• Title/Summary/Keyword: Management outcome

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Diagnosis of Cholestatic Jaundice in Neonates and Infants (영유아에서 담즙정체성 황달의 진단과 치료)

  • Lee, Sung Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.sup2
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    • pp.35-43
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    • 2008
  • Jaundice is common in breast-fed infants. Any infant noted to be jaundiced at 2 weeks of age need to be evaluated for cholestasis with measurement of total and direct serum bilirubin. The most common causes of cholestatic jaundice in infants are biliary atresia and neonatal hepatitis. Genetic causes of the neonatal hepatitis syndrome are increasingly recognized and idiopathic neonatal hepatitis is decreasing. Cholestasis should be investigated using a structured protocol. Early detection and timely, accurate diagnosis is important for successful treatment and a favorable prognosis. In particular, a Kasai portoenterostomy for biliary atresia has the best outcome if performed before the infant is 8 weeks of age. The management of cholestasis is mainly supportive, including nutritional support and alleviation of symptoms to improve the quality of life. Specific treatments are available for some causes of neonatal hepatitis syndrome and should be started as soon as possible. For decompensated liver disease, liver transplantation yields a better 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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    • v.39 no.4
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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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    • v.80 no.4
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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.

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

  • Kim, Jong-Yul;Kang, Chang-Wook;Hwang, In-Keuk
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.34 no.3
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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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    • v.29 no.2
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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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    • v.41 no.2
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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.

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 (경정영양과 중심정맥영양을 공급받는 환자에서 질병의 상태(APACHEIII Score), 과대사 정도가 영양상태 및 임상적 결과에 미치는 영향)

  • Rha Mi yong;Kim Eun mi;Cho Young Y.;Seo Jeong Meen;Choi Hay mie
    • Korean Journal of Community Nutrition
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    • v.11 no.1
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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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    • v.41 no.1
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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

  • Jung, Joung-Ho
    • The Journal of Information Systems
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    • v.26 no.4
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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.

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

  • Ahn, Lee-Su
    • Journal of Digital Convergence
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    • v.13 no.9
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    • pp.323-332
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    • 2015
  • This paper examines the level of the primary care continuity for patients with high blood pressure and the effects of the primary care continuity on their convergence health outcomes. We conducted a retrospective cohort study. A total of 315,791 patients who had received new diagnoses of hypertension. We determined standard indices of continuity of care-MFPC, MMCI, and COC and evaluated their association with study outcomes over three years of follow-up. Outcome measures included hospitalization and emergency room visits. The result of the primary care continuity levels and hazard ratios of health outcome showed that, comparing continuity group, non-continuity group had higher rates of hospitalization by 1.655(95% CI: 1.547-1.771) and emergency room visits by 1.669(95% CI: 1.465-1.903). This paper argues that medical costs of chronic diseases will reduce if low continuity of care turns into high continuity of care.