• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.321-330
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• 1999

Background : Early diagnosis and proper antibiotic treatment are very important in the management of ventilator-associated pneumonia (VAP) because of its high mortality. Bronchoscopy with a protected specimen brush (PSB) has been considered the standard method to isolate the causative organisms of VAP. However, this method burdens consumer economically to purchase a PSB. Another useful method for the diagnosis of VAP is quantitative cultures of aspirated specimens through bronchoscopic bronchoalveolar lavage (BAL), for which the infusion of more than 120 m1 of saline has been recommended for adequate sampling of a pulmonary segment. However, occasionally it leads to deterioration of the patient's condition. We studied the diagnostic efficacy of minibronchoalveolar lavage (miniBAL), which retrieves only 25 ml of BAL fluid, in the isolation of causative organisms of VAP. Methods: We included 38 consecutive patients (41 cases) suspected of having VAP on the basis of clinical evidence, who had received antibiotics before the bronchoscopy. The two diagnostic techniques of PSB and miniBAL, which were performed one after another at the same pulmonary segment, 'were compared prospectively. The cut-off values for quantitative cultures to define causative bacteria of VAP were more than $10^3$ colony-forming units (cfu)/ml for PSB and more than $10^4$ cfu/ml for BAL. Results: The amount of instilled normal saline required to retrieve 25 ml of BAL fluid was $93{\pm}32 ml$ (mean${\pm}$SD). The detection rate of causative agents was 46.3% (19/41) with PSB and 43.9% (18/41) with miniBAL. The concordance rate of PSB and miniBAL in the bacterial culture was 85.4% (35/41). Although arterial blood oxygen saturation dropped significantly (p<0.05) during ($92{\pm}10%$) and 10 min after ($95{\pm}3%$) miniBAL compared with the baseline ($97{\pm}3%$), all except 3 cases were within normal ranges. The significantly elevated heart rate during ($l25{\pm}24$/min, p<0.05) miniBAL compared with the baseline ($1l1{\pm}22$/min) recovered again in 10 min after ($111{\pm}26$/min) miniBAL. Transient hypotension was developed during the procedure in two cases. The procedure was stopped in one case due to atrial flutter. Conclusion: MiniBAL is a safe and effective technique to detect the causative organisms of VAP.

• Proceedings of the Korean Information Science Society Conference
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• 2006.06c
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• pp.181-183
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• 2006

UML 2.0의 시퀀스 다이어그램은 실시간 특성을 표기할 수 있는 표기법이 추가됨으로써 시간의 엄격성이 중요하게 여겨지는 임베디드 소프트웨어의 행위를 보다 정확하고 상세하게 모델링 할 수 있게 되었다. 시퀀스 다이어그램은 전체 시스템의 부분적인 행위를 기술하여 같은 행위가 여러 다이어그램에 걸쳐서 기술되어지므로 이들 다이어그램들은 서로 일관성을 가져야 하는데 복잡한 시스템에서 일관성을 검사하는 것은 어려운 일이다. 본 논문에서는 행위 모델을 표현하는 시퀀스 다이어그램과 다른 다이어그램에 기술된 실시간 특성들의 일관성을 자동으로 검사할 수 있는 방법을 제안한다. 먼저 서로 다른(inter) 다이어그램들 사이의 시간적인 일관성을 유지하기 위한 제약사항을 파악하여 정의한다. 그리고 모델을 구성하는 인스턴스들에 대한 제약사항을 OCL로 기술하는데 이는 UML 2.0이 발표되면서 모델의 의미를 정확하고 상세하게 표현할 수 있는 메타 모델과 그들의 연관관계가 추가되고 명확하게 정의됨에 따라 가능하게 된 것이다. 이렇게 OCL로 정형화되어 기술된 식은 UML 2.0 메타 모델을 이용한 어느 모델에나 적용 가능하며 모델의 문제점을 발견하고 정확한 모델을 구축하도록 도와준다.

• Clinical and Experimental Pediatrics
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• v.49 no.10
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• pp.1056-1060
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• 2006

Purpose : As hearing ability affects language and cognitive development, early detection and intervention of congenital hearing defects is very important. We analyzed the result of newborn hearing screening using automated auditory brainstem response and estimated the incidence of congenital hearing defects in newborn infants in Korea. Methods : Hearing screening tests were done on 7,218 newborn infants who were delivered at Cheil General Hospital from July 1, 2004 to June 30, 2005. The first screening test was done on the second day of life with automated auditory brainstem response(AABR) using $ALGO{\bigcirc}^{(3)}$ Newborn hearing screener($Natus^{(R)}$ Medical Incorporated, San Carlos, USA) with 35 dB sound level. The newborn infants who did not pass the initial screening test took the second screening AABR test before discharge from the nursery. Infants who did not pass these screenings at the nursery were followed up at the Department of Otorhinolaryngology, Samsung Seoul Hospital. Results : Total 7,218 infants(83.3 percent of total 8,664 live births of the Cheil General Hospital) were screened in the nursery, and 55 of them failed to pass the newborn screening. Among 55 infants who were referred, six were lost during follow-up, and 14 were confirmed as hearing impaired. Six of them(42.8 percent) do not have any risk factors for hearing impairment. We can estimate that the incidence of hearing defects is about 1.9-2.8 per 1,000 live births. Conclusion : Automated auditory brainstem response is an effective tool to screen the hearing of newborn infants. Congenital hearing loss is more frequent than metabolic diseases on which screening tests are available in the newborn period. About 40 percent of infants who have hearing defects do not have any risk factors for hearing impairment. Therefore, universal newborn hearing screening must be recommended to all neonates.

• Journal of Yeungnam Medical Science
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• v.17 no.1
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• pp.39-48
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• 2000

Background: There arc two theories in the development of colon cancer. One is the adenoma-carcinoma sequence theory and the other is the de novo cancer theory. Western countries believe in the adenoma-carcinoma sequence theory, however there are many recent reports from, Japan about cancers developing from small adenomas. Methods: The present study analyzed 408 polyps from 508 cases that were taken by colonoscopic polypectomy at the Department of internal Medicine, Yeungnam University Hospital. Results: The percentage of patients who had a polyp was 41.3% (210 cases out of 526 cases), and the peak incidence was noted in patients in their 50s and 60s, There was no difference between the sexes, but we noted significant increase in the incidence of polyps in patients over the age of thirty. We found 395 polyps below 1cm and 13 polyps above 1cm. Among 408 polyps, 5 cases were cancerous polyps and 3 cases showed polyp size of less than 1cm each. The first case was a polyp of 0.4cm in size with elevated mucosa at the ascending colon. The second was 0.5cm in size with round elevation and hyperemic mucosa in the rectum. The third was 0.6cm in size with tubular elevation at the hepatic flexure. Conclusions: Colon polyp is a common disease in Koreans, Even small polyps can have cancer tissue, which should be removed if discovered during colonoscopy. We believe that not all colon cancer originates in the manner described by the adenoma-carcinoma sequence theory. However further studies with a larger sample population arc needed to determine the exact role of colon polyps in the development of colon cancer.

• Proceedings of the Korean Association for Survey Research Conference
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• 2002.06a
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• pp.8-34
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• 2002

This paper is concerned with evaluating the fidelity of a non-cognitive test adaptation for use in multiple languages and cultures using two differential item functioning(DIF) techniques: (a) PSIBTEST, and (b) Logistic Discriminant Function Analysis(LDFA). In particular, this study focused on how DIF research can best be extended to the problem of evaluating the equivalence of tests across cultures and languages. The Sixteen Personality Factor (16PF) questionnaire was administered in English to 844 American college students and in Korean to 538 Korean college students. This study attempted to identify the best matching criterion for the translated tests by using both a multivariate matching technique and iterative purification process. The results generally showed a small number of DIF items on each scale, except for scales A and N where about half of the items showed DIF. The choice of matching variables based on a combination of internal measures appeared to have little effect and the iterative purification method was unsuccessful. Finally, the results were discussed and methodological implications were also presented.

• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.700-711
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• 2002

Purpose : Early identification and treatment of developmental disabilities is of considerable importance in the health care of children. Screening of development is aimed at identifying infants who may need more comprehensive evaluations. Methods : A new test, the Ewha Infant Development Screening Test(EDST) has been created to screen the development of infants, 0-4 years of age. EDST was constructed so that results can be calculated into developmental ages and developmental quotients. The test consists of three sectors, e.g. language, social-adaptive and motor, and of 158 test items. A total of 104 infants, aged from one month to four years, including healthy infants as well as 10 with chief complaints of developmental delay, who visited the pediatric clinic of Ewha Womans University Dongdaemun Hospital, from June, 25 to November 30, 2001, were given the Bayley Scale of Infant Development as a base test and EDST. Results : The result showed the appropriate cut-off of EDST was 90 with better sensitivity and specificity, compared to cut-offs of 85 or 80. Conclusion : Further study with a large number of infants in the future is needed to make EDST more reliable and accurate.

• Korean Journal of Clinical Laboratory Science
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• v.55 no.1
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• pp.16-28
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• 2023

Lung adenocarcinoma accounts for about 40% of all lung cancers. With the recent development of gene profiling technology, studies on mutations in oncogenes and tumor suppressor genes, which are important for the development and growth of tumors, have been actively conducted. Companion diagnosis using next-generation sequencing helps improve survival with targeted therapy. In this study, formalin-fixed paraffin-embedded tissues of non-small cell lung cancer patients were subjected to hematoxylin and eosin staining for detecting genetic mutations that induce lung adenocarcinoma in Koreans. Immunohistochemical staining was also performed to accurately classify lung adenocarcinoma tissues. Based on the results, next-generation sequencing was applied to analyze the types and patterns of genetic mutations, and the association with smoking was established as the most representative cause of lung cancer. Results of next-generation sequencing analysis confirmed the single nucleotide variations, copy number variations, and gene rearrangements. In order to validate the reliability of next-generation sequencing, we additionally performed the existing genetic testing methods (polymerase chain reaction-epidermal growth factor receptor, immunohistochemistry-anaplastic lymphoma kinase (D5F3), and fluorescence in situ hybridiation-receptor tyrosine kinase 1 tests) to confirm the concordance rates with the next-generation sequencing test results. This study demonstrates that next-generation sequencing of lung adenocarcinoma patients simultaneously identifies mutation.

• Clinical and Experimental Pediatrics
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• v.46 no.5
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• pp.440-446
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• 2003

Purpose : The genetic disturbance of galactosemia is expressed as a cellular deficiency of either galactose-1-phosphate uridyltransferase(GALT) or galactokinase(GALK) or UDP galactose 4-epimerase(GALE). To find-out the pattern of galactosemia in Korea, we retrospectively analyzed cases of galactosemia detected by neonatal screening program. Methods : We analyzed medical records of patients who visited Soonchunhyang University Hospital at age of 1 month after showing abnormalities in neonatal screening of galactosemia. For accurate diagnosis, galactose was measured by enzyme immunoassay(EIA) and fluorophotometer, also galactose-1-phosphate by fluorophotometer. Enzyme activities of GALK, GALT and GALE in RBC and galactose-1-phosphate were measured by radioisotope assay(RIA). Beutler test were done. Patients went on a lactose-free diet and follow-up tests for galactose, galactose-1-phosphate level and enzyme activity were performed. Results : 10 patients(male : 6, female : 4) were diagnosed as galactosemia. Two patients had GALK deficiency and two had GALT deficiency. Six were GALE deficient showing the largest number. In two patients with GALK deficiency, GALT and GALE activities were normal but GALK activities showed respectively reduced activity. For GALT deficiency, two patients had low GALT activity in RBC and showed genotype of Duarte 2/G(galactosemia) in DNA analysis. In one patient, GALT activity was normal. Three patients seemed to be heterozygote state of GALE deficiency according to GALE activity levels. Four patients showed GALK hyperactivity. Conclusion : GALE deficiency provided the highest number. After lactose-free diet, galactose and galactose-1-phosphate were normaly maintained. Neonatal screening on galactosemia is essential for preventing life-threatening symptoms and an accurate diagnosis is needed for finding out the type of galactosemia which is important for prognosis.

• Journal of Yeungnam Medical Science
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• v.20 no.2
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• pp.197-205
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• 2003

서론: 급성 관동맥 증후군과 심근경색증의 진단과 예후 예측에 도움을 주는 새로운 심효소인자가 여러 가지 발견이 되어 현재 응급의료센터에서도 기본적으로 허혈성 흉통이 있는 환자에게 많이 사용하고 있다. 특히 최근에는 troponin과 CK-MB의 유용성에 대해서 많이 언급을 하고 있다. CRP도 역시 급성 관상동맥증후군에서 중요성이 인식되고 있다. 저자들은 세 가지 인자를 동시에 평가하여 상승되는 인자 수에 따라 그 중요성이 다를 수 있다는 가정 하에 총체적인 환자에 대한 정보를 제공할 수 있고, 응급실 근무 의사에게 급성 심근 경색증 환자를 좀 더 효율적으로 평가 할 수 있도록 하기 위하여 다표지 인자에 관한 연구를 시작하였다. 방법: 저자들은 응급의료센터에 내원한 급성 허혈성 흉통이 있는 환자 중 심효소 검사와 심전도에서 급성 심근 경색증에 합당한 소견을 보이고 이후 검사한 심혈관 조영술에서 심근경색증으로 확진된 환자를 대상으로 하였다. 내원 초기에 troponin T와 CK-MB, CRP를 동시에 측정하였고 또한 후향적으로 환자에 대한 기본적인 특징과 정보, 심전도 소견, 합병증 발생, 심혈관 조영술 소견과 경색관련 혈관 수, 치료 및 치료결과 등에 대한 자료를 정리하여 분석하여 보았다. 이때 환자는 두 군으로 나누어 분석하였는데, 1군은 증가된 효소수가 1개 이하인 경우이고, 2군은 2개 또는 3개 및 좌주관상동맥을 포함한 경우로 하였다. 결과: 전체 130명의 환자가 대상이 되었고, 1군 40례, 2군 90례로 2군이 훨씬 많았다. 과거력에서 이전에 관동맥 성형술을 시술받은 경우가 2군에서 유의 있게 많았다(p<0.05). 이전의 약물 복용은 전체적으로 1군에서 많았으나 질산제 복용(p<0.05)을 제외하고는 의의가 없었다. 치료는 혈전용해제 사용이 오히려 1군에서 의의있게 많았으나(p<0.05), 합병증으로 쇽이나 폐부종을 동반한 경우가 2군에서 많았다. 하지만 본 연구에서는 6개월 추적 기간중의 사건 발생이나 합병증, 예후 결과에 대한 양군간의 차이를 발견하지 못했다. 결론: 급성 심근경색증 환자에게 다표지 인자를 이용한 접근법을 적용한 결과, 기본적으로 환자에 대한 몇 가지 정보, 즉 과거에 약물 투여 여부와 혈전용해제 사용, 혈관성형술을 시술 받은 경력과 같은 기초자료에 대한 제한적인 차이를 발견할 수 있었으나, 본 연구에서는 다표지 인자를 이용하여 추적기간중 환자의 상태와 예후를 평가하고 합병증을 조기에 예측한다든지 하는 중요한 역할을 발견하지 못하였다. 그래서 향후 이에 대한 제한점을 해결한 더 보완된 연구가 필요할 것으로 사료된다.

• Journal of Preventive Medicine and Public Health
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• v.24 no.1 s.33
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• pp.93-97
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• 1991

The time honoured tuning fork at present widely available for examining vibration sensation is brought about the problem of great interobserver variation. To resolve t his problem, author developed a divice using electric magnet that stimulates constantly tuning fork. The perception time of vibration from tunung fork by this device was tested on the index finger of dominant hand of twenty eight subjects. It was 12.44 seconds on average and ranged from 9.47 to 17.25. Coefficient of variation of it was 16.89 percent. Correlation coefficient between test and retest after 30 minutes was 0.957(p<0.01). This device is portable. Test procedure in non-invasive, non-aversive and simple, can be performed within one minute, and does not require the skilled technician. It is felt that this device testing vibration perception time is suitable as screening tool for early detection of occupational peripheral neuropathy.