• Radiation Oncology Journal
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• v.17 no.2
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• pp.146-150
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• 1999

Myasthenia gravis (MG) is relatively rare ouuring as one of important autoimmune disease to affect neuromuscular junction. This study was clinically to evaluate total body irradiation (TBI) against two patients including 33-year and 39-year females for chronic MG with thymoma who hospitalized in the St. Mary's Hospital, Catholic University since 1994 as well as who showed no response by thymectomy, immunotherapy and hormonal therapy. TBI designed by the dose of 150$\~$180 cGy consisting of 10 cGy per fraction, three times a week, for 5~e weeks using linear accelerator of 6 MV. During the treatment of TBI, they did complain acute side effect such as vomiting and also appear improved physical condition from 4$\~$6 weeks after TBI. Through the follow-up period of 18 or 42 months after TBI, they did not have any symptomatic recurrence. Consequently, the results suggest that TBI can be used as an alternative tool for the patients concurrently for MG with thymoma who had been refractory to various conventional therapies like thymectomy, immunotherapy and hormonal therapy.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.10
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• pp.4910-4918
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• 2013

This study aims to design a Severity-Adjusted LOS(Length of Stay) Model in order to efficiently manage LOS of AMI(Acute Myocardial Infarction) patients. We designed a Severity-Adjusted LOS Model with using data-mining methods(multiple regression analysis, decision trees, and neural network) which covered 6,074 AMI patients who showed the diagnosis of I21 from 2004-2009 Korean National Hospital Discharge in-depth Injury Survey. A decision tree model was chosen for the final model that produced superior results. This study discovered that the execution of CABG, status at discharge(alive or dead), comorbidity index, etc. were major factors affecting a Sevirity-Adjustment of LOS of AMI patients. The difference between real LOS and adjusted LOS resulted from hospital location and bed size. The efficient management of LOS of AMI patients requires that we need to perform various activities after identifying differentiating factors. These factors can be specified by applying each hospital's data into this newly designed Severity-Adjusted LOS Model.

• Journal of Digital Convergence
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• v.18 no.3
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• pp.383-393
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• 2020

The purpose of this study is to investigate the condition of the production facilities of severely impaired products for two years from 2017 to 2018, and to suggest ways to improve the preferential purchase system for the severely disabled comparison with previous study. As of June 2018, 267 out of 544 sites were research and analyzed. As a result, first, the average number of severely disabled workers is 16.51, and the total number of workers, disabled workers who participated in direct production, and non-disabled workers showed the trend of increase in 2018. Second, the average monthly wage of workers with disabilities participating in direct production increased slightly from 790,977 won in 2017 to 829,810 won in 2018. Third, Analysis of changes in sales of production facilities before and after designations showed that overall sales of production facilities increased after designations and after designations. Improvement measures include preferential purchase rate improvement and support for production facilities and purchasing public institutions, classification of roles of performance organizations, Clarification of the role of priority purchasing promotion committee for products produced by people with severe disabilities, complementing the minimum wage exclusion system.

• Pediatric Infection and Vaccine
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• v.25 no.1
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• pp.8-16
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• 2018

Purpose: In this study, the clinical and epidemiological characteristics of patients admitted for viral croup were analyzed to evaluate disease severity based on the organism that caused the infection. Methods: We retrospectively reviewed the medical records of 302 patients who were admitted to the Department of Pediatrics at the Wonju Severance Hospital between May 2013 and December 2016 for viral croup. Patients who showed positive results on multiplex polymerase chain reaction were subsequently diagnosed with respiratory virus infection. The Westley scoring system was used to evaluate the severity of viral croup. Results: Of the 302 patients, 149 were admitted due to severe viral croup, including 88 boys and 61 girls, with a boy-to-girl ratio of 1.44:1. About 110 cases of parainfluenza virus infection have been reported, which accounted for almost half of the total cases. The other identified viruses included influenza virus, human rhinovirus, and respiratory syncytial virus. Analysis of the association between severe viral croup and causative pathogen revealed that only parainfluenza type 2 virus showed a significantly high risk. Parainfluenza type 2 virus did not show an age-based difference in frequency but showed relatively a higher frequency of infections during the summer and fall. Conclusions: In this study, parainfluenza virus type 2 was the only virus associated with severe viral croup. To facilitate proper preventive management, treatment, and prognosis evaluation of viral croup, prospective and multicenter studies should assess the additional variables and the severity of the virus. Additionally, further studies should be conducted to assess age-dependent influences, as well as the regional and seasonal incidence of viral infection.

• 재활복지
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• v.20 no.4
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• pp.79-106
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• 2016

This study examined the meanings of the disability education of the mothers who reared their children with brain lesions. For this purpose, Rennie's hermeneutic grounded theory was applied and the consented 7 mothers participated in this study. With the in-depth interviews, 53 meaning units, 16 subordinate categories and 7 hermeneutic categories were classified. These 7 hermeneutic categories were 'wailing miserably everyday', 'social mobilization of the surroundings', 'straight forward', 'smash rock with the eggs', 'looking at a faraway', 'learning together' and 'subjectivation of disability education.' The experience of disabled children education process was concurrent experience of frustration and hoping that moving toward a big hope through the resignation stage, the chasing stage, the vision stage, the challenge stage, and the small achievement stage. Repetitive common patterns of behavior revealed three types: wishy-washy type, realistic-strategy type, and indomitable-challenge type. Moreover, the core category of educational experience was concluded to be 'a pedagogical process of turning despair from severe disabilities into hope through education.' Based on the analysis results, concrete intervention plans for social welfare practice were suggested to support the disabled children's lives with high quality of education.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.11
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• pp.126-136
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• 2018

The purpose of this study was to develop a severity-adjustment model for predicting mortality in acute stroke patients using machine learning. Using the Korean National Hospital Discharge In-depth Injury Survey from 2006 to 2015, the study population with disease code I60-I63 (KCD 7) were extracted for further analysis. Three tools were used for the severity-adjustment of comorbidity: the Charlson Comorbidity Index (CCI), the Elixhauser comorbidity index (ECI), and the Clinical Classification Software (CCS). The severity-adjustment models for mortality prediction in patients with acute stroke were developed using logistic regression, decision tree, neural network, and support vector machine methods. The most common comorbid disease in stroke patients were hypertension, uncomplicated (43.8%) in the ECI, and essential hypertension (43.9%) in the CCS. Among the CCI, ECI, and CCS, CCS had the highest AUC value. CCS was confirmed as the best severity correction tool. In addition, the AUC values for variables of CCS including main diagnosis, gender, age, hospitalization route, and existence of surgery were 0.808 for the logistic regression analysis, 0.785 for the decision tree, 0.809 for the neural network and 0.830 for the support vector machine. Therefore, the best predictive power was achieved by the support vector machine technique. The results of this study can be used in the establishment of health policy in the future.

• Korean Journal of Child Education & Care
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• v.19 no.1
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• pp.159-174
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• 2019

Objective: The study wanted to find out what changes the mother, who is the main parent of the severely disabled children, experienced in their lives through the use of day hospitals and child care services, and what difficulties they had, and discussed policy practical improvements that could satisfy both the medical and developmental needs of the severely disabled. Methods: The participants of the study were 9 mothers of a child with severe disabilities who had experience using hospitals and kindergarten. They were recruited by snowball sampling method. Focus group interview and individual interview were conducted. Results: As a result of the analysis, the mother of severely handicapped child gradually began to seek the balance of life as her child grew and became aware of the institution other than the day hospital. - (e.g) Although I was distracted and worried for the first time, I was gradually adjusting to the time away from my child thinking positively. Children with severe disabilities were also positively influenced by various experiences. They become to show som positive behavior or feeling such as brightening facial expressions or smile as they were using daycare centers or kindergartens in addition to daytime hospitals. Conclusion/Implications: Through the results of this study, comprehensive policy proposals on child care, welfare, and medical care were discussed.

• Proceedings of the Korea Contents Association Conference
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• 2012.05a
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• pp.177-178
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• 2012

응급실을 내원한 중증외상 환자로 등록된 환자 중 중등도 분석의 객관상과 진단을 위한 영상의학검사을 시행 받은 환자를 대상으로 생존군과 사망군을 비교하여 생존의 영향을 미치는 인자에 대하여 알아보고자 하며 진단적 영상의학 검사의 유용성과 적절한 영상의학 검사의 시행시점을 알아보기 위한 것이다.

• Tuberculosis and Respiratory Diseases
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• v.46 no.2
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• pp.204-214
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• 1999

Background: Resting pulmonary function tests(PFTs) are routinely used in the evaluation of pulmonary impairment/disability. But the significance of the cardiopulmonary exercise test(CPX) in the evaluation of pulmonary impairment is controvertible. Many experts believe that dyspnea, though a necessary part of the assessment, is not a reliable predictor of impairment. Nevertheless, oxygen requirements of an organism at rest are different from at activity or exercising, and a clear relationship between resting PFTs and exercise tolerance has not been established in patients with chronic pulmonary disease. As well, the relationship between resting PFTs and dyspnea is complex. To investigate the relationship of dyspnea, resting PFTs, and CPX, we evaluated the patients of stabilized chronic pulmonary disease with clinical dyspnea rating(baseline dyspnea index, BDI), resting PFTs, and CPX. Method: The 50 patients were divided into two groups: non-severe and severe group on basis of results of resting PFTs(by criteria of ATS), CPX(by criteria of ATS or Ortega), and dyspnea rating(by focal score of BDI). Groups were compared with respect to pulmonary function, indices of CPX, and dyspnea rating. Results: 1. According to the criteria of pulmonary impairment with resting PFTs, $VO_2$max, and focal score of BDI were significantly low in the severe group(p<0.01). According to the criteria of $VO_2$max(ml/kg/min) and $VO_2$max(%), the parameters of resting PFTs, except $FEV_1$ were not significantly different between non-severe and severe(p>0.05). According to focal score($FEV_1$(%), FVC(%), MW(%), $FEV_1/FVC$, and $VO_2$max were significantly lower in the severe group(p<0.01). However, in the more severe dyspneic group(focal score<5), only $VO_2$max(ml/kg/min) and $VO_2$max(%) were low(p<0.01). $FEV_1$(%) was correlated with $VO_2$max(%)(r=0.52;p<0.01), but not predictive of exercise performance. The focal score had the correlation with max WR(%) (r=0.55;p<0.01). Sensitivity and specificity analysis were utilized to compare the different criteria used to evaluate the severity of pulmonary impairment, revealed that the classification would be different according to the criteria used. And focal score for dyspnea showed similar sensitivity and specificity. Conclusion : According to these result, resting PFTs were not superior to rating of dyspnea in prediction of exercise performance in patients with chronic pulmonary diseases and less correlative with focal score for dyspnea than $VO_2$max and max WR. Therefore, if not contraindicated, CPX would be considered to evaluate the severity of pulmonary impairment in patients with chronic pulmonary diseases, including with severe resting PFTs. Current criteria used to evaluate the severity of impairment were insufficient in considering the degree of dyspnea, so new criteria, including the severity of dyspnea, may be necessary.

• Journal of the korean veterinary medical association
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• v.32 no.5
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• pp.342-344
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• 1996