• Title/Summary/Keyword: PCI

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Predictors of Readmission after Inpatient Plastic Surgery

  • Jain, Umang;Salgado, Christopher;Mioton, Lauren;Rambachan, Aksharananda;Kim, John Y.S.
    • Archives of Plastic Surgery
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    • v.41 no.2
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    • pp.116-121
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    • 2014
  • Background Understanding risk factors that increase readmission rates may help enhance patient education and set system-wide expectations. We aimed to provide benchmark data on causes and predictors of readmission following inpatient plastic surgery. Methods The 2011 National Surgical Quality Improvement Program dataset was reviewed for patients with both "Plastics" as their recorded surgical specialty and inpatient status. Readmission was tracked through the "Unplanned Readmission" variable. Patient characteristics and outcomes were compared using chi-squared analysis and Student's t-tests for categorical and continuous variables, respectively. Multivariate regression analysis was used for identifying predictors of readmission. Results A total of 3,671 inpatient plastic surgery patients were included. The unplanned readmission rate was 7.11%. Multivariate regression analysis revealed a history of chronic obstructive pulmonary disease (COPD) (odds ratio [OR], 2.01; confidence interval [CI], 1.12- 3.60; P=0.020), previous percutaneous coronary intervention (PCI) (OR, 2.69; CI, 1.21-5.97; P=0.015), hypertension requiring medication (OR, 1.65; CI, 1.22-2.24; P<0.001), bleeding disorders (OR, 1.70; CI, 1.01-2.87; P=0.046), American Society of Anesthesiologists (ASA) class 3 or 4 (OR, 1.57; CI, 1.15-2.15; P=0.004), and obesity (body mass index ${\geq}30$) (OR, 1.43; CI, 1.09-1.88, P=0.011) to be significant predictors of readmission. Conclusions Inpatient plastic surgery has an associated 7.11% unplanned readmission rate. History of COPD, previous PCI, hypertension, ASA class 3 or 4, bleeding disorders, and obesity all proved to be significant risk factors for readmission. These findings will help to benchmark inpatient readmission rates and manage patient and hospital system expectations.

An Experimental Research on the Shear Friction Behavior of Beam-Column Joints of Partial Precast Concrete Structures (부분PC 보-기둥 접합부의 전단 마찰 거동에 관한 실험 연구)

  • Kim, Sang-Yeon
    • Land and Housing Review
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    • v.5 no.2
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    • pp.91-97
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    • 2014
  • An experimental program was initiated to investigate the structural capacity of PC (Precast Concrete) beam-column joints used for the underground parking structure. Static testing of 4 typical PC beam-column joints specimens was conducted. Specimens were designed to span a range of parameters typically encountered for such members, based on findings from the survey of existing PC joint details used in the construction fields in Korea. The specimens were four by their joint types and testing parameters. The specific structural behavior germane to each specimen, and general observations on overall member behavior as a function of the considered parameters, are reported. From the results of tests on four PC joints specimens, the beam-column joints of PC structure used for the underground parking building was found to have similar structural capacities when comparing to the cast-in-place concrete system.

Comparison of Vessel Elasticity according to Risk Factors for Coronary Artery Disease, and the Mediating Effects of Treatment Compliance among Patients with Percutaneous Coronary Intervention (관상동맥질환 위험정도와 혈관탄성의 관계에서 치료지시이행의 매개효과: 경피적 관상동맥 중재술 환자 대상)

  • Yeo, Ga Ram;Sung, Kyung Mi
    • Journal of East-West Nursing Research
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    • v.22 no.1
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    • pp.32-40
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    • 2016
  • Purpose: This study aimed to provide basic data for vascular health of patient who underwent percutaneous coronary intervention (PCI) by verifying the mediating effect of compliance in the relationship between risk level of coronary artery disease (CAD) and blood vessel elasticity. Methods: This is a descriptive study with 115 patients, who underwent the PCI a year ago and visited in the cardiology department from January to March, 2015. The risk level of CAD, blood vessel elasticity and the compliance were measured. For data analysis, SPSS/WIN 21.0 and AMOS (IBM) 21.0 were used. Results: There were a positive correlation with blood vessel elasticity score (i.e. inelasticity of the blood vessel wall) (r=.189) and a negative correlation with compliance (r=-.658) in mediating effect of risk level of CAD. There was a negative correlation between compliance and blood vessel elasticity (r=-.482). The direct effect (${\beta}=-.226$), indirect effect (${\beta}=.415$) and total effect (${\beta}=.186$) of mediating effect of risk level of CAD on blood vessel elasticity were significant. Compliance had a partial mediating effect of risk level of CAD on blood vessel elasticity. Conclusion: The results of this study suggest that managing and preventing moderating effect of risk level of CAD on compliance is helpful in restoring blood vessel elasticity.

Effect of Triple Compared to Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation in Percutaneous Coronary Intervention (관상동맥 약물 용출 스텐트 삽입 후 항혈소판제제 3제요법과 2제요법의 임상적 효과 비교)

  • Ye, Kyong-Nam;Kim, Jeong-Tae;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.2
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    • pp.113-122
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    • 2012
  • ACC/AHA/SCAI Guideline recommends for administration dual antiplatelet therapy after drug-eluting stent (DES) to prevent restenosis and stent thrombosis in patients with percutaneous coronary intervention (PCI). Recently triple antiplatelet therapy including cilostazol is known to reduce restenosis and stent thrombosis significantly after DES implantation. However, there is lack of data providing the efficacy of triple antiplatelet therapy. The purpose of this study is to evaluate the clinical effects of the triple therapy after DES implantation compared with the dual therapy. This retrospective study collected data from medical charts of 251 patients who received DES implantation between Jul 2006 and Jun 2008. They received either dual antiplatelet therapy (N = 154 clopidogrel and aspirin; Dual group) or triple antiplatelet therapy (N = 97 cliostazol, clopidogrel and aspirin; Triple group). Major adverse cardiac event rates (MACE, included total death, myocardial infarction, target lesion revascularization) at 12 months, 24 months, stent thrombosis, rates of bleeding complications and adverse drug reactions were compared between these two groups. Compared with the dual group, the triple group had a similar incidence of the MACE rates at 24months (12.3% vs. 12.4%, p = 0.99). There is no difference in overall stent thrombosis between two groups (Dual group 2.6% vs. Triple group 4.1%, p = 0.5). Subgroup analysis showed that diabetic patients got more benefit in reducing MACE rates but, there is no statistical difference. Bleeding complications and adverse drug effects were not different significantly. As compared with dual antiplatelet therapy, triple antiplatelet therapy did not reduce the 12-months, 24-months MACE rates and stent thrombosis. Bleeding complications and adverse drug effects were not different.

Implementation of External Memory Expansion Device for Large Image Processing (대규모 영상처리를 위한 외장 메모리 확장장치의 구현)

  • Choi, Yongseok;Lee, Hyejin
    • Journal of Broadcast Engineering
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    • v.23 no.5
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    • pp.606-613
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    • 2018
  • This study is concerned with implementing an external memory expansion device for large-scale image processing. It consists of an external memory adapter card with a PCI(Peripheral Component Interconnect) Express Gen3 x8 interface mounted on a graphics workstation for image processing and an external memory board with external DDR(Dual Data Rate) memory. The connection between the memory adapter card and the external memory board is made through the optical interface. In order to access the external memory, both Programmable I/O and DMA(Direct Memory Access) methods can be used to efficiently transmit and receive image data. We implemented the result of this study using the boards equipped with Altera Stratix V FPGA(Field Programmable Gate Array) and 40G optical transceiver and the test result shows 1.6GB/s bandwidth performance.. It can handle one channel of 4K UHD(Ultra High Density) image. We will continue our study in the future for showing bandwidth of 3GB/s or more.

Effects of Prostacyclin [PGI2] on Myocardial Protection in the Isolating Working Heart Model (적출활동심장에서 Prostacyclin [PGI2]의 심근보호효과)

  • Lee, Gil-No;Kim, Gyu-Tae
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.643-654
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    • 1987
  • The effect of prostacyclin[PGI, ] on myocardial preservation during global ischemia was studied in the isolating working rabbit heart model. Forty hearts underwent a 15 minute period of retrograde nonworking perfusion with Krebs-Henseleit buffer solution [37*C] and were switched over to the working mode for 15 minutes. After baseline measurement of heart rate, peak aortic pressure, aortic flow, and coronary flow, all hearts were subjected to 60 minutes of ischemic arrest at 10*C induced with St. Thomas Hospital cardioplegic solution: Group I had single dose cardioplegia, Croup II double dose, Croup III oxygenated double dose, and Group IV single dose with PCI, infusion [10ng/min./gm heart weight]. Hearts were then revived with 15 minute period of nonworking reperfusion at normothermia, followed by 30 minutes of working perfusion. Repeat measurements of cardiac function were obtained and expressed as a percent of the preischemic baseline values. Oxygen content of arterial perfusate and coronary effluent was measured by designed time interval. Leakage of creatine kinase was determined during post-ischemic reperfusion period. Finally wet hearts were weighed and placed in 120*C oven for 36 hours for measurement of dry weight. In the PGI, treated group [IV], heart rate increased consistently throughout the period of reperfusion from 100*5.0% [p<0.001] to 107*6.2% [p<0.001]. The percent recovery of aortic flow showed 95*5.7% [p<0.001] at the first 3 minute and full recovery through the subsequent time. Coronary flow was augmented significantly in the 3 minute [96*6.2%, p<0.001] and then sustained above baseline values. Among the Croup I, II, and III, all hemodynamic values were significantly below preischemic levels. PGI2 relatively increased oxygen delivery [1.22*0.19ml/min, p<0.001] and myocardial oxygen consumption [0.90*0.13ml/min, p<0.001] during reperfusion period. Leakage of creatine kinase in the PGI2 group was 9.3*1.58IU/15min [p<0.001]. This was significantly lower than Group I [33.0*2.68 IU/15min]. The water content of PCI2 treated hearts [81*0.9%, p<0.001] was also lower than the other groups.

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A Water Quality Management System at Mokhyun Stream Watershed Using GIS and RS (GIS와 RS를 이용한 목현천 수질관리 정보체계)

  • Lee, In Soo;Lee, Kyoo Seock
    • Journal of Environmental Impact Assessment
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    • v.8 no.4
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    • pp.1-12
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    • 1999
  • The purpose of this study is to develop a Water Quality Management System(WQMS), which calculates pollutant discharge and forecasts water quality with a water pollution model. Operational water quality management requires not only controlling pollutants but acquiring and managing exact information. A GIS software, ArcView 3.1 was used to enter or edit geographic data and attribute data, and Avenue Script was used to customize the user interface. PCI, a remote sensing software, was used to derive land cover classification from 20 m resolution SPOT data by image processing. WQMS has two subsystems, database subsystem and modelling subsystem. The database subsystem consisted of watershed data from digital maps, remote sensing data, government reports, census data and so on. The modelling subsystem consisted of NSPLM(NonStorm Pollutant Load Model) and SPLM(Storm Pollutant Load Model). It calculates the amount of pollutant and predicts water quality. These two subsystems were connected through a graphic display module. This system has been calibrated for and applied to Mokhyun Stream watershed.

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The Effects of Height of Shoe Lifts on Gait and Balance in Hemiplegic Patients. (편마비 환자에서 신발 높이의 차이가 보행과 균형에 미치는 영향)

  • Lee, Ju-Sang;Yang, Young-Ae;Hur, Jin-Gan
    • Journal of Korean Physical Therapy Science
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    • v.10 no.2
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    • pp.29-36
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    • 2003
  • The purpose of this study was to investigate the effects of height of shoe lifts on gait and balance in hemiplegic patients. Twenty-two hemiplegic patients who were receiving rehabilitation treatment at Hanyang University Seoul Hospital and National Rehabilitation Center participated in this study from November 8, 2002 through March 20, 2003. Data analysis using repeated measures ANOVA and Bonferroni method, for a post-test. The results of this study were as follows : First, shoe lift on the height of 3mm, 6mm, 9mm, 12mm significantly improved, as compared to un-lift status, in gait velocity, PCI, weight bearing(p<0.05). Second, gait velocity was significantly difference between 3mm and 9mm, and between 3mm and 12mm, and weight bearing on the affected side was significantly difference between 3mm and 12mm, and between 6mm and 12mm(p<0.05). Third, after the shoe lift removed was significantly improved in gait velocity, PCI, weight bearing than before shoe lifts being added(p<0.05). These results suggest that shoe lift on the unaffected side may helpful for improving the gait efficiency and symmetrically of weight bearing. Furthermore, persistence of gait efficiency and symmetrically of weight bearing after removing the shoe lift suggests carryover effect of gait training on shoe lift of unaffected side.

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Development of Mortality Model of Severity-Adjustment Method of AMI Patients (급성심근경색증 환자 중증도 보정 사망 모형 개발)

  • Lim, Ji-Hye;Nam, Mun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.6
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    • pp.2672-2679
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    • 2012
  • The study was done to provide basic data of medical quality evaluation after developing the comorbidity disease mortality measurement modeled on the severity-adjustment method of AMI. This study analyzed 699,701 cases of Hospital Discharge Injury Data of 2005 and 2008, provided by the Korea Centers for Disease Control and Prevention. We used logistic regression to compare the risk-adjustment model of the Charlson Comorbidity Index with the predictability and compatibility of our severity score model that is newly developed for calibration. The models severity method included age, sex, hospitalization path, PCI presence, CABG, and 12 variables of the comorbidity disease. Predictability of the newly developed severity models, which has statistical C level of 0.796(95%CI=0.771-0.821) is higher than Charlson Comorbidity Index. This proves that there are differences of mortality, prevalence rate by method of mortality model calibration. In the future, this study outcome should be utilized more to achieve an improvement of medical quality evaluation, and also models will be developed that are considered for clinical significance and statistical compatibility.

Optimum Slab-Lifting Positions for Precast Concrete Pavement Construction (프리캐스트 콘크리트 포장 시공 시 최적 슬래브 리프팅 위치)

  • Kim, Seong-Min;Cho, Byoung-Hooi;Han, Seung-Hwan
    • International Journal of Highway Engineering
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    • v.9 no.2 s.32
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    • pp.27-37
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    • 2007
  • This research was conducted to determine the optimum lifting positions on precast concrete slabs for precast concrete pavement construction, based on the analysis of concrete stress distribution under various lifting conditions. To analyze stresses in concrete slabs, the finite element method was implemented and a numerical model of the precast slab that was going to be used in the experimental construction was developed. Changes in the stress distribution due to the lifting angle were investigated because slab lifting is not always performed in the perpendicular direction to the slab surface. In addition, the effect of the lifting level, the distance between the neutral axis of the slab and the lifting point, on the stress distribution was investigated since the lifting point is not always at the neutral axis of the slab. To consider the actual steel design of the precast slab, the effect of the reinforcement near the lifting point was also investigated. From this study, the optimum lifting positions of the precast slabs were determined according to the lifting angle and level, and the results were compared with the lifting positions used in the PCI standards.

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