• Title/Summary/Keyword: Risk-Factor

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Risk factor analysis of additional administration of sedative agent and patient dissatisfaction in intravenous conscious sedation using midazolam for third molar extraction

  • Shin, Dong-Whan;Cho, Jin-Yong;Han, Yoon-Sic;Sim, Hye-Young;Kim, Hee-Sun;Jung, Da-Un;Lee, Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.4
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    • pp.229-238
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    • 2017
  • Objectives: The primary purpose of this study was to investigate the factors related with additional administration of sedative agent during intravenous conscious sedation (IVS) using midazolam (MDZ). The secondary purpose was to analyze the factors affecting patient satisfaction. Materials and Methods: Clinical data for 124 patients who had undergone surgical extraction of mandibular third molar under IVS using MDZ were retrospectively investigated in this case-control study. The initial dose of MDZ was determined by body mass index (BMI) and weight. In the case of insufficient sedation at the beginning of surgery, additional doses were injected. During surgery, peripheral oxygen saturation, bispectral index score (BIS), heart rate, and blood pressure were monitored and recorded. The predictor variables were sex, age, BMI, sleeping time ratio, dental anxiety, Pederson scale, and initial dose of MDZ. The outcome variables were additional administration of MDZ, observer's assessment of alertness/sedation, intraoperative amnesia, and patient satisfaction. Descriptive statistics were computed, and the P-value was set at 0.05. Results: Most patients had an adequate level of sedation with only the initial dose of MDZ and were satisfied with the treatment under sedation; however, 19 patients needed additional administration, and 13 patients were unsatisfied. In multivariable logistic analysis, lower age (odds ratio [OR], 0.825; P=0.005) and higher dental anxiety (OR, 5.744; P=0.003) were related to additional administration; lower intraoperative amnesia (OR, 0.228; P=0.002) and higher BIS right before MDZ administration (OR, 1.379; P=0.029) had relevance to patient dissatisfaction. Conclusion: The preoperative consideration of age and dental anxiety is necessary for appropriate dose determination of MDZ in the minor oral surgery under IVS. The amnesia about the procedure affects patient satisfaction positively.

VRIFA: A Prediction and Nonlinear SVM Visualization Tool using LRBF kernel and Nomogram (VRIFA: LRBF 커널과 Nomogram을 이용한 예측 및 비선형 SVM 시각화도구)

  • Kim, Sung-Chul;Yu, Hwan-Jo
    • Journal of Korea Multimedia Society
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    • v.13 no.5
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    • pp.722-729
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    • 2010
  • Prediction problems are widely used in medical domains. For example, computer aided diagnosis or prognosis is a key component in a CDSS (Clinical Decision Support System). SVMs with nonlinear kernels like RBF kernels, have shown superior accuracy in prediction problems. However, they are not preferred by physicians for medical prediction problems because nonlinear SVMs are difficult to visualize, thus it is hard to provide intuitive interpretation of prediction results to physicians. Nomogram was proposed to visualize SVM classification models. However, it cannot visualize nonlinear SVM models. Localized Radial Basis Function (LRBF) was proposed which shows comparable accuracy as the RBF kernel while the LRBF kernel is easier to interpret since it can be linearly decomposed. This paper presents a new tool named VRIFA, which integrates the nomogram and LRBF kernel to provide users with an interactive visualization of nonlinear SVM models, VRIFA visualizes the internal structure of nonlinear SVM models showing the effect of each feature, the magnitude of the effect, and the change at the prediction output. VRIFA also performs nomogram-based feature selection while training a model in order to remove noise or redundant features and improve the prediction accuracy. The area under the ROC curve (AUC) can be used to evaluate the prediction result when the data set is highly imbalanced. The tool can be used by biomedical researchers for computer-aided diagnosis and risk factor analysis for diseases.

Direct Relationship between Angiographic Characteristics of Carotid Atherosclerotic Plaque and Filling Defect in the Cerebral Protection Filters : Based on the Conventional Angiography

  • Choi, Jae-Hyung;Park, Hyun-Seok;Kim, Dae-Hyun;Cha, Jae-Kwan;Huh, Jae-Taeck;Kang, Myongjin
    • Journal of Korean Neurosurgical Society
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    • v.54 no.2
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    • pp.93-99
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    • 2013
  • Objective : Neurologic complications during carotid artery stenting (CAS) are usually associated with distal embolic event. These embolic incident during CAS are highly associated with the carotid plaque instability. The current study was undertaken to identify the angiographic characteristics of carotid plaque vulnerability, which was represented as filling defect in the cerebral protection filters during CAS. Methods : A total of 107 patients underwent CAS with use of a distal protection filter. Angiographic carotid plaque surface morphology was classified as smooth, irregular, and ulcerated. To determine predictable factors of filling defect in the protection filters, 11 variables were retrospectively analyzed which might influence filling defect in the protection filters during CAS. Results : Filling defects during CAS were presented in the 33 cerebral protection filters. In multivariate analysis, angiographic ulceration [odds ratio (OR), 6.60; 95% confidence interval (CI) : 2.24, 19.4; p=0.001], higher stenosis degree (OR, 1.06; 95% CI : 1.00, 1.12; p=0.039), and coexistent thrombus (OR, 7.58; 95% CI : 1.69, 34.05; p=0.08) were highly associated with filling defect in the cerebral protection devices during CAS. Among several variables, angiographic surface ulceration was the only significant factor associated with flow stagnation during CAS (OR, 4.11; 95% CI : 1.33, 12.72; p=0.014). Conclusion : Plaque surface morphology on carotid angiography can be a highly sensitive marker of plaque instability during CAS. The independent risk factors for filling defect in the filter devices during CAS were plaque ulceration, stenosis degree, and coexistent thrombus.

Measurement of Total Plasma Homocysteine in Patients with Chronic Renal Failure Using HPLC/FLD (만성신부전증환자에서 HPLC/FLD를 이용한 혈장 Homocysteine의 측정)

  • Kyung-Ok Lee;Bo-Kyung Kang;Hyung-Jin Roh;Kwang-Suk Ryoo;Jeong-Yeon Yoo;Man-Jeong Paik;Kang-Hyeob Lee
    • Biomedical Science Letters
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    • v.3 no.1
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    • pp.29-35
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    • 1997
  • Cardiovascular disease has been the leading cause of death among patients with chronic renal failure. Many reports have been described that homocysteine is one of the independent risk factor to the occulsive vascular disease. In this study, HPLC/FLD (high performance liquid chromatography-fluorescence detector) technique was used to measure homocysteine level in patients with chronic renal failure and normal control group. The detection limit and recovery of total plasma homocysteine using HPLC/FLD were 98.6$\pm$5.8% and 0.2 nmol/ml, respectively. The linearity of this method was established in concentration range of 2~50 nmol/ml (correlation coefficient=0.9997). The concentrations of total plasma homocysteine were 6.81$\pm$1.54 nmol/ml and 27.28$\pm$14.94 nmol/ml in normal control (n=20) and patient group (n=90), respectively (p<0.05). In this study, the HPLC/FLD method showed high sensitivity and reproducibility for a routine clinical laboratory testing. Moreover determination of homocysteine level in plasma might be useful for a biochemical marker for predicting the cardiovascular diseases and for monitoring of therapeutic effect of lowering homocysteine in patients with chronic renal failure.

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Analysis of large-scale flood inundation area using optimal topographic factors (지형학적 인자를 이용한 광역 홍수범람 위험지역 분석)

  • Lee, Kyoungsang;Lee, Daeeop;Jung, Sungho;Lee, Giha
    • Journal of Korea Water Resources Association
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    • v.51 no.6
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    • pp.481-490
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    • 2018
  • Recently, the spatiotemporal patterns of flood disasters have become more complex and unpredictable due to climate change. Flood hazard map including information on flood risk level has been widely used as an unstructured measure against flooding damages. In order to product a high-precision flood hazard map by combination of hydrologic and hydraulic modeling, huge digital information such as topography, geology, climate, landuse and various database related to social economic are required. However, in some areas, especially in developing countries, flood hazard mapping is difficult or impossible and its accuracy is insufficient because such data is lacking or inaccessible. Therefore, this study suggests a method to delineate large scale flood-prone area based on topographic factors produced by linear binary classifier and ROC (Receiver Operation Characteristics) using globally-available geographic data such as ASTER or SRTM. We applied the proposed methodology to five different countries: North Korea Bangladesh, Indonesia, Thailand and Myanmar. The results show that model performances on flood area detection ranges from 38% (Bangladesh) to 78% (Thailand). The flood-prone area detection based on the topographical factors has a great advantage in order to easily distinguish the large-scale inundation-potent area using only digital elevation model (DEM) for ungauged watersheds.

Test methodology of acceleration life test on feeder cable assembly (Feeder Cable Assembly의 가속수명시험법 개발)

  • Han, Hyun Kak
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.62-68
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    • 2016
  • The feeder cable assembly is an automotive part used for telecommunication. If it malfunctions, the control and safety of the automobile can be put at risk. ALT (Accelerated Life Testing) is a testing process for products in which they are subjected to conditions (stress, strain, temperatures, etc.) in excess of their normal service parameters in an attempt to uncover faults and potential modes of failure in a short amount of time. Failure is caused by defects in the design, process, quality, or application of the part, and these defects are the underlying causes of failure or which initiate a process leading to failure. Thermal shock occurs when a thermal gradient causes different parts of an object to expand by different amounts. Thermal shock testing is performed to determine the ability of parts and components to withstand sudden changes in temperature. In this research, the main causes of failure of the feeder cable assembly were snapping, shorting and electro-pressure resistance failure. Using the Coffin-Manson model for ALT, the normal conditions were from Tmax = $80^{\circ}C$ to Tmin = $-40^{\circ}C$, the accelerated testing conditions were from Tmax = $120^{\circ}C$ to Tmin = $-60^{\circ}C$, the AF (Acceleration Factor) was 2.25 and the testing time was reduced from 1,000 cycles to 444 cycles. Using the Bxlife test, the number of samples was 5, the required life was B0.04%.10years, in the acceleration condition, 747 cycles were obtained. After the thermal shock test under different conditions, the feeder cable assembly was examined by a network analyzer and compared with the Weibull distribution modulus parameter. The results obtained showed good results in acceleration life test mode. For the same reliability rate, the testing time was decreased by a quarter using ALT.

The Relation of Biochemical Examination, Metabolic Syndrome and Life Style of the Gallbladder Polyp in Health Examination Examinees (건강검진 수진자에서 담낭용종과 생화학적검사, 대사증후군 및 생활습관의 관련성)

  • Park, Yoen-Hwa;Kang, Jae-Sun;Lee, Hea-Nam
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.386-393
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    • 2016
  • The incidence of gallbladder polyps are increasing due to the extended use of ultrasonography. Although there are various reports on the risk of gallbladder polyps, there are few studies of the relationships among the presence of metabolic syndrome including serum biochemistry, lifestyle and the development of gallbladder polyps. The aim of this study was to determine association of the presence of metabolic syndrome, including serum biochemistry, with the development of gallbladder polyps in the Korean population. Among the health examination examinees, 596 people, who underwent abdominal ultrasonography from January, 2013 to December 2013, were included in this study. Physical measurements also taken, such as height, weight, blood pressure, waist measurement, and BMI. The general characteristics including age, sex, smoking, and drinking as the related factors were checked. At the same time, various blood tests were performed and the fasting blood sugar was analyzed through blood-gathering to determine the presence of metabolic syndrome. Regarding the factors associated with gallbladder polyps, the results showed that being male, smoking, non-drinking were significantly high. In addition, testing positive for HBsAg and an increasing BMI was apparently higher the group with metabolic syndrome than the non-metabolic syndrome group. The highest predictive factors for gallbladder polyps was being male (1.8 times), followed by metabolic syndrome (2.3 times) and testing positive for HBsAg (2.6 times).

The association between menarche experience and mental health in middle school girls (여중생의 초경경험과 정신건강의 연관성 연구)

  • Ahn, Kyung-Min;Hong, Kyung-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.11
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    • pp.5737-5744
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    • 2013
  • This study was performed to identify the association between the menarche experience and mental health in middle school girls aged 14. The subjects were selected using data from the 8th Korean Youth Risk Behavior Web-based Survey (KYRBWS-V), which included 5,991 girls in 1st grade of middle school. Data were analyzed using the PASW 18.0 program for frequency analysis, t-test, chi square and logistic regression analysis. As to results, we found 4,473 girls who had experienced menarche (mean age, 12.8 0.9 years) and 1,518 girls hadn't experienced menarche. In the logistic regression analysis between the menarche experience and mental health behaviors, the odds ratio (OR) [95% confidence interval (CI)] for perceived stress (OR=1.39, 1.20-1.62, p<0.001), perceived depression (OR=1.25, 1.10-1.42, p<0.05), suicide thinking (6OR=1.60, 1.38-1.87, <0.001), suicide planning (OR=1.66, 1.33-2.81, p<0.001) and suicide trial (OR=1.42, 1.09-1.86, p<0.05) were higher in the menarche experience group than in the menarche non-experience group. Our results indicate, a viable association between the menarche experience and mental health in the 1st grade of middle school girls, and suggests that the menarche experience is an important factor influencing adolescent girls' mental health.

Clinical study of Bangpoongtongsungsan on body weight change in subjects with obesity (방풍통성산이 비만인에 미치는 영향에 대한 임상적 연구)

  • Shin, Dae-Hee;Cho, Guk-Hyun;Lee, Hyuck;Moon, Mi-Kyung;Kang, Dae-Gill;Yun, Young-Gab;Park, Do-Shim;Juhng, Seon-Kwan;Lee, Ho-Sub
    • Herbal Formula Science
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    • v.16 no.2
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    • pp.133-144
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    • 2008
  • Recently, people are becoming fatter in most parts of the world. Obesity is regarded as an important risk factor to adversely affect the health of humans, associated with hypertension, hyperlipidemia, diabetes, and cardiovascular diseases. In the present study, therefore, we tested the short time efficiency and safety of Bangpoongtongsungsan as a drug to decrease body weight in subjects with obesity. A total 48 volunteers (24 man, 24 woman) with body mass index (BMI : weight in kg divided by square of height in meters) of $23㎏/m^2$ participated in clinical study for 12 weeks, from 2008, March 01 to 2008, Jun 30. The subjects was received a dietary supplement of 12 pieces hard capsules per day (4 pieces in one, 3 times in a day) during the clinical study. At the end of clinical study, body weight of subjects was significantly decreased from $72.21{\pm}11.44\;kg$ to $70.53{\pm}11.67\;kg$ (p<0.05). Waist circumferences of subjects were reduced $91.58{\pm}6.43\;cm$ to $85.25{\pm}7.70\;cm$ (p<0.05). Also, a BMI of subjects was significantly decreased $26.07{\pm}2.35\;kg/m^2$ to $25.63{\pm}2.63\;kg/m^2$ (p<0.05). Particularly, a decrease in body weight, waist circumferences, and BMI was more significant in woman than man. But, other biochemical levels including lipid and glucose in plasma had no changes at the end of clinical study. In conclusion, administration of Bangpoongtongsungsan in subjects with high body weight fat could inhibit obesity associated with a decrease in body weight, waist circumferences, and BMI.

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The Noxiousness of Aldosterone Analogue-induced Senile Disease-related Hypertension and Inhibition of the Aldosterone by Silver Spike Point Electrical Stimulation in Elderly People -The Approach of Basic Physical Therapy for the Study of Cardiovascular Disease-related Specialized Physical Therapy- (알도스테론 동족체-유도 노인성질환-연관 고혈압의 유해와 노인에 적용한 은침점전기자극의 알도스테론 억제 -심혈관질환전문물리치료 연구를 위한 기초물리치료학적 접근을 중심으로-)

  • Lee, Sook-Hee;Kang, Joon-Hwan;Lee, Sang-Bin;An, Ho-Jung;Kim, Moo-Gi;Kim, Soon-Hee;Kim, Jung-Hwan
    • Journal of Korean Physical Therapy Science
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    • v.13 no.2
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    • pp.67-83
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    • 2006
  • The present study examined that in Vivo/Vitro test is investigated in normotensive sham-operated rats (NSR) and aldosterone-analogue deoxycorticosterone acetate (DOCA)-salt hypertensive rats (ADHR) and that the antihypertensive effect was induced by silver spike point (SSP) electrical stimulation at meridian points(CV-3, -4, Ki-12, SP-6, LR-3, BL-25, -28, -32, -52), specifically, such as aldosterone in 24 hour urine analysis from healthy volunteer. The gross examination and morphometric-histological changes, such as hypertrophy, production of necrotic tissues, and the changes of cell arrangement on the kidney, and adrenal gland were markedly observed in aldosterone-analogue DOCA-salt hypertensive rats compared with those from normotensive sham-operated rats. The systolic blood pressure, weight of kidney and adrenal gland were significantly increased in ADHR than that in NSR. The required time of PSS-induced resting tone was significantly increased in ADHR than that in NSR. However, the voltage-dependent K+ (Kv) currents were significantly decreased in ADHR than that in NSR. The urine analysis showed that the concentration of aldosterone was significantly decreased in resting state from the elderly people compared with those from the adolescent healthy volunteer. The current of 1 Hz continue type of SSP electrical stimulation significantly decreased in the concentration of aldosterone of 24 hour urine from the elderly people. These results suggest that the development of aldosterone analogue-induced hypertension is associated with changed the weight of kidney and adrenal gland, blood pressure, resting tone and Kv currents, which directly affects blood pressure. Therefore, the hypertension is a risk factor on cerebrovascular disease. Moreover, these results suggest that the diminished responsiveness to SSP electrical stimulation, especially current of 1Hz continue type, in elderly people may be, in part, related by the increased of antihypertensive effects.

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