• Title/Summary/Keyword: patient variation

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A Study on analysis of severity-adjustment length of stay in hospital for community-acquired pneumonia (지역사회획득 폐렴 환자의 중증도 보정 재원일수 분석)

  • Kim, Yoo-Mi;Choi, Yun-Kyoung;Kang, Sung-Hong;Kim, Won-Joong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.3
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    • pp.1234-1243
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    • 2011
  • Our study was carried out to develop the severity-adjustment model for length of stay in hospital for community-acquired pneumonia so that we analysed the factors on the variation in length of stay(LOS). The subjects were 5,353 community-acquired pneumonia inpatients of the Korean National Hospital Discharge In-depth Injury Survey data from 2004 through 2006. The data were analyzed using t-test and ANOVA and the severity-adjustment model was developed using data mining technique. There are differences according to gender, age, type of insurance, type of admission, but there is no difference of whether patients died in hospital. After yielding the standardized value of the difference between crude and expected length of stay, we analysed the variation of length of stay for community-acquired pneumonia. There was variation of LOS in regional differences and insurance type, though there was no variation according whether patients receive their care in their residences. The variation of length of stay controlling the case mix or severity of illness can be explained the factors of provider. This supply factors in LOS variations should be more studied for individual practice style or patient management practices and healthcare resources or environment. We expect that the severity-adjustment model using administrative databases should be more adapted in other diseases in practical.

Development of Error Analysis Program for Phase-based Respiratory Gating Radiation Therapy (위상기반 호흡연동 방사선치료 시 오차 분석 프로그램 개발)

  • Song, Ju-Young;Nah, Byung-Sik;Chung, Woong-Ki;Ahn, Sung-Ja;Nam, Taek-Keun;Yoon, Mi-Sun
    • Progress in Medical Physics
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    • v.17 no.3
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    • pp.136-143
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    • 2006
  • The respiratory gating radiation therapy which Irradiates only in the stable respiratory period with analyzing the periodic motion of a reflective marker on the patient's abdomen has been applied to the precise radiation treatment in order to minimize the effect of organ motion induced by the respiration. This respiratory gating system establishes irradiation region using the amplitude-based or phase-based method. Although phase-based method Is preferred because of the stability in the real treatment conditions, it has some limits to explain the exact correlation between the marker motion and organ motion. Even when the variation of amplitude which can introduce target motion considered as an error is produced, the phase-based method has the possibility to irradiate including the error positions. In this study, the error analysis program was developed for the verification of the tumor position's variation correlated with the variation of marker's amplitude which can be occurred during a phase-based respiratory sating treatment. The analysis program was tested with a virtual treatment record file and with a record file using moving phantom which were modified considering the irregular amplitude's variation simulating the real clinical situations. In both cases, accurate discrimination of error points and error calculation were produced. When the treatment record files of a real patient were analyzed with the program, the accurate recognition and calculation of the error points were also verified. The analysis program developed in this study will be applied as a useful tool for the analysis of errors due to the irregular variation of patients' respiration during the phase-base respiratory gating radiation treatment.

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Atypical Correlation between CTG Repeat Size Variation and Clinical Manifestation in Brothers of Myotonic Dystrophy (임상양상과 유전자수가 비전형적인 연관관계를 갖는 근긴장성 이영양증 형제 1례)

  • Kim, Jung-Mee;Cho, Eun-Kyoung;Cho, Jeong-Seon;Choi, Yong-Suk;Han, Young-Su;Han, Jeong-Ho;Kim, Doo-Eung
    • Annals of Clinical Neurophysiology
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    • v.6 no.1
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    • pp.61-63
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    • 2004
  • The copy numbers of the CTG repeats are known to relate to the severity of clinical symptoms for myotonic dystrophy. The positive correlation between clinical manifestations and CTG repeat size has been demonstrated previously. A genetically confirmed myotonic dystrophy patient with 90 CTG repeat number had more severe clinical manifestation than brother with 120 CTG repeats, in adulthood.

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A long head of the biceps tendon confluent with the intraarticular rotator cuff: arthroscopic and MR arthrographic fndings

  • Kim, Kyung-Cheon;Rhee, Kwang-Jin;Shin, Hyun-Dae;Byun, Ki-Yong
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2008.03a
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    • pp.162-162
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    • 2008
  • Many anomalous origins of the long head of the biceps tendon (LHBT) have been reported. However, developmental anomalies of the LHBT are rarely encountered in daily practice. We report a patient with an anomalous LHBT that was adherent to and confluent with the rotator cuff throughout its intra-articular course and present the clinical, magnetic resonance arthrography, and arthroscopic findings.

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Hemodynamic studies early after open heart surgery: comparison of repair of ventricular septal defect and mitral valvular reconstruction (개심술후 조기 혈행동태심실중격결손증 교정과 승모판재건술에 대한 비교)

  • 문병탁
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.59-66
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    • 1984
  • After open heart surgery, the patient must be carefully observed and adequately managed for his survival. This report reviewed 10 cases of ventricular septal defect and 12 mitral valvular diseases as hemodynamics early after open heart surgery. For postoperative 24 hours, clinical status was evaluated for left atrial pressure, central venous pressure,DP[LAP-CVP], peak systolic pressure, heart rate, urine amount, and other clinical findings. Especially, on postoperative fourth hour, cardiac output was most decreased, when the changes of monitoring were compared with two groups with or without using cardiotonics. Finally, we concluded as followings; 1.Postoperatively, variation of CVP was noted in VSD, but mitral valvular disease was more variable change of LAP. 2.DP was 1.3\ulcorner.4 cmH2O in VSD, and 6.4\ulcorner.2 cmH2O in mitral valvular disease. 3.Parameter using cardiotonic was CVP in VSD, and LAP in mitral valvular disease.

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An Alternative RBRVS System for Oriental Medical Services in the Korean National Health Insurance (한방의료서비스의 건강보험 상대가치체계 개편방안)

  • Kim Jin-Hyun;Lim Byung-Mook
    • The Journal of Korean Medicine
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    • v.26 no.2 s.62
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    • pp.105-125
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    • 2005
  • Objectives: The purpose of this study was to identify resources put into clinical. activities and identify a new RBRVS for oriental medical services in the Korean National Health Insurance. Methods: Based on a survey of physician's time, physical effort & technical skill, mental effort & judgment, and stress that were used for patient treatments, relative input values for the relevant clinical activities were estimated and rearranged in a way to be compared. with the current values in health insurance. Results: We found the actual resource-based relative values for oriental medical services statistically different from the current values, with a narrower variation in value distribution. Conclusions: The findings suggest the C\lrrent RBRVS should be revised to reflect the actual input resources into physicians activities and to avoid a distortion of physicians behavior.

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Zigbee Based Wireless Respiration Monitor System (지그비 통신 기반의 근거리 무선 호흡모니터 시스템)

  • Lee, In-Kwang;Kim, Seong-Sik;Jang, Jong-Chan;Kim, Koon-Jin;Kim, Kyung-Ah;Lee, Tae-Soo;Cha, Eun-Jong
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.57 no.1
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    • pp.142-147
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    • 2008
  • Abdominal circumference changes due to breathing by the respiratory muscle activity such as diaphragm, which would partially represent the lung volume variation. The present study introduced conductive rubber molded in a cord shape incorporated with a patient's pants. The conductive rubber cord operated as a displacement transducer to measure the lung or abdominal volume changes. Signal extraction circuitry was developed to obtain the volume and its derivative(or the flow) signals followed by wireless transmission based on the Zigbee communication protocol in a size of $65mm{\times}105mm$ easily put in pocket. Breathing frequency was accurately evaluated and breath pattern analysis seemed feasible, since respiratory behaviours such as maximal inspiration and cough were well identified. Remote wireless receiver module also enabled to monitor both volume and flow signals during resting breathing on a PC terminal.

Design of Filter to Reject Motion Artifacts of PPG Signal by Using Two Photosensors

  • Lee, Ju-Won;Nam, Jae-Hyun
    • Journal of information and communication convergence engineering
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    • v.10 no.1
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    • pp.91-95
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    • 2012
  • The photoplethysmography (PPG) signal measured from a mobile healthcare device contains various motion artifacts occurring from a patient’s movements. Recently, to reject the motion artifacts, the method of using an acceleration sensor was suggested, but such sensors are very expensive. Therefore, this study deals with a novel sensor device to replace the acceleration sensor, and evaluated the performance of the proposed sensor experimentally. In the results of the experiments, it is shown that the proposed sensor device can reconstruct the PPG signal despite the occurrence of motion artifacts, and also that the variation rate in heart rate analysis was 1.22%. According to the experimental results, the proposed method can be applied to design a low-cost device.

Two Cases with Persistent Falcine Sinus as Congenital Variation

  • Kim, Myoung-Soo;Lee, Ghi-Jai
    • Journal of Korean Neurosurgical Society
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    • v.48 no.1
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    • pp.82-84
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    • 2010
  • The falcine sinus is an abnormal anatomic structure located in the falx cerebri that is closed after birth and is rarely observed. We describe two cases of persistent falcine sinus. A 60-year-old woman presented with headache. An 11-year-old girl presented with intermittent headache and a palpable scalp mass in the middle of the high parietal area. The straight sinuses were absent in both patients. In both patients, drainage of the galenic system took place through a sinus within the falx, also known as a falcine sinus. Suspicious dysplastic tentorium cerebelli was observed in one patient. It can be concluded that a mesenchymal disorder can be the primary cause for a persistent falcine sinus.

Active contrl of an ambulane\ce stretcher: Simulation study

  • Sagawa, K.;Inooka, H.;Ino-Oka, E.
    • 제어로봇시스템학회:학술대회논문집
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    • 1994.10a
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    • pp.100-105
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    • 1994
  • In this paper, we discuss a method for design of an ambulance stretcher which call decrease blood pressure fluctuation caused by ambulance acceleration. Recently, a lot of stretchers which can isolate the vertical vibration to reduce body resonances (4-10 Hz) have been used during ambulance transport. However, we have found that blood pressure of a patient laying in the stretcher fluctuates when the ambulance accelerates or decelerates. Since the enforced change of the blood pressure may deteriorate the patent's condition, a stretcher to cancel head-to-foot acceleration and to decrease the blood pressure variation (BPV) is expected for safe transport. We propose a method to design a stretcher which is tilted according to an adequate angle to cancel head-to-foot acceleration by gravity when the ambulance accelerates or decelerates. A control method of the stretcher is constructed by means of simulation analysis using acceleration data measured during ambulance transport. It is confirmed that the active controlled stretcher proposed has good performance for the BPV reduction.

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