• Title/Summary/Keyword: appendicitis

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Length-of-Stay Prediction Model of Appendicitis using Artificial Neural Networks and Decision Tree (신경망과 의사결정 나무를 이용한 충수돌기염 환자의 재원일수 예측모형 개발)

  • Chung, Suk-Hoon;Han, Woo-Sok;Suh, Yong-Moo;Rhee, Hyun-SiIl
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.6
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    • pp.1424-1432
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    • 2009
  • For the efficient management of hospital sickbeds, it is important to predict the length of stay (LoS) of appendicitis patients. This study analyzed the patient data to find factors that show high positive correlation with LoS, build LoS prediction models using neural network and decision tree models, and compare their performance. In order to increase the prediction accuracy, we applied the ensemble techniques such as bagging and boosting. Experimental results show that decision tree model which was built with less number of variables shows prediction accuracy almost equal to that of neural network model, and that bagging is better than boosting. In conclusion, since the decision tree model which provides better explanation than neural network model can well predict the LoS of appendicitis patients and can also be used to select the input variables, it is recommended that hospitals make use of the decision tree techniques more actively.

A Comparison of Medical Care Services by Type of Medical Care Facility -In cases of normal spontaneous vaginal delivery and acute appendicitis- (의료기관 종류별 진료내역 비교 -정상분만과 급성 충수염을 중심으로-)

  • Lee, Young-Doo
    • Journal of Preventive Medicine and Public Health
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    • v.18 no.1
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    • pp.41-50
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    • 1985
  • To find out the differences in medical practice according to the environment of patient care and managerial situation of the medical care institutions, normal spontaneous vaginal delivery and acute appendicitis were selected, which is suitable for comparison because of their high comparability. A total of 473 cases of normal spontaneous vaginal delivery and 408 cases of acute appendicitis was sampled from the claims to Korea Medical Insurance Cooperations during January to June 1984. Complicated cases were excluded from population and sampling was restricted from 40 to 60 percentile for total charges by the type of medical care facility in order to rule out the influence originating from case mix. Important items representing type and quantity of medical care service were compared by type of facility. Major findings are as follows : 1. University hospital shows the highest in charges per case and decrease in order of general hospital, and clinic. 2. In case of normal spontaneous vaginal delivery, average length of stay shows statistically significant difference by type of facility. 3. Charge amount for each service item affected by practice pattern shows statistically significant difference mostly by type of facility. It is suggested that medical practice pattern is different by type of facility for medical services. 4. Difference in total medical expenditure by type of facility is affected more with charges for materials, consumables and drugs than with fee for service activity. 5. In administering drugs to patients, hospital and clinic show higher injection rate than university and general hospital. 6. Clinical Laboratory tests were common in order of uninalysis, hemoglobin, hematocrit, white blood cell count, urine microscopic examination in cases of normal spontaneous vaginal delivery; white blood cell count, urinalysis, hemoglobin, hematocrit, urine microscopic examination, white blood cell differential count, in cases of acute appendicitis. 7. The result for Laboratory test and Radiologic study shows extreme difference by type of facility. Test rate is lowest in clinic and increase hospital, general hospital, and university hospital in order, both in type and frequency.

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Imaging Findings of Gastrointestinal Emergency in Infants and Young Children (영유아 환자 위장관 응급 질환의 영상 소견)

  • Ji Young Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.794-805
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    • 2020
  • Acute abdomen is a condition with sudden abdominal pain that may require immediate surgical treatment. The causes of acute abdomen in pediatric patients are diverse, and can be categorized in broad range from diseases requiring surgery to diseases requiring medication or clinical observation only. The role of the imaging study in children with acute abdomen is to distinguish between patients who need medication and patients who need surgery by identifying diseases that cause abdominal pain, if possible. Since intussusception and appendicitis are the leading causes of acute abdomen requiring surgical treatment in children, it is important to exclude intussusception in young infants complaining of acute abdominal pain and exclude acute appendicitis in older children with acute abdomen. In this paper, we introduce intussusception, acute appendicitis, midgut volvulus, Meckel's diverticulum and duplication cyst, which has characteristic imaging finding of the disease that can cause acute abdomen in pediatric patients.

Analysis of charges per case by hospital characteristics - In regard to acute appendicitis and NSVD - (병원 특성에 따른 건당 진료비 분석 - 급성충수염과 정상분만을 대상으로 -)

  • Jung, Sang-Hyuk;Yu, Seung-Hum;Kim, Han-Joong
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.2 s.30
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    • pp.216-223
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    • 1990
  • To identify the factors influencing the charges per case of acute appendicitis and normal spontaneous vaginal delivery (NSVD), the personal data-base files and hospital-characteristics-reporting data files of Korea Medical Insurance Corporation were analyzed. One hundred and twenty-nine institutions were selected. The results of this study were as follows 1. The differences of charges per case with respect to hospital ownership, location, and equipment levels were statistically significant. 2. The results of multiple regression analysis revealed that bed capacity was the most significant variable in both diseases. 3. Ownership was significant variable in acute appendicitis. In NSVD, ownership and hospital equipment level were statistically significant. In conclusion, bed capacity was statistically the most significant variable in the analysis of charages per case. And we thought that the results of this study would influence the policy of the hospital bed supply.

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Septic encephalopathy: Atypical clinical manifestations of Appendicitis (패혈성 뇌증 : 급성 충수염의 비정형적인 임상양상)

  • Lee, Soo Young;Seung, So Jin;Kwak, Ga Young;Hwang, Hui Sung;Chung, Seung Yun;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.15 no.1
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    • pp.68-71
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    • 2008
  • Septic encephalopathy is defined as brain dysfunction secondary to sepsis. It occurs in septic patients as a manifestation of multi-organ dysfunction. Without evidence of intracranial infection, various extracranial infections causing severe sepsis may induce septic encephalopathy. We report a patient with septic encephalopathy complicating acute appendicitis. Initially, the patient presented with impaired mental state and raised liver enzymes.

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A Case of the Diarrhea-associated Hemolytic Uremic Syndrome Developing Simultaneously with an Acute Appendicitis (급성충수염과 동시에 발생한 설사 연관형 용혈성 요독 증후군 1례)

  • Oh Ji-Eun;Chang Ji-Yeon;Jung Kyeong-Hun;Kim Soon-Ki;Hong Young-Jin;Son Byong-Kwan;Lee Ji-Eun
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.77-81
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    • 2003
  • Diarrhea-associated hemolytic uremic syndrome is rarely accompanied by complications requiring surgical intervention. We report a case of the diarrhea-associated hemolytic uremic sydrome which developed simultaneously with an acute appendicitis.

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Down the Rabbit Hole-Considerations for Ingested Foreign Bodies

  • Brown, Jerry;Kidder, Molly;Fabbrini, Abigail;deVries, Jonathan;Robertson, Jason;Chandler, Nicole;Wilsey, Michael
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.6
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    • pp.619-623
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    • 2019
  • We report the case of a seven-year-old boy with an ingested foreign body, which was retained within the appendix for a known duration of ten months, ultimately requiring appendectomy. The ingested foreign body was incidentally discovered by abdominal x-ray at an emergency room visit for constipation. Despite four bowel cleanouts, subsequent x-rays showed persistence of the foreign body in the right lower quadrant. While the patient did not have signs or symptoms of acute appendicitis, laparoscopic appendectomy was performed due to the risk of this foreign body causing appendicitis in the future. A small metallic object was found within the appendix upon removal. This case highlights the unique challenge presented by foreign body ingestions in non-verbal or developmentally challenged children and the importance of further diagnostic workup when concerns arise for potential retained foreign bodies.

Ileocolic Intussusception Accompanied with Inflamed Appendix: 2 Case Reports (염증성 충수돌기를 동반한 회결장 장중첩증: 2예 보고)

  • Hyung Ju Lee;Sook Min Hwang;Young Joo Won;Ji Young Woo;Kon Hee Lee;Min Eui Hong
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.708-714
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    • 2021
  • Intussusception and acute appendicitis are common emergency conditions in children. They should be promptly differentiated in pediatric patients presenting with suggestive symptoms. However, both diseases may occur simultaneously. Herein, we present two cases of intussusception of the appendix accompanied with appendicitis.

Acute Appendicitis: A Rare But Probable Manifestation of Kawasaki Disease

  • Wonshik Choi;Sin Weon Yun;Mineui Hong;Suk-Won Suh;Dae Yong Yi;Ji Young Park
    • Pediatric Infection and Vaccine
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    • v.30 no.2
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    • pp.97-103
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    • 2023
  • Kawasaki disease (KD) is an acute, systemic inflammatory disorder that often targets coronary arteries. Being the common cause of acquired heart disease in children, timely diagnosis and intravenous immunoglobulin treatment are crucial. However, it is challenging for physicians to diagnose KD if it presents with atypical manifestations. We report the case of a 5-year-old boy who initially presented with appendicitis; after an appendectomy, he had a prolonged fever. He was finally diagnosed with atypical KD and successfully recovered after intravenous immunoglobulin treatment. Through a literature review, we found 21 cases of appendicitis associated with KD. In most cases, the patients were male with a mean age of 5.3 years. Most had higher proportions of incomplete KD and coronary artery complications than expected for typical KD. In conclusion, appendicitis could be a rare complication of KD; therefore, multidisciplinary cooperation and early recognition of atypical KD are essential for timely diagnosis.

Appendiceal Visualization on 2-mSv CT vs. Conventional-Dose CT in Adolescents and Young Adults with Suspected Appendicitis: An Analysis of Large Pragmatic Randomized Trial Data

  • Jungheum Cho;Youngjune Kim;Seungjae Lee;Hooney Daniel Min;Yousun Ko;Choong Guen Chee;Hae Young Kim;Ji Hoon Park;Kyoung Ho Lee;LOCAT Group
    • Korean Journal of Radiology
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    • v.23 no.4
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    • pp.413-425
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    • 2022
  • Objective: We compared appendiceal visualization on 2-mSv CT vs. conventional-dose CT (median 7 mSv) in adolescents and young adults and analyzed the undesirable clinical and diagnostic outcomes that followed appendiceal nonvisualization. Materials and Methods: A total of 3074 patients aged 15-44 years (mean ± standard deviation, 28 ± 9 years; 1672 female) from 20 hospitals were randomized to the 2-mSv CT or conventional-dose CT group (1535 vs. 1539) from December 2013 through August 2016. A total of 161 radiologists from 20 institutions prospectively rated appendiceal visualization (grade 0, not identified; grade 1, unsure or partly visualized; and grade 2, clearly and entirely visualized) and the presence of appendicitis in these patients. The final diagnosis was based on CT imaging and surgical, pathologic, and clinical findings. We analyzed undesirable clinical or diagnostic outcomes, such as negative appendectomy, perforated appendicitis, more extensive than simple appendectomy, delay in patient management, or incorrect CT diagnosis, which followed appendiceal nonvisualization (defined as grade 0 or 1) and compared the outcomes between the two groups. Results: In the 2-mSv CT and conventional-dose CT groups, appendiceal visualization was rated as grade 0 in 41 (2.7%) and 18 (1.2%) patients, respectively; grade 1 in 181 (11.8%) and 81 (5.3%) patients, respectively; and grade 2 in 1304 (85.0%) and 1421 (92.3%) patients, respectively (p < 0.001). Overall, undesirable outcomes were rare in both groups. Compared to the conventional-dose CT group, the 2-mSv CT group had slightly higher rates of perforated appendicitis (1.1% [17] vs. 0.5% [7], p = 0.06) and false-negative diagnoses (0.4% [6] vs. 0.0% [0], p = 0.01) following appendiceal nonvisualization. Otherwise, these two groups were comparable. Conclusion: The use of 2-mSv CT instead of conventional-dose CT impairs appendiceal visualization in more patients. However, appendiceal nonvisualization on 2-mSv CT rarely leads to undesirable clinical or diagnostic outcomes.