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Machine Learning Model to Predict Osteoporotic Spine with Hounsfield Units on Lumbar Computed Tomography

  • Nam, Kyoung Hyup;Seo, Il;Kim, Dong Hwan;Lee, Jae Il;Choi, Byung Kwan;Han, In Ho
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.442-449
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    • 2019
  • Objective : Bone mineral density (BMD) is an important consideration during fusion surgery. Although dual X-ray absorptiometry is considered as the gold standard for assessing BMD, quantitative computed tomography (QCT) provides more accurate data in spine osteoporosis. However, QCT has the disadvantage of additional radiation hazard and cost. The present study was to demonstrate the utility of artificial intelligence and machine learning algorithm for assessing osteoporosis using Hounsfield units (HU) of preoperative lumbar CT coupling with data of QCT. Methods : We reviewed 70 patients undergoing both QCT and conventional lumbar CT for spine surgery. The T-scores of 198 lumbar vertebra was assessed in QCT and the HU of vertebral body at the same level were measured in conventional CT by the picture archiving and communication system (PACS) system. A multiple regression algorithm was applied to predict the T-score using three independent variables (age, sex, and HU of vertebral body on conventional CT) coupling with T-score of QCT. Next, a logistic regression algorithm was applied to predict osteoporotic or non-osteoporotic vertebra. The Tensor flow and Python were used as the machine learning tools. The Tensor flow user interface developed in our institute was used for easy code generation. Results : The predictive model with multiple regression algorithm estimated similar T-scores with data of QCT. HU demonstrates the similar results as QCT without the discordance in only one non-osteoporotic vertebra that indicated osteoporosis. From the training set, the predictive model classified the lumbar vertebra into two groups (osteoporotic vs. non-osteoporotic spine) with 88.0% accuracy. In a test set of 40 vertebrae, classification accuracy was 92.5% when the learning rate was 0.0001 (precision, 0.939; recall, 0.969; F1 score, 0.954; area under the curve, 0.900). Conclusion : This study is a simple machine learning model applicable in the spine research field. The machine learning model can predict the T-score and osteoporotic vertebrae solely by measuring the HU of conventional CT, and this would help spine surgeons not to under-estimate the osteoporotic spine preoperatively. If applied to a bigger data set, we believe the predictive accuracy of our model will further increase. We propose that machine learning is an important modality of the medical research field.

CORRELATION BETWEEN DEPRESSION OF MOTHERS WITH AUTISTIC CHILDREN AND SEVERITY OF AUTISTIC SYMPTOMS OF THEIR CHILDREN (자폐장애아 어머니의 우울정도와 그들 자녀의 자폐증상간의 상관관계)

  • Kwak, Young-Sook;Lee, Soo-Kyung;Kang, Kyung-Mi
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.148-153
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    • 1998
  • Objectives:This study investigated the severity and frequency of depression in mothers with autistic children and the correlation between K-BDI score of mothers with autism and severity of autistic symptoms of their children. Methods:The subjects for this study consisted of 45 autistic children and their mothers. The severity of autistic symptoms of children were evaluated by K-CARS and severity of depressive symptoms of mothers with autistic children evaluated by the K-BDI. Results:1) Total K-BDI scores of mothers with autistic children were $17.3{\pm}10.9$ and this score was belonged to subclinical depression on the K-BDI STEN score. There were significant differences of total KBDI score between in mothers with autistic children and in those of normal control. The 26.7% of 45 mothers with autistic children were depression. 2) There was no correlation between total K-BDI score and each factor of mothers with autistic children and K-CARS score of the their children. Conclusion:There were many depression in mothers with autistic children than in those of normal control. This result suggested that the education and the supportive psychotherapy for mothers with autistic children is as important as the treatment for autism.

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Effect of Direction to be Used for the Timed Up and Go Test on Walking Time in Stroke Patients (일어서서 걷기 검사 시 회전 방향이 뇌졸중 환자의 보행 시간에 미치는 영향)

  • Lee, Geon;Cho, Cheol-hoon;Lim, Kyung-jin;Lee, Joo-hyun;Yoon, Gyu-ri;Woo, Young-keun
    • Physical Therapy Korea
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    • v.23 no.2
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    • pp.11-19
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    • 2016
  • Background: In the stroke patients with the characteristics of hemiplegic gait, turning direction of the affected and unaffected side influences turning time. Therefore, it is important to investigate the walking response to turning directions in stroke patients. Objects: This study aimed to measure the walking time while turning direction in hemiplegic patients depending on balance ability measured by Berg Balance Scale. Methods: A group of forty-five subjects with stroke (Berg Balance Scale score${\geq}46$ were twenty-eight, Berg Balance Scale score${\leq}45$ were seventeen) were enrolled in this study. Subjects were asked to perform the Timed Up and Go test. Testing indications included two directions for turning in each subject. These indications were for turning toward the affected and unaffected side in stroke patients. The duration of total analysis duration, sit to stand phase, stand to sit phase, mid-turning phase, and end turning phase were recorded. The obtained data were analyzed by using paired t-test and Wilcoxon signed rank test in the group that are below and above 45 points of Berg Balance Scale score. The significance level was set at ${\alpha}=.05$. Results: There were significant increase time in the analysis duration and end turning phase duration while subjects were turned the unaffected side in stroke patients that presented a Berg Balance Scale score${\leq}45$ (p<.05). However, the comparison between the affected side and the unaffected side in the stroke patients with Berg Balance Scale score${\geq}46$, revealed no significant differences of the measured parameters. Conclusion: This finding should be suggested in the specific definition of turning direction for evaluation with Timed Up and Go test in the Berg Balance Scale score${\leq}45$, and other intervention for hemiplegic patients need to be suggested the direction of turning during walking training program.

A Study on the Sanitary Perception of the Food Suppliers for the Business and Industry Foodservice in Busan Area (부산지역 사업체급식소 식품공급업자의 위생인식조사)

  • Choe, Mi-Ok;Park, Eun-Yeong;Kim, Ji-Yeong
    • Journal of the Korean Dietetic Association
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    • v.7 no.1
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    • pp.19-27
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    • 2001
  • It is thought that the sanitary perception and hygienic food treatment of food suppliers as the first handlers of foodstuffs are extremely significant for the safe and sanitary management of food in group meal services. So in this study, a survey of 103 food suppliers who provide raw materials for 80 meal services in business places around Busan area was conducted on general matters, participation in sanitation education, sanitary perception, sanitary treatment of foodstuffs, knowledge of sanitation, etc. The results of the survey are as follows: 1. 42.7% of the subjects have worked for the food supply companies for one to five years and the main job of 36.9% of them is delivery service. Food suppliers who handle over two foodstuffs are 6839%. 2. Concerning the participation in sanitation education, 43.7% of the subjects have not experienced any such education, The reason of 23.3% of them for not having the education is that there have been no opportunity for them at all. And 83.5% of them regard the education on hygiene as necessary. 3. In the sanitary perception, 93.1% of the subjects considered the temperature control of the food delivery vehicles as important and 82.5% of them replied on of the leading causes of food poisoning as foodstuffs. 64.0% thought of their knowledge of food sanitation as not very good, but moderate. 4. Concerning sanitary treatment of foodstuffs, 50.5% of delivery vehicles were wearing sanitary uniforms and 24.3% of them washed their hands while supplying food. 5. In the score of hygienic knowledge, the average score of all food suppliers was 60.6 point. In the score of hygienic knowledge on general matters, managing supervisors got 6.31$\pm$1.70. In the score of hygienic knowledge based on the perception of food sanitation, the food suppliers with the experience of sanitation education scored 6.42$\pm$1.93 point and the point was significant(p<0.01), compared with that of the food suppliers without the experience of sanitation education. The food suppliers who answered their knowledge was very good scored the highest point, 8.00$\pm$1.41. The food suppliers who replied that sanitation education was truly necessary recorded the hygienic knowledge score of 6.75$\pm$1.77, significantly(p<0.01) high. In the score of hygienic knowledge on the basis of the practical degree of sanitary handling of food materials, the food suppliers who answered they cleaned their delivery vehicles everyday scored 6.48$\pm$1.93, the food suppliers who answered they sterilized their delivery vehicles everyday scored 6.29$\pm$1.89, the food suppliers who answered they controlled the temperature of their delivery vehicles irregularly scored 6.58$\pm$1.79 and the food suppliers who answered they washed their hands every time when they were working scored 6.86$\pm$2.24, significantly(p<0.05) high in comparison with every item in other factors. And the food suppliers who answered they were wearing sanitary uniforms irregularly while supplying foodstuffs scored the highest point, 6.66$\pm$2.92.

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Mid to Long - Term Results of Meniscal Allograft Transplantation (동종 반월상 연골 이식술 후 중장기 추시 결과)

  • Chun, Churl-Hong;Kweon, Seok-Hyun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.1
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    • pp.19-25
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    • 2009
  • Purpose: We report mid to long - term results of meniscal transplantation and evaluate the important factors for successful outcomes. Materials and Methods: Between December 1999 and September 2002, 25 meniscal transplantations were performed using fresh frozen allograft. The lateral meniscus was transplanted in 19 cases and medial meniscus in 6 cases. The mean age was 34 years (range, 17~50 years) and the mean follow up was 54.8 months (range, 6~85 months). Preoperative measurements were made using a ruler graded in millimeters. Lateral meniscus was fixed by keyhole technique and medial meniscus was fixed by double bone plug technique with suturing the periphery of the meniscal transplant. All patients were evaluated with Knee Assessment Scoring System (KASS), Lysholm knee score, and Tegner activity scale for daily activity. Results: Symptoms improved in all cases. The average KASS score increased from 61.7 preoperatively to 83.8 postoperatively. The average Lysholm knee score increased from 77.7 preoperatively to 87.7 postoperatively (excellent in 3 cases, good in 17 cases, fair 4 cases, poor 1 case). But painful swellings were 3 cases, numbness in 1 case, and granuloma due to non-absorbable suture material in 1 case. Peroneal nerve palsy in 1 case was recovered after 6 weeks postoperatively. Conclusion: Meniscal allograft transplantation after subtotal or total menisectomy can significantly relieve pain and improve function of the knee joint. The exact preoperative sizing and secure fixation are essential for successful outcomes.

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Gait Analysis After Posterior Cruciate Ligament Reconstruction Using Fresh-Frozen Achilles Allograft (신선 동결 아킬레스 동종건을 이용한 후방십자인대 재건술 후 보행분석)

  • Chun, Churl-Hong;Cho, Jae-Deuk;Chun, Keun-Churl
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.2
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    • pp.76-82
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    • 2009
  • Purpose: The purpose of this study was to analyze the clinical result and the gait patterns for patients who had undergone the arthroscopic posterior cruciate ligament (PCL) reconstruction using Achilles allograft. Materials and Methods: Among the patient who had undergone the arthroscopic PCL reconstruction using fresh-frozen Achilles allograft between March 2004 to March 2005, we selected 12 patients who compliance to our rehabilitation program. Clinical result and gait analysis were carried out at 36 months postoperatively. There were measured by using range of motion (ROM), Lysholm knee score, Tegner activity score, IKDC score, posterior stress test, and posterior translation measured by using Telos stress arthrometer. Kinematic gait analysis was carried out using 3-dimensional gait analysis system. Results: The PCL reconstruction surgery yielded statistacally significant results in all of clinical evaluation. In gait analysis, the average knee flexion angle increased during stance phase and decreased during the swing phase, but was not statistically significant and there were no significant difference between both sides of their knees overall. Conclusion: Since there was no statistically significant difference between the injured and uninjured sides as a result of the gait evaluation of the patients who had arthroscopic reconstruction surgery on their PCL injured knee and conformed to the rehabilitation program, systemic and strict rehabilitation ought to be important in the reconstruction surgery.

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A Study on Perceived Family Support and the Quality of Life in the Elderly (노인의 가족지지와 삶의 질)

  • Shin, Dong-Sun;Hong, Chun-Sil
    • Journal of Home Health Care Nursing
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    • v.4
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    • pp.76-85
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    • 1997
  • In modern society, the human average life span has been prolonged due to medical benefits and changes in society, which results in the rapid and world -wide increase in the population of elderly. Consequently, the field of nursing science, as well as the field of many other discipline, has shown increasing interests in issues on the elderly. In addition, to improve the quality of life for elderiy people a great deal of effort has been made. The purpose of our study is to analyze the correlation between family support and quality of life in order to develop basic data for nursing interventions to maintain life satisfaction of the elderly. The sample consists of 108 subjects residing at home whose ages are over 65 years old. The data has been collected, from November 11, 1996 to November 23, 1996, through interviewing the elderly using a questionnarie. For the family supoort we used two: 1) the 5 - point Likert scale questionnarie developed by Gallo and Warren (Family support I) and 2) the 5-point Likert scale developed by H. S. Kang(Family support II), and for the quality of life we used the 3 - point likert scale questionnarie developed by Choi, Young Hee. For data analysis we used percentages, means, Pearson Correlation Coefficient and ANOVA. The results of our study are as follows: 1. For perceived family support I & II, the minimum score is 12 & 19, the maximum score is 32 & 46, the mean score is 24.49 & 34.90, respectively. 2. For Quality of life, the minimum score is 13, the maximum score is 39, the mean score is 28.61. 3. there is a very strong correlation between the perceived family support of the subjects and Quality of life (for I r=0.35047, p<.001 and for II r= 0.60558, p<.001). 4. The relationship between the general characteristics of the elderly and our two variables. family support and Quality of life, is as follows: 1) According to age(for II F=5.32, p<.01), the amount of monthly pocket money(for II F= 3.52, p<.05), inmate(for I F=2.93, p<.05, for II F=2.84, p<.05), economics(for I F=8.99, p<.01. for II F=7.51. p<.01), supporter(for I F=4.01. p<.01. for II F=3.43, p<.01), there is a statistically significant difference in family support. 2) According to the amount of monthly pocket money(F=6.69, p<.01), inmate(F=2.24, p<.05), economics(F=15.38, p<.01), there is a statistically significant difference in Quality of life. In conclusion, it can be said that the family support is an important variable to the Quality of the elderly life.

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Involvement of Mothers of Developmentally Delayed Children in Home Treatment (발달장애 아동 어머니의 가정치료 참여도)

  • Doo, Jung Hee;Kim, Suhn-Yeop
    • Physical Therapy Korea
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    • v.2 no.2
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    • pp.24-39
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    • 1995
  • For the purpose of clarifying to what degree the mothers of developmentally delayed children are involved in treating their child at home. 193 mothers were sampled from 220 mothers of developmentally delayed children below 12 years of age who have visited one of four institutions: the Rehabilitation Hospital of Yonsei Medical Center, Inchon Severance Hospital, Disabled Welfare Center in Myongil-dong, and Nambu Disabled Welfare Hall. The study period was from Mar. 25, 1995 through Apr. 15, 1995. A questionnaire survey was conducted listing the characteristics of the developmentally delayed children, their mothers, mother's satisfaction with their therapists, and the actual conditions of the home treatment. 1. The mothers who treat their child at home for more than 31 minutes a day show a high involvement score, while the mothers of those who give treatment for less than 30 minutes a. day show a low involvement score. That is, the longer the treatment, the greater the involvement score. This indicates a statistically significant result(p<0.01). 2. In cases where a child's father is involved in the home treatment, his/her mother discloses a statistically high involvement score(p<0.001). 3. The result of analysis of cases where other family members, relatives or friends (fathers excepted) reveals a statistically significant high involvement score(p<0.05) for the mother. 4. Mothers in general represent a statistically significant high involvement in home treatment. In the meantime, the mothers in a nuclear family show a higher involvement home treatment than mothers in an extended family(p<0.01). 5. Among those respondents who think that home treatment is helpful and that mothers' involvement in home treatment is helpful, the mothers record a statistically significant high involvement score(p<0.05). When seen from the above perspectives, it seems of much significance that fathers and other relatives or family members play an important role in enhancing the involvement of mothers in home treatment. One point to note here is that providing a long home treatment time is crucial. Therefore, it is recommended that family members have access to rehabilitation treatment for training developmentally delayed children or their care giver; and moreover, we needed to carry out family training or at least arrange for meetings between the family members and medical personnel involved in the child's rehabilitation.

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Cross Sectional Assessment of Health Related Quality of Life (HRQoL) among Patients with Cancer in Malaysia

  • Farooqui, Maryam;Hassali, Mohamed Azmi;Knight, Aishah;Shafie, Asrul Akmal;Farooqui, Muhammad Aslam;Saleem, Fahad;ul Haq, Noman;Othman, Che Noriah;Aljadhey, Hisham
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.3017-3021
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    • 2013
  • Background: Health Related Quality of Life (HRQoL) is an important aspect in identifying cancer patients' perceptions of being diagnosed with cancer and the assessment of treatment outcomes. The present study aimedto assess the profile and predicators of HRQoL of Malaysian oncology patients. Materials and Methods: A cross sectional study adopting the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was conducted. All cancer patients attending Penang General Hospital between August-November 2011 were approached. Descriptive statistics were used to assess demographic and disease related characteristics of the patients. All analyses were performed using SPSS v 16.0. Results: Three hundred and ninety three cancer patients met the inclusion criteria and were enrolled in the study. The mean age was 53.9 ($SD{\pm}13$) years. The cohort was dominated by females (n=260, 66.2%). Nearly half (n=190, 48.3%) of the participants were of Malay ethnicity, practicing Islam as their religion (n=194, 494%). Two hundred and ninety six (n=296, 75.3%) had beene diagnosed with cancer within six months to 3 years previously. The most common primary cancer site was breast (n=143, 36.4%). The mean Global Health Status (GHS) score was 60.7 (SD=21.3). Females (mean GHS score of 62.3, p=0.035) with Malay ethnicity (mean GHS score of 63.8, p=0.047), practicing Islam as their religion (mean GHS score of 63.0, p=0.011) had better GHS scores. Patients having medical insurance had good scores (mean 65.6, p-0.021). Marital status was significantly associated with GHS scores (p=0.022). Bone cancer patientshad the lowest mean GHS score of 49.2 (p=0.044). Patients at very advanced stages of cancer featured a low GHS mean score of 52.2 (p<0.001). Conclusions: The present study identified many demographic and disease related factors which may contribute to the HRQoL of cancer patients, pointing to the necessity for improved management of disease symptoms and provision of psychological and financial support.

Relationships among Study on Family Functioning, Communication and Spiritual Wellbeing, in Adult Women (성인여성의 가족기능, 의사소통 및 영적 건강과의 관계 연구)

  • Won, Jeong-Sook;Jang, Mi-Hee;Lee, Myung-Hee;Park, Young-Mi;Shin, Sung-Hee
    • Journal of East-West Nursing Research
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    • v.10 no.1
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    • pp.86-94
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    • 2004
  • This study has verified Family Functioning, Communication and Spiritual Wellbeing, to increase the family functioning in Adult Women. 236 adult women were chosen as the samples for the study, they are now currently registered in the church adult women in Seoul. The instruments used for this study were the Family functioning scale by Olson, the communication scale by David H. Olson and Howard L. Barnes and spiritual wellbing Scale by Palautzian and Ellison Folkman. Data collection were form March to April, 2003. To get the descriptive statistics, SPSS Program, Pearson Correlation Coefficients and stepwise multiple regression were used for analyzing data. The results were as following: 1. Represents the degree of family functioning, communication and spiritual wellbeing, on subjects. Means scores of this study are following: spiritual wellbeing 67.92, lower level of cohesive(5.19) and adaptive(3.93), communication 58.14, lower level of open(5.15) and closed(4.71) and family functioning 95.58, lower level of religious(7.70) and existential(7.63). All each lower level of family functioning, communication and spiritual wellbeing, on subjects were derived significantly different(p.05). There were significant correlation among the variables of subjects. The cohesive family functioning score was significant related to the adapted(r=.588). Especially, the closed communication score showed inverse correlations open family functioning(r=-.424) and open communication score(r=-.680). The existential spiritual wellbeing score also was significant related to the cohesive(p<.001) and adaptive(p<.05) family functioning, open communication(p<.05). Especially, the closed communication score showed inverse correlations existential spiritual wellbeing (r=-.202). The existential spiritual wellbeing score also was significant related to the religious(r=.815, p<.001). These results will not only emphasis the need of family functioning to elevate and decrease the Closed family communication but suggest the important points of gathering various data and analysis about economic, education and marital status. Finally, related to mental health nursing, a community can get the utmost out of these results to keep offering education and practice of family mental health for adult women.

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