• Title/Summary/Keyword: 중증도 분류

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Assessment of Nutritional Status in Hospitalized Pediatric Patients (입원 환아의 영양상태 평가)

  • Lee, Dong-Gon;Rho, Young-Ill;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.83-91
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    • 2001
  • Purpose: The aim of this study was to investigate the current prevalence of protein-energy malnutrition (PEM) and the nutritional status of hospitalized pediatric patients. Methods: We evaluated the nutritional status of the 200 patients from February to July 1994 and the 233 patients from February to July 1999 admitted to Pediatric Department of Chosun University Hospital. Nutritional status was assessed by anthropometric and laboratory data. The nutritional status was classified according to based on the Waterlow criteria and using the laboratory data obtained between 3 days to 5 days after admission. Results: 1) The prevalence of acute PEM (weight for height) was as follows: severe, 0.5%; moderate, 7%; mild, 18%; and none, 74.5% in 1994 and severe, 2.24%; moderate, 3.59%; mild, 19.73%; and none, 74.4% in 1999. 2) The prevalence of chronic PEM (height for age) was as follows: severe, 5%; moderate, 5.5%; mild, 25.5%; and none, 64% in 1994 and severe, 2.24%; moderate, 4.04%; mild, 22.87%; and none, 70.85% in 1999. There was not a statistically significant difference between 1994 and 1999. 3) The prevalence of PEM according to age group, all age group had in general higher prevalence of mild PEM. 4) Values for hemoglobin and albumin were below than total lymphocyte values in PEM. Conclusion: The prevalence of acute or chronic PEM was common in hospitalized children. Therefore, the assessment of nutritional status may an important role to establish effective nutritional support and to improve their subsequent hospital course in hospitalized pediatric patient.

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Circulating Cytokine Levels and Changes During the Treatment in Patients with Active Tuberculosis in Korea (결핵 환자의 치료경과 중 혈청 내 Cytokine 분비와 변화)

  • Ryu, Yon-Ju;Kim, Yun-Jung;Kwon, Jung-Mi;Na, Youn-Ju;Jung, Yu-Jin;Seoh, Ju Young;Cheon, Seon Hee
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.2
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    • pp.140-153
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    • 2003
  • Background : The cell-mediated immune reaction to tuberculosis infection involves a complex network of cytokines. The extent of inflammation, tissue damage and severity of the disease suggested to be determined by the balance between extent and duration of the proinflammatory cytokine response versus those of the suppressive cytokines. The systemic cytokine response in pathogenesis of tuberculosis can be assessed by measuring serum cytokine levels. Method : Serum interleukin-1 beta(IL-$1{\beta}$), IL-2, IL-4, IL-6, IL-10, IL-12(p40), tumor necrosis factor-alpha(TNF-${\alpha}$), interferon-gamma(IFN-${\gamma}$) and transforming growth factor-beta(TGF-${\beta}$) levels were measured in 83 patients with pulmonary tuberculosis, 10 patients with endobronchial tuberculosis before treatment and 20 healthy subjects by using a sandwich ELISA. In patients with pulmonary tuberculosis, they were divided into mild, moderate and far advanced group according to the severity by ATS guidelines. To compare with those of pretreatment levels, we measured serum IL-$1{\beta}$, IL-2, IL-4, IL-6, IL-10, IL-12(p40), TNF-${\alpha}$, IFN-${\gamma}$ and TGF-${\beta}$ levels in 45 of 83 patients with pulmonary tuberculosis after 2 and 6 months of treatment. Results : 1) In sera of patients with active pulmonary tuberculosis(n=83), IL-$1{\beta}$, IL-6(p<0.05), TNF-${\alpha}$, and IFN-${\gamma}$ were elevated and TGF-${\beta}$ was decreased comparing to control. IL-2, Il-12(p40), IL-4 and IL-10 were similar between the patients with tuberculosis and control. 2) In endobronchial tuberculosis, IL-6 and TNF-${\alpha}$ were elevated and TGF-${\beta}$ was decreased comparing to control. IL-12(p40) seemed to be elevated comparing to pulmonary tuberculosis. 3) Far advanced tuberculosis showed markedly elevated IL-6 and IFN-${\gamma}$ level(p<0.05). 4) The significant correlations were noted between IL-1, IL-6 AND TNF-${\alpha}$ and between IL-12, Il-2 and IL-4(p<0.01). 5) After 2 and 6 months of standard treatment, the level of IL-6 and IFN-${\gamma}$ was significantly decreased(p<0.05). Conclusion : These results showed that an altered balance between cytokines is likely to be involved in the extent of inflammation, tissue damage and severity of the disease tuberculosis. But, it should be considered diversities of cytokine response according to type of tuberculosis and immunity in clinical application and interpreting future studies.

The Effect of Day-Hospital Rehabilitation Program on Gross Motor Function for Children with Cerebral Palsy (재활 낮병동 프로그램이 뇌성마비아동의 대동작기능에 미치는 효과)

  • Kim, Ki-Jeon
    • The Journal of the Korea Contents Association
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    • v.14 no.5
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    • pp.262-271
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    • 2014
  • The purpose of this study was to find the effect of Day Hospital Rehabilitation programs on gross motor function in children with cerebral palsy. The subjects were 57 children with spastic cerebral palsy with no previous botulinum toxin injection or operation history within 6 months. The Gross Motor Function Measure(GMFM) score and Gross Motor Function Classification System(GMFCS) were used to evaluate as functional change and functional level. The Programs for Day Hospital Rehabilitation period for cerebral palsy children was 8 weeks. The results of the study are as follows: 1, GMFM Score of pre- and post-programs for Day Hospital Rehabilitation showed the statistically significant difference(p <.001). 2, The age group in 1-2 was higher than age 5-6 group, 3-4 was higher than age 5-6 group by Post-hoc analysis. Lastly, there was significantly different of GMFM in GMFCS level(p<.05), especially mild(GMFCS level I) and moderate(GMFCS level II, III) of CP showed that gross motor function was significantly different than severe(GMFCS level IV, V). The programs for Day Hospital Rehabilitation was effective on gross motor function for children with cerebral palsy, and for early intervention needs to mild, moderate CP, and below age 4 group.

Non-alcoholic Fatty Liver Disease Classification using Gray Level Co-Ocurrence Matrix and Artificial Neural Network on Non-alcoholic Fatty Liver Ultrasound Images (비알콜성 지방간 초음파 영상에 GLCM과 인공신경망을 적용한 비알콜성 지방간 질환 분류)

  • Ji-Yul Kim;Soo-Young Ye
    • Journal of the Korean Society of Radiology
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    • v.17 no.5
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    • pp.735-742
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    • 2023
  • Non-alcoholic fatty liver disease is an independent risk factor for the development of cardiovascular disease, diabetes, hypertension, and kidney disease, and the clinical importance of non-alcoholic fatty liver disease has recently been increasing. In this study, we aim to extract feature values by applying GLCM, a texture analysis method, to ultrasound images of patients with non-alcoholic fatty liver disease. By applying an artificial neural network model using extracted feature values, we would like to classify the degree of fat deposition in non-alcoholic fatty liver into normal liver, mild fatty liver, moderate fatty liver, and severe fatty liver. As a result of applying the GLCM algorithm, the parameters Autocorrelation, Sum of squares, Sum average, and sum variance showed a tendency for the average value of the feature values to increase as it progressed from mild fatty liver to moderate fatty liver to severe fatty liver. The four parameters of Autocorrelation, Sum of squares, Sum average, and sum variance extracted by applying the GLCM algorithm to ultrasound images of non-alcoholic fatty liver disease were applied as inputs to the artificial neural network model. The classification accuracy was evaluated by applying the GLCM algorithm to the ultrasound images of non-alcoholic fatty liver disease and applying the extracted images to an artificial neural network, showing a high accuracy of 92.5%. Through these results, we would like to present the results of this study as basic data when conducting a texture analysis GLCM study on ultrasound images of patients with non-alcoholic fatty liver disease.

Surgical Treatment and Assessment of Prognostic Factors of Thymoma (흉선종의 수술적 치료 및 예후인자의 평가)

  • 정경영;김길동
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.734-740
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    • 1996
  • The relative importance of various factors influencing the prognosis and survival in the treatment of thymoma is still controversial. Sixty ave patients operated on for thymoma from Jan. 1981 to Dec. 1994 were evaluated, 28 patients (43.1 %) with myasthenia gravis and 37 patients (56.9%) without. Masaoka staging revealed stage I disease in 28 patie ts(4).1%) , stage ll in 1) patients(20.0%), stage 111 In 22 patients(33.8%), stage IVa in 1 patients(1.5%), and stage IVb in 1 patient(1.5%). There was no operative mortality. A complete resection was performed in 48 patients (73.8%) patients, associated in 10 patients (15.4%) with postoperative adjuvant treatment(radiotherapy 5; chemotherapy 1: radio- and chemotherapy 4). Thymomas were found to be predominantly of the epithelial type in 16 patients(24.6%), predominantly Iymphocytic type in 18 patients(27.7%), and mlxed in 22 patients (33.9%). The overall 5- and 10-year survival rates were 87% and 82%, respectively, Factors indicating a poor prognosis included local invasion, incomplete excision, thymic carcinoma, advanced staging and myasthenia gravis. The de- gree of tumor invasion turned out to be the main prognostic factor, and treatment should be planned ac- cordingly. The prognosis is best predicted by the stage of the tumor as determined intraoperatively and is poorer in patie ts with incomplete resection than in those with complete resection of the thynoma. No recurrence developed In patients with stage I disease.

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Evaluation of Clinical Usefulness of Critical Patient Severity Classification System(CPSCS) and Glasgow coma scale(GCS) for Neurological Patients in Intensive care units(ICU) (신경계 중환자에게 적용한 중환자 중증도 분류도구와 Glasgow coma scale의 임상적 유용성 평가)

  • Kim, Hee-Jeong;Kim, Jee-Hee
    • Proceedings of the KAIS Fall Conference
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    • 2012.05a
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    • pp.22-24
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    • 2012
  • The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors influencing on the quality of treatment that patients receive and one of the contributing factors for their prognosis and safety. The purpose of this study was to identify the goodness-of-fit of CPSCS of critical patient severity classification system(CPSCS) and Glasgow coma scale(GCS) and the clinical usefulness of its death rate prediction. Data were collected from the medical records of 187 neurological patients who were admitted to the ICU of C University Hospital. The data were analyzed through $x^2$ test, t-test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and ROC curve. In accordance with patients' general and clinical characteristics, patient mortality turned out to be statistically different depending on ICU stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Homer-Lemeshow goodness-of-fit tests were CPSCS and GCS and the results of the discrimination test using the ROC curve were $CPSCS_0$, .734, $GCS_0$,.583, $CPSCS_{24}$,.734, $GCS_{24}$, .612, $CPSCS_{48}$,.591, $GCS_{48}$,.646, $CPSCS_{72}$,.622, and $GCS_{72}$,.623. Logistic regression analysis showed that each point on the CPSCS score signifies1.034 higher likelihood of dying. Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.

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Development of Human-machine Interface based on EMG and EOG (근전도와 안전도 기반의 인간-기계 인터페이스기술)

  • Gang, Gyeong Woo;Kim, Tae Seon
    • Journal of the Institute of Electronics and Information Engineers
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    • v.50 no.12
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    • pp.129-137
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    • 2013
  • As the usage of computer based systems continues to increase in our normal life, there are constant efforts to enhance the accessibility of information for handicapped people. For this, it is essential to develop new interface ways for physical disabled peoples by means of human-computer interface (HCI) or human-machine interface (HMI). In this paper, we developed HMI using electromyogram (EMG) and electrooculogram (EOG) for people with physical disabilities. Developed system is composed of two modules, hardware module for signal sensing and software module for feature extraction and pattern classification. To maximize ease of use, only two skin contact electrodes are attached on both ends of brow, and EOG and EMG are measured simultaneously through these two electrodes. From measured signal, nine kinds of command patterns are extracted and defined using signal processing and pattern classification method. Through Java based real-time monitoring program, developed system showed 92.52% of command recognition rate. In addition, to show the capability of the developed system on real applications, five different types of commands are used to control ER1 robot. The results show that developed system can be applied to disabled person with quadriplegia as a novel interface way.

A Study on Correlation between ARIA, TNSS and Nasal Endoscopy as Instruments of Evaluation for Allergic Rhinitis (비내시경 소견의 알레르기비염 분류 도구와 중증도 평가도구의 상관성 연구)

  • Lee, Kyu-Jin;Yun, Young-Hee;Kim, Kyu-Seok;Jang, Soo-Bin;Choi, In-Hwa;Ko, Seong-Gyu
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.28 no.1
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    • pp.109-118
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    • 2015
  • Objectives : We performed a clinical study to investigate characteristics of pattern identifications using nasal endoscopy for allergic rhinitis (AR). Methods : We assessed 32 patients with allergic rhinitis using nasal endoscopy, classifications of allergic rhinitis and it's impact on asthma (ARIA) and total nasal symptom score (TNSS). Results : The watery rhinorrhea score of nasal endoscopy was significantly high in 'persistent and moderate/severe' group (P<0.05). Patients were classified as rhinorrhea group and nasal obstruction group according to nasal endoscopy. TNSS and rhinorrhea score was significantly high in rhinorrhea group (P<0.05). Conclusions : The result may provide that the watery rhinorrhea of nasal endoscopy is useful as 'Cold' and 'Deficiency' pattern identification diagnostic tool.

Clinical Usefulness of Critical Patient Severity Classification System(CPSCS) and Glasgow coma scale(GCS) for Neurological Patients in Intensive care units(ICU) (Glasgow coma scale의 임상적 유용성 평가 - 중환자 중증도 분류도구 -)

  • Kim, Hee-Jeong;Kim, Jee-Hee;Roh, Sang-Gyun
    • Proceedings of the Korea Institute of Fire Science and Engineering Conference
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    • 2012.04a
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    • pp.190-193
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    • 2012
  • The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors influencing on the quality of treatment that patients receive and one of the contributing factors for their prognosis and safety. The purpose of this study was to identify the goodness-of-fit of CPSCS of critical patient severity classification system(CPSCS) and Glasgow coma scale(GCS) and the clinical usefulness of its death rate prediction. Data were collected from the medical records of 187 neurological patients who were admitted to the ICU of C University Hospital. The data were analyzed through $x^2$ test, t-test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and ROC curve. In accordance with patients' general and clinical characteristics, patient mortality turned out to be statistically different depending on ICU stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Homer-Lemeshow goodness-of-fit tests were CPSCS and GCS and the results of the discrimination test using the ROC curve were $CPSCS_0$,.734, $GCS_0$,.583, $CPSCS_{24}$,.734, $GCS_{24}$,.612, $CPSCS_{48}$,.591, $GCS_{48}$,.646, $CPSCS_{72}$,.622, and $GCS_{72}$,.623. Logistic regression analysis showed that each point on the CPSCS score signifies1.034 higher likelihood of dying. Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.

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The Effect of Internet Addiction on Depression and Job Stress among IT Engineer (전산직 종사자의 인터넷 중독 정도가 우울감 및 직무스트레스에 미치는 영향)

  • Hwang, Jeoung-Gyun;Lee, Moo-Sik;Na, Bak-Ju;Hong, Jee-Young;Lim, Nam-Gu
    • Proceedings of the KAIS Fall Conference
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    • 2010.05b
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    • pp.845-850
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    • 2010
  • 본 연구는 전산직과 비전산직 종사자의 인터넷 중독 정도가 직무스트레스 및 우울감에 미치는 영향을 파악하고자, 2009년 10월 25일부터 12월 9일까지 서울 및 대전에 소재한 2개의 공공기관 건물내 근무하고 종사자 500명을 대상으로 구조화된 설문지를 이용하여 일반적 특성, 직무스트레스, 우울감 정도, 일상적인 인터넷 이용, 인터넷 중독 자가진단을 조사하였다. 주요 결과는 첫째, 일반적 특성에 따른 직무스트레스 요인별 분류에서는 개인 관련요인이 낮은 연령과 미혼인 경우, 아파트 외 기타에서 거주하는 경우 높게 나타났고, 조직 외 요인의 직무스트레스에서는 전산직에 비해 비전산직이 통계적으로 높게 나타났다(p<0.05). 둘째, 인터넷 중독에 따른 직무스트레스에서는 직무 관련요인, 개인 관련요인, 조직 외 요인 모두 일반 사용자보다 잠재적 위험사용자가 높게 나타났다(p<0.05). 셋째, 우울감 정도에 따른 직무스트레스에서는 우울감 정도가 정상인 경우에 비해 경미함 및 중증도의 경우가 직무 관련요인, 개인 관련요인, 조직 외 요인 모두 높은 직무스트레스를 나타냈다(p<0.05). 넷째, 직무스트레스와 우울감을 종속변수로 한 다중회귀분석 결과를 보면 직무스트레스는 결혼여부, 가족구성원 수, 인터넷 중독이 유의한 변수였고, 25.6%의 설명력을 나타냈다. 우울감은 결혼여부와 인터넷 중독이 유의한 변수였고, 26.4%의 설명력을 나타냈다. 전산직 및 비전산직의 인터넷 중독과 직무스트레스 및 우울감은 관련성이 있는 것으로 나타났고, 인터넷 중독이 심할수록 직무스트레스가 높았으며, 우울감 정도가 심할수록 역시 직무스트레스가 높은 것으로 나타났다.

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