• 제목/요약/키워드: Management outcome

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Application of Virtual Surgical Planning with Computer Assisted Design and Manufacturing Technology to Cranio-Maxillofacial Surgery

  • Zhao, Linping;Patel, Pravin K.;Cohen, Mimis
    • Archives of Plastic Surgery
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    • 제39권4호
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    • pp.309-316
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    • 2012
  • Computer aided design and manufacturing (CAD/CAM) technology today is the standard in manufacturing industry. The application of the CAD/CAM technology, together with the emerging 3D medical images based virtual surgical planning (VSP) technology, to craniomaxillofacial reconstruction has been gaining increasing attention to reconstructive surgeons. This article illustrates the components, system and clinical management of the VSP and CAD/CAM technology including: data acquisition, virtual surgical and treatment planning, individual implant design and fabrication, and outcome assessment. It focuses primarily on the technical aspects of the VSP and CAD/CAM system to improve the predictability of the planning and outcome.

WHO Treatment Guidelines for Drug-Resistant Tuberculosis, 2016 Update: Applicability in South Korea

  • Jeon, Doosoo
    • Tuberculosis and Respiratory Diseases
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    • 제80권4호
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    • pp.336-343
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    • 2017
  • Despite progress made in tuberculosis control worldwide, the disease burden and treatment outcome of multidrug-resistant tuberculosis (MDR-TB) patients have remained virtually unchanged. In 2016, the World Health Organization released new guidelines for the management of MDR-TB. The guidelines are intended to improve detection rate and treatment outcome for MDR-TB through novel, rapid molecular testing and shorter treatment regimens. Key changes include the introduction of a new, shorter MDR-TB treatment regimen, a new classification of medicines and updated recommendations for the conventional MDR-TB regimen. This paper will review these key changes and discuss the potential issues with regard to the implementation of these guidelines in South Korea.

클레임코스트를 고려한 프로젝트의 시간-비용 혼합정수계획모형 (Considering Claim Costs in Project Time-Cost Mixed Integer Programming Model)

  • 김종열;강창욱;황인극
    • 산업경영시스템학회지
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    • 제34권3호
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    • pp.97-105
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    • 2011
  • Previous researches have focused on the efficiency of project execution and the satisfaction of internal customers In view of the fact that a project is successful if any defects are not found in the short-term performance test of the project final outcome. To execute a project that both internal customer and external customer are satisfied in terms of longer-term benefit perspective, the project claim costs (PCC) which may occur for the warranty period of the project final outcome should be considered. We propose a model included PCC to the linear programming between time and cost to expedite a project and perform the validity test by applying the model to an example project. This model and related procedure will contribute to overall project activities' cost reduction by taking preventive actions for PCC.

Investigating Signals on Equity Crowdfunding: Human Capital, Earlier Investors, and Social Capital

  • Jungkook An;Hee-Woong Kim
    • Asia pacific journal of information systems
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    • 제29권2호
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    • pp.283-307
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    • 2019
  • Although crowdfunding has emerged as a promising route to fundraising success, little is known about the specifics of equity-based crowdfunding. Using a data set of 1,111 start-ups with investment funding totaling over $4.67 billion, we analyzed the association between a start-up's underlying characteristics and its funding outcome. We found that a start-up's funding outcome is positively associated with its human capital, but negatively associated with earlier investors' business experience. Furthermore, our analyses revealed that investors have higher levels of social capital are a noise signal to later investors. These findings shed light on the critical role of human capital, investors' experience, and social capital as credible signals for start-up investment in equity crowdfunding.

The Predictors of Survival and Functional Outcome in Patients with Pontine Hemorrhage

  • Jung, Dae-Sung;Jeon, Byung-Chan;Park, Yong-Sook;Oh, Hyung-Suk;Chun, Tae-Sang;Kim, Nam-Kyu
    • Journal of Korean Neurosurgical Society
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    • 제41권2호
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    • pp.82-87
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    • 2007
  • Objective : Pontine hemorrhages usually result in a much higher morbidity and mortality than any other intracranial vascular lesion. The purpose of this study was to evaluate survival and the contributing factors for patients with pontine hemorrhage. Methods : Of the 41 patients who were admitted to our hospital with their first acute pontine hemorrhage from 1997 to 2005, 35 patients were included in this study. Medical records were reviewed to confirm the accuracy of diagnosis and collect demographic, clinical and radiological data. The patients were divided into two groups, survivors and deceased patients; then the survivors were divided again into a group of patient with good results and those with poor results. The location of the hematoma, maximum anteroposterior [AP] diameter, maximum transverse diameter, hematoma volume, ventricular extension, extension into the midbrain, hydrocephalus and initial Glasgow coma scale [GCS] were evaluated. Results : The two year survival rate was 58.5%. The survival of patients with pontine hemorrhage was affected by initial GCS score and transverse hematoma dimeter. Functional outcome of patients who survived was affected by initial GCS, maximum transverse diameter, maximum AP diameter and hematoma volume. Conclusion : The rate of survival after pontine hemorrhage is associated with the transverse diameter of the hematoma and more importantly the initial GCS. Long-term outcome of survivors is influenced by the initial GCS, transverse diameter, AP diameter and volume. Through the multivariate analysis, initial GCS is the only significant factor on survival. Strictly speaking, initial GCS is not modifiable. However, surgical reduction may be considered to amend theses decisive factors. Additional study for indication, timing and method of surgical management is needed.

경정영양과 중심정맥영양을 공급받는 환자에서 질병의 상태(APACHEIII Score), 과대사 정도가 영양상태 및 임상적 결과에 미치는 영향 (Effects of the APACHEIII Score, Hypermetabolic Score on the Nutrition Status and Clinical Outcome of the Patients Administered with Total Parenteral Nutrition and Enteral Nutrition)

  • 라미용;김은미;조영연;서정민;최혜미
    • 대한지역사회영양학회지
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    • 제11권1호
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    • pp.124-132
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    • 2006
  • The aim of this study is to evaluate the clinical outcome. Between January 1,2002 to September 30, 2002, we prospectively and retrospectively recruited III hospitalized patients who received Enteral Nutrition (EN group n = 52) and Total Parenteral Nutrition (TPNgroup n = 59) for more than seven days. The factors of clinical outcomes are costs, incidences of infection, lengths of hospital stay, and changes in weight. The characteristics of patients were investigated, which included nutritional status, disease severity CAP ACHE III score) and hypermetabolic severity Chypermetabolic score). Hypermeta-bolic scores were determined by high fever (> $38^{\circ}C$), rapid breathing (> 30 breaths/min) , rapid pulse rate (> 100 beats/min), leukocytosis (WBC > 12000 $mm^{3}$), leukocytopenia (WBC > 3000 $mm^{3}$), status of infection, inflammatory bowel disease, surgery and trauma. There was a positive correlation between hypermetabolic score and length of hospital stay (ICU), medical cost, weight loss, antibiotics adjusted by age while APACHEIII score did not show correlation to clinical outcome. Medical cost was higher by $18.2\%$ in the TPN group than the EN group. In conclusion, there was a strong negative correlation between the clinical outcome (cost, incidence of infection, hospital stay) and hypermetabolic score. Higher metabolic stress caused more malnutrition and complications. For nutritional management of patients with malnutrition, multiple factors, including nutritional assessment, and evaluation of hypermetabolic severity are needed to provide nutritional support for critically ill patients.

Penetrating Gunshot Injuries to the Brain

  • Kim, Tae-Won;Lee, Jung-Kil;Moon, Kyung-Sub;Joo, Sung-Pil;Kim, Jae-Hyoo;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • 제41권1호
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    • pp.16-21
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    • 2007
  • Objective : Civilian gunshot injuries to the brain are relatively rare and study of these injuries has been neglected in South Korea. We present our experience with penetrating gunshot injuries to the brain and review the outcome of surgical management, as well as other clinical predictors influencing the prognosis. Methods : We present a retrospective analysis of 13 patients with penetrating gunshot injuries to the brain who were treated at our hospital over a period of 22 years. Results : The Glasgow Coma Scale[GCS] score on admission was recorded to be : 3-5 in 1 patient, 6-8 in 3 patients, 9-12 in 2 patients and 13-15 in 7 patients. There were 11 patients who underwent surgical treatment, and the surgical mortality rate was 0%. The admission GCS score was the most valuable prognostic factor. The best results were found to be in patients admitted with an initial GCS higher than 13. There were no favorable outcomes in patients admitted with a GCS of 8 or lower. There was a correlation between the presence of a transventricular or bihemispheric trajectory and poor outcome. The patients admitted with unilobar wounds resulted in better outcome than those with bilobar or multilobar wounds. Retained deep intracranial bone or metal fragments were the most common postoperative complication. However, retained fragments did not increase the risk of infection or seizure. Conclusion : Our results suggest that a less aggressive approach, consisting of minimal local debridement and removal of the bone and metal fragments that are easily accessible, can be successfully used in civilian gunshot wounds to the brain.

Process Performance Feedback and Quality Goal Setting as Sources of Process Restrictiveness and Behavior Guidance in Electronic Brainstorming

  • 정종호
    • 한국정보시스템학회지:정보시스템연구
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    • 제26권4호
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    • pp.1-15
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    • 2017
  • Purpose Through the provision of real time performance information about who is contributing and who is not in Electronic Brainstorming, prior studies evidenced a significant performance gain. However, it has been observed that the quantity-based performance feedback alone does not have enough restrictiveness to guide the performance behavior throughout the idea generation session. We included the notion of goal setting into the process performance feedback mechanism in an effort to regulate performance behavior and to better understand why individuals in Electronic Brainstorming are not obtaining enough stimulation benefits in the group interaction process. Design/methodology/approach We had developed real-time visual process performance feedback and modified to include goal setting. This mechanism visually displays individuals' performances two-dimensionally (quality for each idea vertically and quantity of ideas horizontally along with their goals). As individuals' contributions accumulate, the mechanism reveals performance histories by connecting the sequence of ideas in a time-series format, telling stories of individuals' performances. Then, we compared the performance outcome from this study with the outcomes from two prior studies (i.e., Jung et al., 2010 and Jung, 2014). Findings The results showed that the inclusion of goal setting into the process performance feedback solved the issue in the previous study. That was the lower than expected magnitude of performance enhancement of process performance feedback when compared to that of quantity-based feedback. It appears that goals as a motivational technique provide standards for systematic self-evaluation, serving as a cue to regulate performance behavior by strengthening the linkage between effort and performance. Thus, goals seem to set up a self-fulfilling prophecy, preconditioning better performance. However, the outcome still showed that its performance magnitude is unsatisfactory because the outcome of this study turned out to be close to the outcome of just quantity-based performance feedback in Jung et al.'s (2010) study.

진료지속성이 의료이용에 미치는 영향 : 융복합 성향점수매칭 방법 적용 (Effects of the Continuity of Care on Hospital Utilization : Convergence A Propensity Score Matching Analysis)

  • 안이수
    • 디지털융복합연구
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    • 제13권9호
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    • pp.323-332
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    • 2015
  • 본 연구는 고혈압 환자의 일차의료 지속성 수준을 파악하고, 일차 의료 지속성 수준이 환자의 입원 및 응급실이용에 미치는 영향을 실증하는 융복합적 결과연구(outcome research)이다. 후향적 코호트(retrospective cohort study)연구로써 건강보험 청구자료를 사용하여 고혈압을 주상병으로 진단받은 315,791명을 3년 동안 추척 관찰하였다. 지속성지표는 MFPC, MMCI, COC를 적용하였고 결과변수는 입원 및 응급실 방문을 고려하였다. 일차의료의 지속성 수준과 입원 및 응급실이용의 위험도를 분석한 결과, 지속성 낮은 군이 지속성 높은 군 보다 입원 할 위험도가 1.655배(95% CI: 1.547-1.771), 응급실이용은 1.669배(95% CI: 1.465-1.903) 높았다. 따라서 우리나라 고혈압 환자의 진료지속성을 높이는 정책은 급증하는 만성질환 의료비를 줄일 수 있을 것이다.

Outcome Analysis of External Neurolysis in Posture-Induced Compressive Peroneal Neuropathy and the Utility of Magnetic Resonance Imaging in the Treatment Process

  • Junmo Kim;Jinseo Yang;Yongjun Cho;Sukhyung Kang;Hyukjai Choi;Jinpyeong Jeon
    • Journal of Korean Neurosurgical Society
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    • 제66권3호
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    • pp.324-331
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    • 2023
  • Objective : We aimed to analyze the effectiveness of external neurolysis on the common peroneal nerve (CPN) in patients with posture-induced compressive peroneal neuropathy (PICPNe). Further, we aimed to examine the utility of magnetic resonance imaging (MRI) in assessing the severity of denervation status and predicting the postoperative prognosis. Methods : We included 13 patients (eight males and five females) with foot drop who underwent CPN decompression between 2018 and 2020. We designed a grading system for assessing the postoperative functional outcome. Additionally, we performed MRI to evaluate the denervation status of the affected musculature and its effect on postoperative recovery. Results : The median time to surgery was 3 months. The median preoperative ankle dorsiflexion and eversion grades were both 3, while the average functional grade was 1. Posterior crural intermuscular septum was the most common cause of nerve compression, followed by deep tendinous fascia and anterior crural intermuscular septum. There was a significant postoperative improvement in the median postoperative ankle dorsiflexion and eversion grades and average postoperative functional (4, 5, and 2.38, respectively). Preoperative ankle eversion was significantly correlated with denervation status. Additionally, the devernation status on MRI was positively correlated with the outcome favorability. However, denervation atrophy led to a less favorable outcome. Conclusion : Among patients with intractable PICPNe despite conservative management, surgical intervention could clinically improve motor function and functional ability. Additionally, MRI examination of the affected muscle could help diagnose CPNe and assess the postoperative prognosis.