• Title/Summary/Keyword: Patient's data

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Development of Intelligent Severity of Atopic Dermatitis Diagnosis Model using Convolutional Neural Network (합성곱 신경망(Convolutional Neural Network)을 활용한 지능형 아토피피부염 중증도 진단 모델 개발)

  • Yoon, Jae-Woong;Chun, Jae-Heon;Bang, Chul-Hwan;Park, Young-Min;Kim, Young-Joo;Oh, Sung-Min;Jung, Joon-Ho;Lee, Suk-Jun;Lee, Ji-Hyun
    • Management & Information Systems Review
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    • v.36 no.4
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    • pp.33-51
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    • 2017
  • With the advent of 'The Forth Industrial Revolution' and the growing demand for quality of life due to economic growth, needs for the quality of medical services are increasing. Artificial intelligence has been introduced in the medical field, but it is rarely used in chronic skin diseases that directly affect the quality of life. Also, atopic dermatitis, a representative disease among chronic skin diseases, has a disadvantage in that it is difficult to make an objective diagnosis of the severity of lesions. The aim of this study is to establish an intelligent severity recognition model of atopic dermatitis for improving the quality of patient's life. For this, the following steps were performed. First, image data of patients with atopic dermatitis were collected from the Catholic University of Korea Seoul Saint Mary's Hospital. Refinement and labeling were performed on the collected image data to obtain training and verification data that suitable for the objective intelligent atopic dermatitis severity recognition model. Second, learning and verification of various CNN algorithms are performed to select an image recognition algorithm that suitable for the objective intelligent atopic dermatitis severity recognition model. Experimental results showed that 'ResNet V1 101' and 'ResNet V2 50' were measured the highest performance with Erythema and Excoriation over 90% accuracy, and 'VGG-NET' was measured 89% accuracy lower than the two lesions due to lack of training data. The proposed methodology demonstrates that the image recognition algorithm has high performance not only in the field of object recognition but also in the medical field requiring expert knowledge. In addition, this study is expected to be highly applicable in the field of atopic dermatitis due to it uses image data of actual atopic dermatitis patients.

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The Mediating Effect of Nurse's Communication on the Relationship between Nursing Needs and Nursing Satisfaction in hospital patients. (입원환자가 인지하는 간호요구도와 간호만족도의 관계에 영향을 미치는 간호사 의사소통 매개효과)

  • Choi, Un Jong;Kang, Ji Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.4
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    • pp.374-382
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    • 2018
  • This study aimed to identify the mediating effect of nurse's communication on the relationship between nursing needs and nursing satisfaction in hospital patients. After IRB approval, this study was performed by administering questionnaires to 180 university hospital patients between April and June, 2017. Collected data were analyzed with SPSS 22.0. The average score of nurse's communication, nursing needs, and nursing satisfaction were $3.88{\pm}0.52$, $3.96{\pm}0.55$, and $3.74{\pm}0.59$ out of 5, respectively. There were significant differences in educational and therapeutic needs versus satisfaction. As for nurse's communication and nursing satisfaction, there were significant differences by patient's room. There were positive correlations among nurse's communication and nursing needs (r=.286, p<.001) as well as nurse's communication and nursing satisfaction (r=.524, p<.001), In addition, there were positive correlations between nursing needs and satisfaction (r=.488, p<.001). Nursing communication had a partial mediating effect between nursing needs and satisfaction, which showed significance in Sobel's test (Z=2.450, p=.014). Therefore, it is suggested that a continuous program for strengthening communication of hospital nurses is needed.

Comparison of Mineralization in Each Passage of Dental Pulp Stem Cells from Supernumerary Tooth (과잉치 치수 세포의 계대별 석회화 비교)

  • Shin, Jisun;Kim, Jongbin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.3
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    • pp.350-357
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    • 2017
  • The purpose of this study was to evaluate the difference of differentiation potential in each passage of dental pulp stem cells from supernumerary tooth (sDPSCs). The sDPSCs were obtained from a healthy 6-year-old male patient under the guidelines and got the informed consent. Cells were cultured until passage number 16 and divided into two groups; 1 - 8 passages as a young group and 9 - 16 passages as an old group. It was taken $2.25{\pm}0.46days$ in a young group and $3.25{\pm}0.46days$ in an old group to propagate cells of each passage until confluence and there were statistically significant differences between two groups (p < 0.05). In every passage, cell morphology was observed with microscope and evaluated the capacity to form high levels of minerals by alizarin red solution staining after treating differentiation medium. Fibroblast-like, spindle shaped, elongated cells and a few nodules were found in uninduced cultures of passage number 1, 8 and 9. But at 16 passage culture, cell size became larger and broader and observed with more nodules. After inducing differentiation, mineralized nodules were detected at the first passage of 7th day culture whereas at the 8 passage culture, nodules were seen clearly at 14th day culture. In addition, the amount of mineralized nodules were remarkably decreased after passage 9. From the data presented in this study, it is recommended to use sDPSCs of passage number within 8 for utilizing as stem cells.

Radiation Treatment for Primary Adenocarcinoma of Bartholin's Gland - A Case Report and Review of Literature - (Bartholin 씨선(氏腺)에서 발생한 선암(腺癌)의 방사선치료)

  • Oh, Won-Yong;Whang, In-Soon
    • Radiation Oncology Journal
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    • v.7 no.1
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    • pp.71-76
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    • 1989
  • A patient with primary adenocarcinoma of Bartholin's gland is reported and the literatures relevant to this disease reviewed. Not only this disease is very rare but also primary carcinomas of Bartholin's gland are misdiagnosed as cysts or abscesses in half of the cases, leading to considerable delay in diagnosis. And so, It was wasted long time before definitive therapy. However, because of a different clinical behavior, cancer of the Bartholin's gland should be distinguished from other vulvar carcinomas. Histologically, squamous cell carcinoma and adenocarcinoma are the most common. Virtually all histologic types of Bartholin's gland carcinoma metastasize to lymph node, bone, lung and liver in distant sites. The authors data and a review of the literature support the concept that radical vulvectomy with or without bilateral inguinal-femoral lymphadenectomy is required. On the other hand, except primary radiation treatment for small or medium sized cancers, the results obtained by radiation therapy in carcinoma of the vulva including Bartholin's gland are generally discouraging. A role for postoperative adjuvant radiation therapy suggests because of high incidence of positive inguinal-femoral Iymph nodes. In the near time, natural history and biological behavior of Bartholin's gland cancer must be disclosed in detail. And also optimal treatment modality and prognostic factors shall be determine.

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Comparison of the Efficacy and Safety of EFGR Tyrosine Kinase Inhibitor Monotherapy with Standard Second-line Chemotherapy in Previously Treated Advanced Non-small-cell Lung Cancer: a Systematic Review and Meta-analysis

  • Qi, Wei-Xiang;Shen, Zan;Lin, Feng;Sun, Yuan-Jue;Min, Da-Liu;Tang, Li-Na;He, Ai-Na;Yao, Yang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.5177-5182
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    • 2012
  • Purpose: To compare the efficacy and safety of epidermal growth factor receptor tyrosine kinase inhibitormonotherapy (EFGR-TKIs: gefitinib or erlotinib) with standard second-line chemotherapy (single agent docetaxel or pemetrexed) in previously treated advanced non-small-cell lung cancer (NSCLC). Methods: We systematically searched for randomized clinical trials that compared EGFR-TKI monotherapy with standard second-line chemotherapy in previously treated advanced NSCLC. The end points were overall survival (OS), progression-free survival (PFS), overall response rate (ORR), 1-year survival rate (1-year SR) and grade 3 or 4 toxicities. The pooled hazard ratio (HR) or risk ratio (RR), with their corresponding 95% confidence intervals (CI) were calculated employing fixed- or random-effects models depending on the heterogeneity of the included trials. Results: Eight randomized controlled trials (totally 3218 patients) were eligible. Our meta-analysis results showed that EGFR-TKIs were comparable to standard second-line chemotherapy for advanced NSCLC in terms of overall survival (HR 1.00, 95%CI 0.92-1.10; p=0.943), progression-free survival (HR 0.90, 95%CI 0.75-1.08, P=0.258) and 1-year-survival rate (RR 0.97, 95%CI 0.87-1.08, P=0.619), and the overall response rate was higher in patients who receiving EGFR-TKIs(RR 1.50, 95%CI 1.22-1.83, P=0.000). Sub-group analysis demonstrated that EGFR-TKI monotherapy significantly improved PFS (HR 0.73, 95%CI: 0.55-0.97, p=0.03) and ORR (RR 1.96, 95%CI: 1.46-2.63, p=0.000) in East Asian patients, but it did not translate into increase in OS and 1-year SR. Furthermore, there were fewer incidences of grade 3 or 4 neutropenia, febrile neutropenia and neutrotoxicity in EGFR-TKI monotherapy group, excluding grade 3 or 4 rash. Conclusion: Both interventions had comparable efficacy as second-line treatments for patients with advanced NSCLC, and EGFR-TKI monotherapy was associated with less toxicity and better tolerability. Moreover, our data also demonstrated that EGFR-TKImonotherapy tended to be more effective in East Asian patients in terms of PFS and ORR compared with standard second-line chemotherapy. These results should help inform decisions about patient management and design of future trials.

A Study about medical records in ${\ulcorner}$Gyojubuin-yangbang${\lrcorner}$ (${\ll}$교주부인양방(校注婦人良方)${\gg}$에 수재된 의무기록 의안(醫案)에 관한 연구)

  • Oh, Chang-Young;Kim, Ra-Young;Park, Young-Soo;Kim, Byoung-Hoe;Joh, Ho-Geun;Kim, Joong-Oh;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.2
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    • pp.226-239
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    • 2006
  • Background : Medical records are documents in files which consist of all diagnostic studies and medical treatments patients had received while they were hospitalized or treated as outpatients. A doctor or medical team can use medical records as a data for diagnosis, treatment, and education. In traditional eastern asian medicine, medical reports have different forms and contents. The most important thing in medical reports of traditional eastern asian medicine was how to express practitioner's medical ideas. So it has a weak point, for example, it has poor information about patient and clinical process, which make some trouble to understand it. Methods and Results : We studied medical records in Gyojubuin-yangbang, a commentary book of Chen-zi-ming's Obstetrics and Gynecology textbook done by Xue-ji in Ming dynasty, China. This book consists of 10 parts; treatment of menstruation disorders and leukorrhea, general gynecology, treatment of infertility, education for fetus, diagnosis of fetus and gravida, treatment of general and obstetrical disease in gravida, care for delivery, postpartum care and treatment, and treatment of mass and inflammation. It has 546 medical records about women's disease that commonly believed as Xue-ji's case reports. They are all review articles and made during about 23 years from A.D 1523 to 1546. Most patients of Xue-ji's case reports were common people, this fact is different from that of case reports in Chen-zi-ming's Obstetrics and Gynecology textbook. Conclusion : Xue-ji was a very famous Ob&Gy doctor who was from Suzhou Jingsu province in China. He was born in A.D 1468, died in A.D 1588. He emphasize emotional factors in pathology and to tonify spleen and kidney. We think Xue-ji's medical records are good references for us to treat psychosomatic Ob&Gy disease and chronic women's disease.

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Locking horizontal mattress suture as the alternative closure method for scalp lacerations difficult to suture with staple (두피 봉합기로 봉합하기 어려운 두피 열상에 시행한 잠금 수평 매트리스 봉합법의 유용성 관찰 연구)

  • Sah, Seung Woo;Seol, Seunghwan;Lee, Woon Jeong;Woo, Seon Hee;Kim, Dae Hee;Lee, June Young;In, Sangkook;Kim, Bonggyeom
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.6
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    • pp.649-655
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    • 2018
  • Objective: This paper reports the possibility of using of a locking horizontal mattress suture technique in repairing lacerations that are difficult to suture with staples. Methods: Data were collected retrospectively over a 6-month period regarding the routine repair of scalp lacerations: those in areas injured by a high energy blunt mechanism, continued to bleed after pressure, nonlinear or damaged skin repaired with a locking horizontal mattress technique, and simple interrupted technique. The effects of the two techniques used to repair scalp lacerations on wound healing, complication rate, and patient satisfaction were examined. The categorical variables are expressed as the number and percent. A Mann-Whitney-Wilcoxon test was used for statistical analysis. A P-value less than 0.05 was considered significant. Results: Thirty-seven consecutive patients with scalp lacerations presented for care. Wound closure was accomplished with the locking horizontal mattress sutures in 40.5% (n=15) (median length, 5.0 cm; interquartile range [IQR], 4.0-7.0 cm). Simple interrupted sutures (median length, 4 cm; IQR, 3.0-5.0 cm) were used in 59.5% (n=22) (P=0.015). The frequency of additional bandage compression (P=0.008), frequency of exudative hemorrhage (P=0.018), and suture mark frequency at suture removal (P=0.047) were significantly lower in the locking horizontal mattress group. Conclusion: The locking horizontal mattress suture, which has the advantage of a horizontal mattress suture, may be one of the ways that can be used alternatively to treat scalp lacerations that difficult to suture with staples.

Effects of consultation length and the number of outpatients on physicians' occupational burnout (의사의 진찰시간과 진료환자 수가 직무소진에 미치는 영향)

  • Sungje, Moon;Jeong Hun, Park;Jung Chan, Lee
    • Korea Journal of Hospital Management
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    • v.27 no.4
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    • pp.22-35
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    • 2022
  • Purpose: Physician's occupational burnout has been a very important issue that can cause negative consequences not only for individual's physical and mental health, but also for patient's health and the overall national healthcare system. For the reason, this study confirmed how consultation length and the number of outpatients affect physician's occupational burnout in the medical environment. Methodology: In the study, the data of '2020 Korean Physician Survey' conducted by Korean Medical Association(KMA) was used for the analysis, and a total of 4,215 physicians were selected as study samples. The differences in the degree of occupational burnout according to the physicians' general characteristics were confirmed through uni-variate analysis, and also a regression analysis was conducted to confirm the effects of consultation length and the number of outpatients on physician's occupational burnout. Findings: As a result. the overall degree of physician's occupational burnout decreased(𝛽=-0.051, p<0.01) as the consultation length increased. Specifically, the physician's emotional exhaustion increased(𝛽=0.051, p<0.01), while the reduction of accomplishment decreased(𝛽=-0.131, p<0.001). Furthermore, the overall occupational burnout decreased(𝛽=-0.047, p<0.01) as a proportion of advice and education during the consultation increased, and it had an effect on the decrease in depersonalization(𝛽=-0.045, p<0.01) and the reduction of accomplishment(𝛽=-0.065, p<0.001). At last, as the number of outpatients increased, the overall occupational burnout increased(𝛽=0.041, p<0.05) with more emotional exhaustion(𝛽=0.095, p<0.001), depersonalization(𝛽=0.065, p<0.001), and less reduction of personal achievement(𝛽=-0.081, p<0.001). Practical implication: Consequently, it is necessary to prevent physician's occupational burnout by ensuring sufficient consultation length and providing a medical environment to treat an appropriate number of patients. Therefore, national policies should expand health insurance coverage and compensate medical fees for sufficient consultation length that both patients and physicians can satisfy. It will ultimately contribute to ensuring the patients' health and improving the quality of national healthcare services.

Uncertainty, Anxiety and Coping with Mastectomy for Breast Cancer (유방절제술 환자의 불확실성, 불안 및 대처방식)

  • Cho, Ok-Hee
    • Journal of Korean Academy of Nursing
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    • v.30 no.4
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    • pp.1006-1017
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    • 2000
  • The purpose of this study was to provide basic information for developing a nursing intervention that helps patients learn how to acquire coping to reduce post operation uncertainty and anxiety by investigating the level of uncertainty and anxiety experienced by mastectomy patients. The subjects were 134 patients selected from St. Mary's Kangnam and St. Mary's hospital, and the data collection period was from October to December of 1998. Uncertainty was measured by using Mishel Uncertainty in Illness Scale (MUIS), anxiety measured by using State-Trait Anxiety Inventory(STAI), and coping by using a questionnaire developed by Kim & Yoo (1996). Data were analyzed with SAS program by t-test, ANOVA, Duncan's multiple range test, Pearson correlation coefficients, and stepwise multiple regression. The results were as follows : 1. The mean uncertainty score was 57.6. The results of the correlation between the compliance of medical regimen and demographic characteristics were as follows ; Those who monthly income over 2,010,000 won had lower than above 1,000,000 won, and those with the experience of chemotherapy had higher than those without, and the patient who has 7∼12 months(1 yr.) post operation period had higher than the one below 6months, 25∼36 months(3 yrs.), 37∼60 months(5 yrs.), and over 61 months. 2. The mean anxiety score was 45.9. Anxiety tended to be increased slightly in subjects with low educational background, poor monthly income, experience of chemotherapy, and 7∼12 months(1 yr.) post operation period, but there was no significant difference by general characteristics 3. The mean value of the coping score was 100.7. The study revealed higher score in problem-focused coping than emotion-focused coping. In regard to coping by demographic characteristics were as follows ; those who had monthly income over 2,010,000 won had higher level of coping than those whose monthly income was between 1,010,000 and 2,000,000 won. In terms of problem- focused coping, those who had 25∼36 months of post operation period showed significantly lower level of coping than those below 6 months or 37∼60 months(5 yrs.) or over 61 months of post operation period. Regarding the emotion-focused coping, those with the christianity had significantly lower level of coping than those without it. Also, those whose monthly income over 2,010,000 won had significantly higher coping level than those with income of between 1,010,000 and 2,000,000 won. 4. A positive relationship was found between uncertainty and anxiety. Patients who experienced more uncertainty also showed more anxiety. Problem-focused coping was inversely related to uncertainty and anxiety. 5. The major variable that affected uncertainty was anxiety, explaining 63.3% of the uncertainty. In addition to this, it would explain 66.4% in total when experience of chemotherapy was added.

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Quality of Sleep in Hospitalized Patients with Lung Cancer (입원 폐암환자의 수면의 질)

  • Han, Young-In;Sohn, Sue-Kyung
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.1-7
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    • 2005
  • Purpose: The purpose of this study was to identify the quality of sleep in hospitalized patients with lung cancer. Methods: The data were collected from January to April 2001. Study subjects were 50 lung cancer patients hospitalized at K University and G hospital in Busan, Korea. Quality of sleep was measured using the Quality of Sleep Scale (range $15{\sim}60$) developed by Oh et al (1999). The data were analyzed with the SPSS 10.0 program using frequency and percentage, mean, standard deviation, t-test, ANOV4 and Post-hoc test (Scheffe's test). Results: The results of this study were as follow; 1) The mean quality of sleep score was $35.64{\pm}7.59$ (range: $21{\sim}52$). 2) There was 3 Significant difference in 'ongoing pain' (t=-1.943, P=.046), 'major caregiver' (F=B863, P=.047), 'change of weight' (F=5.906, P=.019), according to general characteristics in the quality of sleep in hospitalized patients with lung cancer. Conclusion: As a results, the level of the quality of sleep in hospitalized patients with lung cancer was moderate. And, the study results indicate that ongoing pain, major caregiver, change of weight impact the quality of sleep of lung cancer patients. Therefore, nurses should consider those factors in providing nursing care for hospitalized patient with lung cancer.

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