• Korean Journal of Radiology
• /
• v.22 no.7
• /
• pp.1087-1099
• /
• 2021

MRI has become important for the detection of prostate cancer. MRI-guided biopsy is superior to conventional systematic biopsy in patients suspected with prostate cancer. MRI is also increasingly used for monitoring patients with low-risk prostate cancer during active surveillance. It improves patient selection for active surveillance at diagnosis, although its role during follow-up is unclear. We aim to review existing evidence and propose a practical approach for incorporating MRI into active surveillance protocols.

• Nutrition Research and Practice
• /
• v.9 no.3
• /
• pp.268-277
• /
• 2015

BACKGROUND/OBJECTIVES: Although it is crucial to identify those children likely to be treated in an appropriate nutrition rehabilitation programme and discharge them at the appropriate time, there is no golden standard for such identification. The current study examined the appropriateness of using Mid-Upper Arm Circumference for the identification, follow-up and discharge of malnourished children. We also assessed its discrepancy with the Weight-for-Height based diagnosis, the rate of recovery, and the discharge criteria of the children during nutrition rehabilitation. SUBJECTS/METHODS: The study present findings from 156 children (aged 6-59 months) attending a supplementary feeding programme at Makadara and Jericho Health Centres, Eastern District of Nairobi, Kenya. Records of age, weight, height and mid-upper arm circumference were selected at three stages of nutrition rehabilitation: admission, follow-up and discharge. The values obtained were then used to calculate z-scores as defined by WHO Anthro while estimating different diagnostic indices. RESULTS: Mid-upper arm circumference single cut-off (< 12.5 cm) was found to exhibit high values of sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio at both admission and discharge. Besides, children recorded higher rate of recovery at 86 days, an average increment of 0.98 cm at the rate of 0.14mm/day, and a weight gain of 13.49gm/day, albeit higher in female than their male counterparts. Nevertheless, children admitted on basis of low MUAC had a significantly higher MUAC gain than WH at 0.19mm/day and 0.13mm/day respectively. CONCLUSIONS: Mid-upper arm circumference can be an appropriate tool for identifying malnourished children for admission to nutrition rehabilitation programs. Our results confirm the appropriateness of this tool for monitoring recovery trends and discharging the children thereafter. In principle the tool has potential to minimize nutrition rehabilitation costs, particularly in community therapeutic centres in developing countries.

• The Korean Journal of Health Service Management
• /
• v.8 no.1
• /
• pp.151-164
• /
• 2014

This study was conducted to investigate the effect of timing of surgery on outcomes of spine operated patients for lumbar herniated intervertebral disc. The research design was cohort study and based on the data of claims for the medical expenses of health insurance. 21,475 cases who had primary spine surgery between January 1, and December 31, 2003, observed to conservative treatment period in the past two years from preoperative primary diagnosis to timing of primary surgery. According to one and five year follow up monitoring, the probability of occurrence of reoperation was not statistically significant with preoperative duration of symptom. Also one year follow up, the probability of occurrence of complication, was not statistically significant with preoperative duration of symptom. But five year follow up, groups who had one to two month preoperative duration of symptom decreased complication rate than less than a month(95%CI:0.594-0.927). Thus, from the onset of symptoms of back pain before primary surgery with enough and adequate time observation is required. Also, medical consumers or providers to choose surgery in determining prudence is required.

• The Journal of Internal Korean Medicine
• /
• v.42 no.4
• /
• pp.563-571
• /
• 2021

Objectives: This pilot study aimed to confirm the possibility of applying our design to the main study, a retrospective medical record analysis of the diseases which have most frequently been treated with collaborations of Korean and Western medicine, and to identify what corrections and statistical models are needed to conduct the main study. Methods: Data were collected from a case report form developed for patients who received treatment in the medical institutions. Appropriate statistical techniques, like Propensity Score (PS) and Generalized Estimation Equation (GEE) models, were used to compare the indicators of collaboration and non-collaboration groups for patients in comparable diseases. Results: Using PS matching for each M and S disease group, the indicators were compared by balancing the collaboration and non-collaboration group, and the GEE models compared indicators between groups in each disease over follow-up. Through this process we identified two limitations, insufficient samples and a large deviation of the follow-up period. Conclusion: This pilot study confirmed that the study design and case report form are applicable. The main study will be conducted by collecting sufficient samples and reflecting deviation of follow-up period.

• Journal of Korean Society of Rural Planning
• /
• v.25 no.2
• /
• pp.99-117
• /
• 2019

Environmental impact assessment (EIA), which predicts, evaluates, and manages the influences on natural landscape, plays a role of monitoring natural resources for systematic management of natural landscape. However, the function of verification and correction of the system is still insufficient and feed-back, one of the most important features of EIA follow-up, has not been introduced in Korea's EIA system yet. As a procedure, it is required to check if the opinions of the evaluators are properly reflected to the outcomes of the project through a reviewing process after assessing environmental impacts of a development project. In reality, despite the awareness about the importance of follow-up inspection of the conformity with, the system mainly focuses on the agreement during the planning stage of the development project and fails to continuously manage after its completion. There have been various preceding studies related to prediction, evaluation, and management of environmental impacts on natural landscape for better management. They primarily dealt with the problems in the EIA process and suggested improvement measures, including directions for institutional development, step-by-step goals, and operation methods, to address the problems which arise in the EIA follow-up process. However, suggested measures are not actively applied with the focus only put on institutional operation, there are virtually no standardized methods to predict and assess landscape changes due to the development project and to manage landscape after the project. Against this backdrop, this study aims to explore the existing methods to analyze the impacts natural landscape and to establish a system where landscape management is continued after the development project. To this end, we will suggest reducing methods according to the predicted changes in landscape for post-project management of natural landscape. Characteristics of reduction methods by project type were examined through reviewing the guide to natural landscape rating and the importance of development project impacts on natural landscape by type of reduction was evaluated through questionnaire for experts. Evaluated types of reduction are classified and presented by characteristics of each development project and content of reduction type.

• Korean Journal of Clinical Pharmacy
• /
• v.9 no.2
• /
• pp.97-102
• /
• 1999

The effects of pharmacist's intervention for asthma patients using self-monitoring of peak expiratory flow rate in medication teaching model was evaluated for 3 months in improving clinical outcomes including emergency visits, hospitalizations, antibiotics use, symptoms and sleep disturbance. Twenty seven patients were enrolled in study and twenty three patients completed the follow-up schedules. The selected patients were given the pre-designed instruction for medication including appropriate use of medication, metered-dose inhaler(MDI) technique, identifying and controling asthma triggers and recognizing early signs of deterioration. There were significant improvements in clinical outcomes, in terms of emergency visits, hopitalizations, antibiotics use, symptoms and sleep disturbance. There were also significant improvements in the MDI use, environmental control, and medication knowledges. There was a progressive increase in peak expiratory flow rate during the three-month intervention. In conclusion, pharmacist's intervention using self-monitoring of peak expiratory flow rate has a significant impact on improving clinical outcomes in asthma patients.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
• /
• 2009.05a
• /
• pp.337-340
• /
• 2009

Wireless tele-home-care application gives new possibilities for ECG (electrocardiogram) monitoring system with wearable biomedical sensors. Thus, continuously development of high convenient ECG monitoring system for high-risk cardiac patients is essential. This paper describes to monitor a person's ECG using wearable approach. A wearable belt-type ECG electrode with integrated electronics has been developed and has proven long-term robustness and monitoring of all electrical components. The measured ECG signal is transmitted via an ultra low power consumption wireless sensor node. ECG signals carry a lot clinical information for a cardiologist especially the R-peak detection in ECG. R-peak detection generally uses the threshold value which is fixed thus it bring errors due to motion artifacts and signal size changes. Variable threshold method is used to detect the R-peak which is more accurate and efficient. In order to evaluate the performance analysis, R-peak detection using MIT-BIH databases and Long Term Real-Time ECG is performed in this research. This concept able to allow patient to follow up critical patients from their home and early detecting rarely occurrences of cardiac arrhythmia.

• International Journal of Computer Science & Network Security
• /
• v.22 no.1
• /
• pp.269-275
• /
• 2022

Public healthcare has recently become an issue of great importance due to the exponential growth in the human population, the increase in medical expenses, and the COVID-19 pandemic. Speed is one of the crucial factors in saving life, particularly in case of heart attack. Therefore, a healthcare device is needed to continuously monitor and follow up heart health conditions remotely without the need for the patient to attend a medical center. Therefore, this paper proposes a portable electrocardiogram (ECG) monitoring system to improve healthcare for heart attack patients in both home and ambulance settings. The proposed system receives the ECG signals of the patient and sends the ECG values to a MySQL database on the IoT-cloud via Wi-Fi. The signals are displayed as an ECG data chart on a webpage that can be accessed by the patient's doctor based on the HTTP protocol that is employed in the IoT-cloud. The proposed system detects the ECG data of the patient to calculate the total number of heartbeats, number of normal heartbeats, and the number of abnormal heartbeats, which can help the doctor to evaluate the health status of the patient and decide on a suitable medical intervention. This system therefore has the potential to save time and life, but also cost. This paper highlights the five main advantages of the proposed ECG monitoring system and makes some recommendations to develop the system further.

• Journal of Chest Surgery
• /
• v.33 no.1
• /
• pp.45-50
• /
• 2000

Background: The CarboMedics prosthetic heart valve was produced in an attempt to improve the existing valve designs and was especially concerned with easily the implantation and further reduction of turbulence. Precise positioning of the valve in situ was achieved by the abilityof the valve to rotate relative to the sewing ring. Improved monitoring is possible due to increased radiopacity and the dacron sewing ring is coated with carbon to reduce pannus overgrowth. The leaflets have an opening angle of 78 degrees that apparently allows a rapid synchronous closure The aim of this study was to analyze the clinical performance of the CarboMedics valve prostheses(45 mitral 13 aortic and 7 double aortic-mitral valve replacement) were implanted in 65 patients(mean age 48.75$\pm$9.74 years) Result: The operative mortality was 3.1%(2/65) causes of death were low cardiac output syndrome. Total follow up was 1831 patient-months and mean follow up was 29.06$\pm$10.97 months/patient. No structural failure hemorrhage valve thrombosis and late death have been observed. Embolism occurred at a rate of 0.65%/Patient-year. Actuarial survival and thrombo-mbolism free rate at 36 months were 96.9% and 98.4% respectively. Consclusions: The CarboMedics valve stands for low valve related complicatons.

• Journal of Korean Biological Nursing Science
• /
• v.17 no.4
• /
• pp.331-340
• /
• 2015

Purpose: This study was to develop and evaluate an individualized education program based on self-efficacy for patients with kidney transplantation in Korea. Methods: A nonequivalent control group pretest-posttest design was used. The participants consisted of 43 patients who underwent kidney transplants at one hospital in Seoul, from July 2012 to April 2013. The experimental group received an individualized education based on self-efficacy in the hospital and follow-up telephone consultation in the 2nd and 3rd week after discharge. The control group received a routine discharge education. Knowledge, self-efficacy, and compliance related to kidney transplant were measured and analyzed by frequency, average, Mann-Whitney U test, Fisher's exact test, independent t-test, and ${\chi}^2$-test using SPSS WIN 20.0. Results: Significant differences were found in self-efficacy between the experimental group and the control group. But no significant differences were found in knowledge and compliance between two groups. The scores of several items on monitoring health status in compliance were higher in the experimental group than those of the control group. Conclusion: The results of this study demonstrate the fact that an education program based in self-efficacy for patients with kidney transplant would be effective in improving self-efficacy and the ability to monitor their health status.