• Quality Improvement in Health Care
• /
• v.11 no.1
• /
• pp.4-14
• /
• 2004

Background : To examine the problems involved in writing practice of death certificates, we compared the determination of underlying cause of death for vital statistics using recorded underlying cause of death in issued death statistics. Methods : We collected 688 mortality certificates issue in year of 2,000 from 3 university hospitals. And we also collected vital statistics from ministry of statistics. The causes of death were coded by experienced medical record specialists. And causes of death determined at ministry of statistics for national vital statistics were mapped to causes of death recorded at each death certificates. The rate that underlying causes of death for vital statistics were derived from underlying causes of death recorded at issued death certificates were analysed. Results : 64.5% of underlying cause of death for could be derived from underlying cause of death recorded at issued death certificates, 8.6% derived from intermediate cause of death, and 3.9% derived from direct cause of death. In 23% of cases, underlying cause of death could not be derived using issued death certificates. The rate that underlying cause of death for vital statistics could be derived from underlying cause of death recorded at death certificates was different between 3 university hospitals. And the rate was also different between death certificates and postmortem certificates. We classified the causes of death using 21 major categories. The rate was different between diseases or conditions that caused death too. Conclusion : When we examined the correctness of death certificate writing practice using above methods, correctness of writing could not be told as satisfactory. There was difference in correctness of writing between hospitals, between death certificates and postmortem certificates, and between diseases and conditions that caused death. With this results, we suggested some strategy to improve the correctness of death certificate writing practice.

• Nuclear Medicine and Molecular Imaging
• /
• v.41 no.2
• /
• pp.102-111
• /
• 2007

Dementia is a major burden for many countries including South Korea, where life expectancy is continuously growing and the proportion of aged people is rapidly growing. Neurodegenerative disorders, such as, Alzheimer disease, dementia with Lewy bodies, frontotemporal dementia, Parkinson disease, progressive supranuclear palsy, corticobasal degeneration, Huntington disease, can cause dementia, and cerebrovascular disease also can cause dementia. Depression or hypothyroidism also can cause cognitive deficits, but they are reversible by management of underlying cause unlike the forementioned dementias. Therefore these are called pseudodementia. We are entering an era of dementia care that will be based upon the identification of potentially modifiable risk factors and early disease markers, and the application of new drugs postpone progression of dementias or target specific proteins that cause dementia. Efficient pharmacologic treatment of dementia needs not only to distinguish underlying causes of dementia but also to be installed as soon as possible. Therefore, differential diagnosis and early diagnosis of dementia are utmost importance. F-18 FDG PET is useful for clarifying dementing diseases and is also useful for early detection of the diseases. Purpose of this article is to review the current value of FDG PET for dementing diseases including differential diagnosis of dementia and prediction of evolving dementia.

• Journal of Medicine and Life Science
• /
• v.17 no.3
• /
• pp.103-106
• /
• 2020

Bone marrow failure, such as aplastic or myelophthisic anemia, can occur due to an underlying lymphoid malignancy and cause life-threatening events. A 58-year-old man diagnosed with angioimmunoblastic T-cell lymphoma had recently visited the emergency department because of an altered level of consciousness caused by acute severe anemia. The laboratory findings were strongly suggestive of bone marrow failure syndrome. Bone marrow examination was immediately performed and, subsequently, dexamethasone was initiated to control the underlying lymphoma. Intravenous immunoglobulin was also administered in combination due to combined immune hemolytic anemia and thrombocytopenia. Bone marrow examination revealed a packed marrow with marked fibrosis and lymphoma involvement. A diagnosis of secondary myelofibrosis related to the underlying lymphoma was made, and sequential combination chemotherapy was introduced despite the presence of severe anemia and thrombocytopenia. After combination chemotherapy, his hematologic profile and underlying lymphoma improved. Better understanding of various hematologic manifestations and knowledge of the rare condition of lymphoma are essential for appropriate diagnostic approaches and treatment.

• Journal of Korean Society for Quality Management
• /
• v.31 no.2
• /
• pp.183-193
• /
• 2003

A special cause producing temporary deviation in the underlying process can influence on process adjustment in responsive feedback control system. In this paper, the impact of special causes on the EWMA(Exponentially Weighted Moving Average) forecasts and the process adjustment that is based on the EWMA forecasts are derived. For some special causes with patterned type of contamination, the influence of the causes on the output process are explicitly investigated. A data set, contaminated by a special cause of level shift, is analyzed to evaluate the impact numerically.

• Journal of Korean Society for Quality Management
• /
• v.32 no.2
• /
• pp.201-211
• /
• 2004

Process adjustment is a complimentary tool to process monitoring in process control. Process adjustment directs on maintaining a process output close to a target value by manipulating another controllable variable, by which significant process improvement can be achieved. Therefore, this approach can be applied to the 'Improve' stage of Six Sigma strategy. Though the optimal control rule minimizes process variability in general, it may not properly function when special causes occur in underlying process, resulting in off-target bias and increased variability in the adjusted output process, possibly for long periods. In this paper, we consider a responsive feedback control system and the minimum mean square error control rule. The bias in the adjusted output process is investigated in a general framework, especially focussing on stationary underlying process and the special cause of level shift type. Illustrative examples are employed to illustrate the issues discussed.

• Proceedings of the Korean Society for Quality Management Conference
• /
• 2004.04a
• /
• pp.425-429
• /
• 2004

Process adjustment Is a complimentary tool to process monitoring in process control. Process adjustment directs on maintaining a process output close to a target value by manipulating another controllable variable, by which significant process improvement can be achieved. Therefore, this approach can be applied to the 'Improve' stage of Six Sigma strategy. Though the optimal control rule minimizes process variability in general, it may not properly function when special causes occur in underlying process, resulting in off-target bias and increased variability in the adjusted output process, possibly for long periods. In this paper, we consider a responsive feedback control system and the minimum mean square error control rule. The bias in the adjusted output process is investigated in a general framework, especially focussing on stationary underlying process and the special cause of level shift type. Illustrative examples are employed to illustrate the issues discussed.

• Journal of Applied Reliability
• /
• v.16 no.1
• /
• pp.71-77
• /
• 2016

Purpose: Root cause analysis (RCA) refers to any systematic process that identifies the causes that contribute to a focus event. The immediate cause of a focus event is often a symptom of underlying causes and may not truly identify the root causes that should be identified and addressed. Currently many RCA tools are available. Different investigators use different RCA tools on different issues. No standardized or commonly agreed way to analyse root causes exists. The purpose of this study is to propose the methodology of RCA process commonly useable for various issues. Methods: The methodology of RCA process is produced based on the hybrid RCA tools. The effectiveness assessment matrix of actions through the root cause candidates is presented. Results: No single RCA technique proposed has so far covered all necessary aspects. A hybrid approach which combines the best features of various techniques is proposed. The effectiveness assessment matrix helps us to identify the root cause to correct or eliminate system vulnerabilities effectively. Conclusion: This hybrid approach and effectiveness assessment matrix can provide guidance of RCA process across many industries and situations.

• The Journal of the Korea Contents Association
• /
• v.17 no.7
• /
• pp.265-275
• /
• 2017

The aim of this study was to examine fluid excretions and changes in deceased bodies depending on type, location of, and causes of death for hygienic management of funeral homes. Based on the 858 cadavers studied, the average age at the time of death is 68.6 years, 83.0% had illness as the cause of death, and 79.5% passed away in a medical facility. Fluid excretion was observed in 46.2% of the cadavers. In manner of death, 78.8% of deaths -highest percentage- was due to an accident and 10.8% of deaths - lowest percentage- was due to age. Fluid excretion was observed in 46.3% of cadavers from medical facilities, 38.6% of cadavers from homes and 77.4% of cadavers from miscellaneous locations. There were various number of cadavers with recorded immediate, secondary and underlying cause of death; however, the fluid excretion rate was similar. In analyzing the immediate, secondary and underlying cause of death, respiratory and heart disease were the most common causes of death in categories of body organ and system. In terms of fluid excretion, liver disease followed by digestive and circulatory diseases were most common in immediate cause of death. Accidents and miscellaneous circumstances were most common amongst secondary and underlying causes of death for cadavers with fluid excretion. Based on the recorded illnesses of the cadavers, cardiopulmonary failure was most common as evident in 96 cadavers followed by pneumonia and sepsis. Cholangiocarcinoma (73.3%) had the highest rate of fluid excretion followed by pancreatic cancer, severe brain injury and liver cancer amongst categories of illnesses with more than 15 cadavers.

• Childhood Kidney Diseases
• /
• v.21 no.2
• /
• pp.53-60
• /
• 2017

Proteinuria is common in pediatric and adolescent patients. Proteinuria is defined as urinary protein excretion at levels higher than $100-150mg/m^2/day$ in children. It can be indicative of normal or benign conditions as well as numerous types of severe underlying renal or systemic disease. The school urine screening program has been conducted in Korea since 1998. Since then, numerous patients with normal or benign proteinuria as well as early stage renal diseases have been referred to the hospital. Benign proteinuria includes orthostatic proteinuria and transient proteinuria. Most causes of proteinuria can be categorized into 3 types: 1) overflow, 2) tubular, and 3) glomerular. Although treatment should be directed at the underlying cause of the proteinuria, prompt evaluation, diagnosis, and long-term monitoring of these pediatric patients can prevent potential progression of the underlying disease process. This article provides an overview of proteinuria: its causes, methods of assessment, and algorithmic suggestions to differentiate benign from pathologic renal disease.

• Journal of Korean Foot and Ankle Society
• /
• v.2 no.2
• /
• pp.76-81
• /
• 1998

Chiefly, painful heel syndrome is observed at old age. Many possible reasons were bursitis, plantar fasciitis, calcaneal periostitis around the calcaneus and achilles tendon. But the exact cause was not clearly identified due to complexity of subcalcaneal pain mechanism. The incidence of calcaneal spur and overweight were significant in painful heel syndrome. Our purpose of this study was analysis of underlyng cause and correlation about bony spur and overweight in painful heel syndrome. The author used incidence of heel spur on painful heel syndrome and body mass index to evaluate overweight. The material is 55 cases of painful heel syndrome patients and 60 cases of control group. Bony spur was one of the cause of painful heel syndrome. Body weight and calcaneal spur was developing factors on painful heel syndrome. And the result was as follows. 1. Spur formation incidence is 35 cases (63.6 %) in painful heel syndrome, 8 cases (13.3%) in normal control group. So, patient's group is significantly high (p<0.01). 2. Body mass index is 26.48 in painful heel syndromes, 21.75 in normal control groups. Overweight above index 27 is 22 cases (40%) in painful heel syndromes, 3 cases (5%) m normal control groups. So, patient's group is significantly high (p<0.01). 3. In painful heel syndrome, tenderness site is 46 cases (83.6%) in medial calcaneal tuberosity, 4 cases (7.3%) in central calcaneal tuberosity, 1 cases (1.8%) in both site. 4. Underlying causes of painful heel syndrome is 19 cases (34.5%) in plantar fasciitis, 16 cases (29.1%) in calcaneal periostitis, 11 cases (20%) in bursitis, 4 cases (7.3%) in tendinitis, 2 cases (3.6%) in entrapment neuropathy.