• Title/Summary/Keyword: 임상 결과 예측

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Predictable risk factors and clinical courses for prolonged transient tachypnea of the newborn (지속성 신생아 일과성 빈호흡을 예측하게 하는 위험인자와 임상경과)

  • Chang, Ji Young;Kim, Chang Ryul;Kim, Ellen A;Kim, Ki Soo
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.349-357
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    • 2010
  • Purpose : Transient tachypnea of the newborn (TTN) is usually benign and improves within 72 hours. However, it can also progress to prolonged tachypnea over 72 hours, profound hypoxemia, respiratory failure, and even death. The aim of this study is to find predictable risk factors and describe the clinical courses and outcomes of prolonged TTN (PTTN). Methods : The medical records of 107 newborns, >$35^{+0}$ weeks of gestational age with TTN, who were admitted to the NICU at Seoul Asan Medical Center from January 2001 to September 2007 were reviewed. They were divided into 2 groups based on duration of tachypnea. PTTN was defined as tachypnea ${\geq}72$ hours of age, and simple TTN (STTN) as tachypnea <72 hours of age. We randomly selected 126 healthy-term newborns as controls. We evaluated neonatal and maternal demographic findings, and various clinical factors. Results : Fifty-five infants (51%) with total TTN were PTTN. PTTN infants had grunting, tachypnea >90/min, $FiO_2$ >0.4, and required ventilator care more frequently than STTN infants. PTTN had lower level of serum total protein and albumin than STTN. The independent predictable risk factors for PTTN were grunting, maximal respiration rate >90/min, and $FiO_2$ >0.4 within 6 hours of life. Conclusion : When a newborn has grunting, respiration rate >90/min, and oxygen requirement >0.4 of $FiO_2$ within 6 hours of life, the infant is at high risk of having persistent tachypnea ${\geq}72$ hours. We need further study to find the way to reduce PTTN.

STANDARDIZATION STUDY FOR THE KOREAN VERSION OF THE LURIA-NEBRASKA NEUROPSYCHOLOGICAL BATTERY FOR CHILDREN I : SCALE CONSTRUCTION, RELIABILITY & NORMS FOR THE KOREAN VERSION OF LNNB-C (한국판 아동용 Luria-Nebraska 신경심리 검사의 표준화 연구 I: 척도 제작, 신뢰도 및 뇌손상 진단을 위한 규준 산출)

  • Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.54-69
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    • 1994
  • The purpose of present study was to develop the Korean Version of Luria-Nebraska Neuropsychological Battery for Children(LNNB-C), to examine the reliability of it, and to establish the norms for determining the probability of brain damage. The normative group used to standardize the Korean version of LNNB-C was composed of 147 children between the age of 8 and 12(body 74, girl 73). The clinical group consisted of 19 brain damaged, 16 ADHD, and 16 psychiatric controls. The inter-scorer reliability was 96.3%, indicating that the stability of the scoring system for the Korean version of LNNB-C is good. The reliability coefficients(Cronbach's ${\alpha}$) of LNNB-C scales were ranged .51 to .91, which are similar to those of original LNNB-C. To establish the norms for detecting brain damage, the means and standard deviations for normative group were used to calculate T-scores for each scale. To determine a critical level that could successfully predict a normal child's average score at a given age, first the average score of normative group was calculated, and this score was then entered a regression equation with age to predict the average(baseline) acore. Finally, some issues on constructing the Korean version of LNNB-C and the cultural differences between Korean and American children in performing LNNB-C were discussed.

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Arthroscopic treatment of septic arthritis of the knee in adults (성인의 화농성 슬관절염의 관절경적 치료)

  • Kyung Hee-Soo;Ihn Joo-Chul;Oh Chang-Wug;Kim Sung-Jung;Kim Joon-Woo
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.21-24
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    • 2002
  • Purpose : The purpose was to assess the result of arthroscopic management of the septic arthritis on the knee in compromised patients. Materials and Methods : Fourteen patients with septic knee were analyzed. The mean age was 55 years and the mean follow-up period was 14.6 months. Underlying diseases included 4 cases of diabetes, and history of direct acupuncture in 4 cases. Clinical stage of septic arthritis was judged by $G\ddot{a}chter's$ classification, which was determined by arthroscopic findings. After arthroscopic irrigation and debridement, we observed the results of laboratory data and improvement of clinical findings. Results : Causative organism was identified in 7 cases and no organism was detected in the remaining 7 cases. Stage I was 1, stage II 8, stage III 4, and stage IV 1, respectively. Eleven of 14 cases were improved by one stage operation. Two cases of stage III were recurred and additional arthroscopic management was done. In 1 case of stage IV, symptom was not improved and needed arthrotomy. The result was unsatisfactory in patients with stage III and IV. Serum erythrocyte sedimentation rate and C-reactive protein were normalized after 29.3 and 20.8 days following the operation, respectively. Clinical symptoms disappeared average 2 days following the operation. Conclusion : Arthroscopic management of acute septic arthritis of the knee would be an effective and satisfactory treatment modality in that its postoperative pain and complications are minimal, and it can be done with ease repeatedly.

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Development of Crown Fire Propagation Probability Equation Using Logistic Regression Model (로지스틱 회귀모형을 이용한 수관화확산확률식의 개발)

  • Ryu, Gye-Sun;Lee, Byung-Doo;Won, Myoung-Soo;Kim, Kyong-Ha
    • Journal of the Korean Association of Geographic Information Studies
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    • v.17 no.1
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    • pp.1-12
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    • 2014
  • Crown fire, the main propagation type of large forest fire, has caused extreme damage with the fast spread rate and the high flame intensity. In this paper, we developed the probability equation to predict the crown fires using the spatial features of topography, fuel and weather in damaged area by crown fire. Eighteen variables were collected and then classified by burn severity utilizing geographic information system and remote sensing. Crown fire ratio and logistic regression model were used to select related variables and to estimate the weights for the classes of each variables. As a results, elevation, forest type, elevation relief ratio, folded aspect, plan curvature and solar insolation were related to the crown fire propagation. The crown fire propagation probability equation may can be applied to the priority setting of fuel treatment and suppression resources allocation for forest fire.

Two Pediatric Cases of Dengue Fever Imported from Philippines (필리핀에서 유입된 소아 뎅기열 2례)

  • Oh, Mi Ae;Shim, Jae Won;Kim, Duk Soo;Jung, Hye Lim;Park, Moon Soo;Shim, Jung Yeon
    • Pediatric Infection and Vaccine
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    • v.20 no.2
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    • pp.98-104
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    • 2013
  • Dengue fever is an important health problem for international travelers to all endemic areas. The steadily increasing numbers of tourists visiting endemic areas raise the risk of exposure, and imported dengue cases are increasingly observed in nonendemic area. Dengue has a wide spectrum of clinical presentations, often with unpredictable clinical evolution and outcome. While most patients recover following a self-limiting, non-severe clinical course, a small proportion progress to severe disease such as dengue hemorrhagic fever or dengue shock syndrome. Therefore, it is important to suspect dengue fever in every febrile patient returning from the tropics. Whenever it is suspected, a quick diagnosis and adequate managements are essential to avoid complications. We report two cases of imported dengue fever in Korean children presenting with fever, headache, nausea, and rash.

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Analysis of internet addiction in Korean adolescents using sparse partial least-squares regression (희소 부분 최소 제곱법을 이용한 우리나라 청소년 인터넷 중독 자료 분석)

  • Han, Jeongseop;Park, Soobin;Lee, onghwan
    • The Korean Journal of Applied Statistics
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    • v.31 no.2
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    • pp.253-263
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    • 2018
  • Internet addiction in adolescents is an important social issue. In this study, sparse partial least-squares regression (SPLS) was applied to internet addiction data in Korean adolescent samples. The internet addiction score and various clinical and psychopathological features were collected and analyzed from self-reported questionnaires. We considered three PLS methods and compared the performance in terms of prediction and sparsity. We found that the SPLS method with the hierarchical likelihood penalty was the best; in addition, two aggression features, AQ and BSAS, are important to discriminate and explain latent features of the SPLS model.

Prediction of pathogen positive-culture results in acute poisoning patients with suspected aspiration (흡인이 의심되는 급성 중독환자에서 병원균 양성 배양 결과의 예측)

  • Baek Sungha;Park Sungwook
    • Journal of The Korean Society of Clinical Toxicology
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    • v.20 no.2
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    • pp.75-81
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    • 2022
  • Purpose: This study sought to compare the characteristics of patients with pathogen-positive and negative cultures, and to investigate factors predicting pathogen-positive culture results in patients of acute poisoning with suspected aspiration. Methods: Consecutive patients with acute poisoning admitted to an intensive care unit between January 2016 and December 2018 were retrospectively studied. Respiratory specimens were collected from the enrolled patients at the time of the suspected aspiration. We compared the characteristics of patients with pathogen-positive and negative culture results and analyzed the causative pathogens. Results: Among the 526 patients, 325 showed no clinical features that could be attributed to aspiration, and 201 patients had clinical features suggestive of aspiration. Of these, 113 patients had pathogen-positive culture, 61 were negative, and the specimens of 27 patients contained poor-quality sputum. In univariate analysis, patients with a positive culture showed a longer time to culture from ingestion (p=0.01), faster heart rate (p=0.01), and higher partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO2/FiO2) (p=0.02) than patients with negative culture. Multivariate analysis demonstrated that PaO2/FiO2 (adjusted odd ratio, 1.005; 95% confidence interval [CI], 1.002-1.008; p=0.005) was a significant risk factor for pathogen-positive culture. The area under the receiver operating characteristic curve of PaO2/FiO2 was 0.591 (95% CI, 0.510-0.669, p=0.05). Gram-negative pathogens (GNPs) were predominant and at least one GNP was observed in 84 (73.3%) patients among those with pathogen positive culture. Conclusion: We failed to find any clinical factors associated with positive culture results. Antibiotics that cover GNPs could be considered when deciding the initial antibiotic regimen at the time of suspected aspiration.

Clinical Significance of Creatine Kinase MB mass and Cardiac Troponin I as a Marker of Perioperative Myocardial Infarction After Coronary Artery Bypass Grafting (관상동맥 우회술 후 심근경색의 표지자로서 Creatine Kinase MB 농도와 Cardiac Troponon I의 임상적 의의)

  • 이재진;김응중;이원용;신윤철;지현근
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.27-35
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    • 2002
  • Background: A perioperative myocardial infarction(PMI) is one of the major complications after CABG. Among diagnostic methods of PMI, CK-MB activity assays have been increasingly replaced by CK-MB mass assays, which have more sensitive, simple measurement. Also, new cardiac-specific and -sensitive marker, cardiac troponin I(cTnl), has been shown to be a marker of myocardial infarction. We report our evaluation of clinical significance of CK-MB mass and cTnl as a marker of PMI after CABG. Material and Method: We studied 32 patients who underwent CABG at Kangdong Sacred Hospital between April 2000 and April 2001. Postoperative serum CK-MB activity level, serum CK-MB mass, cTnl, electrocardiogram, echocardiogram, and clinical data were recorded prospectively The diagnosis of PMI was defined as positive 2 among 3 or all of the following , by a new Q wave on the electrocardiogram, by serum CK-MB activity higher than 200 lU/L within 72 hours after operation, and by new regional wall motion abnormality on the echocardiogram. Result: After CABG, 3 patients had sustained a PMI according to current diagnostic criteria. As serum CK-MB activity time course, a level of CK-MB activity 12 hours after CABG had very linear correlated significance with serum CK-MB mass 24hours(R=0.946) and cTnl 48 hours(R=0.933) after CABG(p=0.000). As we used a receiver operating characteristics curve(ROC curve) for a diagnostic cutoff value in patients with PMI, serum CK-MB mass levels higher than 30.05 ug/L 24 hours after CABG detected the presence of PMI with an area under the ROC curve of 1.0, a sensitivity of 100%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 100%. Also serum cTnl levels higher than 17.15 ug/L 48 hours after CABG detected the presence of PMI with an area under the ROC curve of 0.98, a sensitivity of 100%, a specificity of 96.6%, a positive preclictive value of 75%, and a negative predictive value of 100% Conclusion: We concluded that both the measurement of CK-MB mass and cTnl are the easier, accurate methods as a diagnostic marker of PMT after CABG, also as a proposal of diagnostic cutoff value enables to an early detection of PMI. However, a 1arger number of patient will be needed because of statistic limitation that a small number of participating patients, a small number of PMI.

A Study on the Validity and Utility of Korean-Age and Stage Questionnaire for Children in Community (지역사회 아동의 Korean-Age and Stage Questionnaire 타당도와 효용성 연구)

  • Lee, Seong-A;Hwang, Sang-Hui
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.9
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    • pp.3390-3397
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    • 2010
  • The purpose of this study was to evaluate the validity and utility of the Korean-Ages and Stages Questionnaires(K-ASQ) as a screening tool for detecting developmental delay of preschool child in community. Informed consents from parents of 229 children were received for the process of the study. The subjects were 229 parents and the children of three to five years old who did not have reported genetic diseases or developmental delays. The result of this study, validity were calculated for the K-ASQ sensitivity 0.41%, specificity 0.76%, hyper-referral 0.14%, hypo-referral 0.21%. Predictive value of delayed development were K-ASQ 0.70% and that of normal development were K-ASQ 0.77%. K-ASQ can be feasibly used in the setting of health clinic and be the highly predictive criteria for delayed development and normal development.

Development of Mortality Model of Severity-Adjustment Method of AMI Patients (급성심근경색증 환자 중증도 보정 사망 모형 개발)

  • Lim, Ji-Hye;Nam, Mun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.6
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    • pp.2672-2679
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    • 2012
  • The study was done to provide basic data of medical quality evaluation after developing the comorbidity disease mortality measurement modeled on the severity-adjustment method of AMI. This study analyzed 699,701 cases of Hospital Discharge Injury Data of 2005 and 2008, provided by the Korea Centers for Disease Control and Prevention. We used logistic regression to compare the risk-adjustment model of the Charlson Comorbidity Index with the predictability and compatibility of our severity score model that is newly developed for calibration. The models severity method included age, sex, hospitalization path, PCI presence, CABG, and 12 variables of the comorbidity disease. Predictability of the newly developed severity models, which has statistical C level of 0.796(95%CI=0.771-0.821) is higher than Charlson Comorbidity Index. This proves that there are differences of mortality, prevalence rate by method of mortality model calibration. In the future, this study outcome should be utilized more to achieve an improvement of medical quality evaluation, and also models will be developed that are considered for clinical significance and statistical compatibility.