• Title/Summary/Keyword: diagnoses

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A Validity Study for Linkage of Nursing diagnosis and Nursing Interventions Classification (NANDA간호진단과 간호중재분류(NIC)의 연계에 관한 타당성 연구)

  • Park, Sung-Ae;Park, Jung-Ho;Jung, Myun-Suk;Joo, Mi-Kyoung;Kim, Bog-Ja;Lee, Eun-Suk;Park, Sung-Hee;Yoo, Mi
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.315-347
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    • 2001
  • The purpose of this study was to validate the linkage of nursing diagnosis(NANDA) and Nursing Interventions Classification(NIC) for implementing the Nursing Diagnosis and Nursing interventions in Korea. 36 nurse experts with over the bacculate degree and over 15 years experiences working in tertiary hospitals participated in this study. 5 point Likert scales on each NIC linked 136 NANDA diagnoses were adopted. The results were as follows: 1. In a validity of linkage of nursing diagnosis and nursing interventions classification, the highest score is in 'Chronic low self esteem'(4.66), the lowest score is in 'sensory/Perceptual alterations; Auditory'(3.34) and the average validity score of the total items is 4.27. 2. There was significant differences by educational level and experience in validity score. 3. The nurses who have master degree have higher score than bachelor degree in the diagnoses; 'fatigue', 'health seeking behaviors', 'nutrition: potential for more than body requirements, altered', 'powerlessness'. 4. The nurses with experience over 20 years have higher validity score than less 15 years in 'breast-feeding, effective'. In conclusion, this research indicates that the linkage of NANDA diagnoses and NIC with high validity score can be applied to nursing practice in Korea. And further studies of nursing intervention are needed in Korean culture.

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FUZZY LOGIC KNOWLEDGE SYSTEMS AND ARTIFICIAL NEURAL NETWORKS IN MEDICINE AND BIOLOGY

  • Sanchez, Elie
    • Journal of the Korean Institute of Intelligent Systems
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    • v.1 no.1
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    • pp.9-25
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    • 1991
  • This tutorial paper has been written for biologists, physicians or beginners in fuzzy sets theory and applications. This field is introduced in the framework of medical diagnosis problems. The paper describes and illustrates with practical examples, a general methodology of special interest in the processing of borderline cases, that allows a graded assignment of diagnoses to patients. A pattern of medical knowledge consists of a tableau with linguistic entries or of fuzzy propositions. Relationships between symptoms and diagnoses are interpreted as labels of fuzzy sets. It is shown how possibility measures (soft matching) can be used and combined to derive diagnoses after measurements on collected data. The concepts and methods are illustrated in a biomedical application on inflammatory protein variations. In the case of poor diagnostic classifications, it is introduced appropriate ponderations, acting on the characterizations of proteins, in order to decrease their relative influence. As a consequence, when pattern matching is achieved, the final ranking of inflammatory syndromes assigned to a given patient might change to better fit the actual classification. Defuzzification of results (i.e. diagnostic groups assigned to patients) is performed as a non fuzzy sets partition issued from a "separating power", and not as the center of gravity method commonly employed in fuzzy control. It is then introduced a model of fuzzy connectionist expert system, in which an artificial neural network is designed to build the knowledge base of an expert system, from training examples (this model can also be used for specifications of rules in fuzzy logic control). Two types of weights are associated with the connections: primary linguistic weights, interpreted as labels of fuzzy sets, and secondary numerical weights. Cell activation is computed through MIN-MAX fuzzy equations of the weights. Learning consists in finding the (numerical) weights and the network topology. This feed forward network is described and illustrated in the same biomedical domain as in the first part.

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The Diagnostic Accuracy of Endoscopic Biopsy for Gastric Dysplasia

  • Lee, Sung-Bae;Kang, Hye-Yun;Kim, Kwang-Il;Ahn, Dae-Ho
    • Journal of Gastric Cancer
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    • v.10 no.4
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    • pp.175-181
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    • 2010
  • Purpose: There is controversy over the treatment for low grade dysplasia, while resection is recommended for high grade dysplasia. But the concordance of the grade of dysplasia between pre- and post-resection is low because of sampling errors with endoscopic biopsy. We attempted to establish a clearer direction for the treatment of dysplasia by clarifying the discrepancy between the pre- and postresection diagnoses. Materials and Methods: We performed a retrospective review of 126 patients who had undergone resection with the diagnosis of dysplasia on biopsy at Bundang CHA Hospital from 1999 to 2009. Results: Seventy patients were diagnosed with low grade dysplasia and 56 patients were diagnosed with high grade dysplasia. Among the 33 patients who received gastrectomy with lymph node dissec-tion, 30 patients were revealed to have invasive cancers and 4 patients showed lymph node metastasis. Discordance between the diagnoses from biopsy and resection occurred in 55 patients (44%). There was no correlation on the comparative analysis between the size, location or gross type of lesion and the grade of dysplasia. Conclusions: The rate of discordance between the diagnoses of endoscopic biopsy and the post resection pathologic report was as high as 44%. Endoscopic mucosal resection was not sufficient for some patients who were diagnosed with dysplasia on biopsy due to the presence of lymph node metastasis. It is necessary to be prudent when determining the follow-up and treatment based solely on the result of the biopsy.

A Study on the Change of Occlusal Contacts and Lateral Cephalometric Variables after Stabilization Splint Therapy in Temporomandibular Disorders Patients

  • Na, Hyojung;Lee, Jeong-Yun
    • Journal of Oral Medicine and Pain
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    • v.40 no.1
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    • pp.28-34
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    • 2015
  • Purpose: The aim of this study is to assess the relationship between possible occlusal change after stabilization splint therapy and the research diagnostic criteria for temporomandibular disorders (RDC/TMD) Axis I diagnoses and lateral cephalometric variables. Methods: Clinical and radiographic records of 47 TMD patients wearing stablization splint were reviewed. The number of occluding teeth was recorded and lateral cephalogram was taken at pre-treatment and 6-month post-treatment. They were divided into two groups. The control group consists of patients with the unchanged number of occluding teeth throughout 6-month splint therapy (19 females and 4 males), and occlusal-loss group with the number of occluding teeth decreased (19 females and 5 males). The difference of RDC/TMD diagnoses and cephalometric variables were compared between two groups. Results: In the control group, RDC group I, muscle disorders, was 39.1% (9/23), group II, disc displacements, was 17.4% (4/23), group III OA, osteoarthritis/osteoarthrosis, was 73.9% (17/23), and group III pain, arthralgia, was 82.6% (19/23). In the occlusal-loss group, group I was 41.7% (10/24), group II was 41.7% (10/24), group III OA was 70.8% (17/24), and group III pain was 83.3% (20/24). The frequency of RDC groups was not different between two groups, analyzed by binomial logistic regression. Pre-treatment cephalometric variables were not different between two groups. However, articular angle, AB to mandibular plane and ODI decreased and gonial angle increased significantly in the occlusal-loss group, implying clockwise rotation of the mandible, between pre-treatment and 6-month post-treatment, while none of cephalometric variables showed any statistical difference in the control group. Conclusions: Change in the number of occluding teeth was not related to the RDC/TMD diagnoses. Cephalometric values changed only in the occlusal-loss group as a result of mandibular clockwise rotation. None of cephalometric variables before the stabilization splint therapy was statistically different between the control and occlusal loss group.

Study on the Development of Home Care Nursing Intervention Protocol for Stroke Patients (뇌졸중 환자의 가정간호중재 프로토콜 개발)

  • Yoo Ji-Soo
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.1
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    • pp.122-136
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    • 2000
  • Stroke patient needs rehabilitation after receiving an acute treatment in a hospital. When stroke patient gets involved in an early discharge program, home care nurse plays a pivotal role to make them to gain a full strength and to come back to his/her prior life before he/she is sick. In spite of the importance of home care nursing intervention protocol for home care nurses to perform home care nursing autonomously, home care nursing intervention protocol for stroke patient is rarely developed. Therefore this study was conducted to develop home care nursing protocol that is applicable for stroke patients in home care nursing area. 41 home care nursing charts for stroke patients registered in home care nursing agencies from December 1st 1994 to August 31st 1999 at Y hospitals in Seoul and Won-Ju city were analyzed. 44 home care nurses who were having over three years' experience on stroke patients were participated in this study as a user validity validation group. The results of this study are as follows. 1. 28 nursing diagnoses were selected on the basis of evaluation of nursing diagnoses of stroke patients presented in a previous literature and case studies on home care nursing. 2. 17 nursing diagnoses were classified through the frequency analysis of home care nursing charts for 41 stroke patients who had received home care nursing. The order of sequence was like these: impaired skin integrity, risk for infection, nutritional deficit, impaired physical mobility, constipation, knowledge deficit, ineffective airway clearance, anxiety in family members, risk for aspiration, self care deficit, altered urinary elimination, ineffective individual coping, social isolation, risk for injury, self-esteem disturbance, impaired verbal communication, fatigue of family caregiver. 3. Based on validation on expert and user validities, 44 nursing interventions which were above ICV=.80 were chosen. 4. Nursing intervention protocols which showed above ICV=.90 were developed and were like these; pressure ulcer care, position change, preventive care for circulatory dysfunction, tube care : catheter, vital sign monitor, constipation/impaction management, artificial airway management, suction of airway secretion, environmental management : safety, and fall prevention.

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Fine Needle Aspiration Cytology of Palpable Lymph Nodes -A Single Institutional Experience of 1,346 Cases- (촉지 림프절의 세침흡인 세포검사 - 단일 기관의 1,346예 경험 -)

  • Shin, Dong-Hoon;Kim, Jee-Yeon;Kang, Hyun-Jeong;Kim, Ick-Doo;Sol, Mee-Young;Choi, Kyung-Un
    • The Korean Journal of Cytopathology
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    • v.18 no.2
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    • pp.126-132
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    • 2007
  • The aim of this study was to evaluate the diagnostic value of fine needle aspiration cytology (FNAC) for the assessment of palpable enlarged lymph nodes. The authors reviewed the results of 1,346 FNACs of palpable enlarged lymph nodes performed at Pusan National University Hospital from 1998 to 2004. Of the 1,346 cases, 1,265 (94.0%) were satisfactory and 81 (6.0%) unsatisfactory. Cytologic diagnoses were judged in 488 cases, based on subsequent histologic diagnoses, clinical follow up, or both. Global results for all malignancies (lymphoid and non-lymphoid neoplasms) based on cases with final diagnoses, showed a sensitivity of 87.4% and a specificity of 98.7%. The overall diagnostic accuracy was 93,2%, and the false negative rate reduced from 12,6% to 7,3% when lymphomatous cases were excluded. The annual data for this period showed that the number of diagnostic lymph node biopsies and the rate of inadequately sampled material markedly decreased. Gene rearrangement studies for IgH and TCR ${\gamma}$ were helful in 30 cases. FNAC is a useful initial diagnostic procedure for the evaluation of palpable enlarged lymph nodes. However, the technique should be assisted by the appropriate ancillary studies and by proper interpretation by a cytopathologist.

Second Opinion Diagnoses of Cytologic Specimens on Consultation : Asan Medical Center Experience (세포 병리 자문 재판독의 진단 불일치에 관한 연구: 서울아산병원의 경험)

  • Park, So-Hyung;Ro, Jae-Y.;Cho, Kyung-Ja;Gong, Gyung-Yub;Cho, Yong-Mee;Khang, Shin-Kwang
    • The Korean Journal of Cytopathology
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    • v.19 no.2
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    • pp.99-106
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    • 2008
  • Background : Second opinion diagnosis of outside pathology slides is a common practice for efficient and proper patient management. We analyzed cytology slides from outside hospitals submitted for a second opinion diagnosis to determine whether the second opinion diagnosis had any influence on patient care. Methods : We reviewed 1,153 outside cytology slides referred to Asan Medical Center for second opinions from January, 2007, to December, 2007. All cases were categorized into three groups; no diagnostic discrepancy, minor diagnostic discrepancies (no impact on the management), and major diagnostic discrepancies (significant impact on the management and subsequent follow-up). Results : The thyroid was the most common organ system (933 cases, 80.9%), Forty cases (3.6%) belonged to the major diagnostic discrepancy group and 149 cases (12.8%) to the minor discrepancy group. For validation of second opinion diagnoses in major discrepancy cases, subsequent biopsy or surgical resection specimens and clinical information were reviewed, which were available in 29 cases. The second opinion diagnoses resulted in alteration of clinical management in 21 of 29 cases. Conclusion : For all referred patients, second opinion diagnosis is important and mandatory for appropriate patient care.

A Deep Learning Part-diagnosis Platform(DLPP) based on an In-vehicle On-board gateway for an Autonomous Vehicle

  • Kim, KyungDeuk;Son, SuRak;Jeong, YiNa;Lee, ByungKwan
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.13 no.8
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    • pp.4123-4141
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    • 2019
  • Autonomous driving technology is divided into 0~5 levels. Of these, Level 5 is a fully autonomous vehicle that does not require a person to drive at all. The automobile industry has been trying to develop Level 5 to satisfy safety, but commercialization has not yet been achieved. In order to commercialize autonomous unmanned vehicles, there are several problems to be solved for driving safety. To solve one of these, this paper proposes 'A Deep Learning Part-diagnosis Platform(DLPP) based on an In-vehicle On-board gateway for an Autonomous Vehicle' that diagnoses not only the parts of a vehicle and the sensors belonging to the parts, but also the influence upon other parts when a certain fault happens. The DLPP consists of an In-vehicle On-board gateway(IOG) and a Part Self-diagnosis Module(PSM). Though an existing vehicle gateway was used for the translation of messages happening in a vehicle, the IOG not only has the translation function of an existing gateway but also judges whether a fault happened in a sensor or parts by using a Loopback. The payloads which are used to judge a sensor as normal in the IOG is transferred to the PSM for self-diagnosis. The Part Self-diagnosis Module(PSM) diagnoses parts itself by using the payloads transferred from the IOG. Because the PSM is designed based on an LSTM algorithm, it diagnoses a vehicle's fault by considering the correlation between previous diagnosis result and current measured parts data.

Differences in Psychopathology between Offspring of Parents with Bipolar I Disorder and Those with Bipolar II Disorder: A Cross-Sectional Study

  • Lee, Hyeon-Ah;Kim, Ji-Sun;Lee, Yeon-Jung;Heo, Nam-Hun;Shim, Se-Hoon;Kwon, Young-Joon
    • Psychiatry investigation
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    • v.15 no.12
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    • pp.1135-1143
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    • 2018
  • Objective The aim of this study was to evaluate differences in psychopathology between offspring of parents with bipolar I disorder (BP-I) and those with bipolar II disorder (BP-II). Methods The sample included 201 offspring between 6 and 17 years of age who had at least one parent with BP-I or BP-II. The offspring were diagnostically evaluated using the Korean Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. Psychopathology and Clinical characteristics were evaluated, including lifetime DSM-5 diagnoses, depression, and childhood trauma. Lifetime DSM-5 diagnoses were also compared between schoolchildren aged 6 to 11 years and adolescents aged 12 to 17 years. Results In lifetime DSM-5 diagnoses, offspring of parents with BP-I had significantly increased risk of developing MDD and BP-I than those with BP-II. Regarding clinical characteristics, ADHD rating scale and childhood trauma scale were significantly higher in offspring of parents with BP-I than that in those with BP-II. Conclusion The present study supports that BP-I may be etiologically distinct from BP-II by a possible genetic liability. Our findings indicate that additional research related to bipolar offspring is needed to enhance understanding of differences between BP-I and BP-II.

Association between the Use of Humidifier Disinfectants and Bronchiolitis and Allergic Rhinitis Diagnoses in Korean Children (가습기살균제 사용과 모세기관지염 및 알레르기성 비염 진단과의 관계에 관한 연구)

  • Cho, Jun Ho
    • Journal of Environmental Health Sciences
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    • v.45 no.4
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    • pp.381-393
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    • 2019
  • Objectives: The purpose of this study was to assess the association between the use of humidifier disinfectant (HD) and bronchiolitis and allergic rhinitis diagnoses in Korean children. Methods: This study used data from the $8^{th}$ panel study on Korean children in 2015. Of these 2150 cases, 1598 cases were used for the final study. Diagnoses of bronchiolitis and allergic rhinitis by medical doctors were self-reported as outcome variables. Whether children had used HDs or not, the periods of using HDs were used as independent variables. Results: A total of 77.0% had used a humidifier, and the rate of HD usage among humidifier users was found to be 35.4%. When comparing 'children who had used HDs for less than 12 months' and 'children who had used HDs for more than 12 months' with 'children who had not used HDs', the adjusted odds ratio (OR)s for 'bronchiolitis' were 1.38 (95% confidence interval (CI), 1.36-1.40) and 1.80 (95% CI, 1.71-1.89), respectively. When comparing 'children who had used HDs for less than 12 months' and 'children who had used HDs for more than 12 months' with 'children who had not used HDs', the adjusted ORs for 'allergic rhinitis' were 1.44 (95% CI, 1.42-1.46) and 1.43 (95% CI, 1.37-1.49), respectively. Conclusions: The period of using HDs was statistically significantly associated with increased odds of bronchiolitis and allergic rhinitis. The results of this study will provide a very useful scientific basis for establishing the environmental health policy and using the educational data related to the use of humidifier disinfectant in the future.