• 제목/요약/키워드: Prognosis of stroke

검색결과 88건 처리시간 0.026초

선박 추진용 2행정 저속엔진의 고장모드 데이터 개발 및 LSTM 알고리즘을 활용한 특성인자 신뢰성 검증연구 (The Study of Failure Mode Data Development and Feature Parameter's Reliability Verification Using LSTM Algorithm for 2-Stroke Low Speed Engine for Ship's Propulsion)

  • 박재철;권혁찬;김철환;장화섭
    • 대한조선학회논문집
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    • 제60권2호
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    • pp.95-109
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    • 2023
  • In the 4th industrial revolution, changes in the technological paradigm have had a direct impact on the maintenance system of ships. The 2-stroke low speed engine system integrates with the core equipment required for propulsive power. The Condition Based Management (CBM) is defined as a technology that predictive maintenance methods in existing calender-based or running time based maintenance systems by monitoring the condition of machinery and diagnosis/prognosis failures. In this study, we have established a framework for CBM technology development on our own, and are engaged in engineering-based failure analysis, data development and management, data feature analysis and pre-processing, and verified the reliability of failure mode DB using LSTM algorithms. We developed various simulated failure mode scenarios for 2-stroke low speed engine and researched to produce data on onshore basis test_beds. The analysis and pre-processing of normal and abnormal status data acquired through failure mode simulation experiment used various Exploratory Data Analysis (EDA) techniques to feature extract not only data on the performance and efficiency of 2-stroke low speed engine but also key feature data using multivariate statistical analysis. In addition, by developing an LSTM classification algorithm, we tried to verify the reliability of various failure mode data with time-series characteristics.

Predictors of Good Outcomes in Patients with Failed Endovascular Thrombectomy

  • Hyungjong Park;Byung Moon Kim;Jang-Hyun Baek;Jun-Hwee Kim;Ji Hoe Heo;Dong Joon Kim;Hyo Suk Nam;Young Dae Kim
    • Korean Journal of Radiology
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    • 제21권5호
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    • pp.582-587
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    • 2020
  • Objective: Endovascular thrombectomy (EVT) fails in approximately 20% of anterior circulation large vessel occlusion (AC-LVO). Nonetheless, the factors that affect clinical outcomes of non-recanalized AC-LVO despite EVT are less studied. The purpose of this study was to identify the factors affecting clinical outcomes in non-recanalized AC-LVO patients despite EVT. Materials and Methods: This was a retrospective analysis of clinical and imaging data from 136 consecutive patients who demonstrated recanalization failure (modified thrombolysis in cerebral ischemia [mTICI], 0-2a) despite EVT for AC-LVO. Data were collected in prospectively maintained registries at 16 stroke centers. Collateral status was categorized into good or poor based on the CT angiogram, and the mTICI was categorized as 0-1 or 2a on the final angiogram. Patients with good (modified Rankin Scale [mRS], 0-2) and poor outcomes (mRS, 3-6) were compared in multivariate analysis to evaluate the factors associated with a good outcome. Results: Thirty-five patients (25.7%) had good outcomes. The good outcome group was younger (odds ratio [OR], 0.962; 95% confidence interval [CI], 0.932-0.992; p = 0.015), had a lower incidence of hypertension (OR, 0.380; 95% CI, 0.173-0.839; p = 0.017) and distal internal carotid artery involvement (OR, 0.149; 95% CI, 0.043-0.520; p = 0.003), lower initial National Institute of Health Stroke Scale (NIHSS) (OR, 0.789; 95% CI, 0.713-0.873; p < 0.001) and good collateral status (OR, 13.818; 95% CI, 3.971-48.090; p < 0.001). In multivariate analysis, the initial NIHSS (OR, 0.760; 95% CI, 0.638-0.905; p = 0.002), good collateral status (OR, 14.130; 95% CI, 2.264-88.212; p = 0.005) and mTICI 2a recanalization (OR, 5.636; 95% CI, 1.216-26.119; p = 0.027) remained as independent factors with good outcome in non-recanalized patients. Conclusion: Baseline NIHSS score, good collateral status, and mTICI 2a recanalization remained independently associated with clinical outcome in non-recanalized patients. mTICI 2a recanalization would benefit patients with good collaterals in non-recanalized AC-LVO patients despite EVT.

일과성허혈발작 및 급성뇌경색환자에서 경두개도플러로 측정된 중간대뇌동맥 비대칭 지수가 환자 예후에 미치는 영향 (Impact of Asymmetric Middle Cerebral Artery Velocity on Functional Recovery in Patients with Transient Ischemic Attack or Acute Ischemic Stroke)

  • 한민호;남효석
    • 대한임상검사과학회지
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    • 제50권2호
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    • pp.126-135
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    • 2018
  • 본 연구는 일과성허혈발작 및 급성뇌경색환자에서 양쪽 중 간대뇌동맥의 혈류속도 차이가 예후를 예측할 수 있는 지표가 될 수 있고, 이러한 예후예측력이 뇌졸중 아형 간에 차이가 있는 지를 관찰하는 것이다. 모든 대상자는 일과성허혈발작 및 급성뇌경색환자들이며, 기본적인 평가와 경두개도플러검사(TCD)가 실시되었다. 중간대뇌동맥 비대칭 지수(MCA asymmetry index)는 다음의 공식에 의해 구해졌다; MCA asymmetry index=(|RMCA MFV-LMCA MFV|/mean MCA MFV) ${\times}100$. 뇌경색 분류는 TOAST classification에 따라 진행되었다. 나쁜 예후(poor functional outcome)는 mRS score ${\geq}3$ at 3 months after stroke onset로 정의하였다. 총 988명의 급성뇌경색환자가 분석에 포함되었고, 그 중 157명(15.9%)이 나쁜 예후를 가지고 있었다. 뇌경색 하위유형 및 여러 혼란변수를 보정 후 실시한 다변량분석에서 중간대뇌동맥 비대칭 지수만 유일하게 독립적으로 나쁜 예후와 연관성을 보였다. ROC curve 분석에서 중간대뇌동맥 비대칭 지수를 예측모형에 투입하였을 때 투입 전에 비해 나쁜 예후를 예측하는 능력이 상승하는 것을 관찰하였다(from 88.6% [95% CI, 85.2-91.9] to 89.2% [95% CI, 85.9-92.5]). 급성뇌경색환자에서 중대뇌동맥 비대칭 지수는 나쁜 예후를 독립적으로 예측하였다. 따라서 경두개도플러검사는 급성뇌경색환자에서 나쁜 예후를 예측하는데 유용하게 사용될 수 있을 것이다.

Clinical Effect of Left Ventricular Dysfunction in Patients with Mitral Stenosis after Mitral Valve Replacement

  • Park, Kwon Jae;Woo, Jong Soo;Park, Jong Yoon;Jung, Jae Hwa
    • Journal of Chest Surgery
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    • 제49권5호
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    • pp.350-355
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    • 2016
  • Background: Mitral stenosis (MS) remains one of the important heart diseases. There are many factors that influence the clinical outcomes, and little is known about how left ventricular (LV) dysfunction clinically affects the prognosis of the patient with MS after mitral valve replacement (MVR). We reviewed our clinical experiences of MVR in patients with MS who had LV dysfunction. Methods: Between January 1991 and January 2013, 110 patients with MS who underwent MVR were analyzed and divided into two groups according to ejection fraction (EF). Group 1 ($EF{\leq}45%$) included 13 patients and group 2 (EF>45%) included 97 patients. Results: Thromboembolism occurred in 8 patients after MVR (group 1: n=3, 23.1%; group 2: n=5, 5.2%) and its incidence was significantly higher in group 1 than in group 2 (p=0.014). There were 3 deaths each in groups 1 and 2 during follow-up. The overall rate of cardiac-related death in group 1 was significantly higher than in group 2 (group 1: n=3, 23.1%; group 2: n=3, 3.1%; p=0.007). The cumulative survival rate at 1 and 15 years was 83.9% and 69.9% in group 1 and 97.9% and 96.3% in group 2 (p=0.004). The Cox regression analysis revealed that survival was significantly associated with postoperative stroke (p=0.011, odds ratio=10.304). Conclusion: This study identified postoperative stroke as an adverse prognostic factor in patients with MS after MVR, and a s more prevalent in patients with LV dysfunction. Postoperative stroke should be reduced to improve clinical outcomes for patients. Preventive care should be made in multiple ways, such as management of LV dysfunction, atrial fibrillation, and anticoagulation.

변증록(辨證錄) 권지십사(卷之十四)에 대(對)한 연구(硏究) (A Study on "Byun Jeung Rok(辨證錄)" Vol.14)

  • 이현정;송지청;정현종;이종환;금경수
    • 대한한의정보학회지
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    • 제17권1호
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    • pp.257-293
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    • 2011
  • "Byun Jeung Rok(辨證錄)" written by Jinsatak(陳士鐸) is composed of 14 volumes. In relation to the contents, it is organized into 126 gates(門) and 770 remaining syndromes(餘證) where internal medicine, external medicine, pediatrics, gynecology(內科 外科 小兒 婦人), etc. are divided into sub-sections of cold damage, cold stroke, wind stroke(傷寒 中寒 中風), etc. He explained the symptom, cause of disease, method of treatment, prescription, construction of prescription, instruction of medicine and prognosis(症狀 病因 治法 處方 處方構成 服用法 預後) thoroughly. This study, as an inquiry of the sec 14 volume pediatrics(小兒), deals with febrile fit cacotrophy vomiting diarrhea(驚疳吐瀉), coprozoic parasite(便蟲), smallpox(痘瘡), eruption(疹症), eating mud(喫泥), fetal toxin(胎毒). It was written very logically so it is easy to understand. The analysis of the symptoms are brief and appropriate. Therefore, it is considered to have significant clinical value for future generations and is applied by them. Finally, this topic was studied in hopes of helping later pediatrics clinical treatment.

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편마비 환자의 밀기증후군 유무에 따른 기능 회복의 특성 (Characteristics of Functional Recovery in Hemiplegia with and without Pusher Syndrome)

  • 김승원;장우남;황병용
    • The Journal of Korean Physical Therapy
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    • 제15권4호
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    • pp.34-45
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    • 2003
  • A 'pusher syndrome' encompassing postural imbalance and hemi-neglect is believed to aggravate the prognosis of stroke patients. The patients with pusher syndrome show a particular posture that pushing away from the unaffected side of the body. The objective of this study was to investigate associated proprioception, associated neuro-psychological symptoms and characteristics of functional outcome with and without pusher syndrome. The subjects of this study were 58 acute stroke patients who been rehabilitated at two university hospitals in Seoul and Buchun. Data were collected using proprioception test and line bisection test. The ability of ADL was assessed by the Modified Barthel Index, transfer by the Functional Independence Measure, and balance by the Modified Motor Assessment Scale. The results were that significant difference was found in the presence of proprioception, in the incidence of hemineglect and anosognosia, and in the score of ADL, transfer and balance between patients with and without pusher syndrome. Patients without pusher syndrome gained more motor score than patients with pusher syndrome. From improvement of view, patients with pusher syndrome gained the lowest score in ability of transfer. The finding suggest that the patients with pusher syndrome is a poorer functional outcome, be related to proprioception, hemineglect and anosognosia.

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Optimal Rhythm Control Strategy in Patients With Atrial Fibrillation

  • Daehoon Kim;Pil-Sung Yang;Boyoung Joung
    • Korean Circulation Journal
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    • 제52권7호
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    • pp.496-512
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    • 2022
  • For almost 20 years, data regarding the effect of rhythm control therapy for atrial fibrillation (AF) on cardiovascular prognosis in comparison with rate control therapy has not been conclusive. The safety of rhythm control and anticoagulation therapy has generally improved. Recently, it was revealed that a rhythm-control strategy reduced the risk of adverse cardiovascular events than usual rate control in patients with recent AF (diagnosed within 1 year). Within 1 year after the AF diagnosis, early initiation of rhythm control led to more favorable cardiovascular outcomes than rate control. Early rhythm control reduced the risks of stroke and heart failure-related admission than rate control. Moreover, rhythm control was associated with lower dementia risk than rate control. Finally, early rhythm control treatment was also effective in patients with asymptomatic AF but less effective in older adults. Therefore, in patients with AF, rhythm control should be considered at earlier stages, regardless of symptom.

Review of ginsenosides targeting mitochondrial function to treat multiple disorders: Current status and perspectives

  • Huang, Qingxia;Gao, Song;Zhao, Daqing;Li, Xiangyan
    • Journal of Ginseng Research
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    • 제45권3호
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    • pp.371-379
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    • 2021
  • Mitochondrial dysfunction contributes to the pathogenesis and prognosis of many common disorders, including neurodegeneration, stroke, myocardial infarction, tumor, and metabolic diseases. Ginsenosides, the major bioactive constituents of Panax ginseng (P. ginseng), have been reported to play beneficial roles in the molecular pathophysiology of these diseases by targeting mitochondrial dysfunction. In this review, we first introduce the types of ginsenosides and basic mitochondrial functions. Then, recent findings are summarized on different ginsenosides targeting mitochondria and their key signaling pathways for the treatment of multiple diseases, including neurological disorders, cancer, heart disease, hyperglycemia, and inflammation are summarized. This review may explain the common targets of ginsenosides against multiple diseases and provide new insights into the underlying mechanisms, facilitating research on the clinical application of P. ginseng.

Moyamoya Biomarkers

  • Smith, Edward R.
    • Journal of Korean Neurosurgical Society
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    • 제57권6호
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    • pp.415-421
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    • 2015
  • Moyamoya disease (MMD) is an arteriopathy of the intracranial circulation predominantly affecting the branches of the internal carotid arteries. Heterogeneity in presentation, progression and response to therapy has prompted intense study to improve the diagnosis and prognosis of this disease. Recent progress in the development of moyamoya-related biomarkers has stimulated marked interest in this field. Biomarkers can be defined as biologically derived agents-such as specific molecules or unique patterns on imaging-that can identify the presence of disease or help to predict its course. This article reviews the current categories of biomarkers relevant to MMD-including proteins, cells and genes-along with potential limitations and applications for their use.

흉통 및 뇌졸중 증상 환자에 대한 전화 중증도분류 지침의 유용성 (Utility of the Dispatch Protocol to Triage the Emergency Patients who presented with Symptoms of Stroke or Chest Pain)

  • 조석주;안병기;박재용
    • 한국콘텐츠학회논문지
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    • 제12권12호
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    • pp.345-355
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    • 2012
  • 심뇌혈관 질환의 초기 처치가 지연되면 예후가 불량하고, 치료 후 심각한 후유증이 남으므로. 신속하고 적절한 처치를 위해 병원 전 단계 응급의료전화상담원에 의한 적절한 환자 분류와 병원 선정이 중요하다. 여러 선진국에서는 현장에 출동시킬 구급대 자원의 결정이나 각 병원에의 환자분산을 위해 응급의료전화상 담원이 표준화된 환자분류 지침을 사용하고 있다. 하지만, 우리나라의 경우 응급의료전화상담원의 심뇌혈관 환자 중증도 분류를 위한 표준화된 지침이 개발되어 있지 않다. 저자들은 영국의 NHS direct와 캐나다의 CTAS 체계에 기반하여, 뇌졸중 증상과 흉통 환자 분류를 위한 표준화 지침을 개발하였다. 환자가 내원한 응급실에서 시행된 중증도 분류를 기준으로 표준화된 지침을 사용한 군과 사용하지 않은 군을 비교하였다. 흉통환자에서 표준화된 지침을 사용한 군의 정확도가 높았다.(70.0% VS 94.0% p<0.01). 뇌졸중 환자에서도 같은 결과를 보였다. (64.2% VS 84.6% p<0.01). 결론적으로 응급의료정보센터의 응급의료전화상담원에 의한 뇌졸중 증상과 흉통 항목의 중증도 판단에 있어, 응급의료전화상담원의 주관적인 판단보다는 표준화된 지침을 이용한 판단이 병원에서 시행한 중증도 분류와 보다 일치하였다.