• Nuclear Engineering and Technology
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• v.54 no.10
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• pp.3620-3630
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• 2022

The diagnosis of abnormalities in a nuclear power plant is essential to maintain power plant safety. When an abnormal event occurs, the operator diagnoses the event and selects the appropriate abnormal operating procedures and sub-procedures to implement the necessary measures. To support this, abnormality diagnosis systems using data-driven methods such as artificial neural networks and convolutional neural networks have been developed. However, data-driven models cannot always guarantee an accurate diagnosis because they cannot simulate all possible abnormal events. Therefore, abnormality diagnosis systems should be able to detect their own potential misdiagnosis. This paper proposes a rulebased diagnostic validation algorithm using a previously developed two-stage diagnosis model in abnormal situations. We analyzed the diagnostic results of the sub-procedure stage when the first diagnostic results were inaccurate and derived a rule to filter the inconsistent sub-procedure diagnostic results, which may be inaccurate diagnoses. In a case study, two abnormality diagnosis models were built using gated recurrent units and long short-term memory cells, and consistency checks on the diagnostic results from both models were performed to detect any inconsistencies. Based on this, a re-diagnosis was performed to select the label of the second-best value in the first diagnosis, after which the diagnosis accuracy increased. That is, the model proposed in this study made it possible to detect diagnostic failures by the developed consistency check of the sub-procedure diagnostic results. The consistency check process has the advantage that the operator can review the results and increase the diagnosis success rate by performing additional re-diagnoses. The developed model is expected to have increased applicability as an operator support system in terms of selecting the appropriate AOPs and sub-procedures with re-diagnosis, thereby further increasing abnormal event diagnostic accuracy.

• Journal of Oral Medicine and Pain
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• v.47 no.3
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• pp.109-116
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• 2022

Purpose: This study was conducted to analyze the clinical characteristics and distribution of the tongue-related diagnoses in patients with tongue symptoms. Methods: The subjects were patients who visited Chosun University Dental Hospital with tongue symptoms from January 1, 2021, to December 31, 2021. We analyzed 491 patients (139 males and 352 females) with tongue-related diagnostic code names in the Korean Standard Classification of Disease (KCD) in the Electronic Medical Record (Dentopinformation Technology Co., Seoul, Korea). Results: On analyzing the diagnoses of tongue diseases using the KCD, glossopyrosis (44.8%) and painful tongue (15.2%) showed high rates. Of the 491 patients, 139 (28.3%) were males and 352 (71.7%) were females, and the average age was 58.1 years. As for systemic diseases, there were many patients with diseases of the circulatory system (27.0%) and endocrine, nutritional, and metabolic diseases (13.7%). Tongue symptoms were discomfort in 58 patients, pain in 329 patients, paresthesia in 10 patients, burning sensations in 222 patients, dysgeusia in 25 patients, dryness in 110 patients, fissures in 57 patients, and other symptoms in 72 patients. Areas with tongue symptoms were the anterior area in 102 patients, the lateral area in 140 patients, the posterior area in 12 patients, the dorsal area in 140 patients, the ventral area in 42 patients, and which area in 126 patients overall. Patients with burning mouth syndrome and oral candidiasis had significantly more tongue symptoms. Conclusions: Patients with tongue symptoms exhibited a variety of tongue diseases. Tongue symptoms were more common in women over 50 years of age and were frequently seen in patients with burning mouth syndrome and oral candidiasis.

• PNF and Movement
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• v.21 no.1
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• pp.129-137
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• 2023

Purpose: The physical therapy diagnosis process requires high-level background knowledge, the ability to obtain added information from patients, accurate examination skills, and a framework for transforming thoughts into a diagnostic decision. Thus, the physical therapy diagnostic process is highly complicated and difficult work. To function as autonomous professionals, physical therapists must develop effective clinical diagnosis skills. As such, mobile application aids can help with accurate and scientific diagnoses. Therefore, this study aims to develop and evaluate the usability of a mobile application for physical therapy diagnoses. Methods: In this study, a diagnostic application was developed using App Inventor, the development environment was the Chrome web browser for Windows 10, and the mobile application was run on a Google Pixel 5. The developed application was evaluated for usability by 20 physical therapists with more than 5 years of clinical experience in the musculoskeletal physical therapy field, and a usability evaluation was conducted using a 5-point Likert scale for accuracy, convenience, satisfaction, and usability. The collected Likert scores were converted into percentages and analyzed as descriptive statistics. Results: The graphical user interface consisted of an initial screen with program guidance, 18 screens presenting the algorithm, and 12 screens presenting the estimated diagnosis based on the algorithm. As such, the usability evaluation of the developed application was as follows: accuracy 100%, convenience 90%, satisfaction 91%, and usability 88%. Conclusion: The newly developed mobile application for physical therapeutic diagnoses has a high accuracy, and it will aid in building an easy and reliable physical therapy diagnosis system.

• Korean Journal of Radiology
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• v.23 no.2
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• pp.280-288
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• 2022

Objective: To compare core needle biopsy (CNB) and repeat fine-needle aspiration (rFNA) to reduce the rate of diagnostic surgery and prevent unnecessary surgery in nodules initially diagnosed as atypia/follicular lesions of undetermined significance (AUS/FLUS). Materials and Methods: This study included 231 consecutive patients (150 female and 81 male; mean age ± standard deviation, 51.9 ± 11.7 years) with 235 thyroid nodules (≥ 1 cm) initially diagnosed as AUS/FLUS, who later underwent both rFNA and CNB. The nodules that required diagnostic surgery after the biopsy were defined using three different scenarios according to the rFNA and CNB results: criterion 1, surgery for low-risk indeterminate (categories I and III); criterion 2, surgery for high-risk indeterminate (categories IV and V); and criterion 3, surgery for all indeterminate nodules (categories I, III, IV, and V). We compared the expected rates of diagnostic surgery between CNB and rFNA in all 235 nodules using the three surgical criteria. In addition, the expected rates of unnecessary surgery (i.e., surgery for benign pathology) were compared in a subgroup of 182 nodules with available final diagnoses. Results: CNB showed significantly lower rates of nondiagnostic, AUS/FLUS, and suspicious for malignancy diagnoses (p ≤ 0.016) and higher rates of follicular neoplasm or suspicious for a follicular neoplasm (p < 0.001) and malignant diagnoses (p = 0.031). CNB showed a significantly lower expected rate of diagnostic surgery than rFNA for criterion 1 (29.8% vs. 48.1%, p < 0.001) and criterion 3 (46.4% vs. 55.3%, p = 0.029), and a significantly higher rate for criterion 2 (16.6% vs. 7.2%, p = 0.001). CNB showed a significantly lower expected rate of unnecessary surgery than rFNA for criterion 1 (18.7% vs. 29.7%, p = 0.024). Conclusion: CNB was superior to rFNA in reducing the rates of potential diagnostic surgery and unnecessary surgery for nodules initially diagnosed as AUS/FLUS in a scenario where nodules with low-risk indeterminate results (categories I and III) would undergo surgery.

• Quality Improvement in Health Care
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• v.9 no.1
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• pp.52-64
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• 2002

Background : Coding of principal diagnosis is essential component for producing reliable health statistics. We performed this study to evaluate the current practice of principal diagnoses determination and coding, and to give some basic data to improve coding of principal diagnosis. Method : Nineteen medical record administrators (MRAs) of 3 university hospitals participated in coding principal Dx. from August 1, 2001 to August 31, 2001. From each hospital, 10 medical records of patients with high frequency disease were selected randomly. Each 10 medical records were grouped into three (A. B, C). Then, these 30 medical records were given to each MRAs for coding. At the same time questionnaire was given to each of them. Questions were to prove how they decide and code the principal diagnosis among many current diagnoses; how they decide and code the principal diagnosis when they see irrelevant diagnosis recorded as the principal diagnosis in medical record, when only tentative diagnoses were recorded without final diagnosis, and when different diagnoses were recorded in different sheets of same record. Agreement of coding among 3 hospitals were compared and survey results were analysed with SAS 6.12. Results : Agreement of coding was found in medical records 5-6 of each 10 medical records. Causes of disagreement were as follows. Difference of clinician's opinion from each hospital; mixed use of guideline from KCD-3 and guideline from DRG; difference in 4th digit classification according to the absence of pathology report in the medical record; difference of abbreviations among hospitals. 57.9% of MRAs selected the principal diagnosis recorded by physician, 42.1% of MRAs decided principal diagnosis after consulting to KCD-3 guideline. When there were difficulties in determining the principal diagnosis, 42.1% of MRAs decided principal diagnosis after discussion with the physician, 26.3% after discussion with fellow MRAs. Conclusion : There were differences in codings among hospitals. To minimize the difference, we suggest the development of disease-specific guidelines for coding in addition to the current general guideline such as KCD-3. To do this, Coding Clinic which can produce guidelines is needed.

• The Journal of Korean Physical Therapy
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• v.22 no.1
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• pp.75-81
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• 2010

Purpose: The purpose of this study was to apply association rule mining to explore the labyrinthine network of cerebral infarction comorbidity and basic data supply to develop cutting-edge physical therapy protocols for cerebral infarction with comorbidity Methods: From clinic records of enrollees of A Hospital in D city, patients over 18 years of age with cerebral infarction and cerebral infarction comorbidity were recruited as a case group. All diagnoses of that hospital were categorized according to the "International Classification of Disease (ICD)" diagnosis system. We extracted code I63 from the "Korea Classification of Disease (KCD)-4". Associated rule mining was done with a priori modeling and Web nodes to examine the strengths of associations among those diagnoses. The support and confidence values of associated rule mining results were examined. Results: The subjects of this study were 2,267 cerebral infarction patients. E11 (Non-insulin-dependent diabetes mellitus), E78 (Disorders of lipoprotein metabolism and other lipidaemias), G81 (Hemiplegia), I10 (Essential hypertension), and K29 (Gastritis and duodenitis) were high frequency diagnoses, being found in 10% or more of total diagnoses of cerebral infarction from frequency analysis results. The highest frequency diagnosis was 1,042 (46.0%) for I10. The second most frequent diagnosis was for E11(21.5%) while the third most frequent diagnosis was E78 (20.2%). Results from a priori modeling and Web nodes indicated that cerebral infarction has a strong association withessential hypertension, non-insulin-dependent diabetes mellitus, disorders of lipoprotein metabolism and other lipidaemias. Conclusion: Cerebral infarction is associated with hypertension, diabetes mellitus, and disorders of lipoprotein metabolism and other lipidaemias. The result of this study will be helpful to clinicians treating patients with cerebral infarction.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.120-132
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• 2009

Purpose: We diagnosed pediatric functional gastrointestinal disorders in Korean children and adolescents using Rome III criteria and investigated the clinical validity of QPGS-Rome III. Methods: Diagnosis based on QPGS was compared with the physician's diagnosis based on Rome III criteria. One hundred and thirty eight children and their parents completed the QPGS. Agreement rates were measured using Kappa method. Results: In physician's diagnoses, the most prevalent disorders were functional dyspepsia (39.1%), irritable bowel syndrome (38.4%), and functional abdominal pain (18.8%). Among QPGS based diagnoses, the most prevalent disorders were irritable bowel syndrome (39.1%), functional dyspepsia (29.7%), and functional abdominal pain (21.7%). The agreement rate was substantial (${\kappa}$=0.72, p=0.00). Diagnostic disagreements probably resulted from different patient responses to bowel movement form and bowel frequency. Conclusion: Functional dyspepsia, irritable bowel syndrome, and functional abdominal pain were the most common disorders by Rome III criteria in the Korean pediatric and adolescent patients. The agreement rate between physician's diagnoses and QPGS based diagnoses supported the validity of the QPGS-Rome III in Korean pediatric and adolescent patients. QPGS seems to be useful in diagnosis of patients with functional gastrointestinal disorders by Rome III criteria.

• Health Policy and Management
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• v.4 no.1
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• pp.49-76
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• 1994

Small area variations in health care utilization have long been studied as an important issue related to boto cost containment and quality assurance. This study was conducted to investigate if variations in hospital services across small geographic areas in Korea existed. The claims data of the fiscal year 1992 obtained from the regional health insurance societies were used for the study. Main findings of the research can be summarized as follows : 1. Extremal Quotients(EQ) of hospital expenditure per capita and hospital days per capita varied among diagnosis types. The EQ ranged from 2.05(cataract) to 41.67(pneumonia) in hospital expenditure per capita and from 1.86(cataract) to 45.89(pneumonia) in hospital days per capita. The diagnosis groups which showed high variation were pneumonia, cephalo-pelvic disproportion, gastritis and duodenitis, fracture of rib, and acute bronchitis. Those which showed low variation were acute appendicitis and cataract. 2. The EQ level of admission rate was different in terms of diagnosis types, ranging from 2.57(catarct) to 44.45(pneumonia). The variations were high in medical disorders such as pneumonia, oephalo-pelvic disproportion, gastritis and duodenitis and acute bronchitis, while relatively low in surgical conditions such as acute appendicitis and cataract. 3. As an indicator of service intensity, the EQ of expenditure per admission ranged from 1.67(acute appendicitis) to 31.27(essential hypertension). The diagnoses which had high variation were essential hypertension, gastric ulcer, whereas those which had low variation were cephalopelvic disproportion and acute appendicitis. With regard to hospital days per admission, the EQ ranged from 1.55(acute appendicitis) to 28.13(gastric ulcer) by diagnosis types. The diagnosis groups with showed high variation were gastric ulcer, essential hypertension, and acute bronchitis, whereas those with low variation were cephalo-pelvic disproportion, intervertebral disc disorders, and acute appendicitis. Both the expenditure and hospital days per admission showed lewwer variations than the expenditure per capita, hospital days per capita and admission rate. 4. Comparing patterns of variation in utilization indices, diagnoses such as essential hypertension, gastric ulcer, fracture of rib showed higher variations in expenditure per admission than in admission rates, whereas diagnoses such as pneumonia, cephalo-pelvic disproportion and gastric ulcer showed higher variations in admission rate than expenditure per admission. These findings suggest that wide variations existed in several diagnoses groups across small areas in Korea. Further research should be performed to investigate factors related to small area variations including provider behavior.

• Proceedings of the Korean Society for Agricultural Machinery Conference
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• v.11 no.1
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• pp.98-103
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• 2006

• Journal of Korean Neurosurgical Society
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• v.67 no.3
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• pp.308-314
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• 2024

Vein of Galen aneurysmal malformation is one of important pediatric arteriovenous shunt diseases, especially among neonates and infants. Here, early history of the disease identification, basic pathoanatomy with a focus on the embryonic median prosencephalic vein, classification and differential diagnoses, and recent genetic studies are reviewed.