• Title/Summary/Keyword: diagnosis model

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The Risk Factors for Infectious Complications after Elective Gastrectomy for Gastric Cancer (위암의 정규 위절제술 후 감염성 합병증의 위험인자)

  • Kim, Seon-Kwang;Kim, Chan-Young;Yang, Doo-Hyun
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.237-243
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    • 2008
  • Purpose: Postoperative Infectious complications are recognized as major complications that are associated with surgery. Although many studies have focused on the risk factors of postoperative complications, little is known about the risk factors of infectious complications after gastric cancer surgery, and especially after elective gastrectomy. There is now more and more interest in the risk factors of infectious complications in relation to controlling infection and as indicators of qualitatively assessing infectious complications. The aim of this study was to evaluate the risk factors related with infectious complications after performing elective gastrectomy for treating gastric cancer. Materials and Methods: We retrospectively reviewed a total of 788 patients who had undergone elective gastrectomy for gastric cancer between Jan. 2000 and Dec. 2007. The characteristics of the patients were divided according to the patients' factors and the operations' factors. Results: The patients' mean age was 58.9 (range: 24~91) years; 545 were male and 243 were female. The mean duration of the hospital stay was 20.3 days (range: 5~135 days), the mean operation time was 181.3 minutes (range: 65~440 minutes). The total complication rate was 17.1% (n=135) and the complication rate was 38.5% (n=52) among the 135 patients with infectious complications. The infectious complications were surgical site infection (59.7%), Pneumonia (19.3%), intra-abdominal abscess (11.5%), pseudomembranous colitis (5.7%), bacteremia (1.9%) and hepatic abscess (1.9%). On the univariate analysis, the significant risk factors were male gender, blood transfusion, smoking at the time of diagnosis, alcohol drinking, diabetes mellitus and previous cardiovascular disease (P<0.05 for all). On multivariate analysis that used a logistic regression model, the significant independent risk factors were smoking at the time of diagnosis (OR: 2.877. 95% CI: 1.449~5.713), blood transfusion (OR: 3.440, 95% CI: 1.241~9.534), diabetes mellitus (OR: 3.150, 95% CI: 1.518~6.538), and previous cardiovascular disease (OR: 2.784, 95% CI: 1.4731~5.2539). Conclusion: Pre- or post-operative blood transfusion and the patient's medical history such as previous cardiovascular disease, diabetes mellitus, smoking etc. are the risk factors for infectious complications after undergoing elective gastrectomy for gastric cancer. The patients that have these risk factors need to be treated with great care to prevent infectious disease after elective gastrectomy.

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Prognostic Factors of Malignant Pleural Effusion in Non-small Cell Lung Cancer (비소세포폐암에 발생한 악성 흉수의 예후 인자)

  • Lim, Chang-Young;Lee, Gun;Lee, Hyeon-Jae
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.109-113
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    • 2007
  • Background: In non-small cell lung cancer (NSCLC), malignant pleural effusion is a frequently observed com-plication, and is an important negative prognostic factor. Although many studies concerned to diagnosis and treatment of malignant pleural effusion have been performed, prognostic factors of malignant pleural effusion have rarely been investigated. This study was performed to determine the prognostic factors of malignant pleural effusion n non-small cell lung cancer. Material and Method: We evaluated 33 NSCLC patients with malignant effusion treated between January 2002 and December 2003. We analyzed possible factors: gender, age, TNM Stage, fluid analysis (pH, CEA, LDH, glucose, albumin) and treatment modality. Median survival time of each factor was calculated by Kaplan-Meier method and difference of median survival time between groups of factor compared by log-rank test. The Cox proportional hazards regression model was used to confirm the significance of prognostic factor. Results: Of the 33 patients, 23 (69.7%) patients were adenocarcinoma. The median interval of the diagnosis of lung cancer and malignant effusion was 7.3 months ($25^{th}{\sim}75^{th}:\;3.9{\sim}11.8$), and the median survival time was 3.6 months (95% Confidence Interval: $1.14{\sim}5.99$). In the univariate analysis, using the log-rank test, those with an adenocarcinoma showed a relatively longer median survival time than those of a non-adenocarcinoma (4.067 vs. 1.867 months, p=0.067) without statistical significance. In the multivariate analysis, using the Cox regression, those with a non-adenocarcinoma showed a trend of high risk of cancer death than those with an adenocarcinoma without statistical significance (Relative risk; 2.754, 95% Cl: $0.988{\sim}7.672$, p=0.053). Conclusion: We could not find an independent prognostic factor of malignant pleural effusion in NSCLC. As there was a trend of high risk of cancer death according to histology, further study will be needed.

Characteristics of posteroanterior cephalometric analysis in children with skeletal Class I malocclusion (성장기 골격성 I 급 부정교합 환자의 정모두부방사선 계측의 특징)

  • Moon, Yoon-Shik;Kim, Jung-Kook;Jung, Hyun-Sung;Sung, Sang-Jin
    • The korean journal of orthodontics
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    • v.31 no.2 s.85
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    • pp.159-172
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    • 2001
  • Three dimensional analysis of malocclusion and craniofacial deformation is essential for the successful orthodontic treatment. But the orthodontists are not familiar with diagnosis and treatment plane based on lateral cephalometric analysis. Since orthodontists do not posses a sufficient knowledge in standard value of posteroanterior cephalometric anaysis and of clinical importance for transverse jaw growth. In this study male(n=130) and female(n=171) aged from 6 to 16 and diagnosed as Class I malocclusion were selected to analysis width of cranium, maxilla and mandible on the posteroanterior cephalogram. The changes as a function of chronologic age and cervical vertebrae maturity index(CVXI) were examined. The Proper regression model was selected by sex with polynominal regression models and method of variable selection. Mean of each measurements and 70% confidence interval of individual measurement according to age was assesed and a graphs were made. Results are as follows :1. All the measurements for the width are gradually incresed as increase in chronologic age and CVMI. From the total amount of change between age 6 and 16, there is a tendency that mandibular width is broader than maxillary width and the width of male is broader than female. 2. There is no statistically significant sexual difference in Mx-Mn difference, Mx-Mn width differential, Mx/Mn ratio according to age and CVMI. 3. Mean of each measurement and 70% confidence interval of individual measurement according to age and sex were assessed and graphs were made for maxillary width, mandibular width, Mx-Mn difference, Mx/Mn ratio. 4. The width of maxilla and mandible in Korean children are broader than Western children during growth period.

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Occupation-based Occupational Therapy for an Youth With Sensory Integrative Dysfunction - A Single Case Study (감각통합기능장애를 가진 청소년의 작업수행에 초점을 맞춘 작업치료 사례)

  • Ji, Seok-Yeon;Lee, Kyoung-Min;Kim, Mi-Sun
    • The Journal of Korean Academy of Sensory Integration
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    • v.6 no.1
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    • pp.47-62
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    • 2008
  • Introduction : Sensory Integration(SI) theory, science it is developed by an occupational therapist A. Jean Ayres, is the one of the most popular frames of reference used in occupational therapy(OT) intervention. It has been proved as a scientific theory especially in neuroscience discipline through abundant research and practice. Occupational therapists apply the SI therapy with strong clinical reasoning to improve adaptive behaviors of their clients and try to link the adaptive behaviors with occupational performance in the clients' everyday life. One of the manners regarding clinical reasoning is Top-down approach. In occupational therapy discipline, Top-down approach is well-reflected within two evaluation tools; Canadian Occupational Performance Measure(COPM) and Assessment of Motor and Process Skills(AMPS) and two models of practice; Canadian Model of Occupational Performance(CMOP) and Occupational therapy intervention process model(OTIPM). Objective : The purpose of this paper demonstrates how SI therapy can be employed within OTIPM and how the OT process (evaluation-intervention-outcome) can be structuralized based on the Top-down approach. This single-case study recognizes the impact of a SI therapy for a male adolescent on his occupational performance. Intervention Examined : "P" was 16 years old male adolescent with no diagnosis and junior of the high school when he was referred. P was always with mouth opened, showed difficulties in gathering things need to be prepared and managing and paying money for shopping, and his colleges dislike getting close to him because he can't was his body well. AMPS was administrated in initial evaluation and reevaluation of P's occupation performance, Bruininks-Oserestky Test of Motor Proficiency-2(BOT-2) was carried out to assess motor functions and perception skills related in sensory integration, and occupational therapist performed clinical observation in order to complement the evaluation quantitatively and quantitatively. Based on the evaluation, it is concluded that the SI therapy is primary means to improve P's occupational performance, and three therapeutic approaches were constructed; restorative, acquired and compensatory approach. P showed improved motor and process skills in occupational performance after undergone the occupational therapy. Conclusions : The sensory integration therapy was practical enough to build the bridge between the occupational performance(Top) and the underlying component problems (Bottom). The OTIPM was helpful to identify meaningful occupation for P and P's family within P's contexts, and the AMPS was valuable to analyze and clarify the cause of difficulties in the chosen occupational performance.

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Diagnosis and Improvements Plan Study of CIPP Model-based Vocational Competency Development Training Teacher Qualification Training (Training Course) (CIPP 모형 기반 직업능력개발훈련교사 자격연수(양성과정) 진단 및 개선 방안 연구)

  • Bae, Gwang-Min;Woo, Hye-Jung;Choi, Myung-Ran;Yoon, Gwan-Sik
    • Journal of vocational education research
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    • v.36 no.2
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    • pp.95-121
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    • 2017
  • The vocational competency development training teacher must complete the training course for the training of vocational competency development training instructor and get the qualification of the vocational competency development training teacher from the Ministry of Employment & Labor with the criteria set by the Presidential Decree. Therefore, it can be said that H_university 's educational performance, which is the only vocational competency development training teacher in Korea and that plays a role of mass production in the labor market, has a great influence on vocational competency development training. The purpose of this study is to identify the problems through the analysis of actual condition of vocational competency development training education based on CIPP model, Furthermore, it was aimed to suggest improvement plan of qualification training education. In order to accomplish the purpose of the research, the present situation of the training course for the vocational competency development training teacher training students was grasped. And We conducted a survey to draw out the improvement plan and utilized the results of 173 copies. We conducted interviews by selecting eight subjects for in-depth analysis and Understand the details of the results of the surveys conducted. As a result of the study, positive responses were obtained from the educational objectives and educational resources in the context factors. On the other hand, there were negative opinions about the curriculum reflecting the learner and social needs. In the input factors, positive opinions were derived from the educational objectives and training requirements. However, there were many negative opinions about the achievement of the learner's educational goals. In addition, there were many negative opinions of online contents education. In the process factors, positive evaluation was high in class related part, learner attendance management, and institutional support. However, negative opinions were drawn on the comprehensive evaluation of qualification training period, and the learner's burden due to lack of learning period appeared to be the main reason. In the factor of calculation, Positive opinions were derived from the applicability of the business curriculum for training courses for training teachers who are in charge of education and training in industry occupations. However, there were negative opinions such as learning time, concentration of learning, and communication of instructors. Based on the results of the study, suggestions for improving the operation of vocational competency training teacher qualification training are as follows. First, it is necessary to flexibly manage the training schedule for the weekly training course for vocational competency development training teachers. Second, it is necessary to seek to improve the online education curriculum centered on consumers. Third, it is necessary to seek access to qualification training for local residents. Fourth, pre - education support for qualified applicants is required. Finally, follow-up care of qualified trainees is necessary.

A COVID-19 Diagnosis Model based on Various Transformations of Cough Sounds (기침 소리의 다양한 변환을 통한 코로나19 진단 모델)

  • Minkyung Kim;Gunwoo Kim;Keunho Choi
    • Journal of Intelligence and Information Systems
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    • v.29 no.3
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    • pp.57-78
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    • 2023
  • COVID-19, which started in Wuhan, China in November 2019, spread beyond China in 2020 and spread worldwide in March 2020. It is important to prevent a highly contagious virus like COVID-19 in advance and to actively treat it when confirmed, but it is more important to identify the confirmed fact quickly and prevent its spread since it is a virus that spreads quickly. However, PCR test to check for infection is costly and time consuming, and self-kit test is also easy to access, but the cost of the kit is not easy to receive every time. Therefore, if it is possible to determine whether or not a person is positive for COVID-19 based on the sound of a cough so that anyone can use it easily, anyone can easily check whether or not they are confirmed at anytime, anywhere, and it can have great economic advantages. In this study, an experiment was conducted on a method to identify whether or not COVID-19 was confirmed based on a cough sound. Cough sound features were extracted through MFCC, Mel-Spectrogram, and spectral contrast. For the quality of cough sound, noisy data was deleted through SNR, and only the cough sound was extracted from the voice file through chunk. Since the objective is COVID-19 positive and negative classification, learning was performed through XGBoost, LightGBM, and FCNN algorithms, which are often used for classification, and the results were compared. Additionally, we conducted a comparative experiment on the performance of the model using multidimensional vectors obtained by converting cough sounds into both images and vectors. The experimental results showed that the LightGBM model utilizing features obtained by converting basic information about health status and cough sounds into multidimensional vectors through MFCC, Mel-Spectogram, Spectral contrast, and Spectrogram achieved the highest accuracy of 0.74.

Development of a Rapid Enrichment Broth for Vibrio parahaemolyticus Using a Predictive Model of Microbial Growth with Response Surface Analysis (미생물 생장 예측모델과 반응표면분석법을 이용한 Vibrio parahaemolyticus의 신속 증균배지 개발)

  • Yeon-Hee Seo;So-Young Lee;Unji Kim;Se-Wook Oh
    • Journal of Food Hygiene and Safety
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    • v.38 no.6
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    • pp.449-456
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    • 2023
  • In this study, we developed Rapid Enrichment Broth for Vibrio parahaemolyticus (REB-V), a broth capable enriching V. parahaemolyticus from 100 CFU/mL to 106 CFU/mL within 6 hours, which greatly facilitates the rapid detection of V. parahaemolyticus. Using a modified Gompertz model and response surface methodology, we optimized supplement sources to rapidly enrich V. parahaemolyticus. The addition of 0.003 g/10 mL of D-(+)-mannose, 0.002 g/10 mL of L-valine, and 0.002 g/10 mL of magnesium sulfate to 2% (w/v) NaCl BPW was the most effective combination of V. parahaemolyticus enrichment. Optimal V. parahaemolyticus culture conditions using REB-V were at pH 7.84 and 37℃. To confirm REB-V culture efficiency compared to 2% (w/v) NaCl BPW, we assessed the amount of enrichment achieved in 7 hours in each medium and extracted DNA samples from each culture every hour. Real-time PCR was performed using the extracted DNA to verify the applicability of this REB-V culture method to molecular diagnosis. V. parahaemolyticus was enriched to 5.452±0.151 Log CFU/mL in 2% (w/v) NaCl BPW in 7 hours, while in REB-V, it reached 7.831±0.323 Log CFU/mL. This confirmed that REB-V enriched V. parahaemolyticus to more than 106 CFU/mL within 6 hours. The enrichment rate of REB-V was faster than that of 2% (w/v) NaCl BPW, and the amount of enrichment within the same time was greater than that of 2% (w/v) NaCl BPW, indicating that REB-V exhibits excellent enrichment efficiency.

Effects of Nursing Ethics Education on Moral Reasoning and Ethical Decision Making for Student Nurses (간호윤리 교육이 간호학생의 도덕적 사고와 윤리적 딜레마 상황에서의 의사결정에 미치는 효과)

  • Han, Sung-Suk;Ahn, Sung-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.2
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    • pp.268-284
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    • 1995
  • This study was designed to test effects of nursing ethics education (NEE) on moral reasoning and ethical decision making of subjects. This NEE that was teached for 10 hours course was composed of these : Nurses' ethical code, moral responsibility, Moral value and professional accountability, Respect for human life, General ethics, Theory and Norms of biomedical ethics, Ethical decision making model and Discussion about hypothetical ethical dilemmas Twenty-five senior student nurses were sampled from four year college of nursing from Nov. 3rd, 1993 to Nov. 24th, 1993. Data were collected through self-reported questionnaires included two kinds of tests. Rest's Defining Issues Test was adopted to measure the stage of moral development, which was classified with the stage 2 (instrumental relativist orientation), the stage 3 (interpersonal concordance), the stage 4 (law and order), the stage 5A (societal consensus), and the stage 5B (intuitional humanism), the stage 6 (universal ethical practice). In particular, the level of principled thinking (P) was measured by summing these scores of the stages 5A, 5B, and 6. The possible range of P is 0 to 95. As for measuring the levels of morality and nursing dilemma, Crisham's Nursing Dilemma Test was adopted. This test generated the morality score(MS) and the dilemma score (DS). The data were analyzed by t-test, ANOVA, Kruskal-Wallis test, Mc Nemar's test and Pearson correlation coefficients. The results were as follows ; 1. For the Moral Reasoning both before and after NEE, The Mean score of the stage 5A was significantly higher than that of other stages.(P=0.0001) Before NEE, the mean score of the stage 4 was significantly different from stage 2, 3, 5A, and after NEE, different from stage 2, 5B,6. 2. The analysis of change of moral development level revealed that the score of stage 4 increased after NEE.(P=0.0004) 3. The Effect of NEE for the mean score of 5A, 6, P after education was significantly different by birth place. 4. With regard to the five dilemmas postulated such as forcing medication performing cardiac pulmonary resuscitation, reporting a medication error, informing diagnosis to terminally ill adult, and providing new-nurse orientation, the mean score of the MS and the DS was no significant difference with general characteristics of the students. Effect of NEE morality score and dilemma score after education was no significant difference. 5. As for the correlations between moral reasoning and decision making, the score of the stage 2, 5A, 6, DS was positively correlated with the scores of before and after. Positive correlation was also observed between the scores of stage 2 and stage 4, stage 3 and 6. On the other hand, the score of P was negatively correlated with the scores of stage 2 and of stage 4 and of stage 5A. The score of the stage 5A was also negatively correlated with the score of the sge 6.

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A study for the relationship between the cognition difference and satisfaction for the medical service and the revisiting (의료서비스의 인식차이와 만족이 재방문에 미치는 영향에 관한 연구)

  • Lee, Kyoung-Woo
    • Korea Journal of Hospital Management
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    • v.8 no.3
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    • pp.143-160
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    • 2003
  • Due to the dramatic and situational change in medical industry, it has became very important to keep existing patients and to attract new patients by monitoring the medical consumer's expectation and various needs and ensuring the patients' satisfaction. This study regards the patients' satisfaction as the final object of medical service. So the object of this study is to provide useful data for the decision making and medical service marketing by exploring the problems generated by the cognition difference for the medical service between inpatients and outpatients, by responding for the problems and by examining the relationship between the satisfaction with the medical service and revisiting. To achieve the object of this study, literature research and empirical analysis were used. I establish the research model based on the existing service marketing and some hypotheses were chosen for the empirical analysis. As a result of empirical analysis for the five hypotheses, two hypotheses were chosen. First, there was cognition difference about accessibility and convenience between inpatient and outpatient. I guess that the satisfaction degree of inpatient is higher than the outpatient because the inpatient has the reliability for the hospital and determines the hospitalization or emergent coming to hospital. Second, the fifth hypothesis, "the satisfaction of patient will influence the revisiting." was chosen. The hypothesis is not only coincident with existing scholars and studies but also it provides the meaningful points for medical service marketing. The result shows that the parties concerned with hospital management should endeavor for the patient satisfaction in medical service, and that hospital management should be medical consumer centered. To measure the quality of medical service, the cognition differences for accessibility, convenience, physical environment, and human service were evaluated and the result shows that the cognition difference for the accessibility and convenience was outstanding. The analysis shows that there was cognition difference in the four categories among six subcategories in the human service -- the attitude of medical technologist, the attitude of doctor, the length of time for doctor's diagnosis for the patient and doctor's explanation. Therefore, I think that further study is required for the cause analysis for service categories which have cognition difference between inpatient and outpatient. I think the result will be very useful. Through this study, the relationship between patient satisfaction with the medical service and revisiting was verified. And it suggests that, to face the changing medical environment actively and to improve the quality of medical service, marketing strategy should be focused not on medical service providers but on medical service consumers and that the further studies for the medical consumer should be continued.

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The Design of Maternity Monitoring System Using USN in Maternity Hospital (USN을 이용한 산모 모니터링 시스템 모델 설계)

  • Lee, Seo-Joon;Sim, Hyun-Jin;Lee, A-Rom;Lee, Tae-Ro
    • Journal of Digital Convergence
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    • v.11 no.5
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    • pp.347-354
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    • 2013
  • In contrast to the increase in demand for high quality healthcare, there is limited medical human resources such as doctors and nurses so an excessive amount of workload is being forced to them. Therefore, a patient monitoring system using USN(Ubiquitous Sensor Network) is becoming a solution. This paper proposes a patient monitoring system applying USN in maternity hospital to reduce the workload of nurses. According to the efficiency evaluation test based on the model of two university hospitals(S, K University Hospital) and their doctor's diagnosis, the results showed that under the circumstances that one nurse is in charge of 12 patients(6 normal delivery patients and 6 cesarean delivery patients), a total of 1,260 minutes of workload was saved during hospitalization period(5 days). Also, we compared the workload of nurses with or without our proposed system, and the figures showed that in case of normal delivery patients, the workload of nurses decreased by 50 minutes per patient, whereas in case of cesarean delivery patients, the workload of nurses decreased by 130 minutes per patient.