• Title/Summary/Keyword: Severity-Adjustment

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Association of Nose Size and Shapes with Self-rated Health and Mibyeong (코의 크기 및 형태와 자가건강, 미병과의 상관성)

  • Ahn, Ilkoo;Bae, Kwang-Ho;Jin, Hee-Jeong;Lee, Siwoo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.35 no.6
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    • pp.267-273
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    • 2021
  • Mibyeong (sub-health) is a concept that represents the sub-health in traditional East Asian medicine. Assuming that the nose sizes and shapes are related to respiratory function, in this study, we hypothesized that the nose size and shape features are related to the self-rated health (SRH) level and self-rated Mibyeong severity, and aimed to assess this relationship using a fully automated image analysis system. The nose size features were evaluated from the frontal and profile face images of 810 participants. The nose size features consisted of five length features, one area feature, and one volume feature. The level of SRH and the Mibyeong severity were determined using a questionnaire. The normalized nasal height was negatively associated with the self-rated health score (SRHS) (partial ρ = -0.125, p = 3.53E-04) and the Mibyeong score (MBS) (partial ρ = -.172, p = 9.38E-07), even after adjustment for sex, age, and body mass index. The normalized nasal volume (ρ = -.105, p = 0.003), the normalized nasal tip protrusion length (ρ = -.087, p = 0.014), and the normalized nares width (ρ = -.086, p = .015) showed significant correlation with the SRHS. The normalized nasal area (ρ = -.118, p = 0.001), the normalized nasal volume (ρ = -.107, p = .002) showed significant correlation with the MBS. The wider, longer, and larger the nose, the lower the SRHS and MBS, indicating that health status can be estimated based on the size and shape features of the nose.

A STUDY ON THE PARENTAL MARITAL RELATIONSHIP OF CHILD PSYCHIATRIC PATIENTS (소아정신과 환아 부모의 부부관계에 대한 연구)

  • Lim, Ke-Won;Hong, Kang-E;Rhee, Kun-Hoo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.2 no.1
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    • pp.160-175
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    • 1991
  • The purpose of this study is to investigate the parental marital relationships and the parent-child relationships of child psychiatric parents and its control group. This study was carried out two questionnaire instruments ; The marital satisfaction inventory(MSI) and the dyadic adjustment scale(DAS). The subjects are parents of the child psychiatric patients. A matched control group and parents of child psychiatric parents in Seoul area which were collected from July 1987 to September 1987, and classified into five subgroups : 1 Psychiatric disorder 2) Neurotic disorder 3) Tic disorder 4) Autistic disorder 5) Mental retardation. The results are as following ; 1) M.S.I scale scores of parents of patients group are lower than that of control group. 2) D.A.S scale score of parents of patients group is significantly lower than that of the control group(P<0.01). 3) The global distress scale(GDS) of the M.S.I. was most positively correlated with affective communication(AFC) and problem-sloving communication(PSC). 4) Female shoed more modern concept of role identification than male but tend to have heavier role assignment especially in child rearing practices which could be characterized by maternal domination. 5) Affective communication and sexual relationship between married couple and child rearing practices are influenced by their own family history of distress. 6) The marital global distress scale(GDS) score was highest in the parents of psychosis, the next in the parents of neurosis, autism, mental retardation, and tic disorder in descending order of severity. 7) The dyadic maladjustment score was highest in the parents of psychosis, the next in the parents of neurosis, tic, autism and mental retardation in descending order of severity. 8) Conflict in child rearing and parenting problems were particularly prominent in parents of the tic patients, and their marital relationship was not significantly disturbed. The above finding suggested that couple adjustment and marital dissatisfaction were closely related with child rearing problems and the children's disorder. So marital dissatisfaction and marital maladjustment seem to play a significant role in the genesis of psychosis and neurosis not much in autism and mental retardation.

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Prosthodontic Treatment of Persons with Disabilities Under Dental Sedation and General Anesthesia (치과진정법과 전신마취를 이용한 장애환자의 보철치료)

  • Kim, Yun-Hee;Lee, Jin-Han
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.3
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    • pp.183-191
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    • 2012
  • In most persons with disabilities had poor oral hygiene because of less attention and ability to perform a dental care. So the increased prevalence and severity of dental disease were common oral state. Although most persons with disabilities need a adequate dental treatment, it is often very difficult to treat because of noncooperativity and involuntary muscle movements. Dental treatments under sedation and general anesthesia were make to provide a high-quality dental service because of decreased anxiety and fear associated dental treatment in persons with disabilities. The dental professionals must be able to select and apply the proper sedation methods in agreement with the characteristics of the disabilities, general conditions, sedation experience and capacity of dentist, type and time of dental treatment, equipments of dental clinic, consent of patient's protector. The proshodontic treatment procedures, such as abutment preparation, dental impression taking process, try-in process of prosthesis and adjustment of occlusion, are difficult even for patients without disabilities. Those procedures are more difficult to patients with disability because it's too hard to control breathing and muscle. In this report, we performed prosthetic dentistry procedures to three patients with disabilities under dental sedation and general anesthesia.

The impact of comorbidity (the Charlson Comorbidity Index) on the health outcomes of patients with the acute myocardial infarction(AMI) (급성심근경색증 환자의 동반상병지수에 따른 건강결과 분석)

  • Lim, Ji-Hye;Park, Jae-Yong
    • Health Policy and Management
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    • v.21 no.4
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    • pp.541-564
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    • 2011
  • This study aimed to investigate health outcome of acute myocardial infarction (AMI) patients such as mortality and length of stay in hospital and to identify factors associated with the health outcome according to the comorbidity index. Nation-wide representative samples of 3,748 adult inpatients aged between 20-85 years with acute myocardial infarction were derived from the Korea National Hospital Discharge Injury Survey, 2005-2008. Comorbidity index was measured using the Charlson Comorbidity Index (CCI). The data were analyzed using t-test, ANOVA, multiple regression, logistic regression analysis in order to investigate the effect of comorbidity on health outcome. According to the study results, the factors associated with length of hospital stay of acute myocardial infarction patients were gender, insurance type, residential area scale, admission route, PCI perform, CABG perform, and CCI. The factors associated with mortality of acute myocardial infarction patients were age, admission route, PCI perform, and CCI. CCI with a higher length of hospital stay and mortality also increased significantly. This study demonstrated comorbidity risk adjustment for health outcome and presented important data for health care policy. In the future study, more detailed and adequate comorbidity measurement tool should be developed, so patients' severity can be adjusted accurately.

Associations Between Heart Rate Variability and Symptom Severity in Patients With Somatic Symptom Disorder (신체 증상 장애 환자의 심박변이도와 증상 심각도의 연관성)

  • Eunhwan Kim;Hesun Kim;Jinsil Ham;Joonbeom Kim;Jooyoung Oh
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.108-117
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    • 2023
  • Objectives : Somatic symptom disorder (SSD) is characterized by the manifestation of a variety of physical symptoms, but little is known about differences in autonomic nervous system activity according to symptom severity, especially within patient groups. In this study, we examined differences in heart rate variability (HRV) across symptom severity in a group of SSD patients to analyze a representative marker of autonomic nervous system changes by symptoms severity. Methods : Medical records were retrospectively reviewed for patients who were diagnosed with SSD based on DSM-5 from September 18, 2020 to October 29, 2021. We applied inverse probability of treatment weighting (IPTW) methods to generate more homogeneous comparisons in HRV parameters by correcting for selection biases due to sociodemographic and clinical characteristic differences between groups. Results : There were statistically significant correlations between the somatic symptom severity and LF (nu), HF (nu), LF/HF, as well as SD1/SD2 and Alpha1/Alpha2. After IPTW estimation, the mild to moderate group was corrected to 27 (53.0%) and the severe group to 24 (47.0%), and homogeneity was achieved as the differences in demographic and clinical characteristics were not significant. The analysis of inverse probability weighted regression adjustment model showed that the severe group was associated with significantly lower RMSSD (β=-0.70, p=0.003) and pNN20 (β=-1.04, p=0.019) in the time domain and higher LF (nu) (β=0.29, p<0.001), lower HF (nu) (β=-0.29, p<0.001), higher LF/HF (β=1.41, p=0.001), and in the nonlinear domain, significant differences were tested for SampEn15 (β=-0.35, p=0.014), SD1/SD2 (β=-0.68, p<0.001), and Alpha1/Alpha2 (ß=0.43, p=0.001). Conclusions : These results suggest that differences in HRV parameters by SSD severity were showed in the time, frequency and nonlinear domains, specific parameters demonstrating significantly higher sympathetic nerve activity and reduced ability of the parasympathetic nervous system in SSD patients with severe symptoms.

Recent outcome of extremely low birth weight infants - The use of CRIB(clinical risk index for babies) II score for analyzing the survival rate - (초극소 저출생 체중아의 최근 치료 성적 - CRIB(clinical risk index for babies) II 점수를 이용한 생존율 분석 -)

  • Kim, Do-Hyeon;Shim, So-Yeon;Kim, Jae-Ri;Shin, Seung-Han;Kim, Eun Sun;Joung, Kyoung-Eun;Kim, Sang Duk;Lee, Jin A;Choi, Chang Won;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong Il;Choi, Jung-Hwan
    • Clinical and Experimental Pediatrics
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    • v.49 no.9
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    • pp.952-958
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    • 2006
  • Purpose : The survival rate of infants weighing less than 1,000 g at birth(extremely low birth weight infants, ELBWI) has increased due to recent advances in perinatal and neonatal intensive care. The purpose of this study was to evaluate the survival rates of ELBWI born at Seoul National University Hospital during the last six years. Methods : A total of 99 infants were divided into three groups(period I: 2000 to 2001, period II: 2002 to 2003, period III : 2004 to 2005) based on date of birth. We compared the survival rate of ELBWI over the three periods, using CRIB II score for adjustment for clinical severity. Results : Overall survival rate of ELBWI was 74.7 percent. The survival rate of ELBWI increased over the three periods(period I: 60.7 percent, period II : 73.3 percent, period III : 85.3 percent). The threshold of viability(defined as survival of at least 50 percent of infants) was 25 weeks of gestation and 600 g at birth. The birth weight-specific survival rates increased considerably over the three periods for infants <750 g at birth(period I: 10 percent, period II: 46.2 percent, period III : 70.6 percent). The survival rates of ELBWI over the three periods increased much remarkably after adjustment for clinical severity by CRIB II score. Conclusion : In our institution, survival rates of ELBWI during the last six years continued to improve, particularly for infants weighing <750 g at birth. This increase in survival rates was not associated with the clinical severity of ELBWI.

Development of Speed Limits Estimation Model and Analysis of Effects in Urban Roads (도시부도로 제한속도 산정모형 개발 및 효과분석 연구)

  • Kang, Soon Yang;Lee, Soo Beom;Lim, Joon Beom
    • Journal of the Korean Society of Safety
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    • v.32 no.2
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    • pp.132-146
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    • 2017
  • Appropriate speed limits at a reasonable level in urban roads are highly important factors for efficient and safe movement. Thus, it is greatly necessary to develop the objective models or methodology based on engineering study considering factors such as traffic accident rates, roadside development levels, and roadway geometry characteristics etc. The purpose of this study is to develop the estimate model of appropriate speed limits at each road sections in urban roads using traffic information big data and field specific data and to review the effects of accident decrease. In this study, the estimate method of appropriate speed limits in directional two or more lanes of urban roads is reflecting features of actual variables in a form of adjustment factor on the basis of the maximum statutory speed limits. As a result of investigating and testing influential variables, the main variables to affect the operating speed are the function of road, the existence of median, the width of lane, the number of traffic entrance/exit path and the number of traffic signal or nonsignal at intersection and crosswalk. As a result of testing this model, when the differences are bigger between the real operating speed and the recommended speed limits using model developed in this study, the accident rate generally turns out to be higher. In case of using the model proposed in this study, it means accident rate can be lower. When the result of this study is applied, the speed limits of directional two or more lane roads in Seoul appears about 11km/h lower than the current speed limits. The decrease of average operating speed caused by the decrease of speed limits is 2.8km/h, and the decrease effect of whole accidents according to the decrease of speed is 18% at research road. In case that accident severity is considered, the accident decrease effects are expected to 17~24% in fatalities, 11~17% in seriously injured road user, 6~9% in slightly injured road user, 5~6% in property damage only accidents.

Evaluating the economic benefit of diverse drought mitigation strategies for Korean reservoir systems based on simulated inflow sequences (유입량 모의 기법을 활용한 국내 다목적댐 가뭄 대책의 경제적 효과 평가)

  • Ji, Sukwang;Shin, Geumchae;Lee, Seungyub;Ahn, Kuk-Hyun
    • Journal of Korea Water Resources Association
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    • v.56 no.8
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    • pp.485-496
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    • 2023
  • Recently, South Korea has been making efforts to mitigate the risk of water scarcity during droughts by utilizing various drought response measures in dam operations. While various studies have been conducted on this topic, there is currently a lack of research on the economic effects of drought response measures. In this study, we evaluated the economic effects of drought response measures on nationwide multipurpose dams by using a long-term simulated inflow model based on ARIMA and Copula and a dam operation model that reflects drought response measures. The results showed that the expected benefits per unit flow rate were highest for coordinated operation and alternative water supply measures, at KRW 1,176 and KRW 1,139, respectively, while the benefits of emergency water supply utilization and water supply adjustment were estimated at KRW 956 and KRW 875, respectively. Additionally, when we examined the changes in the economic benefits of drought response measures based on the assumption of increased drought severity in the future, the changes in the drought risk resulting from reduced inflow increased the economic benefits of all drought response measures. The economic benefits of water supply adjustment increased by 2.6% compared to the baseline, while the economic benefits of coordinated operation and alternative water supply measures increased by 11.7% compared to the baseline. This suggests that dam-network-based measures, such as coordinated operation and alternative water supply measures, are crucial as drought risk increases. This study is expected to serve as a fundamental reference for selecting and utilizing drought response measures in the future.

FOLLOWF-UP STUDY OF THE TIC DISORDERS (틱 장애 환자의 추적 조사)

  • Shin, Zong-Hun;Jung, Chul-Ho;Kim, Hee-Cheol
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.1
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    • pp.68-76
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    • 1996
  • 30 DSM-III or DSM-III-R tic patients were assessed by hospital records and Yale Global Tic Severity Scale to study the common characteristics, clinical course and longterm outcome of tic disorders after 3.1-18.1 years, 73.3% of the patients(treated or untreated) have recovered or partially improved. Identifical precipitating factors were found in 9 patients. Associated disorders were ADHD, sleep disorder, and so on. The outcome according to age of onset, duration of follow-up and diagnoses have no statistically significance. Increased age at follow up was influenced improvement of tic symptoms, though statistically not significant(p=0.327). These results suggest that the outcome of tic disorder is not ominous and they are relatively good social adjustment inspite of carrying the tic symptoms. But this study has some limitations such as retrospective study and sample size. Studies designed prospectively with large sample would be needed to generalize theses results.

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Association of Specific Immunoglobulin E to Staphylococcal Enterotoxin with Airway Hyperresponsiveness in Asthma Patients

  • Kim, Seong Han;Yang, Seo Yeon;You, Jihong;Lee, Sang Bae;You, Jin;Chang, Yoon Soo;Kim, Hyung Jung;Ahn, Chul Min;Byun, Min Kwang;Park, Hye Jung;Park, Jung-Won
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.4
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    • pp.295-301
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    • 2016
  • Background: Specific immunoglobulin E (IgE) sensitization to staphylococcal enterotoxin (SE) has been recently considered to be related to allergic disease, including asthma. Despite studies on specific IgE (sIgE) to SE and its relationship to asthma diagnosis and severity, the association of sIgE to SE with airway hyperresponsiveness (AHR) remains unclear. Methods: We enrolled 81 asthma patients admitted to the Severance Hospital in Korea from March 1, 2013, to February 28, 2015 and retrospectively reviewed the electronic medical records of the enrolled subjects. The serum levels of sIgE to SE (A/B) of all subjects was measured using the ImmunoCAP 250 (Phadia) system with SE-sIgE positive defined as >0.10 kU/mL. Results: The SE-sIgE level was not significantly correlated with asthma severity (forced expiratory volume in 1 second [$FEV_1$], $FEV_1$/forced vital capacity, sputum eosinophils, and serum eosinophils), whereas the SE-sIgE level in patients with positive AHR ($mean{\pm}standard$ error of the mean, $0.606{\pm}0.273kU/mL$) was significantly higher than that in patients with negative AHR ($0.062{\pm}0.015kU/mL$, p=0.034). In regression analysis, SE sensitization (sIgE to SE ${\geq}0.010kU/mL$) was a significant risk factor for AHR, after adjustment for age, sex, $FEV_1$, and sputum eosinophils (odds ratio, 7.090; 95% confidence interval, 1.180-42.600; p=0.032). Prevalence of SE sensitization was higher in patients with allergic rhinitis and non-atopic asthma patients, as compared to patients without allergic rhinitis and atopic asthma patients, respectively, but without statistical significance. Conclusion: SE sensitization is significantly associated with AHR.