• Title/Summary/Keyword: risk selection

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A Study on Clinical Variables Contributing to Differentiation of Delirium and Non-Delirium Patients in the ICU (중환자실 섬망 환자와 비섬망 환자 구분에 기여하는 임상 지표에 관한 연구)

  • Ko, Chanyoung;Kim, Jae-Jin;Cho, Dongrae;Oh, Jooyoung;Park, Jin Young
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.101-110
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    • 2019
  • Objectives : It is not clear which clinical variables are most closely associated with delirium in the Intensive Care Unit (ICU). By comparing clinical data of ICU delirium and non-delirium patients, we sought to identify variables that most effectively differentiate delirium from non-delirium. Methods : Medical records of 6,386 ICU patients were reviewed. Random Subset Feature Selection and Principal Component Analysis were utilized to select a set of clinical variables with the highest discriminatory capacity. Statistical analyses were employed to determine the separation capacity of two models-one using just the selected few clinical variables and the other using all clinical variables associated with delirium. Results : There was a significant difference between delirium and non-delirium individuals across 32 clinical variables. Richmond Agitation Sedation Scale (RASS), urinary catheterization, vascular catheterization, Hamilton Anxiety Rating Scale (HAM-A), Blood urea nitrogen, and Acute Physiology and Chronic Health Examination II most effectively differentiated delirium from non-delirium. Multivariable logistic regression analysis showed that, with the exception of vascular catheterization, these clinical variables were independent risk factors associated with delirium. Separation capacity of the logistic regression model using just 6 clinical variables was measured with Receiver Operating Characteristic curve, with Area Under the Curve (AUC) of 0.818. Same analyses were performed using all 32 clinical variables;the AUC was 0.881, denoting a very high separation capacity. Conclusions : The six aforementioned variables most effectively separate delirium from non-delirium. This highlights the importance of close monitoring of patients who received invasive medical procedures and were rated with very low RASS and HAM-A scores.

Breakthrough Urinary Tract Infection: A Clinical Study of Experience of a Single Center (예방적 항생제 사용중에 발생한 요로감염: 단일 병원에서 경험한 임상연구)

  • Bae, Sang-In;Cheon, Chong-Kun;Kim, Su-Young
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.203-209
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    • 2010
  • Purpose : It has been a common medical practice to use prophylactic antibiotics to prevent recurrent urinary tract infections (UTI) in high risk situations such as urinary tract obstruction, vesicoureteral reflux, neurogenic bladder, or urinary stones. But sometimes, we meet difficult situation of breakthrough infections (BI) which might cause new or progressive renal scarring. The clinical characteristics of children contracting breakthrough UTI experienced in a single center were studied. Methods : The study was done retrospectively through medical records of 150 pediatric patients who had been cared in pediatric and urologic clinics of Pusan National University Hospital from Jan. 2001 till June 2006 and had prophylactic antibiotics to prevent recurrent UTI. Results : The starting age of prophylactic antibiotics of 150 patient was 1-76 months, and median age was 5 months. The BI developed 61 times in 43 patients (28.7%), 1.5 times per 100 patient-months. The BI occurred more frequently in patients with higher grade of VUR, and in the cases with abnormal DMSA scan. Co-trimoxazole was more effective than 2nd and 3rd generation cephalosporins to prevent UTI. The distribution of causative organisms was more diverse than usual UTI. The causative organisms were sensitive to the antibiotics used for prophylaxis in 29.5%, and resistant in 59.1%. After experience of BI, 40 percents of patients went to the surgical treatment including endoscopic injection of Deflux, 35% to new antibiotics for prophylaxis, 26% remain on the same antibiotics as the previous one. Conclusion : Based on our study results, preexisting renal scar might be one of the factors which should be considered in favor of early surgical interventions of VUR. Poor compliance and wrong selection of antibiotics such as cephalosporins are important underlying causes of breakthrough UTIs.

Developing Food List for Risk Assessment of Contaminants in Korean Foods (식품으로부터의 오염물질 섭취량 및 위해도 평가를 위한 대표식품 선정)

  • Lee, Haeng-Shin;Kim, Bok-Hee;Jang, Young-Ai;Park, Seon-Oh;Oh, Chang-Hwan;Kim, Ji-Young;Kim, Hee-Yun;Chung, So-Young;Sho, Yoo-Sub;Suh, Jung-Hyuck;Lee, Eun-Ju;Kim, Cho-Il
    • Korean Journal of Food Science and Technology
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    • v.37 no.4
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    • pp.660-670
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    • 2005
  • Standard procedure for development of food list was established based on food intake data of 2001 National Health and Nutrition Survey and 2002 Seasonal Nutrition Survey for Total Diet Study. Foods were sorted in descending order of mean intake, and 54 items within cumulative percentage of 80 were selected, followed by selection of 16 additional items with consumption frequency of 10% or higher. Based on higher consumption in certain seasons, regions, sexes, and age classes, 14 additional items were added. Additional 17 items with probable high contents of heavy metals or 23 items with probable high pesticide residues were added. Altogether, 101 and 107 individual food items were included for heavy metal and pesticide residue lists, accounting for 84.9 and 83.3% mean energy intakes of Korean population, respectively.

Aquatic exercise for the treatment of knee osteoarthritis: a systematic review & meta analysis (무릎 골관절염 환자를 대상으로 한 수중 운동과 지상운동 비교: 체계적 문헌고찰 및 메타분석)

  • Kim, Young-il;Choi, Hyo-Shin;Han, Jung-haw;Kim, Juyoung;Kim, Gaeun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.9
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    • pp.6099-6111
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    • 2015
  • This study was a systematic review and meta-analysis comparing the effects of aquatic exercise and land-based exercise in the treatment of knee osteoarthritis. 7 studies (n=449) met selection and exclusion criteria out of 287 potential studies obtained from the literature search via Ovid-Medline, Cochrane Library CENTRAL, CINAHL, RISS and KISS. The overall risk of bias of selected studies using SIGN (Scottish Intercollegiate Guidelines Network) checklist for randomized controlled trials (RCT) was regarded as low. As a result of meta analysis, Standardized Mean Difference (SMD) for pain was -0.26(95% CI -0.49, -0.03, p=0.03, $I^2=14%$), which implies that aquatic exercise groups had significant less pain than land-based exercise groups. On the other hand, there was no significant difference between aquatic exercise groups and land based exercise groups for flexion Range of Motion (ROM) (-0.12, 95% CI -0.51, 0.27, p=0.53, $I^2=0%$), extension ROM (-0.04, 95% CI -0.55, 0.48, p=0.89, $I^2=43%$), physical function (-0.12, 95% CI -0.44, 0.19, p=0.44, $I^2=0%$), Quality of Life (QOL) (-0.15, 95% CI -0.54, 0.24, p=0.46, $I^2=0%$). This study has some limitations due to few RCTs comparing aquatic exercise groups and land-based exercise groups in the treatment of knee osteoarthritis. Therefore, further RCTs should be conducted along with long-term outcomes.

Lung cancer, chronic obstructive pulmonary disease and air pollution (대기오염에 의한 폐암 및 만성폐색성호흡기질환 -개인 흡연력을 보정한 만성건강영향평가-)

  • Sung, Joo-Hon;Cho, Soo-Hun;Kang, Dae-Hee;Yoo, Keun-Young
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.585-598
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    • 1997
  • Background : Although there are growing concerns about the adverse health effect of air pollution, not much evidence on health effect of current air pollution level had been accumulated yet in Korea. This study was designed to evaluate the chronic health effect of ai. pollution using Korean Medical Insurance Corporation (KMIC) data and air quality data. Medical insurance data in Korea have some drawback in accuracy, but they do have some strength especially in their national coverage, in having unified ID system and individual information which enables various data linkage and chronic health effect study. Method : This study utilized the data of Korean Environmental Surveillance System Study (Surveillance Study), which consist of asthma, acute bronchitis, chronic obstructive pulmonary diseases (COPD), cardiovascular diseases (congestive heart failure and ischemic heart disease), all cancers, accidents and congenital anomaly, i. e., mainly potential environmental diseases. We reconstructed a nested case-control study wit5h Surveillance Study data and air pollution data in Korea. Among 1,037,210 insured who completed? questionnaire and physical examination in 1992, disease free (for chronic respiratory disease and cancer) persons, between the age of 35-64 with smoking status information were selected to reconstruct cohort of 564,991 persons. The cohort was followed-up to 1995 (1992-5) and the subjects who had the diseases in Surveillance Study were selected. Finally, the patients, with address information and available air pollution data, left to be 'final subjects' Cases were defined to all lung cancer cases (424) and COPD admission cases (89), while control groups are determined to all other patients than two case groups among 'final subjects'. That is, cases are putative chronic environmental diseases, while controls are mainly acute environmental diseases. for exposure, Air quality data in 73 monitoring sites between 1991 - 1993 were analyzed to surrogate air pollution exposure level of located areas (58 areas). Five major air pollutants data, TSP, $O_3,\;SO_2$, CO, NOx was available and the area means were applied to the residents of the local area. 3-year arithmetic mean value, the counts of days violating both long-term and shot-term standards during the period were used as indices of exposure. Multiple logistic regression model was applied. All analyses were performed adjusting for current and past smoking history, age, gender. Results : Plain arithmetic means of pollutants level did not succeed in revealing any relation to the risk of lung cancer or COPD, while the cumulative counts of non-at-tainment days did. All pollutants indices failed to show significant positive findings with COPD excess. Lung cancer risks were significantly and consistently associated with the increase of $O_3$ and CO exceedance counts (to corrected error level -0.017) and less strongly and consistently with $SO_2$ and TSP. $SO_2$ and TSP showed weaker and less consistent relationship. $O_3$ and CO were estimated to increase the risks of lung cancer by 2.04 and 1.46 respectively, the maximal probable risks, derived from comparing more polluted area (95%) with cleaner area (5%). Conclusions : Although not decisive due to potential misclassication of exposure, these results wert drawn by relatively conservative interpretation, and could be used as an evidence of chronic health effect especially for lung cancer. $O_3$ might be a candidate for promoter of lung cancer, while CO should be considered as surrogated measure of motor vehicle emissions. The control selection in this study could have been less appropriate for COPD, and further evaluation with another setting might be necessary.

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A Study on Consumer Characteristics According to Social Media Use Clusters When Purchasing Agri-food Online (온라인 농식품 구매시 소셜미디어 이용 군집에 따른 소비자특성에 대한 연구)

  • Lee, Myoung-Kwan;Park, Sang-Hyeok;Kim, Yeon-Jong
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.16 no.4
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    • pp.195-209
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    • 2021
  • According to the 2019-2020 social media usage survey conducted by the Seoul e-commerce center, 5 out of 10 consumers have experienced shopping through social media. The cost of traditional advertising media has been reduced and advertising spending on social media has risen by 74%, indicating that social media is becoming a more important marketing element. While the number of users of social media has increased and corporate marketing activities have increased accordingly, research has been conducted in various aspects of marketing such as user motivation for social media, satisfaction, and purchase intention. There was no subdivided study on the differences in the social media usage frequency of consumers in actual purchasing behavior. This study attempted to identify differences in consumer characteristics by cluster in the agrifood purchase situation by grouping them by type according to the frequency of use of social media for consumers who purchase agri-food online. Product involvement, product need, and online purchase channel Consumer characteristics such as demographic distribution, perceived risk, and eating and lifestyle in each cluster were checked for the three agrifood purchase situations including choice, and types for each cluster were presented. To this end, questionnaire data on the frequency of social media use and online agrifood purchase behavior were collected from 245 consumers, and the validity of the measurement variables was secured through factor analysis and reliability analysis. As a result of cluster analysis according to the frequency of social media use, it was divided into three clusters. The first cluster was a group that mainly used open social media, and the second cluster was a group that used both open and closed social media and online shopping malls; The third cluster was a group with low online media usage overall, and the characteristics of each cluster appeared. Through regression analysis, the effect on product involvement, product need, and purchase channel selection when purchasing agri-food online through each of the three clusters was confirmed through regression analysis. As a result of the regression analysis, the characteristic of cluster 1 in the situation of purchasing agri-food online is a male in his 30s living in a rural area who has no reluctance to purchase agri-food on social media or online shopping malls. The characteristics of cluster 2 are mainly consumers who are interested in purchasing health food, and the consumer characteristics are represented. In the case of cluster 3, when purchasing products online, they purchase after considering quality and price a lot, and the consumer characteristics are represented as people who are more confident in purchasing offline than online. Through this study, it is judged that by identifying the differences in consumer characteristics that appear in the agri-food purchase situation according to the frequency of social media use, it can be helpful in strategic judgments in marketing practice on social media customer targeting and customer segmentation.

Selection of Rice Varieties for Production of High Quality Rice in Southern Area of Korea (남부 주요 지역별 고품질 쌀 생산을 위한 적정 품종 선발)

  • Seong, Deok-Gyeong;Jin, Young-Min;Kim, Young-Gwang;Joung, Wan-Kyu;Kim, Cheol Soo;Chung, Jung-Sung
    • Journal of agriculture & life science
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    • v.53 no.2
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    • pp.87-95
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    • 2019
  • This study was carried out to select the rice variety for high quality rice according to reducing N application level (7 kg/10 a) in medium altitude and plain of southern Korea. It was cultivated to seven varieties and ten varieties in medium altitude and plain region respectively in this study. In medium altitude region, the yield of head rice was higher in most varieties except for Borami (526 kg/10 a) than the control variety, Chucheongbyeo (533 kg/10 a). On the other hand, Borami, Gopumbyeo, and onnuri were lower in head rice rate than the other varieties. In addition, Borami and Chucheongbyeo shown a lodging risk but the other varieties were safe against lodging. The milled rice protein content of Chucheongbyeo was 6.1% and the other varieties protein content was similar or lower than that of control except for Borami(6.3%). In plain region, the head rice yield of Nampyeongbyeo (527 kg/10 a) was higher than that of control variety, Ilmibyeo (503 kg/10 a). Head rice rate was lower in Hopumbyoe, Sindongjin, and Chilbobyeo than the other varieties. The varieties contained lower protein content compared Ilmibyeo (6.1%) were Hopumbyeo (5.9%), Jinsumi (6.0%), Sindongjin (5.9%), Chilbobyeo (6.0%), Hwangeumnodeul (5.8%), Hopyeongbyeo (6.0%). Amylose content, whiteness, and palatability (Toyo value) were no significant difference among varieties in two different regions. In conclusion, considering head rice rate, yield of head rice, protein content, lodging resistance, ripening rate and palatability, Pungmi1ho, Saenuri, Chilbobyeo in medium altitude region and Jinsumi, Hwanggumnodul in plain region were selected as proper rice varieties for high quality rice production in southern Korea.

Compatibility of Double Cropping of Winter Wheat - Summer Grain Crops in Paddy Field of Southern Korea (남부지역 논의 밀 이모작에서 하계 곡실작물 도입의 적합성)

  • Seo, Jong-Ho;Hwang, Chung-Dong;Oh, Seong-Hwan
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.66 no.1
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    • pp.18-28
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    • 2021
  • The growth period and productivity of cropping system of winter wheat-rice, winter wheat-bean and winter wheat-grain corn for 4 years from 2015 to 2018 were compared at the experimental field of National Institute of Crop Science in Miryang city. The harvest period of winter wheat was in mid-June, and summer crops were sown (transplanted) in late June. In transplanting of rice in late June, there was no difficulty in securing the heading of panicle and the yield of rice, but there was a lot of trouble in sowing wheat in proper time because the harvest time of rice was delayed to early November due to late maturity of rice, particularly in the mid-late maturing cultivar. There was no problem in soybean planting after winter wheat because the proper period of soybean planting is late-June. In addition, there was no problem in winter wheat sowng after soybean because the maturity period of soybean was mid-October. Selection of grain maize in double cropping with winter wheat in terms of growing periods, was desirable because grain maize had the fastest maturity among summer crops. In double cropping of winter wheat-summer crops, wheats combined with soybean and grain maize showed stable yields during three years, but there was a risk of yield declines in the wheat combined with rice in heavy rainfall year. It was possible to secure high yields in three summer crops as yields of rice, soybean, and corn were 600, 350, and 800 kg/10a, respectively. Summer crops with medium maturity was recommended because of no significant difference in yield between medium maturity and medium-late maturity cultivar. Soil physical properties were improved in soils cultivated with soybean and grain maize. Therefore, It was thought that double cropping systems of winter wheat with soybean and grain maize were superior to that of winter wheat with rice in terms of connecting period between winter wheat - summer crops and improvement of soil physical properties, and total income, particularly in soybean.

Quantitative Assessment of Coronary Artery Diameter in Patients with Atrial Fibrillation and Normal Sinus Rhythm (심방세동 환자와 정상 심전도 환자의 관상동맥 직경 정량적 평가)

  • Seo, Young-Hyun
    • Journal of the Korean Society of Radiology
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    • v.16 no.5
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    • pp.567-574
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    • 2022
  • Coronary artery disease (CAD) and atrial fibrillation (AF) are known to share many risk factors. In particular, in the case of acute coronary syndrome, it may be difficult to clearly determine the diameter of the vessel due to complete occlusion of the vessel and thrombus. Thus, the relationship between the diameter of the coronary arteries was evaluated to be used as a reference data before the treatment of coronary arteries and drug selection in patients with AF. From January 2020 to August 2022, images of coronary angiography (CAG) with AF and normal sinus rhythm (NSR) on electrocardiography were target. In both subjects, images of normal coronary artery without lesions as a result of CAG were used. For all vessels, the diameters of the vessels were measured by dividing them into proximal, middle, and distal parts, and the measured diameters were divided by the average for evaluation. As a result of analyzing the left anterior descending artery diameter, the vessel diameter of the AF patient was 2.24±0.26 mm, which was smaller than that of the NSR patient, 2.86±0.38 mm, and was statistically significant. (p<0.001) As a result of analyzing the left circumflex artery diameter, the vessel diameter of the AF patient was 2.34±0.28 mm, which was smaller than the vessel diameter of the NSR patient, 2.87±0.29 mm, and was statistically significant. (p<0.001) As a result of analyzing the diameter of the right coronary artery, the vessel diameter of the AF patient was 2.68±0.5 mm, which was smaller than the vessel diameter of the NSR patient, 3.35±0.4 mm, and was statistically significant. (p<0.001) Considering that the coronary artery size of AF patients is significantly smaller than the coronary vessel size of NSR patients, it is considered as a useful study to be used as a reference for evaluating coronary artery diameter when the arrhythmia is AF. In particular, it is considered to be a study that can be helpful in diagnosing lesions, using drugs before and after surgery, and choosing to use auxiliary devices such as intravascular ultrasound.

Long-Term Survival Analysis of Unicompartmental Knee Arthroplasty (슬관절 부분 치환술의 장기 생존 분석)

  • Park, Cheol Hee;Lee, Ho Jin;Son, Hyuck Sung;Bae, Dae Kyung;Song, Sang Jun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.427-434
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    • 2019
  • Purpose: This study evaluated the long term clinical and radiographic results and the survival rates of unicompartmental knee arthroplasty (UKA). In addition, the factors affecting the survival of the procedure were analyzed and the survival curve was compared according to the affecting factors. Materials and Methods: Ninety-nine cases of UKA performed between December 1982 and January 1996 were involved: 10 cases with Modular II, 44 cases with Microloc, and 45 cases with Allegretto prostheses. The mean follow-up period was 16.5 years. Clinically, the hospital for special surgery (HSS) scoring system and the range of motion (ROM) were evaluated. Radiographically, the femorotibial angle (FTA) was measured. The survival rate was analyzed using the Kaplan-Meier method. Cox regression analysis was used to identify the factors affecting the survival according to age, sex, body mass index, preoperative diagnosis, and type of implant. The Kaplan-Meier survival curves were compared according to the factors affecting the survival of UKA. Results: The overall average HSS score and ROM was 57.7 and 134.3° preoperatively, 92.7 and 138.4° at 1 year postoperatively, and 79.1 and 138.4° at the last follow-up (p<0.001, respectively). The overall average FTA was varus 0.8° preoperatively, valgus 4.1° at postoperative 2 weeks, and valgus 3.0° at the last follow-up. The overall 5-, 10-, 15- and 20-year survival rates were 91.8%, 82.9%, 71.0%, and 67.0%, respectively. The factors affecting the survival were the age and type of implant. The risk of the failure decreased with age (hazard ratio=0.933). The Microloc group was more hazardous than the other prostheses (hazard ratio=0.202, 0.430, respectively). The survival curve in the patients below 60 years of age was significantly lower than those of the patients over 60 years of age (p=0.003); the survival curve of the Microloc group was lower compared to the Modular II and Allegretto groups (p=0.025). Conclusion: The long-term clinical and radiographic results and survival of UKA using old fixed bearing prostheses were satisfactory. The selection of appropriate patient and prosthesis will be important for the long term survival of the UKA procedure.