• Title/Summary/Keyword: Tree Surgery

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An application of datamining approach to CQI using the discharge summary (퇴원요약 데이터베이스를 이용한 데이터마이닝 기법의 CQI 활동에의 황용 방안)

  • 선미옥;채영문;이해종;이선희;강성홍;호승희
    • Proceedings of the Korea Inteligent Information System Society Conference
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    • 2000.11a
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    • pp.289-299
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    • 2000
  • This study provides an application of datamining approach to CQI(Continuous Quality Improvement) using the discharge summary. First, we found a process variation in hospital infection rate by SPC (Statistical Process Control) technique. Second, importance of factors influencing hospital infection was inferred through the decision tree analysis which is a classification method in data-mining approach. The most important factor was surgery followed by comorbidity and length of operation. Comorbidity was further divided into age and principal diagnosis and the length of operation was further divided into age and chief complaint. 24 rules of hospital infection were generated by the decision tree analysis. Of these, 9 rules with predictive prover greater than 50% were suggested as guidelines for hospital infection control. The optimum range of target group in hospital infection control were Identified through the information gain summary. Association rule, which is another kind of datamining method, was performed to analyze the relationship between principal diagnosis and comorbidity. The confidence score, which measures the decree of association, between urinary tract infection and causal bacillus was the highest, followed by the score between postoperative wound disruption find postoperative wound infection. This study demonstrated how datamining approach could be used to provide information to support prospective surveillance of hospital infection. The datamining technique can also be applied to various areas fur CQI using other hospital databases.

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Standard operating procedures for the collection, processing, and storage of oral biospecimens at the Korea Oral Biobank Network

  • Young-Dan Cho;Eunae Sandra Cho;Je Seon Song;Young-Youn Kim;Inseong Hwang;Sun-Young Kim
    • Journal of Periodontal and Implant Science
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    • v.53 no.5
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    • pp.336-346
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    • 2023
  • Purpose: The Korea Oral Biobank Network (KOBN) was established in 2021 as a branch of the Korea Biobank Network under the Korea Centers for Disease Control and Prevention to provide infrastructure for the collection, management, storage, and utilization of human bioresources from the oral cavity and associated clinical data for basic research and clinical studies. Methods: To address the need for the unification of the biobanking process, the KOBN organized the concept review for all the processes. Results: The KOBN established standard operating procedures for the collection, processing, and storage of oral samples. Conclusions: The importance of collecting high-quality bioresources to generate accurate and reproducible research results has always been emphasized. A standardized procedure is a basic prerequisite for implementing comprehensive quality management of biological resources and accurate data production.

A Case of Broncho-esophageal Fistula Associated with Bronchiectasis (기관지확장증과 동반된 식도기관지루 1례)

  • Chung, Hyuck-Joon;Ku, Sung-Hyun;Lee, Sun-Min;Park, Kwang-Joo;Hwang, Sung-Chul;Lee, Yi-Hyeong;Han, Myung-Ho;Kim, Yung-Jin;Lee, Chul-Ju;Lee, Ki-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.729-734
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    • 1999
  • Broncho-esophageal fistula(BEF) is an uncommon clinical entity which can cause severe suppurative lung disease. Acquired fistulas between the esophagus and tracheobronchial tree are relatively uncommon. They are caused by many diseases including malignancy and chronic inflammation such as tuberculosis and have favorable outcome with proper treatment To our knowledge, there has been no description of patients with BEF due to the bronchiectasis. We report a case of broncho-esophageal fistula in association with bronchiectasis in a 35-year-old male patient with hemoptysis. Bronchoscopy revealed mild bleeding from the superior segment of the right lower lobe without specific endobronchial lesion. Barium esophagogram could not confirm the fistula. The diagnosis of a broncho-esophageal fistula was established by an esophagogastroscopy using fistulogram and subsequent bronchoscopy, in which the communication between the bronchial tree and the esophagus was demonstrated by instilling dye selectively through the fistulous opening using esophagogastroscopy and visualizing the fistula and the bronchial tree. The patient was treated with resection of the right lower lobe, extirpation of the diverticulum and surgical closure of the bronchial defect and fistula, but he suffered from pneumonia thereafter and eventually expired due to sepsis and multiple organ failure.

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Surgical Treatments of Complicated Tracheobronchial Stenosis After Insertion of Self Expandable IHetallic Stents 2 Cases Reports (기관 및 기관지 협착 환자에서 자가 팽창성 금속 스텐트 삽입 합병증 수술 치험 2례)

  • Hong, Chi-Uk;Park, Joo-Cheol;Yoon, Yeop
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.219-225
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    • 1997
  • Although most of the patients with endobronchial tuberculosis have some degree of bronchial stenosis, more aggressive treatment is needed to restore the patency of the involved tracheobronchial tree for some patients not responding well to antituberculous chemotherapy combined with steroids. In our first case, we reseated stenotic trachea in a 42 years old women who showe overgrowing granulation tissue through the modified Gianturco steno wire which was previously inserted and anastomosed end to end. Another case was a 37 years old male with left main bronchial rcstenosis complicate, $\boxUl$ after inserting a Strecker stent and sleeve left upper lobectomy was performed.

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Korean Medicine, Complementary and Alternative Medicines (CAM) Therapy after Gastrectomy of Gastric Cancer in a Hospital (위암 환자의 위 절제수술 후 한의학과 대체요법 사용실태 - 지방소재 일개병원의 경험 -)

  • Kim, Chan-Young;Yang, Doo-Hyun;Kang, Jun-Won;Hwang, Eui-Hyoung
    • The Journal of Korean Medicine
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    • v.28 no.3 s.71
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    • pp.86-99
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    • 2007
  • Objectives : Cancer patients who are afraid of unpleasant therapy and doubt a perfect cure often seek out traditional Korean medicine or many other kinds of complementary and alterative medicine (CAM) instead. This study was carried out in order to learn the prevalence and kinds of the traditional Korean medicine and CAM to evaluate awareness of and attitude toward it. Methods : 213 patients with gastric cancer who had undergone surgery in the department of gastrointestinal surgery and visited for routine follow-up from November to December of 2004 were included. A questionnaire survey was done by trained interviewers for CAM and demographic information. Results : 96.7% of patients had experience with CAM. The kinds and frequencies of CAM were diet and nutrition 21.0%, folk remedy 21.0%, pharmacological treatment 13.5%, oriental medicine 5.3% and mind-body intervention 1.4%. 56.8% of patients had experienced 2-6 kinds of CAM, 37.4% more than 7. Among diet and nutrition, ginseng (62.9%) was highest, followed by ox leg bone soup (50.8%) and pumpkin (31.5%). Among the folk remedies, elm tree was highest at 46.5%, followed by phellinus linteus (Sang-Whang) at 26.8% and ganoderma lucidum (Young-Gee) 20.7%.satisfaction with CAM was relatively low (43.2%), many patients (78.2%) replied that they would use it continuously. Conclusion : Most patients had experience with many kinds of CAM, but didn't discuss it with medical doctors. If scientific study proves whether or not each kind of CAM is actually effective ondisease, it will help to improve the health of patients and prevent the inappropriate usage and cost.

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Ultrasonographic Diagnosis of Retained Wood Foreign Body in the Finger (초음파를 이용하여 진단한 수지 잔존 식물성 이물질 - 증례 보고 -)

  • Kim, Joo Yong;Choi, Jang Seok;Kim, Jung Han;Jeong, Dong Woo
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.4 no.1
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    • pp.20-23
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    • 2011
  • Penetrating injury and retained foreign substances in human body are the main causes of visiting to the emergency room. In hand, foreign substances are caused by trauma. The most common plant pieces, the glass fragments and metal fragments should occur in the order. Especially, it's hard to find fragments of plants and plastic materials because of their radiolucency. And although these fragments are removed, it's difficult to differentiated clearly whether residual foreign bodies are in human hand or not. This study reports the authors' experience in the treatment of a patient from whom he removed a residual tree thorn in the operating room. The thorn was found 4 weeks after the trauma by ultrasonography and then the patients' symptoms were improved.

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How different is a web site that many people visit?-focused on the Plastic Surgery Websites in Korea (많은 사람이 방문하는 웹 사이트는 무엇이 다를까? - 2011년 성형외과 웹 사이트의 경우 -)

  • Cho, Yeong-Bin;Kim, Chae-Bogk
    • Management & Information Systems Review
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    • v.32 no.1
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    • pp.43-62
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    • 2013
  • In order to know the characteristics of high visit web sites that many people have visited, 37 high visit websites of plastic surgery were compared to 69 benchmark sites of same industry. We selected 36 web site attributes that can be measured objectively from existing studies and composed the data set of 36 attributes multiplied by 106 websites. For analysis, Multiple Discriminant Analysis(MDA) and Decision Tree Technique are conducted for searching what attributes divide two group definitely. The result of this study shows the dividing attributes fall into 3 categories like 'Community', 'Mobile', 'Up to date'. Thus, we are able to conclude that high visit plastic surgery web sites are community centric site but not contents centric, response a change to mobile environment rapidly and are maintained with tide up to date. The methodology employed in this study provides an efficient way of improving satisfaction of visitors of plastic surgery website.

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A Human Case of Hepatic Resection for Liver Fascioliasis In Korea (간내 간충병에 대한 간절제술 1예)

  • Kim, Hong-Jin;Roh, Sung-Kyun;Shim, Min-Chul;Kwun, Koing-Bo;Lee, Heun-Ju;Chang, Jae-Chun;Lee, Tae-Sook
    • Journal of Yeungnam Medical Science
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    • v.7 no.1
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    • pp.165-171
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    • 1990
  • Human Fasciola hepatica infection is a rare entity involving infestation of the liver and biliary tree with adult flukes. which can result in hepatitis. cirrhos is and biliary tract inflammation. obstruction and lithiasis. The patient had the typical diagnostic tetrad of fever. eosinophilic leukocytos is. tender hepatomegaly and fluke ova in the stools. Theatment consistes of Emetine hydrochloride administration for hepatic involvement and common bile duct exploration for removal of flukes. with cholecystectomy for associated cholelithiasis. The combination of medical and surgical therapy cal be expected to produce an arrest of this infection. The removed liver revealed eggs of the fasciols species in the intrahepatic bile duct. The clinical history. pathological findings and treatment of this case were described.

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Development of a Novel Endoscopic Scoring System to Predict Relapse after Surgery in Intestinal Behçet's Disease

  • Park, Jung Won;Park, Yehyun;Park, Soo Jung;Kim, Tae Il;Kim, Won Ho;Cheon, Jae Hee
    • Gut and Liver
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    • v.12 no.6
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    • pp.674-681
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    • 2018
  • Background/Aims: The cumulative surgery rate and postoperative relapse of intestinal Behçet's disease (BD) have been reported to be high. This study aimed to establish a scoring system based on follow-up endoscopic findings that can predict intestinal BD recurrence after surgery. Methods: Fifty-four patients with intestinal BD who underwent surgery due to bowel complications and underwent follow-up colonoscopy were retrospectively investigated. Their clinical data, including colonoscopic findings, were retrieved. Classification and regression tree analysis was used to develop an appropriate endoscopic classification model that can explain the postsurgical recurrence of intestinal BD most accurately based on the following classification: e0, no lesions; e1, solitary ulcer <20 mm in size; e2, solitary ulcer ${\geq}20mm$ in size; and e3, multiple ulcers regardless of size. Results: Clinical relapse occurred in 37 patients (68.5%). Among 38 patients with colonoscopic recurrence, only 29 patients had clinically relapsed. Multivariate analysis identified higher disease activity index for intestinal BD at colonoscopy (hazard ratio [HR], 1.013; 95% confidence interval [CI], 1.005 to 1.021; p=0.002) and colonoscopic recurrence (HR, 2.829; 95% CI, 1.223 to 6.545; p=0.015) as independent risk factors for clinical relapse of intestinal BD. Endoscopic findings were classified into four groups, and multivariate analysis showed that the endoscopic score was an independent risk factor of clinical relapse (p=0.012). The risk of clinical relapse was higher in the e3 group compared to the e0 group (HR, 6.284; 95% CI, 2.036 to 19.391; p=0.001). Conclusions: This new endoscopic scoring system could predict clinical relapse in patients after surgical resection of intestinal BD.

Predicting Surgical Complications in Adult Patients Undergoing Anterior Cervical Discectomy and Fusion Using Machine Learning

  • Arvind, Varun;Kim, Jun S.;Oermann, Eric K.;Kaji, Deepak;Cho, Samuel K.
    • Neurospine
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    • v.15 no.4
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    • pp.329-337
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    • 2018
  • Objective: Machine learning algorithms excel at leveraging big data to identify complex patterns that can be used to aid in clinical decision-making. The objective of this study is to demonstrate the performance of machine learning models in predicting postoperative complications following anterior cervical discectomy and fusion (ACDF). Methods: Artificial neural network (ANN), logistic regression (LR), support vector machine (SVM), and random forest decision tree (RF) models were trained on a multicenter data set of patients undergoing ACDF to predict surgical complications based on readily available patient data. Following training, these models were compared to the predictive capability of American Society of Anesthesiologists (ASA) physical status classification. Results: A total of 20,879 patients were identified as having undergone ACDF. Following exclusion criteria, patients were divided into 14,615 patients for training and 6,264 for testing data sets. ANN and LR consistently outperformed ASA physical status classification in predicting every complication (p < 0.05). The ANN outperformed LR in predicting venous thromboembolism, wound complication, and mortality (p < 0.05). The SVM and RF models were no better than random chance at predicting any of the postoperative complications (p < 0.05). Conclusion: ANN and LR algorithms outperform ASA physical status classification for predicting individual postoperative complications. Additionally, neural networks have greater sensitivity than LR when predicting mortality and wound complications. With the growing size of medical data, the training of machine learning on these large datasets promises to improve risk prognostication, with the ability of continuously learning making them excellent tools in complex clinical scenarios.