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Mild Impairments in Cognitive Function in the Elderly with Restless Legs Syndrome (노인 하지불안증후군에서의 인지기능 저하)

  • Kim, Eun Soo;Yoon, In-Young;Kweon, Kukju;Park, Hye Youn;Lee, Chung Suk;Han, Eun Kyoung;Kim, Ki Woong
    • Sleep Medicine and Psychophysiology
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    • v.20 no.1
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    • pp.15-21
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    • 2013
  • Objectives: Cognitive impairment in restless legs syndrome (RLS) patients can be affected by sleep deprivation, anxiety and depression, which are common in RLS. The objective of this study is to investigate relationship between cognitive impairment and RLS in the non-medicated Korean elderly with controlling for psychiatric conditions. Method: The study sample for this study comprised 25 non-medicated Korean elderly RLS patients and 50 age-, sex-, and education- matched controls. All subjects were evaluated with comprehensive cognitive function assessment tools- including the Korean version of Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K), severe cognitive impairment rating scale (SCIRS), frontal assessment battery (FAB), and clock drawing test (CLOX). Sleep quality and depression were also assessed with Pittsburgh sleep quality index (PSQI) and geriatric depression scale (GDS). Results: PSQI and GDS score showed no difference between RLS and control group. There was no significant difference between two groups in nearly all the cognitive function except in constructional recognition test, in which subjects with RLS showed lower performance than control group (t=-2.384, p=0.02). Subjects with depression ($GDS{\geq}10$) showed significant cognitive impairment compared to control in verbal fluency, Korean version of Mini Mental Status Examination in the CERAD-K (MMSE-KC), word list memory, trail making test, and frontal assessment battery (FAB). In contrast, no difference was observed between subjects who have low sleep quality (PSQI>5) and control group. Conclusions: At the exclusion of the impact of insomnia and depression, cognitive function was found to be relatively preserved in RLS patients compared to control. Impairment of visual recognition in RLS patients can be explained in terms of dopaminergic dysfunction in RLS.

Development of a Feature Catalogue for Marine Geographic Information (해양 지리정보 피쳐 카탈로그 작성에 관한 연구)

  • Hong, Sang-Ki;Yun, Suk-Bum
    • Journal of Korea Spatial Information System Society
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    • v.6 no.1 s.11
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    • pp.101-117
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    • 2004
  • Standards are essential to facilitate the efficient use of GIS data. International Standards such as ISO TC211's 19100 series and various technical specifications from OpenGIS Consortium are some of the examples of efforts to maintain the interoperability among GIS applications. Marine GIS is no exception to this rule and in this context. developing standards for marine GIS is also in urgent needs. Using the same meaning and definition for the features commonly found in marine GIS applications is one of the ways to increase the interoperability among systems. One of the key requirements for maintaining the standard meanings for features is to build a common feature catalogue. This paper examines the concept of feature catalogue and describe the ways in which the feature catalogue can be organized. To identify the common features found in various marine GIS applications, a comprehensive search has been made to collect and analyze the features used in various applications. To maintain the interoperability with the National GIS (NGIS) system, the features used in various NGIS applications have been analyzed as well. The result of these analyses are used to create a comprehensive list of common features for marine GIS. This paper then explains the common feature catalogue for marine GIS and the provides the appropriate classification and coding systems for the common features. In addition, a registration tool for registering the common features into the standard registry has been developed in this study. This Web-based tool can be used to input features into the feature catalogue by various applications and also to maintain a standard-compliant feature catalogue by standard agencies.

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A Cohort Study on Risk Factors for Chronic Liver Disease: Analytic Strategies Excluding Potentially Incident Subjects (만성간질환 위험요인에 대한 코호트연구: 잠재적 발병자 집단을 감안한 분석전략)

  • Kim, Dae-Sung;Kim, Dong-Hyun;Bae, Jong-Myun;Shin, Myung-Hee;Ahn, Yoon-Ok;Lee, Moo-Song
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.4
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    • pp.452-458
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    • 1999
  • Objectives: The authors conducted the study to evaluate bias when potentially diseased subjects were included in cohort members while analyzing risk factors of chronic liver diseases. Methods: Total of 14,529 subjects were followed up for the incidence of liver diseases from January 1993 to June 1997. We have used databases of insurance company with medical records, cancer registry, and death certificate data to identify 102 incident cases. The cohort members were classified into potentially diseased group(n=2,217) when they were HBsAg positive, serum GPT levels higher than 40 units, or had or has liver diseases in baseline surveys. Cox's model were used for potentially diseased group, other members, and total subjects, respectively. Results: The risk factors profiles were similar for total and potentially diseased subjects: HBsAg positivity, history of acute liver disease, and recent quittance of smoking or drinking increased the risk. while intake of pork and coffee decreased it. For the potentially diseased, obesity showed marginally significant protective effect. Analysis of subjects excluding the potentially diseased showed distinct profiles: obesity increased the risk, while quitting smoking or drinking had no association. For these intake of raw liver or processed fish or soybean paste stew increased risk; HBsAg positivity, higher levels of liver enzymes and history of acute liver diseases increased the risk. Conclusions: The results suggested the potential bias in risk ratio estimates when potentially diseased subjects were included in cohort study on chronic liver diseases, especially for lifestyles possibly modified after disease onset. The analytic strategy excluding potentially diseased subjects was considered appropriate for identifying risk factors for chronic liver diseases.

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The Internal Representations of (1973) as seen through Walter Benjamin's Dialectical Images (프랭크 무리스의 콜라주 애니메이션 <프랭크 필름>(1973)에 나타난 내적 표현 : 발터 벤야민의 변증법적 이미지를 중심으로)

  • Kim, Young-Ok;Moon, Jae-Cheol
    • Cartoon and Animation Studies
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    • s.38
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    • pp.53-70
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    • 2015
  • In industrialized societies throughout the 19th and 20th centuries, Over Produced and Mass consumption images were constantly shown to people via Mass-Media as means to provoke one's desire. Frank Mouris, the American independent animator, captured and showed the infinite nesting of industrialized image with his autobiographical story through his work (1973) and made it as an intense visual flow. This innovative art animation has broke the traditional form of narrative animation and won the Annecy Animation Festival Grand Prix and the Academy Awards in 1974. This was also selected for preservation in the United States National Film Registry by the Library of Congress as being culturally, historically, or aesthetically significant in 1996. This study explores and shows that how these a-half million images to express Franks Mouris's autobiographical story in could be analyzed by the concept of Walter Benjamin's 'dialectical images'. Typically, the term 'dialectic' need to be formed by contradiction or opposite concept in the basic principles, but a dialectical image of Benjamin could be formed without any opposite concept while maintaining the uniqueness of each new relationship of the past. Benjamin's dialectical images are no longer stay in the historical past, It always meets with the present when someone realizes the past in the present moment. I suggest three different aspect according to Benjamin's point of view to analyse this animated film such as 'Historical-dialectical imaging of private/collective memory', 'Reconfiguring of present through analysing the relationship between the image flows and its own time/space', and 'Old future over the existing fragment and the presence of fragment. has the great value not only to present the experimental and innovative aesthetics of animated film, but also to show an analysis of contemporary culture and social aspect in mid-20th century. This study is to explore the diversity of animation representation, aesthetics, and also to suggest a new aspect of animation studies.

A Computed Tomography-Based Anatomic Comparison of Three Different Types of C7 Posterior Fixation Techniques : Pedicle, Intralaminar, and Lateral Mass Screws

  • Jang, Woo-Young;Kim, Il-Sup;Lee, Ho-Jin;Sung, Jae-Hoon;Lee, Sang-Won;Hong, Jae-Taek
    • Journal of Korean Neurosurgical Society
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    • v.50 no.3
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    • pp.166-172
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    • 2011
  • Objective : The intralaminar screw (ILS) fixation technique offers an alternative to pedicle screw (PS) and lateral mass screw (LMS) fixation in the C7 spine. Although cadaveric studies have described the anatomy of the pedicles, laminae, and lateral masses at C7, 3-dimensional computed tomography (CT) imaging is the modality of choice for pre-surgical planning. In this study, the goal was to determine the anatomical parameter and optimal screw trajectory for ILS placement at C7, and to compare this information to PS and LMS placement in the C7 spine as determined by CT evaluation. Methods : A total of 120 patients (60 men and 60 women) with an average age of $51.7{\pm}13.6$ years were selected by retrospective review of a trauma registry database over a 2-year period. Patients were included in the study if they were older than 15 years of age, had standardized axial bone-window CT imaging at C7, and had no evidence of spinal trauma. For each lamina and pedicle, width (outer cortical and inner cancellous), maximal screw length, and optimal screw trajectory were measured, and the maximal screw length of the lateral mass were measured using m-view 5.4 software. Statistical analysis was performed using Student's t-test. Results : At C7, the maximal PS length was significantly greater than the ILS and LMS length (PS, $33.9{\pm}3.1$ mm; ILS, $30.8{\pm}3.1$ mm; LMS, $10.6{\pm}1.3$; p<0.01). When the outer cortical and inner cancellous width was compared between the pedicle and lamina, the mean pedicle outer cortical width at C7 was wider than the lamina by an average of 0.6 mm (pedicle, $6.8{\pm}1.2$ mm; lamina, $6.2{\pm}1.2$ mm; p<0.01). At C7, 95.8% of the laminae measured accepted a 4.0-mm screw with a 1.0 mm of clearance, compared with 99.2% of pedicle. Of the laminae measured, 99.2% accepted a 3.5-mm screw with a 1.0 mm clearance, compared with 100% of the pedicle. When the outer cortical and inner cancellous height was compared between pedicle and lamina, the mean lamina outer cortical height at C7 was wider than the pedicle by an average of 9.9 mm (lamina, $18.6{\pm}2.0$ mm; pedicle, $8.7{\pm}1.3$ mm; p<0.01). The ideal screw trajectory at C7 was also measured ($47.8{\pm}4.8^{\circ}$ for ILS and $35.1{\pm}8.1^{\circ}$ for PS). Conclusion : Although pedicle screw fixation is the most ideal instrumentation method for C7 fixation with respect to length and cortical diameter, anatomical aspect of C7 lamina is affordable to place screw. Therefore, the C7 intralaminar screw could be an alternative fixation technique with few anatomic limitations in the cases when C7 pedicle screw fixation is not favorable. However, anatomical variations in the length and width must be considered when placing an intralaminar or pedicle screw at C7.

Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.163-194
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    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

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Korean Children and Adolescents with Crohn's Disease Are More Likely to Present with Perianal Fistulizing Disease at Diagnosis Compared to Their European Counterparts

  • Kang, Ben;Kim, Jung Eun;Jung, Jae Hun;Choe, Jae Young;Kim, Mi Jin;Choe, Yon Ho;Kim, Seung;Koh, Hong;Lee, Yoo Min;Lee, Jee Hyun;Lee, Yoon;Lee, Ji-Hyuk;Lee, Hae Jeong;Jang, Hyo-Jeong;Choi, Youjin;Choi, So Yoon;Kim, Ju Young;Choe, Byung-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.1
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    • pp.49-62
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    • 2020
  • Purpose: We aimed to investigate the disease phenotype of Korean pediatric Crohn's disease (CD) patients at diagnosis according to the Paris classification by comparison with patients from the European multicenter 5-years recruitment of children with newly developed IBD (EUROKIDS registry). Methods: Korean children and adolescents who had been newly diagnosed with CD at the age of <18 years during 2013-2016 were included in this multicenter retrospective study. Disease phenotype at diagnosis was classified according to the Paris classification, and compared with the published data from the EUROKIDS study. Results: A total of 255 patients were included. The median diagnosis age was 14.7 years (range, 0.8-17.9 years). No significant difference was observed in male-to-female ratio with EUROKIDS (1.9:1 vs. 1.45:1, p=0.062). The proportion of children aged <10 years was significantly lower in Koreans (7.1% vs. 19.6%, p<0.001). Colonic disease was less prominent (10.0% vs. 27.3%, p<0.001), while upper GI involvement was more prominent in Korean children (59.3% vs. 46.2%, p<0.001). The proportion with perianal fistulizing disease at diagnosis was significantly higher in Korean patients (44.8% vs. 8.2%, p<0.001). A separate analysis of Korean patients revealed that perianal fistulizing disease at diagnosis was positively associated with male sex and body mass index z-score (odds ratio [OR]=2.12, 95% confidence interval [CI]=1.20-3.76, p=0.010; and OR=1.29, 95% CI=1.05-1.58, p=0.015, respectively). Conclusion: Approximately half of pediatric CD patients in Korea present with perianal fistulas and/or abscesses at diagnosis, which is a distinct feature of CD in Korean children and adolescents compared to their European counterparts. An underlying genetic difference between ethnicities may play a role in this expression of different phenotypes in pediatric CD.

Peritoneal Dialysis Associated Peritonitis and Empirical Antibiotics Therapy in Korean Children with Chronic Renal Failure (소아 복막 투석 환자에서 발생한 복막염의 경험적 항생제 치료에 관한 연구)

  • Lee, Sang-Goo;Cho, Joong-Bum;Sohn, Young-Bae;Park, Sung-Won;Kim, Su-Jin;Jin, Dong-Kyu;Paik, Kyung-Hoon
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.213-220
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    • 2008
  • Purpose : This study aims to verify the effectiveness of initial empirical antibiotic choice recommended by the International Society for Peritoneal Dialysis(ISPD) guide among Korean children. Methods : We have collected data on peritonitis from January 2001 to December 2007 in Samsung Medical Center. Results : Of the 42 patients, 48 episodes of peritonitis had occurred in 21 patients. The rate of peritonitis was one episode over 35.3 patient-months. Mean dialysis duration before peritonitis was 18.06$\pm$15.81 months. Gram-positive organisms accounted for 58.3% of all episodes. Of the gram-positive organisms, the most common pathogen was Staphylococcus aureus(29.2%), the next common pathogens were Coagulase negative staphylococcus(14.6%) and Streptococcus species(6.3%). 35.7% of gram-positive pathogens were resistant to 1st cephalosporin. However, in patients younger than 4 years old, 50% of gram-positive pathogens were resistant to 1st generation cephalosporin. 10 episodes of peritonitis were methicillin-resistant and were treated by vancomycin. Of the gram-negative organisms, E. coli was the most common (8.3%). 64.8% of all pathogens were sensitive to cephalothin or ceftazidime. Conclusion : The empirical therapy with 1st generation cephalosporin and ceftazidime can be also effective to peritoneal dialysis associated peritonitis in Korean children. However, in patients younger than 4 years old, glycopeptide should be considered as the first empirical therapy in Korean children.

Sequential Chemoradiotherapy for Stage I/II Nasal Natural Killer/T Cell Lymphoma (I/II 병기 비강 Natural Killer/T Cell 림프종에 대한 순차적 항암화학요법과 방사선치료)

  • Noh Young Joo;Ahn Yong Chan;Kim Won Seog;Ko Young Hyeh
    • Radiation Oncology Journal
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    • v.22 no.3
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    • pp.177-183
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    • 2004
  • Purpose: Authors would report the results of sequential CHOP chemotherapy (cyclophosphamide, adriamycin, vincristine, and prednisone) and involved field radiotherapy (IFRT) for early stage nasal natural killer/T-cell Iymphoma (NKTCL). Materials and Methods: Fourteen among 17 patients, who were registered at the Samsung Medical Center tumor registry with stage I and II nasal NKTCL from March 1995 to December 1999 received this treatment protocol. Three to four cycles of CHOP chemotherapy were given at 3 weeks' interval, which was followed by local IFRT including the known tumor extent and the adjacent draining lymphatics. Results: Favorable responses after chemotherapy (before IFRT) were achievable only in seven patients (5 CR's+2 PR's: 50%), while seven patients showed disease progression. There were six patients with local failures, two with distant relapses, and none with regional lymphatic failure. The actuarial overall survival and progression-free survival at 3 years were 50.0% and 42.9%. All the failures and deaths occurred within 13 months of the treatment start. The factors that correlated with the improved survival were the absence of 'B' symptoms, the favorable response to chemotherapy and overall treatment, and the low risk by international prognostic index on univariate analyses. Conclusion: Compared with the historic treatment results by IFRT either alone or followed by chemotherapy, the current trial failed to demonstrate advantages with respect to the failure pattern and survival. Development of new treatment strategy in combining IFRT and chemotherapy is required for improving outcomes.

International Liability for Damage Caused by Space Debris (우주잔해 손해에 대한 국제책임)

  • Kim, Dong-Uk
    • The Korean Journal of Air & Space Law and Policy
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    • v.23 no.2
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    • pp.173-205
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    • 2008
  • Space debris have frequently caused damage to space objects like satellites in orbits and sometimes have fallen on the earth. Such increase in space debris will lead to the high possibility of threatening space activities of mankind. However, it is not so easy for the damage caused both by identified and by unidentified space debris to be recovered since in the regime of the current international law, there is no legislation of prescribing the damage done by space debris. For overcoming the limitation it seems desirable that either the Liability Convention should partly be amended or new international law regime should be established. For instance, 'space debris' should be included in the new definition of 'space object' and the range of launching should also be defined clearly by making the concept of 'launching' somewhat more specified. Moreover, the subject of international liability for damage caused by space debris should be divided into two classes: the subject before and after registration. While in case of before-registration launch states should be held liable for any damage jointly or individually, in case of after-registration 'the state of registry' or 'owner' of the space debris should be. In the event of damage being caused elsewhere than on the surface of the earth to a space object of other State, 'fault-based liability' is currently applied. But it needs to be changed into 'absolutely liability'. In this paper, 'Liability Pool', 'Insurance', 'Market-Share Liability' are presented as aid devices of the damages resulting from unidentified space debris. They should be defined through the amendment of the Liability Convention or another international treaty. Some day there comes a time when our country shall possess many of the astronomical price of satellites. It means that we can't be free from the damage by the increasing number of space debris. Provided that our satellites are damaged by such space debris, it will do the satellites damage and cause impaired functioning or troubles in operation. As a result, if we are not paid for the damage by space debris, we will be confronted with tremendous economic loss because it is necessarily connected with the excess burden of taxation. Thus, an international agreement regarding the measures of the compensation for space debris damage must be made very soon.

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