• Title/Summary/Keyword: 임상의사결정

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Determination of Fire Severity and Deduction of Influence Factors Through Landsat-8 Satellite Image Analysis - A Case Study of Gangneung and Donghae Forest Fires - (Landsat-8 위성영상 분석을 통한 산불피해 심각도 판정 및 영향 인자 도출 - 강릉, 동해 산불을 사례로 -)

  • Soo-Dong Lee;Gyoung-Sik Park;Chung-Hyeon Oh;Bong-Gyo Cho;Byeong-Hyeok Yu
    • Korean Journal of Environment and Ecology
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    • v.38 no.3
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    • pp.277-292
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    • 2024
  • In order to manage large-scale forest fires concentrated in Gangwon-do and Gyeongsangbuk-do with severe topographical heterogeneity, a decision-making process through efficient and rapid damage assessment using satellite images is essential. Accordingly, this study targets a large-scale forest fire that ignited in Gangneung and the Donghae, Gangwon-do on March 5, 2022, and was extinguished around 19:00 on March 8, to estimate the fire severity using dNBR and derive environmental factors that affect the grade. As environmental factors, we quantified the regular vegetation index representing vegetation or fuel type, the forest index that classifies tree species, the regular moisture index representing moisture content, and DEM in relation to topography, and then analyzed the correlation with the fire severity. In terms of fire severity, the widest range was 'Unbured' at 52.4%, followed by low severity at 42.9%, medium-low severity at 4.3%, and medium-high severity at 0.4%. Environmental factors showed a negative correlation with dNDVI and dNDWI, and a positive correlation with slope. Regarding vegetation, the differences between coniferous, broad-leaved, and other groups in dNDVI, dNIWI, and slope, which were analyzed to affect the fire severity, were analyzed to be significant with p-value < 2.2e-16. In particular, the difference between coniferous and broad-leaved forests was clear, and it was confirmed that coniferous forest suffered more damage than broad-leaved forest due to the higher fire severity in the Gangwon-do region, including Pinus densiflora, which are dominant species, as well as P. koraiensis, P. rigida and P. thunbergii.

An Outbreak of Epidemic Keratoconjunctivitis by Adenovirus Type 8 in a Neonatal Intensive Care Unit (신생아 중환자실에서의 아데노바이러스 8형에 의한 유행성 각결막염의 발생)

  • Park, Na-Ri-Mi;Na, Ji-Youn;Joung, Kyoung-Eun;Lee, Ji-Na;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Seong-Joon;Song, Jung-Suk;Oh, Hyang-Soon;Lee, Hoan-Jong;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.44-53
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    • 2008
  • Purpose : Epidemic keratoconjunctivitis (EKC) caused by adenovirus is a highly contagious disease, which has been reported as outbreaks involving adults in the community. However, there has been no report on EKC outbreak by adenovirus in a neonatal intensive care unit (NICU) in Korea. Aims of this study were to investigate the EKC outbreak by adenovirus type 8 in NICU and to confirm an effectiveness of polymerase chain reaction (PCR) for diagnosis. Methods : Conjunctival swab or nasopharyngeal aspirate specimens were taken from all patients and tested by viral culture and PCR. Adenovirus serotype was determined by sequencing of PCR product of selected region of hexon gene using the virus isolates or specimens. Results : An outbreak of EKC occurred which was involving 12 preterm infants in the NICU of the Seoul National University Children's Hospital between July 12th and August 1st, 2005. Three hospital staffs and one family member of the neonate were also affected. Adenovirus was detected in 12/12 (100%), 6/11 (54.5%) by PCR and virus culture, respectively. Eleven PCR-positive neonates were identified as serotype 8 by sequencing. The first affected 4 babies have had routine ROP (retinopathy of prematurity) examinations one week ago. While previous outbreaks were sustained for a few months, the event in our unit was controlled without complications in 3 weeks. Conclusion : We analyzed the EKC outbreak by adenovirus type 8 in NICU. Adenovirus serotype was identified by PCR and sequencing with high sensitivity for the first time in Korea, so we suggest this method can be very useful for rapid diagnosis and infection control.

OBSTETRICIAN'S VIEW OF TEENAGE PREGNANCY:PRESENT STATUS, PREVENTION AND PSYCHIATRIC CONSULTATION (산과 의사가 인지한 10대 임신의 현황, 예방, 정신과 자문)

  • Kim, Eun-Young;Kim, Boong-Nyun;Hong, Kang-E;Lee, Young-Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.117-128
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    • 2002
  • Objectives:For the purpose of obtaining the more vivid present status and prevention program of teenage pregnancy, this survey was done by Obstetricians, as study subject, who manage the pregnant teenager in real clinical situation. Methods:Structured survey form about teenage pregnancy was sent to 2,800 obstetricians. That form contained frequency, characteristics, decision making processes, and psychiatric aspects of the teenage pregnancy. 349 obstetricians replied that survey form and we analysed these datas. Results:(1) The trend of teenage pregnancy was mildly increased. (2) The most common cases were unwanted pregnancy by continuing sexual relationship with boyfriends rather than by forced, accidental sexual relationship with multiple partners. (3) The most common reason of labor was loss the time of artificial abotion. (4) Problems of pregnant girls' were conduct behaviors and poor informations about contraception rather than sexual abuse or mental retardation. (5) Most obstetricians percepted the necessity of psychiatric consultation, however psychiatric consultation was rare due to parents refusal and abscense of available psychiatric facility. (6) For the prevention of teenage pregnancy, the most important thing was practical education about contraception. Conclusions:Based on the result of this study, further study using structured interview schedule with pregnant girl is needed for the detecting risk factor of teenage pregnancy and effective systematic approach to pregnant girl.

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A survey of parental knowledge of vaccination (예방접종에 대한 부모의 인식에 관한 조사)

  • Rhim, Jung Woo;Kim, Chang Hwi;Lee, Won Bae;Kang, Jin Han
    • Clinical and Experimental Pediatrics
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    • v.49 no.3
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    • pp.251-257
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    • 2006
  • Purpose : In this study, we created a questionnaire and collected answers concerning actual conditions of vaccination and parents' knowledge of vaccination issues, in order to find false knowledge of patients. We tried to give correct information and suggested the role of the pediatrician. Methods : We made questionnaires and collected answers from 466 parents from March 2004 to June 2004. Results : Places of vaccination were pediatric clinics(49.4 percent), health centers(27.7 percent), general/university hospitals(15.0 percent) and other clinics(4.9 percent). We found 38.8 percent of parents thought that the reason for vaccination at pediatric clinics was a belief of speciality, even though there is no difference in the vaccination itself. We also found 15.0 percent of parents thought that there were no differences between pediatricians and other physicians, but 52.0 percent of parents wanted to receive vaccination at pediatric clinics in the future. Our study also found that 62.4 percent of parents wanted to make out a preliminary questionnaire for vaccination. Many parents got vaccination information from vaccination record books(57.9 percent), and 52.6 percent of parents incorrectly believed that Hib vaccination could prevent all kinds of meningitis. Conclusion : Our study suggests that pediatricians need to make efforts to give out correct information. It is necessary to use preliminary questionnaires for vaccination and correct vaccination information should be written on the vaccination record book. Also, there needs to be counselling with parents about weaning, growth and development at the time of vaccination, and to point out the differences between pediatricians and other physicians.

A Study of Clinical Model for Radiation Therapy in Lung Cancer Patients of Busan and South Gyeongnam Province (부산, 경남지역 폐암 환자의 방사선치료 이용에 대한 임상 결정 모델 연구)

  • Son, Jongki;Kim, Yunjin;Jo, Deokyoung
    • Journal of the Korean Society of Radiology
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    • v.9 no.6
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    • pp.393-401
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    • 2015
  • Radiation therapy for lung cancer is an effective treatment during monotherapy or combination therapy. Studies have reported that the optimum utilization rate of radiation therapy is estimated at 61% to 74%. Radiation therapy in Korea has been investigated to be low; further studies are needed. This study was intended to assess the appropriateness of the use of radiation and to reveal the use of radiation therapy-related factors by examining radiation therapy in lung cancer patients of Busan and South Gyeongnam Province. This study was aimed at the population diagnosed with lung cancer in Busan and South Gyeongnam Province. To conduct the study, 1036 patients enrolled in two hospitals were collected and 897 appropriate as subjects were selected. We compared the optimum utilization rate and actual rate of radiation therapy, and revealed the adequacy and related factors for use of radiotherapy. Of 897 patients, 503 (56%) were treated with medical therapy and 394 (44%) were given radiotherapy. The radiotherapy utilization rate of all lung cancer patients was 42%. The proportion of non-small cell lung cancer by histologic type was 33% and that of small cell lung cancer was 90%. Factors related to radiation therapy used in cancer were age, histological type, clinical stage, doctor refereed to, and clinical examination. Compared to radiation utilization by region (site), curative chest therapy was 42%; palliative treatment was 26%. In the comparison of histologic types, utilization of small-cell lung cancer is lower; the lowest especially in the stage III. Utilization of radiation therapy in Busan and South Gyeongnam Province was lower than the reasonable one. Utilization difference could be explained by patient factors, tumor factors, and health service factors. To improve utilization,development ofoutreach service programs and activation of the multidisciplinary team are required.

Multi-classification of Osteoporosis Grading Stages Using Abdominal Computed Tomography with Clinical Variables : Application of Deep Learning with a Convolutional Neural Network (멀티 모달리티 데이터 활용을 통한 골다공증 단계 다중 분류 시스템 개발: 합성곱 신경망 기반의 딥러닝 적용)

  • Tae Jun Ha;Hee Sang Kim;Seong Uk Kang;DooHee Lee;Woo Jin Kim;Ki Won Moon;Hyun-Soo Choi;Jeong Hyun Kim;Yoon Kim;So Hyeon Bak;Sang Won Park
    • Journal of the Korean Society of Radiology
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    • v.18 no.3
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    • pp.187-201
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    • 2024
  • Osteoporosis is a major health issue globally, often remaining undetected until a fracture occurs. To facilitate early detection, deep learning (DL) models were developed to classify osteoporosis using abdominal computed tomography (CT) scans. This study was conducted using retrospectively collected data from 3,012 contrast-enhanced abdominal CT scans. The DL models developed in this study were constructed for using image data, demographic/clinical information, and multi-modality data, respectively. Patients were categorized into the normal, osteopenia, and osteoporosis groups based on their T-scores, obtained from dual-energy X-ray absorptiometry, into normal, osteopenia, and osteoporosis groups. The models showed high accuracy and effectiveness, with the combined data model performing the best, achieving an area under the receiver operating characteristic curve of 0.94 and an accuracy of 0.80. The image-based model also performed well, while the demographic data model had lower accuracy and effectiveness. In addition, the DL model was interpreted by gradient-weighted class activation mapping (Grad-CAM) to highlight clinically relevant features in the images, revealing the femoral neck as a common site for fractures. The study shows that DL can accurately identify osteoporosis stages from clinical data, indicating the potential of abdominal CT scans in early osteoporosis detection and reducing fracture risks with prompt treatment.

Development of Forest Fire Information Management System using GIS (GIS를 이용한 산불 정보관리시스템 개발)

  • Jo, Myung-Hee;Oh, Jeong-Soo;Lee, Si-Young;Jo, Yun-Won;Baek, Seong-Ryul
    • Journal of the Korean Association of Geographic Information Studies
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    • v.4 no.3
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    • pp.41-50
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    • 2001
  • Recently our nature of environment has destroyed by a large scaled forest fire. In order to manage these forest fires, forecasting of it is considered as the most important thing. In this paper the database related to forest fire was first built and the efficient forest fire information management system was implemented by using GIS. The main goal of this system is that forest fire managers have GUI(graphic user interface) to analyze data of forest fire effectively and update and retrieve information in database. For the efficient GUI, this system is built in Visual Basic 6.0 and Map Object 2.0. Map Object 2.0 is combined to have various and powerful functionality of GIS analysis as component ware. The Oracle 8.0 is used as DBMS in this study to manage all the spatial and attributed information in database effectively. In the future, this system will play a critical role as making a decision supporting system for scientific forest fire protection and help real time forest fire hazard information offers service for public welfare administration business management.

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SURGICAL REPAIR OF COMPLETE BONY BILATERAL CHOANAL ATRESIA VIA TRANSPALATAL APPROACH (완전 골성 양측성 후비공 폐쇄 환자의 구개부를 통한 외과적 치험례)

  • Kim, Kyoung-Won;Cho, Yong-Seok;Yang, Soo-Nam
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.2
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    • pp.133-138
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    • 1998
  • Choanal atresia may be membrane or bony, unilateral or bilateral. Approximately 90% of the choanal atresia are bony type. Unilateral choanal atresia often eludes the diagnosis because of the absence of subjective symptoms in the neonatal period. However, bilateral choanal atresia presents at birth with cyclic respiratory distress aggravated by feedings. So complete bilateral choanal atresia is considered as a neonatal emergency. Examinations for the diagnosis of chonal atresia include 1) attempt at passing a rubber catheter or probe through the patient s nose, 2) mirror examination of the nasopharynx, 3) digital examination of the nasopharynx, 4) X-ray examination after installation of radiopaque materal into the nasal cavity. But, computed tomography has become accepted method for evaluation of choanal atresia. Surgical repair of choanal atresia is accomplished via transnasal or transpalatal approach. Advantages of the transpalatal approach are improved exposure and the preservation of mucosal flap along the newly formed apertures. On the other hand, the transpalatal approach carries the risk of injury to the greater palatine neurovascular complex, and requires longer operative time. After careful physical and radiographic examinations, we accomplished the surgical repair of the complete bony bilateral choanal atresia via transpalatal approach without complications.

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해안지형분류표준화 동향에 관한 연구 - 환경정보표준 ISO/IEC211 18025 자료와 국내분류체계 비교

  • Chang, Eun-Mi;Park, Kyeong;Seo, Jong-Cheol
    • 한국공간정보시스템학회:학술대회논문집
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    • 2001.11a
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    • pp.275-286
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    • 2001
  • 습지 분류의 목표는 '목록작성(inventory)과 평가와 관리를 위해 자연적인 생태계에 범위를 설정하는 것'이다. 또한 등질적인 속성을 갖는 생태단위를 기술하고, 자원관리 의사결정에 도움을 줄 수 있는 체계로 단위를 만들어내고, 목록작성과 지도화에 필요한 단위를 제공하면, 습지에 관한 개념과 용어의 통일성을 제공하는 것 등이다. 해안지형 가운데 해안 습지의 분류에는 우선, 1) 형태, 2) 생성요인, 3) 자갈, 모래, 펄 같은 기질 물질과 4)현재의 환경이라는 요소가 모두 고려되어야만 하는데 아직 국내에는 이에 대한 연구가 절대적으로 부족하여 이에 대한 규정이 부족한 현실이다. 따라서 현 단계에서 ISO/IEC 규정대로 각 코드는 엄밀히 상호배타적인 개념일 것, 정수로 표시할 것과 순차적으로 증가하는 숫자로 표시할 것 등의 전제조건을 만족시키는 전제 하에서 해안습지를 분류하는 것은 매우 힘든 작업이라 생각한다. 하지만 국토공간의 효율적 관리와 보존을 위해서는 위치와 장소에 따라 차이를 보이는 지질, 지형, 토양, 식생, 수리 현상 등 제반 지표 환경요소에 대한 체계화된 정보의 축척이 있어야 가능하다. 우리나라의 경우 지질 정보는 지질자원연구원에서 발행하는 지질도와, 농촌진흥청에서 발행하는 토양도, 임업연구원에서 발행하는 임상도 등의 주제도가 있으나, 지표환경을 나타내주는 지형에 대한 정보체계는 아직 이루러진 바가 없고, 대학의 석사학위논문이나, 실험적인 수준의 연구에 머물고 있는 실정이다. 이번 연구에서는 지형분류도 작성과 관련한 외국의 사례를 집중적으로 분석하고, 지형정보의 체계적 관리를 위해 가장 필요한 해안습지 지형분류도를 작성하기 위해 가장 기초적인 단계인 해안습지 지형분류체계에 대한 국내외의 연구성과를 비교하여 시안을 작성 표준화를 위한 첫 단계 시도를 소개하였다.분석 결과는 문장, 그림 및 도표, 장 끝의 질문, 학생의 학습 활동 수 등이 $0.4{\sim}1.5$ 사이의 값으로 학생 참여를 적절히 유도하는 발견 지향적 인 것으로 조사되었다. 그러나 장의 요약은 본문 내용을 반복하는 내용으로 구성되었다. 이와 같이 공통과학 과목은 새로운 현대 사회에 부응하는 교과 목표와 체계를 지향하고 있지만 아직도 통합과학으로서의 내용과 체계를 완전히 갖추고 있지 못할 뿐만 아니라 현재 사용되고 있는 7종의 교과서가 교육 목표를 충분히 반영하지 못하고 있다. 따라서 교사의 역할이 더욱더 중요하게 되었다.괴리가 작아진다. 이 결과에 따르면 위탁증거금의 징수는 그 제도의 취지에 부합되고 있다. 다만 제도운용상의 이유이거나 혹은 우리나라 주식시장의 투자자들이 비합리적인 투자형태를 보임에 따라 그 정책적 효과는 때로 역기능적인 결과로 초래하였다. 그럼에도 불구하고 이 연구결과를 통하여 최소한 주식시장(株式市場)에서 위탁증거금제도는 그 제도적 의의가 여전히 있다는 사실이 확인되었다. 또한 우리나라 주식시장에서 통상 과열투기 행위가 빈번히 일어나 주식시장을 교란시킴으로써 건전한 투자풍토조성에 저해된다는 저간의 우려가 매우 커왔으나 표본 기간동안에 대하여 실증분석을 한 결과 주식시장 전체적으로 볼 때 주가변동율(株價變動率), 특히 초과주가변동율(超過株價變動率)에 미치는 영향이 그다지 심각한 정도는 아니었으며 오히려 우리나라의 주식시장은 미국시장에 비해 주가가 비교적 안정적인 수준을 유지해 왔다고 볼 수 있다.36.4%)와 외식을 선호(29.1%)${\lrcorner}$ 하기 때문에 패스트푸드를 이용하게 된 것으로 응답 하였으며, 남 여 대학생간에는 유의한 차이(p<0.05)가 인정되었다. 응답자의 체형은 ${\ulcorner}$

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Development of Occupational Therapist Competency Indicators for Occupation-Based Intervention: Delphi Study (작업기반 중재를 위한 작업치료사 역량지표 개발: 델파이연구)

  • Shin, Jae-Yong;Kim, Jung-Ran;Lee, Ji-Sun
    • Therapeutic Science for Rehabilitation
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    • v.7 no.1
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    • pp.37-50
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    • 2018
  • Objective : The purpose of this study was to develop a competency indicators of occupational therapists for occupation-based intervention by conducting a Delphi survey to occupation-based intervention experts. Methods : After analyzing the data related to occupational therapists indicators in korea, the results of Delphi survey were collected three times from October to December 2016. Based on the results, we developed occupational therapists competency indicators for occupation-based intervention through expert panel's opinions. Results : Based on the eight competency elements, the competency indicators were examined by 133 primary and 133 secondary competency indicators. Finally, 131 competency indicators were developed based on 8 components as occupational therapist competence indicators for occupation-based intervention. The results of the third delphi showed a high level of content validity of .95, stability of .10, convergence of 0, and consensus of 1. Conclusion : The developed occupational therapist competence indicators for occupation-based intervention could be used in various clinical decision making such as occupation-based intervention, education training, education development and evaluation.