• Title/Summary/Keyword: medical costs

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Vessel Tracking Algorithm using Multiple Local Smooth Paths (지역적 다수의 경로를 이용한 혈관 추적 알고리즘)

  • Jeon, Byunghwan;Jang, Yeonggul;Han, Dongjin;Shim, Hackjoon;Park, Hyungbok;Chang, Hyuk-Jae
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.6
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    • pp.137-145
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    • 2016
  • A novel tracking method is proposed to find coronary artery using high-order curve model in coronary CTA(Computed Tomography Angiography). The proposed method quickly generates numerous artificial trajectories represented by high-order curves, and each trajectory has its own cost. The only high-ranked trajectories, located in the target structure, are selected depending on their costs, and then an optimal curve as the centerline will be found. After tracking, each optimal curve segment is connected, where optimal curve segments share the same point, to a single curve and it is a piecewise smooth curve. We demonstrated the high-order curve is a proper model for classification of coronary artery. The experimental results on public data set sho that the proposed method is comparable at both accuracy and running time to the state-of-the-art methods.

SVM Classifier for the Detection of Ventricular Fibrillation (SVM 분류기를 통한 심실세동 검출)

  • Song, Mi-Hye;Lee, Jeon;Cho, Sung-Pil;Lee, Kyoung-Joung
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.42 no.5 s.305
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    • pp.27-34
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    • 2005
  • Ventricular fibrillation(VF) is generally caused by chaotic behavior of electrical propagation in heart and may result in sudden cardiac death. In this study, we proposed a ventricular fibrillation detection algorithm based on support vector machine classifier, which could offer benefits to reduce the teaming costs as well as good classification performance. Before the extraction of input features, raw ECG signal was applied to preprocessing procedures, as like wavelet transform based bandpass filtering, R peak detection and segment assignment for feature extraction. We selected input features which of some are related to the rhythm information and of others are related to wavelet coefficients that could describe the morphology of ventricular fibrillation well. Parameters for SVM classifier, C and ${\alpha}$, were chosen as 10 and 1 respectively by trial and error experiments. Each average performance for normal sinus rhythm ventricular tachycardia and VF, was 98.39%, 96.92% and 99.88%. And, when the VF detection performance of SVM classifier was compared to that of multi-layer perceptron and fuzzy inference methods, it showed similar or higher values. Consequently, we could find that the proposed input features and SVM classifier would one of the most useful algorithm for VF detection.

The study on the relevance of healthy biorhythm and sub-health (생체리듬과 아건강과의 관련성에 관한 연구)

  • Shin, Jae-Kyoung
    • Journal of the Korean Data and Information Science Society
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    • v.28 no.5
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    • pp.1069-1076
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    • 2017
  • Recently, with the development of advanced medical technology and the introduction of most advanced medical equipments, life expectancy increases accordingly. Many people want to live long-lived in health. Therefore, if it is possible to pre-diagnose the sub-health condition and formulate an appropriate treatment plan, we can prevent the disease and reduce social expenditure costs. In this study, we statistically analyzed the data in responding to each questionnaire for healthy biorhythm and sub-health among targeted members of a specific group. The analysis for the effects of healthy biorhythm to male and female showed that there was a significant difference between male and female. In the analysis of the effects of the conditions of healthy biorhythm to the 10 sub-health indicators, the significant effects of good and bad condition has been observed. The results of the decision tree analysis showed that all the respondents with poor hormone and urological sub-health status have bad healthy biorhythms. In summary, in this paper we have shown that it may be possible to improve the sub-health condition and prevent disease in advance if the healthy biorhythm is well controlled.

The New Health Promotion Strategy in Japan-focusing on life-style related diseases (일본의 건강증진 정책의 방향 -생활습관병 대책을 중심으로-)

  • Lee, Jung-Su;Lee, Won-Chul;Lee, Kyeong-Soo;Koh, Kwang-Wook;Choi, Eun-Jin;Park, Chun-Man
    • Korean Journal of Health Education and Promotion
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    • v.25 no.3
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    • pp.167-181
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    • 2008
  • The prevention of life-style related diseases is an increasingly important issue in Japan, because not only have the number of patients with life-style related diseases increased but also medical care costs. This paper gives recent strategies for the prevention of cardiovascular diseases through life-style modification. Health objectives for the year 2010, called "Healthy Japan 21", were established in 2000 by the Ministry of Health, Labour and Welfare and the Health Promotion Act was enacted in 2002 to promote this health policy. However, the prevention efforts for life-style related diseases have not been effective in regard to the evaluation of the strategy objectives. The reform of the medical care system which included a new nationwide prevention strategy for life-style related diseases was presented in 2006. The new strategy starting from April 2008 included a "specific health checkup" and "specific health education" for those with metabolic syndrome. The specific health checkup is used to screen people according to criteria of the metabolic syndrome and divide them into 3 groups. These groups will receive specific health education. The purpose of this strategy is the early detection of those who have cardiovascular risk factors, and the early management of the clustering of cardiovascular risk factors of obese people aged 40-74 years old. It is mandatory for every insurer to conduct a specific health checkup and specific health education under the new Act. The implementation rate of the specific health checkup and the specific health education, and a reduction rate of individuals with metabolic syndrome among insured people will be evaluated every year. The national objective is to increase the rate of those undergoing the specific health checkup to 80% and the rate of those receiving the specific health education to 60% by the year 2015. The national objective also targeted a reduction rate of 25% for those with metabolic syndrome. This new strategy will be the biggest intervention trial in the world, and it will produce a big health care market in Japan. Not only public administrative institutions but also private institutions are now preparing to take part in this new strategy. However, various tasks remain, such as training more professionals in health education, developing more evidence based practices, and encouraging cooperation with various sectors, to enforce this new strategy.

Concept Analysis of Health Inequalities using Hybrid Model (혼종 모형을 이용한 건강 불평등 개념분석)

  • Lee, Ha-na
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.3
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    • pp.520-534
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    • 2018
  • This study was conducted to understand the conceptual definition and characteristics of health inequality. To accomplish this, we analyzed data collected from 14 participants as well as from available literature regarding health inequality using the hybrid model introduced by Schwartz-Barcott and Kim. We categorized health inequality into nine attributes in three dimensions. These dimensions included "target", "precede", and "result," corresponding to the target, cause and consequence of health inequality, respectively. Specifically, we define health inequality as individuals, families, communities, socio-economic, or geographically distinct demographic groups that are treated unfairly and result in several problems such as loss of quality of life, reduction of survival rate, or aggravation of a disease due to (i) poor treatment by a hospital (ii) irregular meals, (iii) desperate need for work (for money), (iv) expensive medical care costs, (v) qualitative differences in medical care by regional groups (vi) the lack of knowledge regarding disease (vii) and inadequate health care because of lack of time. As a result of this unfair treatment, human rights violation occurs. The major contribution from this paper is that we provide a guideline for establishing strategies to reduce health inequality by identifying the concept of health inequality. Based on this study, we recommend development of an educational program to reduce health inequalities.

Attitudes toward Complementary and Alternative Medicine in Suwon City (수원시 주민의 대체의학 수용실태 조사)

  • Chun, Ki-Hong;Song, Hyun-Joug;Park, In-Whee;Yoo, Seung-Chul;Song, Mi-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.2
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    • pp.162-169
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    • 1999
  • Objectives: The aim of this study was to investigate the attitudes toward complementary and alternative medicine among 1,490 residents(339 households) in Suwon city. Methods: All respondents were asked about types, frequency, effects, side-effects, views, and cost of complementary or alternative medicine through a questionnaire from July 24th to 27th. Six therapies were investigated: diet; acupuncture/ massage/ chiropractic etc., mind control such as Ki/ Yoga/ spiritual therapy/ relaxation therapy etc.; nutritional supplements, cultural remedies; and Herb medications Results: The results of this survey were as follows: 35.6% of respondents had experiences with at least one or more types of complementary and alternative medicine. The average number of different types of therapies used was 3.4. More experience with various types of therapies were found among those respondents of higher education, older age group, higher income, married group, religious group than among the opposite groups of respondents. Herb medications were used most frequently(39.8%), followed by minor grains(37.9%), Ginseng(23.8%), Boshintang(21.5%), acupuncture(20.3%), Gaesojou(15.3%) Gingko nut(12.0%), mushroom(11.5%), Cupping therapy(10.2%), and black goat(0.0%). Acupuncture and Herb medications were used for treatment of hypertension the most frequently; minor grains or silkworm for treatment of diabetic mellitus; vegetables for treatment of obesity; acupuncture, Cupping Therapy, Herb medications for treatment of rheumatism; and acupuncture, Herb medications, or exercises for treatment of Cerebro Vascular Accident(CVA). The average costs of treatment were 108,000 Won for hypertension, 87,200 Won for diabetic mellitus, 16,800 Won for obesity, 68,800 Won for rheumatism, and 87,500 Won for CVA. Among 10.9% of respondents, there were 13 cases of side-effects with acupuncture, Herb medications, and Gaesojou. Among the cases of side-effects, majority was due to Herb medications. Respondents reported that Cupping Therapy was the most effective, followed by acupuncture, Ginseng, Gingko nut, Boshintang, black goat, minor grains, Gaesojou, Herb medications, vegetables, and mushroom. In response to the views of complementary and alternative medicine which they had used, they recommended minor grains first, followed by Ginseng, acupuncture, Gingko nut, Cupping Therapy, vegetables, Boshintang, black goat, mushroom and Herb medications. In contrast, they did not recommend Herb medications, acupuncture, nor Gaesojou. Conclusions: These findings indicate that many people use various complementary and alternative medicine without any guidelines for treatment of serious chronic diseases not even to invigorate themselves. It is, therefore, suggested that medical doctors or scientists verify the true effects or side-effects from the most common complementary or alternative therapies through experiments. Also medical doctors should provide a comfortable atmosphere for discussion among doctors and patients who would like to try these therapies.

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Study in Relation to Social Support, Compliance and Psychosocial Adjustment of Rheumatoid Arthritic Patient (류마티스 관절염환자의 사회적 지지, 치료지시 이행 및 사회심리적 적응과의 관계 연구)

  • Soh, In-Ae;Kwon, Young-Sook;Park, Chung-Ja
    • Journal of muscle and joint health
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    • v.6 no.2
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    • pp.211-225
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    • 1999
  • This descriptive correlational study was carried to identify the relationship among social support, compliance, and psychosocial adjustment of patients with rheumatoid arthritis. The study was done with 100 rheumatoid arthritic patients who were visited in Outpatient clinic of university hospital in Taegu, Korea from the 23rd of February to the 20th of March in 1998. The Data were collected through person to person interviews which were performed by five researchers. The instruments used for this study were Yu's social support scale(1996), Cho's compliance scale(1987), and Kim's psychosocial adjustment scale(1997). The data was analyzed by using a t-test, Pearson correlation coefficient, ANOVA, and Tukey test with the SAS Program. The results of this study were as follows ; 1. The mean score of social support was 2.76 for 4 full marks, compliance was 3.20 for 5 full marks, and psychosocial adjustment was 2.26 for 4 full marks. 2. Hypothesis 1 : "The higher the social support degree, the higher the compliance degree of the rheumatoid arthritis patient". It was supported(r=0.54, p<0.001). Hypothesis 2 : "The higher the compliance degree, the higher the psychosocial adjustment degree of the rheumatoid arthritis patient". It was supported(r=0.34, p<0.001). Hypothesis 3 : "The higher the social support degree, the higher the psychosocial adjustment degree of the rheumatoid arthritis patient". It was supported(r=0.24, p<0.05). 3. In general, the spouse group compared to other groups was demonstrated as the most dependable group for patients to trust and expect support. And the sons and daughters group was shown higher than other groups in terms of social support(F=4.19, p=0.01). There was no difference in terms of compliance in degree. In the degree of psychosocial adjustment the highly educated group(more than high school) is a little higher than the lowly educated group(F=3.08, p=0.03). In the costs of medical care, the group that could afford was significant higher than the group which could not afford results in terms of the psychosocial adjustment degree(F=3.99, p=0.01). The outcome of this study is that the social support that related rheumatoid arthritic patients had an effect on the following compliance, and the following compliance helps psychosocial adjustment of patients. It also shows that social support related psychosocial adjustment. Therefore, to increase the level of psychosocial adjustment of rheumatoid arthritic patients, it will be effective in supportive nursing intervention to improve social support and compliance.

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Relationship between Delirium and Clinical Prognosis among Older Patients underwent Femur Fracture Surgery (대퇴부골절 후 수술환자의 섬망과 임상예후와의 관계)

  • Shim, Jae-Lan;Hwang, Seon-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.649-656
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    • 2016
  • This study was a retrospective examination to identify the association of postoperative delirium of the prognosis on following femur fracture surgery in elderly patients. Data was collected from the medical records of elderly patients (aged 65 years or older), who underwent femur fracture surgery from July 2010 to January 2014, following on 3-years in one university hospital. A total of 68 patients were involved. There were 31 cases (45.6%) with delirium and 37 cases (54.4%) without delirium. The participant's average age was 80.8 (patients with delirium), and 81.8 (delirium without patients) years of age, respectively, and most of them were female. There was no significant difference between the two groups. Taking five or more medications, serum creatinine level, and the total medical costs were significantly different in the delirium group and non-delirium group. In addition, the proportional hazard model of Cox to determine the predictors for the major clinical outcome occurring after surgery revealed delirium, five or more multi-drug use, and an experience of transfusion to be significant predictors. In conclusion, postoperative delirium in the elderly undergoing femur fracture surgery can have a negative clinical outcome in patients and caregivers. Therefore, a preoperative evaluation and management of the risk factors will be necessary.

Necessity for a Whole-body CT Scan in Alert Blunt Multiple Trauma Patients. (의식이 명료한 다발성 외상환자에게 전신 전산화단층촬영이 반드시 필요한가?)

  • Mun, You-Ho;Kim, Yun-Jeong;Shin, Soo-Jeong;Park, Dong-Chan;Park, Sin-Ryul;Ryu, Hyun-Wook;Seo, Kang-Suk;Park, Jung-Bae;Chung, Jae-Myung;Bae, Ji-Hye
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.89-95
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    • 2010
  • Purpose: Whole-body CT is a very attractive diagnostic tool to clinicians, especially, in trauma. It is generally accepted that trauma patients who are not alert require whole-body CT. However, in alert trauma patients, the usefulness is questionable. Methods: This study was a retrospective review of the medical records of 146 patients with blunt multiple trauma who underwent whole body CT scanning for a trauma workup from March 1, 2008 to February 28, 2009. We classified the patients into two groups by patients' mental status (alert group: 110 patients, not-alert group: 36 patients). In the alert group, we compared the patients' evidence of injury (present illness, physical examination, neurological examination) with the CT findings. Results: One hundred forty six(146) patients underwent whole-body CT. The mean age was $44.6{\pm}18.9$ years. One hundred four (104, 71.2%) were men, and the injury severity score was $14.0{\pm}10.38$. In the not-alert group, the ratios of abnormal CT findings were relatively high: head 23/36(63.9%), neck 3/6(50.0%), chest 16/36(44.4%) and abdomen 9/36(25%). In the alert group, patients with no evidence of injury were rare (head 1, chest 6 and abdomen 2). Nine(9) patients did not need any intervention or surgery. Conclusion: Whole-body CT has various disadvantages, such as radiation, contrast induced nephropathy and high medical costs. In multiple trauma patients, if they are alert and have no evidence of injury, they rarely have abnormal CT findings, and mostly do not need invasive treatment. Therefore, we should be cautious in performing whole-body CT in alert multiple trauma patients.

Impact of antimicrobial resistance in the $21^{st}$ century

  • Song, Jae-Hoon
    • Proceedings of the Korean Society for Applied Microbiology Conference
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    • 2000.04a
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    • pp.3-6
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    • 2000
  • Antimicrobial resistance has been a well-recognized problem ever since the introduction of penicillin into clinical use. History of antimicrobial development can be categorized based on the major antibiotics that had been developed against emerging resistant $pathogens^1$. In the first period from 1940 to 1960, penicillin was a dominating antibiotic called as a "magic bullet", although S.aureus armed with penicillinase led antimicrobial era to the second period in 1960s and 1970s. The second stage was characterized by broad-spectrum penicillins and early generation cephalosporins. During this period, nosocomial infections due to gram-negative bacilli became more prevalent, while those caused by S.aureus declined. A variety of new antimicrobial agents with distinct mechanism of action including new generation cephalosporins, monobactams, carbapenems, ${\beta}$-lactamase inhibitors, and quinolones characterized the third period from 1980s to 1990s. However, extensive use of wide variety of antibiotics in the community and hospitals has fueled the crisis in emerging antimicrobial resistance. Newly appeared drug-resistant Streptococcus pneumoniae (DRSP), vancomycin-resistant enterococci (VRE), extended-spectrum ${\beta}$-lactamase-producing Klebsiella, and VRSA have posed a serious threat in many parts of the world. Given the recent epidemiology of antimicrobial resistance and its clinical impact, there is no greater challenge related to emerging infections than the emergence of antibiotic resistance. Problems of antimicrobial resistance can be amplified by the fact that resistant clones or genes can spread within or between the species as well as to geographically distant areas which leads to a global concern$^2$. Antimicrobial resistance is primarily generated and promoted by increased use of antimicrobial agents. Unfortunately, as many as 50 % of prescriptions for antibiotics are reported to be inappropriate$^3$. Injudicious use of antibiotics even for viral upper respiratory infections is a universal phenomenon in every part of the world. The use of large quantities of antibiotics in the animal health industry and farming is another major factor contributing to selection of antibiotic resistance. In addition to these background factors, the tremendous increase in the immunocompromised hosts, popular use of invasive medical interventions, and increase in travel and mixing of human populations are contributing to the resurgence and spread of antimicrobial resistance$^4$. Antimicrobial resistance has critical impact on modem medicine both in clinical and economic aspect. Patients with previously treatable infections may have fatal outcome due to therapeutic failure that is unusual event no more. The potential economic impact of antimicrobial resistance is actually uncountable. With the increase in the problems of resistant organisms in the 21st century, however, additional health care costs for this problem must be enormously increasing.

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