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The Variation of Factors of severity-adjusted length of stay(LOS) in acute stroke patients (급성 뇌졸중 환자의 중증도 보정 재원일수 변이에 관한 연구)

  • Kang, Sung-Hong;Seok, Hyang-Sook;Kim, Won-Joong
    • Journal of Digital Convergence
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    • v.11 no.6
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    • pp.221-233
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    • 2013
  • This study aims to develop the severity-adjusted length of stay(LOS) model for acute stroke patients using data from the hospital discharge survey and propose management of length of stay(LOS) for acute stroke patients and using for Hospital management. The dataset was taken from 23,134 database of the hospital discharge survey from 2004 to 2009. The severity-adjusted LOS model for the acute stroke patients was developed by data mining analysis. From decision making tree model, the main reasons for LOS of acute stroke patients were acute stroke type. The difference between severity-adjusted LOS from the decision making tree model and real LOS was compared and it was confirmed that insurance type and bed number of hospital, location of hospital were statistically associated with LOS. And to conclude, hospitals should manage the LOS of acute stroke patients applying it into the medical information system.

A Case of Alagille's Syndrome (Alagille 증후군의 1예)

  • Kim, Sung-Eun;Choe, Won-Sick;Chun, Yong-Soon;Yoon, Hye-Kyoung
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.2
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    • pp.154-158
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    • 2000
  • This is a case report of a 5-month-old male who was brought in to hospital for evaluation of jaundice from birth. The baby had a history of ileal atresia operated 2 days after birth. At the age of one month, Tc-99m DISIDA hepatobiliary scintigraphy was performed at other hospital and reported to show good hepatic uptake of the tracer but no uptake in the biliary tree, gall bladder, or intestine for 24 hours post injection. He was judged to have biliary atresia. However, subsequent exploratory laparotomy revealed that the hepatobiliary tree appeared intact and that there was a gall bladder. Additionally, the patient had central aorto-pulmonary shunt for the right ventricular septal defect with pulmonary stenosis of a peripheral type at the age of 4 months. The second hepatobiliary scintigraphy was performed on admission at the age of 5 months, showing a gall bladder but no intestinal uptake up to 24 hours. Retrospectively, the histological specimen of the liver obtained at the exploratory laparotomy was re-evaluated, and by the histological findings coupled with clinical data, arteriohepatic dysplasia (Alagille's syndrome) was diagnosed. In this report, we emphasize the diagnostic limitation of hepatobiliary scintigraphy and the importance of overall clinical and histologic evaluation in a case of Alagille's syndrome.

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Decision-tree Model of Treatment-seeking Behaviors after Detecting Symptoms by Korean Stroke Patients

  • Oh Hyo-Sook;Park Hyeoun-Ae
    • Journal of Korean Academy of Nursing
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    • v.36 no.4
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    • pp.662-670
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    • 2006
  • Purpose. This study was performed to develop and test a decision-tree model of treatment-seeking behaviors about when Korean patients visit a doctor after experiencing stroke symptoms. Methods. The study used methodological triangulation. The model was developed based on qualitative data collected from in-depth interviews with 18 stroke patients. The model was tested using quantitative data collected from interviews and a structured questionnaire involving 150 stroke patients. The predictability of the decision-tree model was quantified as the proportion of participants who followed the pathway predicted by the model. Results. Decision outcomes of the model were categorized into immediate and delayed treatment-seeking behavior. The model was influenced by lowered consciousness, social-group influences, perceived seriousness of symptoms, past history of hypertension or stroke, and barriers to hospital visits. The predictability of the model was found to be 90.7%. Conclusions. The results from this study can help healthcare personnel understand the education needs of stroke patients regarding treatment-seeking behaviors, and hence aid in the development of educational strategies for stroke patients.

Retrospective analysis of the effects of non-communicable diseases on periodontitis treatment outcomes

  • Kim, Eun-Kyung;Kim, Hyun-Joo;Lee, Ju-Youn;Park, Hae-Ryoun;Cho, Youngseuk;Noh, Yunhwan;Joo, Ji-Young
    • Journal of Periodontal and Implant Science
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    • v.52 no.3
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    • pp.183-193
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    • 2022
  • Purpose: We retrospectively analysed patients' dental and periodontal status according to the presence of non-communicable diseases (NCDs) and the effects of NCDs on periodontal treatment outcomes. Factors influencing disease recurrence were investigated using decision tree analysis. Methods: We analysed the records of patients who visited the Department of Periodontology, Pusan National University Dental Hospital from June 2014 to October 2019. As baseline subjects, 1,362 patients with periodontitis and who underwent full-mouth periodontal examinations before periodontal treatment were selected. Among them, 321 patients who underwent periodontal examinations after the completion of periodontal treatment and 143 who continued to participate in regular maintenance were followed-up. Results: Forty-three percent of patients had a NCD. Patients without NCDs had more residual teeth and lower sum of the number of total decayed, missing, filled teeths (DMFT) scores. There was no difference in periodontal status according to NCD status. Patients with a NCD showed significant changes in the plaque index after periodontal treatment. The decision tree model analysis demonstrated that osteoporosis affected the recurrence of periodontitis. Conclusions: The number of residual teeth and DMFT index differed according to the presence of NCDs. Patients with osteoporosis require particular attention to prevent periodontitis recurrence.

Fractured Tracheostomy Tube as Bronchial Foreign Body in Child (부서진 기관튜브로 발생한 소아 기관지 이물)

  • Han, Min-Seck;Kwon, Seong-Keun
    • Korean Journal of Bronchoesophagology
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    • v.16 no.1
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    • pp.47-50
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    • 2010
  • Fracture of tracheostomy tube with subsequent migration into the tracheobronchial tree is rare, but tracheobronchial foreign body in child carries the potentially fatal risk of respiratory obstruction, We report a case of a 5-year-old girl who had aspirated a fractured tracheostomy tube which was removed under rigid bronchoscope.

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Development of Castleman Disease in the Paravertebral Space Mimicking a Neurogenic Tumor

  • Kwak, Yu Jin;Park, Samina;Kang, Chang Hyun;Kim, Young Tae;Park, In Kyu
    • Journal of Chest Surgery
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    • v.52 no.1
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    • pp.51-54
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    • 2019
  • Castleman disease is a relatively rare disease, characterized by well-circumscribed benign lymph-node hyperplasia. The disease may develop anywhere in the lymphatic system, but is most commonly reported as unicentric Castleman disease in the mediastinum along the tracheobronchial tree. It is usually asymptomatic and detected on plain chest radiography as an incidental finding. We report an incidentally detected case of Castleman disease in the paravertebral space that was preoperatively diagnosed as a neurogenic tumor and treated by complete surgical resection.

Missing teeth after maxillofacial trauma: a case report and management protocol

  • Ramaraj, P.N.;Mahabaleshwara, C.H.;Rohit, Singh;Abhijith, George;Vijayalakshmi, G.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.6
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    • pp.422-427
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    • 2020
  • Management of maxillofacial trauma includes primary care, in which diagnosis and management of dentoalveolar injury play a vital role. Due to the impact sustained during a maxillofacial injury (whether direct or indirect), dentoalveolar injuries can occur, leading to fracture and displacement of teeth and associated alveolar bone into the surrounding soft tissues and associated structures, such as the maxillary sinus, nasal cavity, upper respiratory tract, tracheobronchial tree, or gastrointestinal tract. Undiagnosed displaced teeth may cause complications such as airway obstruction. This paper reports a case of displaced teeth in the nasal cavity and gastrointestinal tract and highlights the management protocol for displaced teeth secondary to maxillofacial trauma.

Effectiveness of Disposable Single Electrocardiogram Electrode (SIM-Tree) Comparing with Conventional Method (일회용 단일 심전도패드(SIM-Tree)의 기존 방법과 비교를 통한 효과 분석)

  • Kim, Hye-Sun;Choi, Hyo-Jeong;Kim, Ho-Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.435-440
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    • 2018
  • This study was conducted to compare the effectiveness of the newly developed electrode pad of ECG with that of a conventional method. To accomplish this, participants who performed both methods on a 46 year old male model were queried and their satisfaction, time, and accuracy were measured by a specialist from 01/06/2018 to 15/06/2018. In the conventional method, a newly developed single pad employing a 12-lead ECG and SIM-Tree was employed. There were 104 total participants in this study (44% medical members). Evaluation of the total procedure time revealed that SIM (mean 65.39 seconds) was more rapid than C (mean 94.38 seconds) (p<0.05). When we evaluated the response after all process, satisfaction with SIM (mean 97.69 seconds) was greater than that with C (mean 68.5 seconds) (p<0.05). Moreover, the intra-class correlation coefficient (ICC) was 0.959 and accuracy was very high (p<0.05). In conclusion, the SIM-Tree was very effective based on procedure time, satisfaction and accuracy when compared with conventional methods.

MRI Predictors of Malignant Transformation in Patients with Inverted Papilloma: A Decision Tree Analysis Using Conventional Imaging Features and Histogram Analysis of Apparent Diffusion Coefficients

  • Chong Hyun Suh;Jeong Hyun Lee;Mi Sun Chung;Xiao Quan Xu;Yu Sub Sung;Sae Rom Chung;Young Jun Choi;Jung Hwan Baek
    • Korean Journal of Radiology
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    • v.22 no.5
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    • pp.751-758
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    • 2021
  • Objective: Preoperative differentiation between inverted papilloma (IP) and its malignant transformation to squamous cell carcinoma (IP-SCC) is critical for patient management. We aimed to determine the diagnostic accuracy of conventional imaging features and histogram parameters obtained from whole tumor apparent diffusion coefficient (ADC) values to predict IP-SCC in patients with IP, using decision tree analysis. Materials and Methods: In this retrospective study, we analyzed data generated from the records of 180 consecutive patients with histopathologically diagnosed IP or IP-SCC who underwent head and neck magnetic resonance imaging, including diffusion-weighted imaging and 62 patients were included in the study. To obtain whole tumor ADC values, the region of interest was placed to cover the entire volume of the tumor. Classification and regression tree analyses were performed to determine the most significant predictors of IP-SCC among multiple covariates. The final tree was selected by cross-validation pruning based on minimal error. Results: Of 62 patients with IP, 21 (34%) had IP-SCC. The decision tree analysis revealed that the loss of convoluted cerebriform pattern and the 20th percentile cutoff of ADC were the most significant predictors of IP-SCC. With these decision trees, the sensitivity, specificity, accuracy, and C-statistics were 86% (18 out of 21; 95% confidence interval [CI], 65-95%), 100% (41 out of 41; 95% CI, 91-100%), 95% (59 out of 61; 95% CI, 87-98%), and 0.966 (95% CI, 0.912-1.000), respectively. Conclusion: Decision tree analysis using conventional imaging features and histogram analysis of whole volume ADC could predict IP-SCC in patients with IP with high diagnostic accuracy.

Management Guidelines of Natural Monuments Old Trees through an Ananlysis of Growing Environments II -A Focus on Seoul, Incheon and Gyeonggi provinces- (생육환경 분석을 통한 천연기념물 노거수의 관리방안 II -서울·인천·경기지역을 중심으로-)

  • Kang, Hyun-Kyung;Lee, Seung-Je
    • Journal of the Korean Society of Environmental Restoration Technology
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    • v.7 no.2
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    • pp.36-45
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    • 2004
  • This study was conducted to formulate management guidelines for monumental old trees in Korea through analysis of growing environments. A total of 20 old trees designated as natural monuments in Seoul, Incheon, and Gyeonggi provinces were surveyed for biological characteristics, surrounding environments, root collar conditions, tree health, and soil characteristics. Relationships among root collar conditions, tree health, and soil characteristics were analyzed by correlation. The old solitary trees designated as natural monuments included Pinus bungeana(4 trees), Juniperus chinensis(3 trees), Ginkgo biloba(3 trees), Poncirus trifoliata(2 trees), Actinidia arguta, Wisteria floribunda, Thuja orientalis, Quercus variabilis, Sophora japonica, Fraxinus rhynchophylla, Zelkova serrata, and Pinus densiflora. The tree height ranged from 3.56 to 67m, and root collar diameter ranged from 1.01 to 15.2m. The monumental old trees were growing on the various sites ranging from gardens, historical sites, open agricultural fields, mountain hills, to near the ocean beaches and streams. The coverage of bald land ranged from 50 to 100%, and depth of filled soil around the root collar ranged from 0 to 50cm. Tree health was expressed as the amount of branch dieback, cavity development, detachment of cambial tissue, infliction by diseases and insects. The branch dieback ranged from 5 to 20%, cavity development ranged from 10 to 100$cm^3$, detachment of cambial tissue ranged from 5 to 45%, and infliction by diseases and insects ranged from 5 to 20%. Soil pH ranged from 5.9 to 8.3, organic matter contents from 12 to 56%, phosphorus contents from 104 to 618ppm, while soil compaction ranged from 7 to 28mm. Results of correlation analysis showed that coverage of bald land was the most serious factor to deteriorate the cavity development and detachment of cambial tissue. In addition, chemical properties of soils seemed to be related to the health of the trees.