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A Study on Regional Variations for Disease-specific Cardiac Arrest (질환성 심정지 발생의 지역별 변이에 관한 연구)

  • Park, Il-Su;Kim, Eun-Ju;Kim, Yoo-Mi;Hong, Sung-Ok;Kim, Young-Taek;Kang, Sung-Hong
    • Journal of Digital Convergence
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    • v.13 no.1
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    • pp.353-366
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    • 2015
  • The purpose of this study was to examine how region-specific characteristics affect the occurrence of cardiac arrest. To analyze, we combined a unique data set including key indicators of health condition and cardiac arrest occurrence at the 244 small administrative districts. Our data came from two main sources in Korea Center For Disease Control and Prevention (KCDC): 2010 Out-of-Hospital Cardiac Arrest Surveillance and Community Health Survey. We analyzed data by using multiple regression, geographically weighted regression and decision tree. Decision tree model is selected as the final model to explain regional variations of cardiac arrest. Factors of regional variations of cardiac arrest occurrence are population density, diagnosis rates of hypertension, stress level, participating screening level, high drinking rate, and smoking rate. Taken as a whole, accounting for geographical variations of health conditions, health behaviors and other socioeconomic factors are important when regionally customized health policy is implemented to decrease the cardiac arrest occurrence.

A Retrospective Review of Tracheobronchial Foreign Bodies (기도 이물의 임상적 고찰)

  • Son, Chang-Young;Wee, Jeong-Ook;Kim, Soo-Ock;Oh, In-Jae;Park, Chang-Min;Kim, Kyu-Sik;Kim, Yu-Il;Lim, Sung-Chul;Lim, Sang-Chul;Kim, Young-Chul;Park, Kyung-Ok
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.6
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    • pp.600-606
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    • 2005
  • Background : The development of bronchoscopic equipment along with the precision of radiographic techniques had reduced the mortality rate of patients with tracheobronchial foreign bodies but has been no change in the incidence of tracheobronchial foreign bodies since their introduction. The aim of this study was to assess the clinical characteristics of a tracheobronchial foreign body aspiration and to evaluate the efficacy of the treatment modality in children and adults. Methods : This is a retrospective review of 64 patients who underwent bronchoscopic procedures for the treatment of aspirated foreign bodies from December 1994 through March 2004 at the Chonnam national university hospital. Results : There were 47 males and 17 females, aged from 1 month to 78 years. Most of the patients had no underlying illness except for one patient with a cerebrovascular accident that contributed to the foreign body aspiration. The most common symptom was cough, which was noted in 54 patients (84.3%). The other presenting symptoms were dyspnea (48.8%), fever (20.3%), sputum (14%), vomiting (7.8%), and chest pain (4.6%). Those whose tracheobronchial foreign bodies were diagnosed more than 2 days after the aspiration (21 patients) were more likely to have pneumonia than those whose foreign bodies were diagnosed within 2 days (p = 0.009). Foreign bodies were visualized in the plain chest radiographs in 12 cases (18.8%), while others showed air trapping (21, 32.8%), pneumonia (15, 23.4%), atelectasis (7, 10.9%), and normal findings (9, 14.1%). The foreign bodies were more frequently found in the right bronchial tree (36) compared with the left bronchial tree (22, p = 0.04). In order to remove the foreign bodies, twenty (31.2%) cases were removed using flexible bronchoscopy, while 42 (65.6%) and 2 (3.2%) cases required rigid bronchoscopy and surgery, respectively. Conclusions : Tracheobronchial Foreign body aspiration had a bimodal age distribution in the infancy and old age around 60 years. They were found more frequently in the right bronchial tree. In addition, patients whose foreign bodies were diagnosed more than 2 days after the aspiration were more likely have a infection. Rigid bronchoscopy is the procedure of choice for uncooperative children and for those with foreign bodies lodged deeply in the small bronchial tree.

Development and Testing of a Machine Learning Model Using 18F-Fluorodeoxyglucose PET/CT-Derived Metabolic Parameters to Classify Human Papillomavirus Status in Oropharyngeal Squamous Carcinoma

  • Changsoo Woo;Kwan Hyeong Jo;Beomseok Sohn;Kisung Park;Hojin Cho;Won Jun Kang;Jinna Kim;Seung-Koo Lee
    • Korean Journal of Radiology
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    • v.24 no.1
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    • pp.51-61
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    • 2023
  • Objective: To develop and test a machine learning model for classifying human papillomavirus (HPV) status of patients with oropharyngeal squamous cell carcinoma (OPSCC) using 18F-fluorodeoxyglucose (18F-FDG) PET-derived parameters in derived parameters and an appropriate combination of machine learning methods in patients with OPSCC. Materials and Methods: This retrospective study enrolled 126 patients (118 male; mean age, 60 years) with newly diagnosed, pathologically confirmed OPSCC, that underwent 18F-FDG PET-computed tomography (CT) between January 2012 and February 2020. Patients were randomly assigned to training and internal validation sets in a 7:3 ratio. An external test set of 19 patients (16 male; mean age, 65.3 years) was recruited sequentially from two other tertiary hospitals. Model 1 used only PET parameters, Model 2 used only clinical features, and Model 3 used both PET and clinical parameters. Multiple feature transforms, feature selection, oversampling, and training models are all investigated. The external test set was used to test the three models that performed best in the internal validation set. The values for area under the receiver operating characteristic curve (AUC) were compared between models. Results: In the external test set, ExtraTrees-based Model 3, which uses two PET-derived parameters and three clinical features, with a combination of MinMaxScaler, mutual information selection, and adaptive synthetic sampling approach, showed the best performance (AUC = 0.78; 95% confidence interval, 0.46-1). Model 3 outperformed Model 1 using PET parameters alone (AUC = 0.48, p = 0.047) and Model 2 using clinical parameters alone (AUC = 0.52, p = 0.142) in predicting HPV status. Conclusion: Using oversampling and mutual information selection, an ExtraTree-based HPV status classifier was developed by combining metabolic parameters derived from 18F-FDG PET/CT and clinical parameters in OPSCC, which exhibited higher performance than the models using either PET or clinical parameters alone.

Clinicoradiologic Characteristics of Intradural Extramedullary Conventional Spinal Ependymoma (경막내 척수외 뇌실막세포종의 임상 영상의학적 특징)

  • Seung Hyun Lee;Yoon Jin Cha;Yong Eun Cho;Mina Park;Bio Joo;Sang Hyun Suh;Sung Jun Ahn
    • Journal of the Korean Society of Radiology
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    • v.84 no.5
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    • pp.1066-1079
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    • 2023
  • Purpose Distinguishing intradural extramedullary (IDEM) spinal ependymoma from myxopapillary ependymoma is challenging due to the location of IDEM spinal ependymoma. This study aimed to investigate the utility of clinical and MR imaging features for differentiating between IDEM spinal and myxopapillary ependymomas. Materials and Methods We compared tumor size, longitudinal/axial location, enhancement degree/pattern, tumor margin, signal intensity (SI) of the tumor on T2-weighted images and T1-weighted image (T1WI), increased cerebrospinal fluid (CSF) SI caudal to the tumor on T1WI, and CSF dissemination of pathologically confirmed 12 IDEM spinal and 10 myxopapillary ependymomas. Furthermore, classification and regression tree (CART) was performed to identify the clinical and MR features for differentiating between IDEM spinal and myxopapillary ependymomas. Results Patients with IDEM spinal ependymomas were older than those with myxopapillary ependymomas (48 years vs. 29.5 years, p < 0.05). A high SI of the tumor on T1W1 was more frequently observed in IDEM spinal ependymomas than in myxopapillary ependymomas (p = 0.02). Conversely, myxopapillary ependymomas show CSF dissemination. Increased CSF SI caudal to the tumor on T1WI was observed more frequently in myxopapillary ependymomas than in IDEM spinal ependymomas (p < 0.05). Dissemination to the CSF space and increased CSF SI caudal to the tumor on T1WI were the most important variables in CART analysis. Conclusion Clinical and radiological variables may help differentiate between IDEM spinal and myxopapillary ependymomas.

A Study on the Changes in Forest Laws and System of Forest Specialists (산림법제도의 변천과 산림전문가 양성의 체계에 관한 연구)

  • Youn, Jong-Myoun;Kim, Dong-Pil;Kim, Yeong-Ha
    • Journal of the Korean Institute of Landscape Architecture
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    • v.49 no.6
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    • pp.1-15
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    • 2021
  • This study considered Forest Specialists, who are nurtured by the legal system through the analysis of laws and regulations under the jurisdiction of the Korea Forest Service. In particular, the transition process of forest-related laws and laws to train forest specialists were identified. In addition, changes and characteristics regarding the cultivation of professional forestry talents according to forestry policy were investigated. As a result, it was found that Forest Specialist on policy dealt with forestry success for forestry promotion, and forestry engineers dealt with technical skills for forestry industry development. In addition, according to the revision of the laws for the sustainable use of timber, wood-structural engineers, timber grade evaluators, and timber education specialists are trained separately. Forest Specialists concerned with forest welfare policies were found to train forest experts and complete specialized training courses to provide various services for forest cultural and recreation facilities, healing forests, and forest leisure sports facilities. There is an instructor for forest leisure sports. Forest welfare experts are divided into forest education experts and forest healing instructors; forest education specialists are further divided into forest interpreters, forest guides for children, and forest trekking guides. Forest Specialists on forest protection policy were found to train arboretum and garden experts for the efficient management and exhibition of arboretums. Gardens and tree doctors and tree treatment technicians for arboretums wer also trained. A tree doctor and a tree treatment technician were found to have the necessary qualifications to run a tree hospital business, diagnosing and treating tree damage. Therefore, it is thought that the Korea Forest Service is nurturing Forest Specialists with technical capabilities for forestry promotion, forest industry development, and tree treatment; and the Forest Specialists can provide education and welfare services at culture, recreation, treatment, and conservation sites in forests.

Cost-Effectiveness Analysis of Different Management Strategies for Detection CIN2+ of Women with Atypical Squamous Cells of Undetermined Significance (ASC-US) Pap Smear in Thailand

  • Tantitamit, Tanitra;Termrungruanglert, Wichai;Oranratanaphan, Shina;Niruthisard, Somchai;Tanbirojn, Patuou;Havanond, Piyalamporn
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.6857-6862
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    • 2015
  • Background: To identify the optimal cost effective strategy for the management of women having ASC-US who attended at King Chulalongkorn Memorial Hospital (KMCH). Design: An Economical Analysis based on a retrospective study. Subject: The women who were referred to the gynecological department due to screening result of ASC-US at King Chulalongkorn Memorial Hospital, a general and tertiary referral center in Bangkok Thailand, from Jan 2008 - Dec 2012. Materials and Methods: A decision tree-based was constructed to evaluate the cost effectiveness of three follow up strategies in the management of ASC-US results: repeat cytology, triage with HPV testing and immediate colposcopy. Each ASC-US woman made the decision of each strategy after receiving all details about this algorithm, advantages and disadvantages of each strategy from a doctor. The model compared the incremental costs per case of high-grade cervical intraepithelial neoplasia (CIN2+) detected as measured by incremental cost-effectiveness ratio (ICER). Results: From the provider's perspective, immediate colposcopy is the least costly strategy and also the most effective option among the three follow up strategies. Compared with HPV triage, repeat cytology triage is less costly than HPV triage, whereas the latter provides a more effective option at an incremental cost-effectiveness ratio (ICER) of 56,048 Baht per additional case of CIN 2+ detected. From the patient's perspective, the least costly and least effective is repeat cytology triage. Repeat colposcopy has an incremental cost-effectiveness (ICER) of 2,500 Baht per additional case of CIN2+ detected when compared to colposcopy. From the sensitivity analysis, immediate colposcopy triage is no longer cost effective when the cost exceeds 2,250 Baht or the cost of cytology is less than 50 Baht (1USD = 31.58 THB). Conclusions: In women with ASC-US cytology, colposcopy is more cost-effective than repeat cytology or triage with HPV testing for both provider and patient perspectives.

A research on the key factors for classification of diabetes based on random forest

  • Shin, Yong sub;Lee, Namju;Hwang, Chigon
    • International Journal of Internet, Broadcasting and Communication
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    • v.12 no.3
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    • pp.102-107
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    • 2020
  • Recently, the number of people visiting the hospital is increasing due to diabetes. According to the Korean Diabetes Association, statistically, 1 in 7 adults over the age of 30 are suffering from diabetes. As such, diabetes is one of the most common diseases among modern people. In this paper, in addition to blood sugar, which is widely used for diabetes awareness, BMI, which is known to be related to diabetes, triglycerides and cholesterol that cause various complications in diabetics it was studied using random forest techniques and decision trees known to be effective for classification. The importance of each element was confirmed using the results and characteristic importance derived using two techniques. Through this, we studied the diabetes-related relationship between BMI, triglyceride, and cholesterol as well as blood sugar, a factor that diabetic patients should pay much attention to.

Analysis of Lipids in Deciduous Teeth by Matrix-Assisted Laser Desorption/Ionization Mass Spectrometry (MALDI MS)

  • Lee, Yujin;Seo, Eunji;Park, Tae-Min;Bae, Kwang-Hak;Cha, Sangwon
    • Mass Spectrometry Letters
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    • v.8 no.4
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    • pp.105-108
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    • 2017
  • Recently, deciduous teeth have been proposed as a promising biomatrix for estimating internal and external chemical exposures of an individual from prenatal periods to early childhood. Therefore, detection of organic chemicals in teeth has received increasing attention. Organic materials in tooth matrix are mostly collagen type proteins, but lipids and other small organic chemicals are also present in the tooth matrix. In this study, matrix-assisted laser desorption/ionization (MALDI) mass spectrometry (MS) was employed to obtain lipid fingerprints from deciduous teeth. Phospholipids and triacylglcerols (TAGs) from deciduous teeth were successfully detected by MALDI MS with 2,5-dihydroxybenzoic acid (DHB) or gold nanoparticle (AuNP) as a matrix.

A clinical pathogenetic study of broncholithiasis (기관지 결석증의 임상적 연구)

  • 김주현
    • Journal of Chest Surgery
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    • v.19 no.2
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    • pp.259-264
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    • 1986
  • Broncholithiasis is defined as a cor9ition in which a concretion is present within a bronchus or a cavity in the lung communicating with a bronchus. The usual causes of broncholithiasis are known as tuberculosis, histoplasmosis, silicosis, aspirated calculi, and a few fungal infections. It is generally accepted that the constant motion created by respiration and beating of the heart may cause the peribronchial calcified lymph node to erode into the tracheobronchial tree and to form broncholith. After the analysis of our 6 cases of broncholithiasis which were treated surgically in the Department of Thoracic Surgery, Seoul National University Hospital from 1960 to December, 1985, we could suggest that intrinsic formation of calculi should be regarded as the pathogenesis of broncholithiasis in addition to the extrinsic formation of calculi.

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Clinical study of Pulmonary Sequestration (폐격리증에 대한 임상적 고찰)

  • Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.320-326
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    • 1985
  • Pulmonary sequestration occurs when some disturbance produces a cystic mass of nonfunctioning lung tissue which lacks normal communication with the tracheobronchial tree. Between 1971 and 1985, pulmonary sequestration was diagnosed in 11 patients, ranging age from 3 to 29 years. All sequestration were intralobar type. Definitive diagnosis can only be obtained by aortography and/or surgical exploration in 10 cases. The other one was confirmed by pathologic examination postoperatively. The presenting complaints were mostly recurrent local pulmonary infection, but in 2 cases mediastinal mass with respiratory symptoms was presented, and cardiac murmur was only finding in one case. Preoperative diagnostic procedure revealed 3 associated anomalies which were funnel chest, right aortic arch, and pulmonic stenosis with vascular ring. Operative treatment for sequestration was lobectomy in 10 cases, and a segmentectomy in one. There was no operative mortality, but 3 complications [empyema, B-P fistula, post-op bleeding] which were controlled by subsequent operations or conservative measure. Aortography is strongly advocated not only for its diagnostic value, but for its preoperative localization of the aberrant vessels that are the major concern to the surgeon.

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