• Title/Summary/Keyword: class interval

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Safety of endoscopic retrograde cholangiopancreatography (ERCP) in cirrhosis compared to non-cirrhosis and effect of Child-Pugh score on post-ERCP complications: a systematic review and meta-analysis

  • Zahid Ijaz Tarar;Umer Farooq;Mustafa Gandhi;Saad Saleem;Ebubekir Daglilar
    • Clinical Endoscopy
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    • v.56 no.5
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    • pp.578-589
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    • 2023
  • Background/Aims: The safety of endoscopic retrograde cholangiopancreatography (ERCP) in hepatic cirrhosis and the impact of Child-Pugh class on post-ERCP complications need to be better studied. We investigated the post-ERCP complication rates in patients with cirrhosis compared with those without cirrhosis. Methods: We conducted a literature search of relevant databases to identify studies that reported post-ERCP complications in patients with hepatic cirrhosis. Results: Twenty-four studies comprising 28,201 patients were included. The pooled incidence of post-ERCP complications in cirrhosis was 15.5% (95% confidence interval [CI], 11.8%-19.2%; I2=96.2%), with an individual pooled incidence of pancreatitis 5.1% (95% CI, 3.1%-7.2%; I2=91.5%), bleeding 3.6% (95% CI, 2.8%-4.5%; I2=67.5%), cholangitis 2.9% (95% CI, 1.9%-3.8%; I2=83.4%), and perforation 0.3% (95% CI, 0.1%-0.5%; I2=3.7%). Patients with cirrhosis had a greater risk of post-ERCP complications (risk ratio [RR], 1.41; 95% CI, 1.16-1.71; I2=56.3%). The risk of individual odds of adverse events between cirrhosis and non-cirrhosis was as follows: pancreatitis (RR, 1.25; 95% CI, 1.06-1.48; I2=24.8%), bleeding (RR, 1.94; 95% CI, 1.59-2.37; I2=0%), cholangitis (RR, 1.15; 95% CI, 0.77-1.70; I2=12%), and perforation (RR, 1.20; 95% CI, 0.59-2.43; I2=0%). Conclusions: Cirrhosis is associated with an increased risk of post-ERCP pancreatitis, bleeding, and cholangitis.

Reliability of the Sundsvall Method for Femoral Offset Evaluation

  • Patrick Kelly;Caitlin Grant;Niall Cochrane;Jonathan Florance;Michael Bolognesi;Sean Ryan
    • Hip & pelvis
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    • v.36 no.3
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    • pp.218-222
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    • 2024
  • Purpose: Acetabular and femoral offset (FO) play an important role in total hip arthroplasty (THA). The Sundsvall method has been proposed to account for both FO and cup offset in one global hip offset measurement. In this study, we examine the agreement and inter-observer reliability of the Sundsvall method of hip offset measurement. Materials and Methods: Four hundred and ninety-nine THA patients at a single tertiary academic institution were retrospectively reviewed. Preoperative hip offset was measured on anteroposterior radiographs of the pelvis on the operative and contralateral side. Hip offset was also measured postoperatively on the operative side. Hip offset was measured using the Sundsvall method as the distance between the femoral axis and midline of the pelvis at the height of the lateral most point of the greater trochanter. All measurements were completed by two raters. Intra-class correlation coefficients (ICC) and Pearson's correlation coefficients were used to evaluate agreement and inter-observer reliability between two raters. Results: There was excellent agreement between raters for preoperative hip offset measurement with an ICC of 0.91 (confidence interval [CI] 0.90-0.93, P<0.01) and R=0.92. There was excellent agreement between raters for postoperative hip offset with an ICC of 0.93 (CI 0.92-0.94, P<0.01) and R=0.93. Conclusion: This study confirms the inter-observer agreement and reliability of the Sundsvall method of hip offset measurement. With its high agreement and reliability, the Sundsvall method is an easy and reliable way to measure hip offset that can be applied in future clinical and research settings.

A Consideration on Intraspecific Competition with Particular Reference to Basal Area-class Structure of Even-aged Coniferous Monocultures (침엽수 동령 인공림내 개목들의 저적면적빈도분포에 의거한 종내경쟁에 대한 고찰)

  • 오계칠
    • Journal of Plant Biology
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    • v.24 no.1
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    • pp.47-57
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    • 1981
  • Girth at breast height was measured to test skewness ($g_1$) and kurtosis ($g_2$) of frequency distribution of the basal area in terms of t-test and Kolmogorov-Smirnov test for a total of forty six monocultures within Sudong and Kwhangnung area in central part of Korean peninsula in 1979 and 1980. The monocultures are about 10 to 50 years old, and four kinds: Pinus koraiensis, Larix kaempferi, Abies holophylla and Pinus rigida. Most of the sample sizes per site were ranged 70 to 110 excluding 4 sites. The number of classes interval was based on Sturges rule for each monoculture and was ranged from 5 to 10. In Sudong the range of age(yr) and basal area (($cm^2$)/tree) of the monocultures were from 10 to 20 and from 27.60 to 383. for Kwhangnung they were from 15 to 47 and mostly 102.15 to 619.14, respectively. All 43 monocultures except 1 showed +$g_1$, which ranged from 0.3 to 2.2 except six sites. Of the total 46 sites, 23 sites showed significant +$g_1$ which includes about 10 year-old monoculture. The number of classes interval with significant positive skewness ranged from 6 to 9. The data suggest that intraspecific competition in terms of stand structure seems to appear from about 10 year-old monocultures, and it may even last to about 50 year-old one. Around 24 monocultures showed nonsignificant -$g_2$ except one. Most -$g_2$ ranged from -0.12 to -0.83. Around 20 monocltures showed positive $g_2$ ranging from +0.13 to +3.841. Of the 22 +$g_1$, majority of 11 were very highly significant. Of all monocultures only 5 showed significant result from Kolmogorov-Smirnov test. Of the 4 species, Larix kaempferi seems to show density stress first then Abies holophylla, and Pinus koraiensis last. Data of this study indicate that adequate number of classes intervals and sample sizes for studying intraspecific competition in terms of basal area are 6 to 9 and 80 trees rather than 12 and 100 trees, respectively. It also suggests that most of the frequency distribution of basal area class are trimodal rather than bimodal under density stress. It is proposed that the leptokurtic distribution appears before normal distribution rather than direct change from platykurtic to normal distribution of basal area for selected stages in the development of stands.

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The relationship between menarche and the ossification stages of the phalanx of the first and third finger (성장기 여아에서 첫째 및 셋째 수지 지절 변화와 초경시기)

  • Kim, Kyung-Ho;Choy, Kwang-Chul;Jung, Kil-Yong
    • The korean journal of orthodontics
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    • v.32 no.4 s.93
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    • pp.265-274
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    • 2002
  • Among many maturation indicators of growing patients, menarche and skeletal maturity are useful to assess growth and development, and the changes of the first and third finger are relatively important in hand-wrist X-rays. The objective of this study was to evaluate the relationship between menarche and the changes of the phalanx of the first and third finger and compare skeletal maturation among different malocclusion types. The sample used in this study was 29 Class 1,27 Class II and 27 Class III females whose hand-wrist X-rays had been taken with 6 month interval before the appearance of ulnar sesamoid ossification till the phalanges of the fingers were almost fused. The results were as follows. 1. There was no skeletal maturity difference among malocclusion types. 2. There was no difference in the mean chronologic age of menarche among different malocclusion types and that was $12.30\pm0.98$ years. 3. The ulnar sesamoid was observed at $10.35\pm1.01$ years, and on distal phalanx of the first finger, epiphyseal capping appeared at $11.26\pm1.04$ years and fusion at $13.12\pm1.06$ years. The epiphyseal capping on middle phalanx of the third finger was observed at $11.57\pm1.02$ years and fusion at $13.72\pm1.04$ years. 4. The timing of menarche occurred around the same time as the fusion process of distal phalanx of the first finger(p<0.001, r=0.82) and the initiation of fusion of middle phalanx of the third finger(p<0.001, r=0.78). Therefore, we can give the aid when we evaluate the growth and development of growing females seeing the changes at phalanx of the first and third finger.

A Longitudinal Study on the Skeletal Maturity of the Hand and Wrist among Various Malocclusion Groups(I) (부정교합자의 수완부 골성숙도에 관한 누년적 연구(I))

  • Kim, Kyung-Ho
    • The korean journal of orthodontics
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    • v.29 no.2 s.73
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    • pp.183-195
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    • 1999
  • Growth and development evaluation of patients with growth potential is of great importance for orthodontic treatment planning. Timing of orthodontic intervention greatly depends on one's developmental status, thus if there is a difference in skeletal maturation among malocclusion types different treatment timing should be applied. The objective of this study was to evaluate and compare skeletal maturation among different malocclusion types. The samples used in this study was 38 Class I, 36 Class II and 33 ClassIII females aging from 8 to 10 years. Handwrist X-rays were taken with 6 month interval till 12-13 years of age. The results were as follows. 1. There was no skeletal maturity difference among different malocclusion types. 2. The hamular process of hamate was observed at $9.16{\pm}0.72$ years, pisiform bone at $9.13{\pm}0.71$ years and the ulnar sesamoid at $10.34{\pm}0.84$ years. 3. The timing of epiphyseal capping on the third finger was $10.96{\pm}0.80$ years for distal phalanx and $11.27{\pm}0.87$ years for middle phalanx, $11.12{\pm}0.85$ years for proximal phalanx of the first finger, $11.21{\pm}0.82$ years for radius and $11.62{\pm}0.85$ years for middle phalanx of the fifth finger. 4. The appearance of pisiform bone showed high correlation with appearance of hamular process of hamate(r=0.91) and ulnar sesamoid bone appearance showed high correlation with advanced ossification of hamular process(r=0.86). Timing of epiphyseal capping among different parts showed high correlation(r=0.80-0.90). 5. The shape of middle phalanx of the fifth finger showed the highest variability ($20.6\%$).

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A Study on the Efficiency of Clinical Practice for Nursing Education in the Junior College of Nursing in Korea (전문대학 간호과의 임상 실험 효율화를 위한 연구)

  • Lee, Kun-Ja;Kim, Myung-Soon;Yang, Young Hee
    • Journal of Korean Public Health Nursing
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    • v.3 no.2
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    • pp.77-108
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    • 1989
  • The purpose of this study was to find out the present condition of clinical practice and to develop a scheme on the efficiency of clinical practice for nursing education in junior college of nursing in korea. This study was conducted by 2 sections. Ist section was to find out the present condition of clinical practice to 42 directors of nursing collegd and data were collected July 8 to September 30, 1988. 2nd section wat to develop a scheme on the efficiency of clinical practice for nursing education and subjects were nursing professors 258: and clinical nurses 223 in 42 junior nursing colleges their clinical settings in korea. So total subjects were 481. Data were collected july 8, 1988 to June 30, 1988 and were analysed to get the mean, standand deviation, frequency, percentage, t-test, x-test used by SPSS - pc. Major findings were as follows: 1. The present condition of clinical education in junior college of nursing in Korea. 1) 32 colleges (76.2%) were managed by a-yeas system. 2) 25 colleges (59.5%) were performed by individual practice for each subject. 3) 4 weeks interval between class education and clinical education was a major type among total colleges(36.6%, J5 colleges) 4) 30 colleges (71.4%) provided clinical education for all subjects that should be practiced. Nursing administration wes not practiced in 5 colleges (41.9%) among the remainder(12 colleges). The main cause that all practice subjects were not practiced was the lack or absence of suitable clinical settings(8 colleges. 66.7%) 5) 18 colleges (42.9%) responded that a clinical educator was, subject-charged professor. 6) 12 colleges (29.3%) responded that a clinical instructor was in charge of 6~10 students. 7) The evaluation ration ratio(professor to head nurse) by each evaluator was mostly 50% to 50 % and 60% to 40%, respectively 11 colleges(27.5%) The most common evaluation methods were evaluation by head nures, report, presence, conference (11 colleges, 27.5%) 8) The field carrier of professor was mostly 2 years (79 persons, 20.7%) and mean was 3.2 years. The education carrier of a professor was mostly over than 6 years (261 persons, 66.4%) and mean was 9.2 years. The charge hours per-week of a professor were mostly 16-18 hours (16 persons, 131.8%) 9) 34 colleges (82.9%) approved that clinical practice hour was class hour and 18 colleges (43.9 %) counted that 2 hours of clinical education equaled 1 hour of class education. 2. A study 'on the efficiency of clinical practice for nursing education. L) general characteristics of subjects were as follows: kung-sang province (145 persons, 30.5%), 30-34 years (190 persons, 39.8%), graduated degree (245 persons, 51.5%), 6-10 years of carrier (199 persons, 41.4%) were the majority. 2) suitable clinical setting was responded the systematic ward with responsible clinical educator by 210 persons(43.8%) The response by working field of subjects showed a significant difference (p< 0.01) 3) 259 subjects (54.0%) responded that the desirable qualfication of clinical instructor was 3-5 years of clinical experience with master degree or higher. 4) The mean score of desirable quality degree of clinical instructor was 3.43 professors, score (3.54) was significantly higher than clinical nurses' (3.28) (p<0.01) 412 subjects (86.0%) responded that the insufficient guality of instructor was improved by continuing to seek more new information in reference. 5) 196 subjects (41.4%) responded that desirable qualification of head nurse was more than 2 years of head position among 5 years of clinical experience. The response by working' field of subjects showed a significant difference (p<0.05) 6) The mean score of desirable quality degree of head nurse was 3.18 Clinical nurses' score(3.38) was significantly higher than professors' (3.01) (p<0.01) 419 subjects (87.8%) responded that the insufficient of head nurse was improved by continuing relationship with instructor and being responsible from planing of clinical education. 7) The mean score of performance level of the desirable clinical education guide incollege was 2.91 Professors' score (2.96) was significantly higher than clinical nurses' (2.84) (p<0.01) 340 subjects (71.1%) responded that the possible resolution for poor performance was the more specified syllabus of clinical education and the satisfiable orientation for students. 8) The mean score of performance level of the desirable clinical education guide in hospital was 3.03 9) 141 subjects (29.6%) responded that the desirable clinical evaluator was the group of professor, head nurse, staff nurse. Response by working field of subjects was a significant difference (p< 0.05) 10) The mean score of performance level of the evaluation content needed in clinical education was 3.50 Clinical nurses' score (3.56) was significantly higher than professors' (3.45) (p<0.01) 11) 433 subjects (90.2%) responded that6 desirable evaluation method for clinical education was the presence. 12) The mean score of performance level about how personal difference among clinical educators was minimized was 2.89 and response by working field of subjects was not significant. The cause of poor performance was too much workload at clinical settings and too many students st colleges by 386 subjects (81.1%).

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STATISTICAL STUDY ON HABITUAL METHODS Of TOILET TRAINING FOR INFANT AND TODDLER (한국 영.유아의 대소변 가리기 훈련습성에 관한 일 연구)

  • 최경자
    • Journal of Korean Academy of Nursing
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    • v.3 no.3
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    • pp.119-132
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    • 1973
  • This study observed on habitual methods of toilet training for infants and toddlers in Korea thru 300 mothers at four medical institutions Ewha Woman′s University Hospital, Ewha Maternal and Child Health Center, Severance Hospital and Seoul National University Hospital) with a design to analyze beginning time, duration of period, methods employed, motives, equipments used, special terminology used for the subject training. The main purpose of this study was to generalize the proper methods of toilet training, and also to contribute a better psychological education for the mother and child. The results obtained from this study were as follows; 1. Majority of (67.3%) observed were in the age category between 30 and 40 years, and dominant numbers (64.7%) were housewives with high level of education and from middle class family background. 2. In the most cases (85%), toilet training was carried out by mothers(including wives who had a job) while more than half of mothers (53.7%) maintained their important motive for the training was "due to having high regard for cleanliness" 3. As for the time of beginning toilet training: finding indicated that starting period was decided (70%) at inconsiderate desertion of each mother. whereas, only minority group (30%) represents the cases where mother started the training when they consider tile child was physically and psychologically randy. Also greater number (77.7%) started bladder training prior to that of bowel. 4. It is noticeable that in course of training a large number of mothers (48.3%) applied strict training method when the child proper talenting, and the more rigid and strict in tile training. the more malformation of personality of the infant and toddler were seen after the training period (P<0.01). 5. Over the half of the total cases denoted (bowel 54.3%, bladder 67.7%) starting period before one year and in most cases (bowel 79.3%, bladder 729)the training was accomplished within 12 month, and therefore it was noted that earlier start(before 1 year) shortened the training period (with 12 month) . There was no significant difference between male and female infants in both starting period and duration of period in bladder training, however, in bowel training there was a tendency that female started earlier(7-12 months needed, 51.4%) than tile male (13-18 months needed, largest number 41.4%), and also in cases of female the period for needed for training were shorter than the cases of male. 6. Many a number (bowel 50.3%, bladder 97.7%) employed the method of continuous talenting at regular interval in accordance with that of child′s habit formed before training. Equipment used were various kinds, however, pieces of paper for male (45.5%) and piss pot or bedpost (42.3%) for female were common, on the other hand, "Eung-ga" for defecation (52.3%) and "Shii" for the urination (95.3%) were most standard expression that used during the training period.

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A CLINICAL REVIEW ON THE DELAYED ERUPTION OF 1ST MOLARS (제1대구치의 맹출지연에 관한 임상적 고찰)

  • Kim, Ju-Mi;WhangBo, Min;Kim, Joo-Young;Eum, Jong-Hyuk;Rhee, Ae-Ryon;Kim, Shin;Seo, Soo-Jeong
    • Journal of the korean academy of Pediatric Dentistry
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    • v.21 no.2
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    • pp.555-560
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    • 1994
  • Among the permanent teeth. the first permanent molars play the greatest role in occlusion and function. So, the congenital missing, abnormal reuption or abnormal formation of the first permanent molars in the course of arch development would inflict normal development of dental arches. Therefore, early detection of abnormal cases related to first permanent molars and understanding of current and predictable clinical problems are essential for proper occlusal guidance in children. With the aim of investigating the clinical patterns of delayed eruption of first permanent molars in children, panoramic tomograms of the childern in mixed and early permanent dentition were observed and analyzed. The results were as follows: 1. Among the delayed eruption of first permanent molars, on tooth or bilateral teeths were affected most frequently. Delayed eruption was more prevalent in maxilla than in mandible. 2. The formation of tardily erupted teeth were also delayed. 3. Delayed eruption was generally limited in first molars or molar segments. 4. Delayed eruption of first permanent molars is accompanied by abnormal position of tooth germs, for example, ectopic eruption, delayed dental age, delayed localized tooth formation and generalized congenital missing. 5. There was a tendency of delayed formation or congenital missing of second molars distal to tardily erupted 1st molars. And that was more marked in maxilla than in mandible. 6. There was reported that affected 1st molars show various size and shapes. Maxillary 1st molars showing delayed eruption showed a tendency of having 3 cusps. But, tardily erupted mandibular 1st molars showed no significant reduction in mesiodistal dimension, as reported. 7. In some cases, the delayed eruption of 1st permanent molars was associated with ectopic eruption, but their formation was not usually retarded. 8. In skeletal class III cases, there showed a tendency of mandibular 1st molars to erupt earlier than maxillary 1st molars with greater interval than in normal occlusion.

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A Study on the Relationship between Self Effcacy and Self Care Behavior in Patients with Pulmonary Tuberculosis (폐결핵 환자가 지각한 자기효능과 자가간호행위와의 관계에 관한 연구)

  • Jung Young Ju;Kim Jung Hyo
    • Journal of Korean Public Health Nursing
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    • v.10 no.2
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    • pp.90-102
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    • 1996
  • This study is a descriptive survey research to investicate the relation between the performance of self-care behavior and degree of self-efficacy by evaluating them respectively. The subjects were consisted of seventy nine tuberculosis patients registered in two different public health care centers in the city of Kwangju from April 1st to 30th June, 1995. The results were as follows : 1) Demorgraphically, the proportion of males was$(59.5\%)$, the highest proportion of age group was twenties with $(31.6\%)$, the higest proportion of the patients graduated high school. the married was much more than the single$(51.9\%)$. The highest proportions in each variables were as followes : middle class in economic status with $70.9%$, the jobless in job status with $26.6\%$. the duration less than 6 months in ailing duration with $63.3\%$. The patients of $60.8\%$ and $74.7\%$ showed no family history and received no health education respectively. 2) The average drgree of self-care behavior was 3.44 points (1-5 points). 3) The average dregee of recognized self efficacy was 78.18 points(10-100points). 4) The recognized self efficacy showed close relationship with the performance of self-care behavior (r=0.6378. p<0.001) 5) The points of performance of self-care nursing behavior showed statistical significance in the variables of martial status. duration of treatment and economic status. (F=3.142. p<0.05), (F=3.701. p<0.05). (F=6.213. p<0.01) 6) The point of self efficacy showed statistical significance in the variables of sex. degree of education and marital status. (F=5.438. p<0.05), (F=4.28. P<0.01), (F=2.899, p<0.05) These results suggest as follows: 1) It is necessary to develop a program to improve the ability of self health care for the family member as well as the patient. 2) It is necessary to do further study on much more variables that influence on the performance of self-care behavior by expanding the number of subjects and duration of study. and to evaluate the self efficacy with time interval.

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Optimum Range Cutting for Packet Classification (최적화된 영역 분할을 이용한 패킷 분류 알고리즘)

  • Kim, Hyeong-Gee;Park, Kyong-Hye;Lim, Hye-Sook
    • Journal of KIISE:Information Networking
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    • v.35 no.6
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    • pp.497-509
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    • 2008
  • Various algorithms and architectures for efficient packet classification have been widely studied. Packet classification algorithms based on a decision tree structure such as HiCuts and HyperCuts are known to be the best by exploiting the geometrical representation of rules in a classifier. However, the algorithms are not practical since they involve complicated heuristics in selecting a dimension of cuts and determining the number of cuts at each node of the decision tree. Moreover, the cutting is not efficient enough since the cutting is based on regular interval which is not related to the actual range that each rule covers. In this paper, we proposed a new efficient packet classification algorithm using a range cutting. The proposed algorithm primarily finds out the ranges that each rule covers in 2-dimensional prefix plane and performs cutting according to the ranges. Hence, the proposed algorithm constructs a very efficient decision tree. The cutting applied to each node of the decision tree is optimal and deterministic not involving the complicated heuristics. Simulation results for rule sets generated using class-bench databases show that the proposed algorithm has better performance in average search speed and consumes up to 3-300 times less memory space compared with previous cutting algorithms.