• Title/Summary/Keyword: diagnostic practices

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Re-reading Chuncheon G5 International Design Competition from a Viewpoint of Landscape Urbanism (랜드스케이프 어바니즘의 관점으로 본 춘천 G5 국제설계경기 출품작 분석)

  • Kim Ah-Yeon;Koh Mi-Jin;Oh Hyung-Seok
    • Journal of the Korean Institute of Landscape Architecture
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    • v.34 no.3 s.116
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    • pp.120-138
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    • 2006
  • A city evolves over time. It grows, transforms, and sometimes degrades. Chuncheon is at a turning point from a city souggling with regulations regarding clean water supply and a military encampment to a masterpiece city with a sustainable vision. The city is getting ready to restructure itself to become a world-famous culture and tourism complex expanding its physical boundary across the Camp Page site and absorbing Jungdo as a major tourist attraction. The landscape in the future blueprint of Chuncheon will play a great role in restructuring urban form. The regenerated in will have a new networked open space system as well as re-evaluated landscape resources. The hybrid theoretical practice called 'landscape urbanism' burgeoning in the fields between 'landscape architecture' and 'urbanism' can guide us in considering the terms of the relationship between a city and landscape when we design a future city Landscape urbanism is considered to be an effective framework by which we can diagnose the current status of a landscape in our contemporary urban design practice in Korea. This paper tries to provide a different perspective from the viewpoint of landscape urbanism to decipher the hidden implications of the social agreement on the role of landscape in urban structure by re-reading eight design proposals presented for the ChunCheon G5 international design competition based on the main principles of landscape urbanism. The G5 design competition is a great opportunity to test out new ideas on a city, demonstrating the relative values among various urban-design professional realms. First, this paper provides an overview of the main ideas of landscape urbanism based on the literature review and case studies. Second, framework categories are suggested in order to extract the explicit and implicit ideas on the landscape. Third, eight proposals are reviewed according to the suggested categories to situate the current landscape design of Korea within the mainstream of contemporary practice of landscape urbanism. Based on the review of eight proposals, the following diagnostic conclusions are made; first, the ideas of landscape urbanism have not been actively introduced in large-scaled urban landscape projects in Korea like Chuncheon G5. Second, it remains to be a big task for landscape professions to be able to participate in design consortiums on an equal footing. Third, In order to introduce and reify the ideas of landscape urbanism in Korea, it is inevitable and critical to test the ideas in both academic fields and professional practices to find the appropriately adjusted model of landscape urbanism.

Interferon-${\gamma}$ Enzyme-Linked Immunospot Assay in Patients with Tuberculosis and Healthy Adults

  • Kim, Cheol-Hong;Kim, Jong-Yeop;Hwang, Yong Il;Lee, Chang Youl;Choi, Jeong-Hee;Park, Yong-Bum;Jang, Seung-Hun;Woo, Heungjeong;Kim, Dong-Gyu;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck;Kim, Hyun Soo
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.1
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    • pp.23-29
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    • 2014
  • Background: Interferon-${\gamma}$ assays based on tuberculosis (TB)-specific antigens have been utilized for diagnosing and ruling out latent TB and active TB, but their utility is still limited for TB incidence countries. The aim of this study is to understand the clinical utility of enzyme-linked immunospot (ELISpot) assays among patients with clinically suspected TB and healthy adults in clinical practices and community-based settings. Methods: The ELISpot assays (T SPOT.TB, Oxford Immunotec, UK) were prospectively performed in 202 patients. After excluding those with indeterminate results, 196 were included for analysis: 41 were TB patients, 93 were non-TB patients, and 62 were healthy adults. Results: The sensitivity and negative predictive values of the T SPOT.TB assays for the diagnosis of TB were 87.8% and 89.1%, respectively, among patients with suspected TB. The agreement between the tuberculin skin test (10-mm cutoff) and the T SPOT.TB assay was 66.1% (kappa=0.335) in all participants and 80.0% (kappa=0.412) in TB patients. Among those without TB (n=155), a past history of TB and fibrotic TB scar on chest X-rays were significant factors that yielded positive T SPOT.TB results. There was a significant difference in the magnitude of T SPOT.TB spot counts between TB patients and non-TB patients or healthy adults. Conclusion: The T SPOT.TB assay appeared to be a useful test for the diagnostic exclusion of TB. A positive result, however, should be cautiously interpreted for potential positives among those without active TB in intermediate TB incidence areas.

A Study on the Regional Function of Health Care by the Disease Pattern of the Inpatients (입원환자 질병유형의 구성에 의한 지역별 진료기능에 관한 연구)

  • Choi, Huyn-Rim;Lee, Sang-Il;Shin, Young-Soo;Kim, Yong-Ik
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.2 s.24
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    • pp.390-403
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    • 1988
  • The objectives of the study were to provide the basic informations needed in the development of balanced medical services throughout the nation. As the national health care system was expanding rapidly along with the economic growth, quantitative re-evaluation of the system is of great need. For that reason, characteristics of the admitted patients were analyzed for the case-mix and patients' flow within and through regions. Materials were 421,530 cases of inpatients, who were reported through Korea Medical Insurance Corporation(KMIC) for insurance claim, during the period of March 1, 1985 through February 28, 1987. Korean Diagnosis Related Groups(K-DRGs) classification system was adopted for the study of case-mix and 189 cities and counties were classified into 5 district groups by factor analysis results of K-DRGS. The major findings of this study were as follows ; 1) Factor analysis of case-mix, employing K-DRG system, revealed 5 distinct funtional district groups. Group A(18 districts) was prominent for tertiary medical care. In group B(36 districts), rather simple procedures were prevalent. Group C(26 districts) was distinctive for the medical care of well organized internal medicine practices with qualified clinical laboratories. Group D(17 districts) was characterized by relatively high balanced medical care. Group E (92 districts) was with very low level of medical care. 2) Analysis of the case-flow through the districts showed 3 types of flow patterns : inflow, outflow, and balanced types. Inflow type of case-flow was found in Group A, C and D while Group B and E showed outflow type. Inflow was most prominent in Group A and Group E was of typical outflow type. Group B was consistently the outflow type except for Major Diagnostic Category XX regardless of the disease treaters, but Group C and D were inflow or outflow types according to the disease tracers.

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Korean physicians' attitudes toward the prenatal screening for fetal aneuploidy and implementation of non-invasive prenatal testing with cell-free fetal DNA

  • Kim, Soo Hyun;Kim, Kun Woo;Han, You Jung;Lee, Seung Mi;Lee, Mi-Young;Shim, Jae-Yoon;Cho, Geum Joon;Lee, Joon Ho;Oh, Soo-young;Kwon, Han-Sung;Cha, Dong Hyun;Ryu, Hyun Mee
    • Journal of Genetic Medicine
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    • v.15 no.2
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    • pp.72-78
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    • 2018
  • Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.

Convergence research on education needs for prevention and control of infectious diseases (감염병 예방 및 관리에 대한 교육요구도 융복합 연구)

  • Kang, Kyung-hee;Park, Arma;Lim, HyoNam;Hwang, Hye-Jeong;Kim, Kwang Hwan
    • Journal of the Korea Convergence Society
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    • v.12 no.4
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    • pp.95-103
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    • 2021
  • This study was aimed to investigate the education needs for prevention and control of infectious diseases by lifecycle based on age group and to provide the fundamental data to develop the educational programs. A research was conducted with 328 adults over 19 years old for a month of February 2021 through online and mobile survey by Gallup Korea. Research contents include the general characteristics, personal hygiene practices related to infection, perceived risks related to infection, importance and level of knowledge on infectious diseases, and education needs for prevention and control of infectious diseases. For the research data analysis, PASW Statistics Ver 20.0 was used as a statistical program. Ranks from analysis upon conversion as the formula of Borich needs to sum up with importance and knowledge level showed first (Borich 3.11) with treatments for infectious diseases; second (Borich 2.15) with process in case of suspicion and diagnosis of infectious diseases; third (Borich 1.75) with transmission routes of infectious diseases; fourth (Borich 1.73) with preventive ways of infectious diseases; fifth (Borich 1.50) with diagnostic and test methods of infectious diseases; sixth (Borich 1.45) with characteristics of infectious diseases; and seventh (Borich1.38) with main symptoms of infectious diseases. It is anticipated that development of educational programs applying education needs for prevention and control of infectious diseases in this research can contribute to enhance the physical health, mental health, and psychological well-being of the subjects.

Classification of Brain MR Images Using Spatial Information (공간정보를 이용한 뇌 자기공명영상 분류)

  • Kim, Hyung-Il;Kim, Yong-Uk;Kim, Jun-Tae
    • Journal of the Korea Society for Simulation
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    • v.18 no.4
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    • pp.197-206
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    • 2009
  • The medical information system is an effective medical diagnosis assistance system which offers an environment in which medial images and diagnosis information can be shared. However, this system can only stored and transmitted information without other functions. To resolve this problem and to enhance the efficiency of diagnostic activities, a medical image classification and retrieval system is necessary. The medical image classification and retrieval system can improve efficiency in a medical diagnosis by providing disease-related images and can be useful in various medical practices by checking diverse cases. However, it is difficult to understand the meanings contained in images because the existing image classification and retrieval system has handled superficial information only. Therefore, a medical image classification system which can classify medical images by analyzing the relation among the elements of the image as well as the superficial information has been required. In this paper, we propose the method for learning and classification of brain MRI, in which the superficial information as well as the spatial information extracted from images are used. The superficial information of images, which is color, shape, etc., is called low-level image information and the logical information of the image is called high-level image information. In extracting both low-level and high-level image information in this paper, the anatomical names and structure of the brain have been used. The low-level information is used to give an anatomical name in brain images and the high-level image information is extracted by analyzing the relation among the anatomical parts. Each information is used in learning and classification. In an experiment, the MRI of the brain including disease have been used.

Conventional Versus Artificial Intelligence-Assisted Interpretation of Chest Radiographs in Patients With Acute Respiratory Symptoms in Emergency Department: A Pragmatic Randomized Clinical Trial

  • Eui Jin Hwang;Jin Mo Goo;Ju Gang Nam;Chang Min Park;Ki Jeong Hong;Ki Hong Kim
    • Korean Journal of Radiology
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    • v.24 no.3
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    • pp.259-270
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    • 2023
  • Objective: It is unknown whether artificial intelligence-based computer-aided detection (AI-CAD) can enhance the accuracy of chest radiograph (CR) interpretation in real-world clinical practice. We aimed to compare the accuracy of CR interpretation assisted by AI-CAD to that of conventional interpretation in patients who presented to the emergency department (ED) with acute respiratory symptoms using a pragmatic randomized controlled trial. Materials and Methods: Patients who underwent CRs for acute respiratory symptoms at the ED of a tertiary referral institution were randomly assigned to intervention group (with assistance from an AI-CAD for CR interpretation) or control group (without AI assistance). Using a commercial AI-CAD system (Lunit INSIGHT CXR, version 2.0.2.0; Lunit Inc.). Other clinical practices were consistent with standard procedures. Sensitivity and false-positive rates of CR interpretation by duty trainee radiologists for identifying acute thoracic diseases were the primary and secondary outcomes, respectively. The reference standards for acute thoracic disease were established based on a review of the patient's medical record at least 30 days after the ED visit. Results: We randomly assigned 3576 participants to either the intervention group (1761 participants; mean age ± standard deviation, 65 ± 17 years; 978 males; acute thoracic disease in 472 participants) or the control group (1815 participants; 64 ± 17 years; 988 males; acute thoracic disease in 491 participants). The sensitivity (67.2% [317/472] in the intervention group vs. 66.0% [324/491] in the control group; odds ratio, 1.02 [95% confidence interval, 0.70-1.49]; P = 0.917) and false-positive rate (19.3% [249/1289] vs. 18.5% [245/1324]; odds ratio, 1.00 [95% confidence interval, 0.79-1.26]; P = 0.985) of CR interpretation by duty radiologists were not associated with the use of AI-CAD. Conclusion: AI-CAD did not improve the sensitivity and false-positive rate of CR interpretation for diagnosing acute thoracic disease in patients with acute respiratory symptoms who presented to the ED.

A Study on the Development of an Integrated Implementation Model for Digital Transformation and ESG Management (디지털 트랜스포메이션과 ESG 경영의 통합 추진을 위한 모델 개발에 관한 연구 )

  • Kim, Seung-wook
    • Journal of Venture Innovation
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    • v.7 no.3
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    • pp.85-100
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    • 2024
  • ESG management refers to corporate management that takes into account environmental, social, and governance factors, while digital transformation goes beyond the mere automation or digitization of existing tasks to drive an innovative change in the essence of work and the way value is created. Therefore, digital transformation can help companies achieve ESG goals and implement sustainable business practices, establishing a complementary relationship between digital transformation and ESG management for corporate sustainability and growth. This relationship maximizes the synergy of integrating digital transformation with ESG management, enabling companies to utilize resources efficiently and prevent redundant investments, ultimately enhancing sustainable management performance. In this study, we propose the simultaneous promotion of business process reengineering (BPR), in which both digital transformation and ESG management are integrated. This is because the collection, analysis, and decision-making processes related to various data for promoting ESG management must be organically integrated with digital transformation technologies. Therefore, we analyzed each ESG management objective presented in the K-ESG guidelines and identified the corresponding digital transformation technologies through expert interviews and a review of prior research. The K-ESG guidelines serve as a useful ESG diagnostic system that enables companies to identify improvement tasks and manage performance based on goals through self-assessment of ESG levels. By developing a model based on the K-ESG guidelines for the integrated promotion of digital transformation and ESG management, companies can simultaneously improve ESG performance and drive digital innovation, reducing redundant investments and trial-and-error while utilizing diverse resources efficiently. This study provides practical and academic implications by developing a concrete and actionable new research model for researchers and businesses.

A study of mothers knowledge of weaning of infants with iron-deficiency anemia (철결핍빈혈 영·유아에서 어머니의 이유지식)

  • Kim, Sung Jin;Kim, Dong Hyun;Chang, Joo Hee;Jun, Yong Hun;Hong, Young Jin;Son, Byong Kwan;Kim, Soon Ki
    • Clinical and Experimental Pediatrics
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    • v.51 no.5
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    • pp.468-473
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    • 2008
  • Purpose : Iron-deficiency anemia (IDA) is still one of the most common nutrient deficiency disorders, despite improvements in general health and nutrition. This study was designed to investigate the diagnostic values of hematological profiles, including the level of ferritin, and to evaluate the knowledge of mothers on weaning practices for infants and young children with IDA. Methods : This study was conducted on 111 infants and young children from six to 40 months of age with IDA. Their parents completed a questionnaire. IDA was defined as a level of hemoglobin <11.0 g/dL, the presence of microcytosis, a level of ferritin <10.0 ng/dL, transferrin saturation <15%, or an 1 g/dL increase in the level of hemoglobin after iron administration. The questionnaire made inquiries into their weaning practices. Results : In 111 infants and young children aged from six to 40 months, the average level of Hb was $9.5{\pm}1.0g/dL$. The prevalence of ferritin level (>10 ng/dL) was 48.6%, in spite of IDA. Seventy-four infants (66.7%) began to wean between four and six months, and 37 infants (33.3%) after seven months of age. The main food given after weaning was rice gruel. The weaning periods showed a significant relationship to the severity of anemia (P<0.05). There was no significant difference in the severity of anemia in terms of the educational levels of the mothers. Fifty-five mothers (49.5%) gave a wrong answer to a questionnaire describing that breast-fed infants aged over four months need to be fed with iron-sufficient food. Of all mothers, 49.6% took one month or more to complete the weaning process and 20% took three months or more. Conclusion : Many infants and young children with IDA have been provided with non-iron fortified foods and inadequate weaning. To improve nutritional status, especially among infants with iron deficiencies, nutritional education for mothers with infants at the weaning age must be increased and related programs must be implemented effectively.

Variation of Hospital Costs and Product Heterogeneity

  • Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.123-127
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    • 1978
  • The major objective of this research is to identify those hospital characteristics that best explain cost variation among hospitals and to formulate linear models that can predict hospital costs. Specific emphasis is placed on hospital output, that is, the identification of diagnosis related patient groups (DRGs) which are medically meaningful and demonstrate similar patterns of hospital resource consumption. A casemix index is developed based on the DRGs identified. Considering the common problems encountered in previous hospital cost research, the following study requirements are estab-lished for fulfilling the objectives of this research: 1. Selection of hospitals that exercise similar medical and fiscal practices. 2. Identification of an appropriate data collection mechanism in which demographic and medical characteristics of individual patients as well as accurate and comparable cost information can be derived. 3. Development of a patient classification system in which all the patients treated in hospitals are able to be split into mutually exclusive categories with consistent and stable patterns of resource consumption. 4. Development of a cost finding mechanism through which patient groups' costs can be made comparable across hospitals. A data set of Medicare patients prepared by the Social Security Administration was selected for the study analysis. The data set contained 27,229 record abstracts of Medicare patients discharged from all but one short-term general hospital in Connecticut during the period from January 1, 1971, to December 31, 1972. Each record abstract contained demographic and diagnostic information, as well as charges for specific medical services received. The 'AUT-OGRP System' was used to generate 198 DRGs in which the entire range of Medicare patients were split into mutually exclusive categories, each of which shows a consistent and stable pattern of resource consumption. The 'Departmental Method' was used to generate cost information for the groups of Medicare patients that would be comparable across hospitals. To fulfill the study objectives, an extensive analysis was conducted in the following areas: 1. Analysis of DRGs: in which the level of resource use of each DRG was determined, the length of stay or death rate of each DRG in relation to resource use was characterized, and underlying patterns of the relationships among DRG costs were explained. 2. Exploration of resource use profiles of hospitals; in which the magnitude of differences in the resource uses or death rates incurred in the treatment of Medicare patients among the study hospitals was explored. 3. Casemix analysis; in which four types of casemix-related indices were generated, and the significance of these indices in the explanation of hospital costs was examined. 4. Formulation of linear models to predict hospital costs of Medicare patients; in which nine independent variables (i. e., casemix index, hospital size, complexity of service, teaching activity, location, casemix-adjusted death. rate index, occupancy rate, and casemix-adjusted length of stay index) were used for determining factors in hospital costs. Results from the study analysis indicated that: 1. The system of 198 DRGs for Medicare patient classification was demonstrated not only as a strong tool for determining the pattern of hospital resource utilization of Medicare patients, but also for categorizing patients by their severity of illness. 2. The wei틴fed mean total case cost (TOTC) of the study hospitals for Medicare patients during the study years was $11,27.02 with a standard deviation of $117.20. The hospital with the highest average TOTC ($1538.15) was 2.08 times more expensive than the hospital with the lowest average TOTC ($743.45). The weighted mean per diem total cost (DTOC) of the study hospitals for Medicare patients during the sutdy years was $107.98 with a standard deviation of $15.18. The hospital with the highest average DTOC ($147.23) was 1.87 times more expensive than the hospital with the lowest average DTOC ($78.49). 3. The linear models for each of the six types of hospital costs were formulated using the casemix index and the eight other hospital variables as the determinants. These models explained variance to the extent of 68.7 percent of total case cost (TOTC), 63.5 percent of room and board cost (RMC), 66.2 percent of total ancillary service cost (TANC), 66.3 percent of per diem total cost (DTOC), 56.9 percent of per diem room and board cost (DRMC), and 65.5 percent of per diem ancillary service cost (DTANC). The casemix index alone explained approximately one half of interhospital cost variation: 59.1 percent for TOTC and 44.3 percent for DTOC. Thsee results demonstrate that the casemix index is the most importand determinant of interhospital cost variation Future research and policy implications in regard to the results of this study is envisioned in the following three areas: 1. Utilization of casemix related indices in the Medicare data systems. 2. Refinement of data for hospital cost evaluation. 3. Development of a system for reimbursement and cost control in hospitals.

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