• 제목/요약/키워드: Function Classification System

검색결과 529건 처리시간 0.024초

Clinical Relevance of Cystatin C as a Renal Marker in Dogs with Chronic Mitral Valve Insufficiency

  • Eom, Na-Young;Choi, Eul-Soo;Song, Joong-Hyun;Lee, Hee-Chun;Jung, Dong-In
    • 한국임상수의학회지
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    • 제33권2호
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    • pp.81-86
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    • 2016
  • Cystatin C is a low molecular weight 13 kilodalton protein. It is known to be a more sensitive marker of glomerular filtration rate than creatinine in humans. The purpose of the present study was to demonstrate the changes of renal markers including cystatin C according to the severity of chronic mitral valve insufficiency (CMVI) and to investigate the clinical relevance of cystatin C as an early renal marker in dogs with CMVI. A retrospective study was performed to assess renal function according to International Small Animal Cardiac Health Council (ISACHC) system classification of heart failure in dogs with CMVI. Thirty seven dogs were divided into a group 1 (healthy dogs ; n = 10), a group 2 (ISACHC I ; n = 10) and a group 3 (ISACHC II-III ; n = 17). In all dogs, serum concentrations of bun (sUr), creatinine (sCr) and cystatin C (sCys-C) were measured with an automated analyzer. In dogs with CMVI, sCys-C concentrations were significantly correlated with sCr concentrations and were independent of age, BW, SBP, and sex. Renal dysfunction tended to occur more frequently as the severity of CMVI increases. In dogs with mild CMVI, only sCys-C concentrations were statistically higher than in healthy dogs. This study demonstrates the clinical relevance of sCys-C. sCys-C may be a valuable renal marker for early diagnosis of renal dysfunction in dogs with CMVI.

Neurodevelopmental outcomes of very low birth weight infants in the Neonatal Research Network of Japan: importance of neonatal intensive care unit graduate follow-up

  • Kono, Yumi
    • Clinical and Experimental Pediatrics
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    • 제64권7호
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    • pp.313-321
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    • 2021
  • Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.

뇌성마비 소아청소년의 발달재활서비스 운동발달재활 영역 이용 및 지원금 현황: 보호자 조사연구 (A Study of Current Use and Subsidy Adequacy of Motor Development Rehabilitation Part of Development Rehabilitation Service in Children and Adolescents with Cerebral Palsy: A Parental Survey)

  • 한승현;함석찬
    • 대한통합의학회지
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    • 제10권2호
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    • pp.155-167
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    • 2022
  • Purpose : Accumulation of accurate data regarding the use and adequacy of subsidies is important to provide optimal development rehabilitation services. However, no reports have discussed the status regarding the use and adequacy of subsidies available for motor development rehabilitation as a part of development rehabilitation services in children and adolescents with cerebral palsy. In this study, we investigated the current use and subsidy adequacy of motor development rehabilitation as an essential part of development rehabilitation services in children and adolescents with cerebral palsy. Methods : The study included parents of children and adolescents with cerebral palsy, who underwent motor development rehabilitation of development rehabilitation services (n=148). The participants were administered a questionnaire to investigate the current use and subsidy adequacy of the motor development rehabilitation part of development rehabilitation services. Results : Most respondents indicated that 310,000-410,000 /month was an appropriate subsidy and agreed that the subsidy should be extended to adults with cerebral palsy. We observed a significant difference in the appropriate subsidy based on age groups (p=.029), as well as type of development rehabilitation service most needed (p=.005) and whether or not agree to extend the subsidy to adults according to gross motor function classification system level (p=.015). There were significant relations of appropriate subsidy (p<.001) and appropriateness of copay (p=.004) according to degree of transportation cost burden. Moreover, there were significant relations of appropriateness of current subsidy (p=.015) and appropriate subsidy (p<.001) according to degree of inconvenience of using transportation. Conclusion : This study highlights the need to increase subsidies for motor development rehabilitation of development rehabilitation services and that the subsidy should be determined based on the burden of transportation costs and the inconvenience of using transportation. Development rehabilitation service for adults with cerebral palsy should also be supported.

ICF 모델 기반 신경계 환자 물리치료 평가 도구 사용 조사 (Evaluation Tools for Patients with Neurologic Disorders Based on the ICF Model: A Survey of Korean Physical Therapists)

  • 이지아;우영근;원종임;김수진
    • PNF and Movement
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    • 제20권3호
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    • pp.359-370
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    • 2022
  • Purpose: Physical therapists are required to properly choose the most appropriate treatment for each patient within the framework of the International Classification of Functioning, Disability, and Health (ICF model). The aims of this study were to determine whether neurological physical therapists in clinical settings in South Korea know about the ICF model and to investigate the current trends of outcome measures (OMs) used by them. Methods: Two hundred and one physical therapists who worked with patients with neurological disorders participated in this study. The survey was conducted via e-mail and asked about commonly used OMs and the considerations for selecting OMs. Results: All physical therapists involved in this study responded completely, and 45.8% of participants learned about the ICF model, while 37.3% understood the detailed information related to the ICF model. The rest of the participants did not know or just heard about the ICF model. The most frequently used tools at the body function/structure level were the Range of Motion (98%), Manual Muscle Test (97%), Berg Balance Scale (83.1%), and Modified Ashworth Scale (70.6%) when allowing repetition. At the activity level, the 10-meter walk test (71.1%), 6-minute walk test (54.2%), and Functional Ambulatory Category (43.3%) were used, while the Activity-Specific Balance Confidence Scale (23.9%) was used at the participation level. There was a positive relationship between the number of tools used and years of work, as well as the level of understanding of the ICF model. Conclusion: The results of this study suggest that it is necessary to learn the ICF model in a clinical setting. In addition, the medical system needs to be modified to encourage physical therapists in South Korea to use proper OMs within the ICF model.

해안재해 대응 그린 인프라스트럭쳐의 국제 연구동향 분석 (An Analysis of International Research Trends in Green Infrastructure for Coastal Disaster)

  • 송기환;송지훈;석영선;김호준;이정아
    • 한국환경복원기술학회지
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    • 제26권1호
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    • pp.17-33
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    • 2023
  • Disasters in coastal regions are a constant source of damage due to their uncertainty and complexity, leading to the proposal of green infrastructure as a nature-based solution that incorporates the concept of resilience to address the limitations of traditional grey infrastructure. This study analyzed trends in research related to coastal disasters and green infrastructure by conducting a co-occurrence keyword analysis of 2,183 articles collected from the Web of Science (WoS). The analysis resulted in the classification of the literature into four clusters. Cluster 1 is related to coastal disasters and tsunamis, as well as predictive simulation techniques, and includes keywords such as surge, wave, tide, and modeling. Cluster 2 focuses on the social system damage caused by coastal disasters and theoretical concepts, with keywords such as population, community, and green infrastructure elements like habitat, wetland, salt marsh, coral reef, and mangrove. Cluster 3 deals with coastal disaster-related sea level rise and international issues, and includes keywords such as sea level rise (or change), floodplain, and DEM. Finally, cluster 4 covers coastal erosion and vulnerability, and GIS, with the theme of 'coastal vulnerability and spatial technique'. Keywords related to green infrastructure in cluster 2 have been continuously appearing since 2016, but their focus has been on the function and effect of each element. Based on this analysis, implications for planning and management processes using green infrastructure in response to coastal disasters have been derived. This study can serve as a valuable resource for future research and policy in responding to and managing various disasters in coastal regions.

이륜차 무인교통단속장비 개발 및 표준규격 연구 (A Study on the Development and Standard Specification of Unmanned Traffic Enforcement Equipment for Two-Wheeled Vehicles)

  • 인병철;유성준;한음;이경진;박성호
    • 한국ITS학회 논문지
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    • 제22권1호
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    • pp.126-142
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    • 2023
  • 본 연구는 이륜차 법규위반 및 교통사고 예방을 위한 무인교통단속장비 및 표준규격 개발을 목적으로 한다. 이를 위해 현재 운영중인 무인교통단속장비의 이륜차 단속의 문제점 및 신기술 검토를 진행하였고, 설문조사를 통해 이륜차 무인교통단속장비 도입타당성 및 기술현황을 조사하였다. 또한 개발장비 현장실험을 통해 이륜차 단속기능을 구현하였고, 성능개선을 통해 단속대상 추가 및 번호인식률이 향상되었다. 현장실험 및 성능평가 결과를 바탕으로 이륜차 무인교통단속장비의 성능기준을 마련하였고 통신프로토콜에서는 차종분류코드 및 위반항목에 이륜차에 관한 사항을 신규로 구성하여 규격을 개발하였다.

상완골 근위부 분쇄 골절에서의 상완골 두 치환술의 단기 추시 결과 (The Short Term Clinical Follow-up Study for Hemiarthroplasty in Proximal Humeral Fracture)

  • 성창민;조세현;정순택;황선철;박형빈
    • Clinics in Shoulder and Elbow
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    • 제10권1호
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    • pp.92-98
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    • 2007
  • 목적: 근위 상완골 골절의 치료 방법은 일반적으로 Neer 분류법에 의하고, 심하게 전위된 3분 골절 및 4분 골절의 경우 상완골두 치환술의 적응증이 된다. 저자들은 근위 상완골의 분쇄 골절로 인하여 상완골두 치환술을 시행 받고, 최소 1년 이상 추시 가능하였던 10례의 단기적 임상적 결과를 보고 하고자 한다. 대상 및 방법: 저자들은 1999년 7월부터 2005년 3월까지 상완골 근위부 골절로 상완골 두 치환술을 시행 받은 환자 중 최소 1년 이상 추시 가능 하였던 10명(10 견관절)의 환자를 대상으로 하였다. Neer 분류법에 의하면 5명은 3분 골절이었고, 나머지 5명은 4분 골절이었으며 외상 후 수술까지 소요 시간은 평균 6.1일 이었다. 남자 4명, 여자 6명이었고, 평균 연령은 67.4세(최소 56세, 최고 76세)였다. 술 후 견관절 기능은 Constant score와 SST(Simple shoulder test) 및 UCLA 평가법(modified UCLA score for hemiarthroplasty)을 이용하여 평가하였다. 결과: 최종 방문 시 Constant 점수는 평균 51.4(최저 34점, 최고 60점)점이었고, 변형된 SST의 경우는 12개 문항 중 평균 7.8개 문항이 가능하다고 하였다. 수상 당시 액와동맥 파열 및 상완신경총 손상이 있었던 1예를 제외한 경우 Constant score는 평균 53.5(최저 44점, 최고 60점)점 이었고, SST의 경우는 12개 문항 중 평균 7.2($1{\sim}8$)개 문항이 가능하다고 하였다. 최종 추시 UCLA score는 동통, 기능성, 근력 및 운동 범위 항목 각각이 평균은 8.2($6{\sim}10$)점, 6.6($2{\sim}8$)점, 6.9($4{\sim}8$)점 이었고, 총점 21.7($12{\sim}26$)점 이었다. UCLA 평가법에 의한 결과는 우수 3예, 양호 6예, 불량 1예 이었고 불량의 경우는 혈관 및 신경 손상이 있었던 1예 이었다. 환자의 주관적 만족도는 10명의 환자 중 2명의 환자는 흡족, 7명의 환자는 양호한 결과라고 하였으나, 1명의 경우는 불만이었다. 결론: 단기 추시 결과이지만, 상완골 두 치환술은 관혈적 정복술이 어려운 상완골 근위부 골절에있어서 일차적 치료방법이라고 생각된다. 상완골 두 치환술은 고령의 환자에게 있어서 강직을 예방할 수 있고 일상적인 생활이 가능하도록 하는 수술 방법이나, 관절운동 범위 및 근력의 회복은 충분하지 않았다.

뇌성마비 환자의 주거 환경과 재활 접근성에 관한 연구 (Study of the Residential Environment and Accessibility of Rehabilitation for Patients with Cerebral Palsy)

  • 조경희;정진엽;이경민;성기혁;조병채;박문석
    • 대한정형외과학회지
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    • 제54권4호
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    • pp.309-316
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    • 2019
  • 목적: 뇌성마비 환자의 주거 환경과 재활 접근성을 조사하여 현재 시행되고 있는 장애인 주거 관련 법률에 대한 문제점에 대해 고찰해보고 장애인 건강권에 관한 법률 제정의 기초 자료를 제공하고자 한다. 대상 및 방법: 주거, 재활, 접근성 3개의 키워드로 문헌을 검색하여 주거 환경, 재활 접근성이라는 2개의 아이템을 선정한 후 설문지를 작성하였다. 문항은 총 51문항을 작성하였고 그중 24문항은 리커트 척도, 27문항은 다지선다형으로 구성되어 있다. 뇌성마비 환자와 보호자를 대상으로 설문조사를 시행하였다. 결과: 연구대상자 100명 중 재가보호 중인 환자는 93명, 시설보호 중인 환자는 7명으로 나타났다. 재가보호 중인 경우 65%는 아파트에 거주하고 있었고, 주로 2층 이상의 지상층에 거주하고 있었으며 그중 40%는 엘리베이터가 없는 건물에 거주하고 있었다. 연구 대상자의 Gross Motor Function Classification System (GMFCS) 단계에 따라 GMFCS I, II, III은 보행가능군, IV, V는 보행불가군으로 나누어 군별로 느끼는 어려움을 조사하였다. 재가보호 중인 경우 두 군 모두 혼자서 재활센터 방문하는 것을 가장 어려워했고, 시설보호 중인 경우 보행가능군은 혼자 시설 밖으로 나가기, 보행불가군은 혼자서 화장실 이용하기를 가장 어려워하는 것으로 나타났다. 응답자의 83%는 뇌성마비 환자에게 재활이 필요하다고 생각하지만, 실제로 재활을 받는 뇌성마비 환자는 33%에 불과했다. 재활을 받는 경우, 평균 주 3.6회, 회당 39분 동안 치료를 받는다고 응답하였다. 결론: 주거약자법은 접근로와 관련된 규정이 없고 장애인등편의법에서는 공동주택에 대한 주 출입구 접근로의 항목만 규정하고 있다. 하지만 본 연구에서 단독주택에 거주하는 뇌성마비 환자는 18%로, 이들은 접근로가 확보되지 않은 주거 환경에서 살고 있다. 뇌성마비 환자들이 고층으로 이동하기 위한 수단에 대한 법률은 없으며, 실내로 진입하기 위한 접근로에 관한 법률은 미흡한 실정이다. 현재 시행 중인 장애인등편의법, 주거약자법 그리고 2017년 12월에 시행된 장애인건강권법의 성공적인 시행을 위해서는 장애인과 보호자가 현실적으로 느끼는 어려움을 반영한 시행 규칙이 제정되어야 할 것이다. 이를 위해 본 연구 결과를 바탕으로 대규모 설문을 통해 뇌성마비 환자의 주거와 재활에 대한 조사가 필요하다고 생각한다.

입원환자 질병유형의 구성에 의한 지역별 진료기능에 관한 연구 (A Study on the Regional Function of Health Care by the Disease Pattern of the Inpatients)

  • 최현림;이상일;신영수;김용익
    • Journal of Preventive Medicine and Public Health
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    • 제21권2호
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    • pp.390-403
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    • 1988
  • The objectives of the study were to provide the basic informations needed in the development of balanced medical services throughout the nation. As the national health care system was expanding rapidly along with the economic growth, quantitative re-evaluation of the system is of great need. For that reason, characteristics of the admitted patients were analyzed for the case-mix and patients' flow within and through regions. Materials were 421,530 cases of inpatients, who were reported through Korea Medical Insurance Corporation(KMIC) for insurance claim, during the period of March 1, 1985 through February 28, 1987. Korean Diagnosis Related Groups(K-DRGs) classification system was adopted for the study of case-mix and 189 cities and counties were classified into 5 district groups by factor analysis results of K-DRGS. The major findings of this study were as follows ; 1) Factor analysis of case-mix, employing K-DRG system, revealed 5 distinct funtional district groups. Group A(18 districts) was prominent for tertiary medical care. In group B(36 districts), rather simple procedures were prevalent. Group C(26 districts) was distinctive for the medical care of well organized internal medicine practices with qualified clinical laboratories. Group D(17 districts) was characterized by relatively high balanced medical care. Group E (92 districts) was with very low level of medical care. 2) Analysis of the case-flow through the districts showed 3 types of flow patterns : inflow, outflow, and balanced types. Inflow type of case-flow was found in Group A, C and D while Group B and E showed outflow type. Inflow was most prominent in Group A and Group E was of typical outflow type. Group B was consistently the outflow type except for Major Diagnostic Category XX regardless of the disease treaters, but Group C and D were inflow or outflow types according to the disease tracers.

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Process Fault Probability Generation via ARIMA Time Series Modeling of Etch Tool Data

  • Arshad, Muhammad Zeeshan;Nawaz, Javeria;Park, Jin-Su;Shin, Sung-Won;Hong, Sang-Jeen
    • 한국진공학회:학술대회논문집
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    • 한국진공학회 2012년도 제42회 동계 정기 학술대회 초록집
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    • pp.241-241
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    • 2012
  • Semiconductor industry has been taking the advantage of improvements in process technology in order to maintain reduced device geometries and stringent performance specifications. This results in semiconductor manufacturing processes became hundreds in sequence, it is continuously expected to be increased. This may in turn reduce the yield. With a large amount of investment at stake, this motivates tighter process control and fault diagnosis. The continuous improvement in semiconductor industry demands advancements in process control and monitoring to the same degree. Any fault in the process must be detected and classified with a high degree of precision, and it is desired to be diagnosed if possible. The detected abnormality in the system is then classified to locate the source of the variation. The performance of a fault detection system is directly reflected in the yield. Therefore a highly capable fault detection system is always desirable. In this research, time series modeling of the data from an etch equipment has been investigated for the ultimate purpose of fault diagnosis. The tool data consisted of number of different parameters each being recorded at fixed time points. As the data had been collected for a number of runs, it was not synchronized due to variable delays and offsets in data acquisition system and networks. The data was then synchronized using a variant of Dynamic Time Warping (DTW) algorithm. The AutoRegressive Integrated Moving Average (ARIMA) model was then applied on the synchronized data. The ARIMA model combines both the Autoregressive model and the Moving Average model to relate the present value of the time series to its past values. As the new values of parameters are received from the equipment, the model uses them and the previous ones to provide predictions of one step ahead for each parameter. The statistical comparison of these predictions with the actual values, gives us the each parameter's probability of fault, at each time point and (once a run gets finished) for each run. This work will be extended by applying a suitable probability generating function and combining the probabilities of different parameters using Dempster-Shafer Theory (DST). DST provides a way to combine evidence that is available from different sources and gives a joint degree of belief in a hypothesis. This will give us a combined belief of fault in the process with a high precision.

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