The most frequent oral lesion detected was oral pseudomembranous candidiasis (80.0%), followed by periodontal disease (40.0%), herpetic lesions (16.0%), hairy leukoplakia (16.0%), gingivitis (20.0%), oral ulceration (12.0%), Kaposi's sarcoma (8.0%), and non-Hodgkin's lymphoma (4.0%). The CD4+ count was <$200cells/mm^3$ in 45 cases (60.0%), between $200-500cells/mm^3$ in 18 cases (24.0%), and >$500cells/mm^3$ in 12 cases (16.0%). The mean CD4+ count was $182.18cells/mm^3$. The mean ratio of CD4+/CD8+ cells was 0.26. All patients showed at least one oral manifestation. Conclusion: There was no correlation between the CD4+/CD8+ cell ratio and the presence of oral lesions. The severity of the lesions was more pronounced when the CD4+ cell count was less than $200cells/mm^3$.
UNGI(運氣) theory is one of the most important theory in Oriental medicine. But it's so difficult to adapt to real medic. Long time ago many Oriental Physicians disscussed this with other physicians, UNGI to Oriental Medicine, and so still now. Remarkably, it is important as a basic theory itself, UNGI exist as a special medic. We can see that in the book of ‘五運六氣韓醫學寶鑑’, ‘運氣演繹方藥篇’ and other such kind of books. The special thing is we can predict each man's disease through the date of his birth. And more, we can make out prescription for each person's health. In addition, by knowing his date of birth, we can calculate his date of pregnancy, and with the same way, we can also predict and prescript that he can be protected from his fateful disease. But, the way like this can make Oriental medic an astrology and a superstition. So I studied on this and concluded as follow, 1. UNGI theory is important in the Oriental Medicine not only in basic but on diagnosis and attendance. 2. Mechanical abuse in the past, make UNGI theory unbelievable. But Liu Ha-gan(劉河間) studied so deeply, and knew the right way to applicate UNGI theory on Oriental medic. 3. It is not logical the pregnant day counted thru birthday, so we have to percept this an abstract idea. And it founded detail way to count the pregnant day. 'UNGI' as a medical system, by knowing his birthday we can predict and prevent his fateful disease. Of course, I cannot find such substances in Neijing, and classic books on Oriental medicine. So queer at a glance, but clinically it has some valuable meanings. However, There's little to prove its foundation. It is similar to astrology, we cannot define its base. The problems we have to trace and find out.
During the period from January, 1975, to June, 1989, one hundred patients with histopathologically proven polymorphic reticulosis in the upper respiratory tract were treated with radiation therapy and the analysis of treatmemt results was undertaken. One hundred patients (69 males, 31 females) with a mean age of 46 years (range 12-79 years) were presented. Nasal cavity was the most frequent site of involvement ($56{\%}$), and 44 cases had multifocal sites of involvement. The incidence of cervical lymph node metastasis at initial diagnosis was $24{\%}$. Staging was determined by Ann-Arbor classification, retrospectively. The number of patients of stage IE, IIE, IIIE and IVE were 35, 60, 1, and 4, respectively. The overall 5 year actuarial survival rates were $38.4{\%}$. The difference in 5 year survival rates between patients with stage IE and IIE, with solitary and multiple, with CR and PR after irradiation were significant statistically. For the analysis of failure patterns, failure sites include the following: local failure alone (30/55=$54.6{\%}$), systemic failure alone (9/55=$16.4{\%}$), both local and systemic failure (16/55=$29.0{\%}$). Retrograde slide review was available in 29 cases of PMR with respect to histopathologic bases, and immunohistochemical studies were performed using MT1 and DACO-UCHL-1 as T-cell markers, MB2 as a B-cell marker and alpha-1-antichymotrypsin as a histiocytic markers. All that 29 cases showed characteristic histologic features similar to those of peripheral T-cell lymphoma and showed positive reactio to the T-cell marker. These findings suggest strongly that quite a significant portion of PMR may be in fact T-cell lymphoma.
Korean Medical Insurance Cooperation executed the physical checkup intended for all the members of public officials, school personnel in private schools, and the insured as a national-wide event in 1980. This is the result of a part of Taegu district and its contiguous country this hospital took charge of. Physical checkup method was divided into the first health examination and tile second health examination. The second health examination was executed for those who needed reexamination according to the result of the first health examination. After that, we passed judgement on the result finally. The total number of the first health examination was 10,779; 4,606 in public officials, 2,327 in police constables, 3,976 in school personnel in private schools. The classification of physical checkup is as follows; A group: normal groups B group: those who do not require immediate medical care but require preventive measures or who are doubtful of disease or who had undetermined diagnosis (attention) C group: those who require immediate medical care but who are able to be on duty (simple recuperation) D group: those who require immediate medical treatment and recuperation (suspension from office and recuperation) Total B group to the in the first health examination was 4.73%, that of total C,D groups 2.21%. That of total C,D groups to the total in the first health examination by occupation was 2.30% in public officials, 2.19% in police constables, 2.04% in school personnel. Consequently there was no different among occupations. Total C,D groups of hypertension to the total in the first health examination was 1.68% and hypertension was 76.05% to all disease. These rates mentioned to above were higher than any other rate in disease. Subsequently, being low, the rate of diabetes was 15.54%. From the view point of age, the higher rate appeared in men and women over 35 years old of B group and over 45 years old of C,D groups in three occupations in comparison with other ages and the older men were, the higher men who took a disease were.
Urban transit is a complex system that is combined electrically and mechanically, it is necessary to construct maintenance system for securing safety accompanying high-speed driving and maintaining promptly. Expert system is a computer program which uses numerical or non-numerical domain-specific knowledge to solve problems. In this research, we intend to develop the expert system which diagnose failure causes quickly and display measures. For the development of expert system, standardization of failure code classification system and creation of BOM(Bill Of Materials) have been first performed. Through the analysis of failure history and maintenance manuals, knowledge base has been constructed. Also, for retrieving the procedure of failure diagnosis and repair linking with the knowledge base, we have built RBR(Rule Based Reasoning) engine by pattern matching technique and CBR(Case Based Reasoning) engine by similarity search method. This system has been developed based on web to maximize the accessibility.
Objectives : The purpose of this study was to examine the effect between job stress in jobholders and xerostomia. Methods : 250 jobholders living in Jecheon city were the subjects of this questionnaire. The questionnaire was made up of three contents and 37 items: general characteristic(13), job stress(14), degree & behavior of xerostomia(10). The data were analyzed by two-sample t-test, one-way ANOVA to examine the subjects general characteristics, job stress and degree of xerostomia and were analyzed by Chi-square test to examine the subjects general characteristics, job stress and behavior of xerostomia. Results : Only 215 jobholders were evaluated due to inadequate responses. The results were as follow. 1. As general characteristic of jobholder, male(83.7%) were more than women(16.3%), 30~39 year-old(47%) in age variable, university graduation(63.7%) in the last educational background variable, 2~3 million won(31.2%) in the month average income variable, 1~5 year(33.5%) in tour of duty variable, non-smoker(47.9%) in smoking variable were most. Married(58.6%) were more than unmarried(39.5%). Alcoholic(69.8%) were more than non-alcoholic(30.2%). 2. As classification of job stress, high strain group was 28.4%, active group was 26%, low strain group was 24.2%, passive group was 21.4%. 3. Analysis of effect between general characteristic and degree & behavior of xerostomia showed smoker were statistical significantly higher than non-smoker on 'dry eat', 'Am-sal', 'Night awake', 'Slip-liq'and 'Gumcandy'(p<0.05) and showed alcoholic were statistical significantly higher than non-alcoholic on 'Dry PM', 'Night awake, $H_2O$-bed'(p<0.05). 4. Analysis of effect between job stress and degree & behavior of xerostomia showed hight strain group were statistical significantly higher than low strain group on 'Dry PM', 'Dry-day', 'Am-sal', 'Eff-life'and 'Night awake'(p<0.05). Conclusions : As high strain group were higher than other groups on degree & behavior of xerostomia, stress would be factor that have an effect on xerostomia. Thus consider and management of stress is necessary for diagnosis and treatment of xerostomia.
Background: Rehabilitations in subacute phase are different from acute treatments regarding the characteristics and required resource consumption of the treatments. Lack of accuracy and validity of the Korean Diagnosis Related Group and Korean Out-Patient Group for the acute patients as the case-mix and payment tool for rehabilitation inpatients have been problematic issues. The objective of the study was to develop the Korean Rehabilitation Patient Group (KRPG) reflecting the characteristics of rehabilitation inpatients. Methods: As a retrospective medical record survey regarding rehabilitation inpatients, 4,207 episodes were collected through 42 hospitals. Considering the opinions of clinical experts and the decision-tree analysis, the variables for the KRPG system demonstrating the characteristics of rehabilitation inpatients were derived, and the splitting standards of the relevant variables were also set. Using the derived variables, we have drawn the rehabilitation inpatient classification model reflecting the clinical situation of Korea. The performance evaluation was conducted on the KRPG system. Results: The KRPG was targeted at the inpatients with brain or spinal cord injury. The etiologic disease, functional status (cognitive function, activity of daily living, muscle strength, spasticity, level and grade of spinal cord injury), and the patient's age were the variables in the rehabilitation patients. The algorithm of KRPG system after applying the derived variables and total 204 rehabilitation patient groups were developed. The KRPG explained 11.8% of variance in charge for rehabilitation inpatients. It also explained 13.8% of variance in length of stay for them. Conclusion: The KRPG version 1.0 reflecting the clinical characteristics of rehabilitation inpatients was classified as 204 groups.
This study aims to compare the experience of selected countries in operating separate payment system for new healthcare technology and to find implications for price setting in Korea. We analyzed the related reports, papers, laws, regulations, and related agencies' online materials from five selected countries including the United States, Japan, Taiwan, Germany, and France. Each country has its own additional payment system for new technologies: transitional pass-through payment and new technology ambulatory payment classification for outpatient care and new technology add-on payment for inpatient care (USA), an extra payment for materials with new functions or new treatment (C1, C2; Japan), an additional payment system for new special treatment materials (Taiwan), a short-term extra funding for new diagnosis and treatment (NUB; Germany), and list of additional payments for new medical devices (France). The technology should be proven safe and effective in order to get approval for an additional payment. The price is determined by considering the actual cost of providing the technology and the cost of existing similar technologies listed in the benefits package. The revision cycle of the additional payment is 1 to 4 years. The cost or usage is monitored during that period and then integrated into the existing fee schedule or removed from the list. We conclude that it is important to set the explicit criteria to select services eligible for additional payment, to collect and analyze data to assess eligibility and to set the payment, to monitor the usage or cost, and to make follow-up measures in price setting for new health technologies in Korea.
KSII Transactions on Internet and Information Systems (TIIS)
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제13권10호
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pp.5179-5196
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2019
To explore an effective non-invasion medical imaging diagnostics approach for hepatocellular carcinoma (HCC), we propose a method based on adopting the multiple technologies with the multi-parametric data fusion, transfer learning, and multi-scale deep feature extraction. Firstly, to make full use of complementary and enhancing the contribution of different modalities viz. multi-parametric MRI images in the lesion diagnosis, we propose a data-level fusion strategy. Secondly, based on the fusion data as the input, the multi-scale residual neural network with SPP (Spatial Pyramid Pooling) is utilized for the discriminative feature representation learning. Thirdly, to mitigate the impact of the lack of training samples, we do the pre-training of the proposed multi-scale residual neural network model on the natural image dataset and the fine-tuning with the chosen multi-parametric MRI images as complementary data. The comparative experiment results on the dataset from the clinical cases show that our proposed approach by employing the multiple strategies achieves the highest accuracy of 0.847±0.023 in the classification problem on the HCC differentiation. In the problem of discriminating the HCC lesion from the non-tumor area, we achieve a good performance with accuracy, sensitivity, specificity and AUC (area under the ROC curve) being 0.981±0.002, 0.981±0.002, 0.991±0.007 and 0.999±0.0008, respectively.
This study was conducted from August, 1980 to March, 9991 to the 40 subjects who were admitted to Kosin Medical Center and received rehabilitation treatment and discharged under the impression of stroke. The objectives are to evaluate the function of the activites of daily living and comprehensive function and find the status of rehabilitation treatment by Modified Barthel Index and PULSES Profile when first requested or rehabilitation treatment(T1), at 2 weeks after rehabilitation treatment(T2), at discharge(T3) and at the time of ambulatory treatment after 2 weeks(T4). The study materials were clinical charts and functional evaluation sheets, and the results are as follows : 21 subject$(52.5\%)$ were male, 19 subjects$(47.5\%)$ were female, and the age distribution was from 19 to 70 in age, the average age was 52.7. By the classification of diagnosis, 21 subjects$(52.5\%)$ were cerebral hemorrhage, 8 subjects$(20.2\%)$ were cerebral thrombosis, 6 subjects$(15.0\%)$ were cerebral embolism, and 5 subjects$(12.5\%)$ were cerebral infarction. The Barthel Index scores were 35.7, 54.5, 71.8, 88.7 on the average at T1, T2, T3, T4 respectively. The PULSES scores were 16.4, 13.7, 11.4, 8.7 on the average at T1, T2, T3, T4 respectively. Regarding the Pearson's correlation coefficient between the Barthel Index scores and the PULSES scores, it was -0.7991(P>0.001) at T1 and -0.8986(P>0.001) at T3, then beth of correlations were very high.
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