Medical Image Segmentation for Mobile Electronic Patient Charts Using Numerical Modeling of IoT

Internet of Things (IoT) brings telemedicine a new chance. This enables the specialist to consult the patient’s condition despite the fact that they are in different places. Medical image segmentation is needed for analysis, storage, and protection of medical image in telemedicine. Therefore, a variety of methods have been researched for fast and accurate medical image segmentation. Performing segmentation in various organs, the accurate judgment of the region is needed in medical image. However, the removal of region occurs by the lack of information to determine the region in a small region. In this paper, we researched how to reconstruct segmentation region in a small region in order to improve the segmentation results. We generated predicted segmentation of slices using volume data with linear equation and proposed improvement method for small regions using the predicted segmentation. In order to verify the performance of the proposed method, lung region by chest CT images was segmented. As a result of experiments, volume data segmentation accuracy rose from 0.978 to 0.981 and from 0.281 to 0.187 with a standard deviation improvement confirmed

Sustained downgaze as the only remained sign after regaining consciousness in hepatic encephalopathy

Sustained downgaze mostly occurs in association with lesions affecting the dorsal midbrain. We report sustained downgaze in a patient with hepatic encephalopathy. The sustained downgaze existed for seven more days after she regained her consciousness. The persistent downgaze even after regaining full consciousness indicates localized pretectal dysfunction rather than diffuse encephalopathy as the mechanism of sustained downgaze in our patient. The ocular motor dysfunction in hepatic encephalopathy may be due to localized dysfunction of the brainstem.OAIID:oai:osos.snu.ac.kr:snu2014-01/102/0000004487/22SEQ:22PERF_CD:SNU2014-01EVAL_ITEM_CD:102USER_ID:0000004487ADJUST_YN:YEMP_ID:A075641DEPT_CD:801CITE_RATE:.244FILENAME:park dg-hepatic encephalopathy-2014.pdfDEPT_NM:의학과SCOPUS_YN:YCONFIRM:

Differences in perspectives of pediatricians on advance care planning: a cross-sectional survey

Background The increase in the number of pediatric patients with complex health conditions necessitates the application of advance care planning for children. Earlier, withdrawal of life-sustaining treatment was taboo in the medical society in South Korea due to the history of such practice being punishable by law, and physicians tended to pursue aggressive treatment. With changes in public opinion on end-of-life care, the Korean government enacted a new law that protect human dignity by respecting patients self-determination and facilitating advance care planning. However, little is known about current state of advance care planning for pediatric patients. The study aimed to assess perceptions regarding advance care planning among South Korean pediatricians and clarify any differences in perception among pediatric subspecialties. Methods This study was an observational cross-sectional survey that used a web-based self-report questionnaire. Participants comprised of pediatricians currently caring for children with life-limiting conditions in 2018. Results Of the 96 respondents, 89 were included in the analysis. In a hypothetical patient scenario, more hemato-oncologists and intensivists than neonatologists and neurologists preferred to provide comfort care than aggressive treatment. While 72.2% of hemato-oncologists reported that they usually or always discuss advance care plans with parents during treatment, more than half of other pediatricians reported that they seldom do so. Furthermore, 65% of respondents said that they never discuss advance care planning with adolescent patients. Moreover, there were no notable differences among subspecialties. The most prevalent answers to factors impeding advance care planning were lack of systemic support after performing advance care planning (82.0%) and uncertain legal responsibilities (70.8%). Conclusions The pediatricians differed in their experiences and attitudes toward advance care planning based on their subspecialty. Consequently, institutional support and education should be provided to physicians so that they can include children and families in discussions on prognosis.The authors disclose receipt of the following financial support for the research, authorship, and/or publication of this article: this work was supported by the Korea National Institute for Bioethics Policy, awarded by the 2018 Bioethics Policy Research Program and partially by the National Cancer Center (No. 1932570–1). The views expressed in this paper are the views of the authors and do not necessarily reflect those of the funders. The funders had no influence on the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript

The Role of Alcoholics' Insight in Abstinence from Alcohol in Male Korean Alcohol Dependents

This study was performed to examine the relationship between the abstinence results of alcohol dependents after discharge and the level of insight at the time of discharge. 117 male Korean alcohol dependents discharged from a community-based alcohol treatment center were followed up to determine the initial months of abstinence on a successive basis (IMA), total months of abstinence during 12-month period (TMA), and complete abstinence for one full year after discharge. Analyses of abstinence results with adjustment for the differences in baseline characteristics were performed for subjects' insight levels (poor, fair and good). The mean IMA of patients with good insight was significantly (p<0.01) longer than that of patients with poor insight and TMA of patients with good insight was significantly (p<0.001) longer than that of others. Using patients with good insight as the reference, patients with poor insight showed an adjusted odds ratio (OR) of 0.07 (95% confidence interval [CI]=0.01-0.75, p<0.05) for complete abstinence for one full year after discharge and patients with fair insight, adjusted OR of 0.17 (95% CI=0.03-0.81, p<0.05). These results suggest that alcohol dependents' insight could be regarded as a factor related with abstinence