• Title/Summary/Keyword: 어려운 환자

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The Usefulness of Rapid Triple Test for Cardiac Marker in Forensic Paragnosis of Sudden Cardiac Death (심장표지물질 간이검사의 급성심장사 법의학적 사후진단 유용성에 관한 연구)

  • Lim, Chae-Won;Kim, Jin-Gak
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.2
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    • pp.108-113
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    • 2017
  • A sudden cardiac death (SCD) is defined as an unnatural sudden death caused by heart disease. To determine the cause of death, observation of the microscopic change in cardiac muscle tissue is suggested, rather than visual postmortem examination. However, this suggestion is time consuming to be applied in the field, is cost-ineffective, and is inconvenient. Therefore, the purpose of this study is to understand whether temporary inspection used to examine the cardiac marker (Myoglobin, CK-MB, cTn I) in postmortem blood via rapid cardiac triple test kit (which is used by clinics to diagnose patients with acute myocardial infarction) can effectively be utilized for the paragnosis of sudden, unnatural cardiac death. The results of postmortem examination and temporary investigation found that 23 groups (76.7%), among the 30 experimental groups, were assumed to be non-traumatic sudden cardiac deaths, which indicated a positive response (according to comparison with forensic autopsy); 4 groups, among the 10 control groups, were assumed to be cerebrovascular disease, which indicated a negative response; 1 group was assumed to be alcoholic and drug poisoning, indicating a positive response; and 1 group was assumed to be oxygen deficiency due to suffocation, indicating a positive response. Hence, it was found that the level of sensitivity and specificity of cardiac marker's temporary inspection showed significant result, 76.7% and 80% respectively. Given this, temporary inspection can be effectively used for the paragnosis of sudden cardiac death when the medical history, situation of the site, and postmortem interval are considered together. With the result of precedent research on time of first revelation and extinction in blood, and difference in concentration over time progress according to the characteristic of cardiac marker's (myoglobin, CK-MB, cTn I) individual material, further research on concentration of cardiac marker per each post time needs to be conducted in order to estimate time science death (which is required to identify the cause of death and investigation).

Comparison of crown designs of different dental occupational groups, using CAD-CAM (CAD-CAM을 이용하여 디자인한 금관의 치과 직업군에 따른 형태 비교)

  • Kim, TaeHyeon;Kim, Jong-Eun;Lee, Ah-Reum;Park, Young-Bum
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.3
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    • pp.234-238
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    • 2016
  • Purpose: Increasing use of computer aided design-computer aided manufacturing (CAD-CAM) system and number of design software made design of restoration easy and quick. Outcome of restoration has been dependent on dental technician's wax up proficiency, dentists can design restoration for themselves now. This study aims to investigate the outcome of restoration designs, according to handling skill of CAD-CAM design tool. Materials and methods: A patient's mandibular right 1st molar was prepared. After taking impression, stone model was made, scanned the stone model with 3 shape intra-oral scanner, stereolithography (STL) file was extracted. With 3shape dental designer, one dental technician with more than 5 years work experience (designer 0) and three dental technicians with less than 2years work experience (designer 1, 2, 3-group DT) and 4 1st year residents (designer 4, 5, 6, 7-group RT) designed gold crown on the same STL file. Designed crown's MD (mesio-distal) and BL (bucco-lingual) diameter, height of crown, inter-cuspal distance, number of occlusal contact points were compared. Statistical analysis was carried out, test of normality within each group, using independent t-test. Number of contact points were compared, using Wilcoxon signed-rank test. Results: There was no significant difference between group DT and group RT. Number of contact points also resulted in no significant difference. Conclusion: The outcome of each designed crowns showed no statistical differences, in values which can be expressed as numbers. Subjective factors were different. With increasing proficiency in handling designing software, fabrication of restorations according to each designer's occlusal concept can be made easy.

Differentiation of Entomoeba histolyticn and Entcmoeba dispor in cyst-passers by immunoblot (면역이적법을 이용한 아질아메바와 동형아메바의 감별진단)

  • 이미정;홍성태
    • Parasites, Hosts and Diseases
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    • v.34 no.4
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    • pp.247-254
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    • 1996
  • Differentiation of invasive strains of Entamoebn histolytica according to their pathogenicity has been a topic of long debate, but now the pathogenic species only is regarded as E. histolytica while the non-pathogenic species is E. dispar. The present study applied immunoblot to differentiale infections of the two species among microscopically- detected cyst-passers in Korea. The crude extract of 5. histolyticn separated in 5-20% gradient gels, revealed many fractions of 94. 81. 71, 50. 44, 38.5. 37.5, 29, 19. and 18 kDa when the cysteine proteinase inhibitor. E64, was supplemented. The serum IgG antibody of 3 proven E. histolytirc cases reacted loth the antigenic fractions of 117. 110. 99.68,66,60.54.52, 46. and 45 kDa. Sera of PCR confirmed 3 cases of E. disper reacted only to the 117 kDa fraction or the E. histolytica crude extract which was regarded as non specific. To the antitigen of monoxenic E. dispar. sera or E. dispar and E. histolytica cases showed the same immunoblot reactions. The serum IgG antibody reacted with several antigenic fractions of both E. histolytica and E. dispar. but IgM and IgE antibodies showed no reaction to either antigen. Sera of 24 symptomless amebic cyst-passers were screened with the E. histolytica alltigen; two were found to be infected by E. histolytica and 22 were by E. dispar. The present findings suggest that in Korea most of asymptomatic cyst passers of E. histolytica are carriers of E. dispar. Immunoblot using E. histolytica antigen is a good technique for the differentiation of E. histolytica and E. dispar infections.

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An Study on the Correlation between Sound Characteristics and Sasang Constitution by CSL (CSL을 통한 음향특성과 사상체질간의 상관성 연구)

  • Shin, Mi-ran;Kim, Dal-lae
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.1
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    • pp.137-157
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    • 1999
  • The purpose of this study is to help classifying Sasang Constitution through correlation with sound characteristic. This study was done it under the suppose that Sasang Constitution has correlation with sound spectrogram. The following result were obtained about correlation between sound spectrogram and Sasang Constitution by comparison and analysis 1. Soeumin answered his voice low tone, smooth and quiet in the survey. Soyangin answered his voice high, clear, fast and speaking random. Taeumin answered his voice low, thick and muddy. 2. Taeyangin was significantly slow compared with the others in the time of reading composition. Taeyangin was significantly slow compared with the others in Formant frequency 1. Taeyangin was significantly discriminated from Soeumin in Formant frequency 5. Taeyangin was significantly low compared with the others in Bandwidth 2. Soeumln was significantly low compared with Taeyangin in Pitch Maximum and Pitch Maximum-Pitch Minimum. Taeyangin was significantly high compared with the others in Energy mean. 3. In list of specification, the discrimination rate was higher than that by lists of 13 in the results of Multi-dimensional 4-class minimum-distance. The discrimination rate of three disposition except Soyangin was higher than that of four disposition in the results of One way ANOVA and Analysis of dis crimination in SPSS/PC+. In CART, the estimate rate of Sasang Constitution discrimination was higher than any other method. It is considered that there is a correlation between sound spectrogram and Sasang constitution according to the results. And method of Sasang constitution classification through sound spectrogram analysis can be one method as assistant for the objectification of Sasang constitution classification.

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A study on the correlation between Sound Characteristic and Sasang Constitution by Laryngograph, EGG (Laryngograph와 EGG를 이용한 음향특성(音響特性)과 사상체질간(四象體質間)의 상관성(相關性) 연구(硏究))

  • Kim, Sun-hyung;Shin, Mi-ran;Kim, Dal-rae;Kwon, Ki-rok
    • Journal of Sasang Constitutional Medicine
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    • v.12 no.1
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    • pp.144-156
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    • 2000
  • Purpose of this study is to help classifying Sasang Constitution through correlation with Larynx waveform. This study was done it under the suppose that Sasang Constitution would be correlation with Larynx waveform. The following result were obtained about correlation between Erectroglottograph waveform and Sasang Constitution by analysis EGG program. 1. Taeumin was lower than Soyangin in Open Std Deviation, Contact Std Deviation of male/a/(0.5sec) 2. Soeyangin was high compared with the others in Pitch range of maie/a/(2.5sec) 3. Taeumin was higher than Soeumin in Pitch range, Soeyangin in pitch Maximum, and the others in Pitch Std Deviation of female/e/(0.5sec) 4. Taeumin was higher than Soeumin in Contact Maximum and lower than Soeumin in Contact Maximum of female/a/(2.5sec) 5. There was no significantly difference in male/e/(0.5sec), male/e/(2.5sce), female/a/(0.5sec), female/e/(2.5sec) 6. The percent of correctly classified in Soeoumin and Taeumin was high in CART Algolism. The risk estimate of Soyangin was relatively high. The study may be use on of the method to make objective diagnosis in Sasang constitution.

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Effect of Crab Shell on Shelf-life Enhancement of Kimchi (게껍질의 김치보존성 향상효과)

  • 김순동;김미향;김일두
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.25 no.6
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    • pp.907-914
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    • 1996
  • To enhance the shelf-life and quality of baechu kimchi, the effects of CSP(crab shell powder) addition to kimchi was investigated. Overall qualities were deteriorated by fish odor, chewiness of particles, sharp pH increase at the early fermentation stage; therefore in order to solve these problems kimchi fermentation was carried out with kimchi containing 1, 3, 5% CSPB for salted baech weight at $10^{\circ}C$ for 300ays. Quality of kimchi was evalutated by the measurement of pH, acidity, colour L, a, and b value, the number of microbe and lactic acid bacteria, texture. Ten highly trained panelists were involved in the sensory evaluation. During the entire fermentation periods, pH, hardness, colour L, a and b value, the number of lactic acid bacteria of kimchi with CSPB were higher than those of control, but acidity was lower. Sensory quality showed that sour taste of control at 15-day fermentation was already strong. However, sour taste, crispness taste, and overall taste of kimchi with CSPB untill 20-day fermentation were good. Especially, overall taste of kimchi containing 3% CSPB at 30-day fermentation was good, but that of kimchi containing 5% showed fish odor from the early periods of fermentation.

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Prevalence of Arthritis and Health Behavior Related Risk Factors of the Older Residents in Andong Rural Area (안동 농촌지역 중년 및 노인 주민의 관절염 유병율과 건강습관 관련 위험요인 분석)

  • Lee, Hye-Sang;Kwon, Chong-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.9
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    • pp.1187-1194
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    • 2009
  • This study was performed to estimate the prevalence and the risk factors of arthritis in Andong rural area in 2003. The subjects were 1,462 people (544 males, 818 females) aged 45 years and over. The arthritis group was composed of 322 people (72 males, 250 females), diagnosed by doctor or self-diagnosed by the symptoms. Prevalence of arthritis was higher in female (27.2%) compared to male (13.2%). Mean age of arthritis group was significantly higher than that of normal group (male 66.2 vs 62.8, female 62.6 vs 60.1, p<0.001). The anthropometric measurements, such as % body fat, body mass index (BMI), and waist circumference, and the biochemical measurements, such as plasma triglyceride and total cholesterol level, were significantly higher only in female (not in male) arthritis group than those in normal group. Health related lifestyle factors, such as smoking, alcohol drinking, and exercise, were not different between both groups. The risk factors for arthritis were analyzed using the multiple logistic regression method and expressed as odds ratio (OR). The results showed that female compared to male (OR=1.983), over 65 years compared to 45$\sim$64 years (male OR=2.769 and female OR=1.461), and obese female subjects (not for male) by % body fat ($\geq$32% OR=2.035) or BMI ($\geq$25 kg/$m^2$ OR=1.556) showed significantly higher risk factors for arthritis. Regarding nutrient intakes, higher intakes of fat (OR=1.443), calcium (OR=1.503), iron (OR=1.518) and vitamin A (OR=1.390) in female seemed to be risk factors. In contrast to female, higher intakes of vitamin A (OR=0.526) and riboflavin (OR=0.582) seemed to decrease the risk for arthritis in male. This study revealed that the prevalence of arthritis was significantly higher in female and aged individuals. Also, in order to decrease the prevalence and/or prevention of arthritis, female should prevent overfatness and decrease some nutrient intakes, while male should increase their intakes.

Schwannoma of the Extremities (사지에 발생한 신경초종)

  • Bahk, Won-Jong;Rhee, Seung-Koo;Kang, Yong-Koo;Lee, An-Hi
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.2
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    • pp.148-154
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    • 2003
  • Purpose: To correlate the significant MRI findings and histologic features of the Schwannoma of the extremities and to review the clinical characteristic and the result of the surgical enucleation. Materials and Methods: 67 patients with pathologically proven Schwannoma of the extremities, who were surgically treated at our institutes between January 1996 and June 2002, were selected for this study. The clinical records, EMG, MRI and histologic findings were reviewed. Age of the patients ranged from 8 to 75 years with average of 44.7 years. Mean follow-up period was 9.7 months with raging from 3 months to 46 months. Results: On MRI, Schwannoma shows a well-demarcated fusiform mass with a low to intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images, which is connected to parent nerve. A target pattern with peripheral hyperintensive rim and central low intensity on T2-weighted images was seen in 6 cases (15%), and fasciculation pattern with inhomogenous intensity in the hyperintensity on T2-weighted images was observed in 24 cases (62%). Various degree of cystic degeneration was discovered in 25 cases (64%). Postoperative complications include tingling sense or radiating pain in 5 patients, paresthesia in 2 patients, nerve palsy in 2 patients, but all of the complications were recovered during followup period. There were no local recurrence or malignant change. Conclusion: MRI demonstrates characteristic findings of Schwannoma, and very useful tool for preoperative diagnosis and planning of surgery. Exact preoperative diagnosis and meticulous enucleation are enough option of treatment.

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Clinical Review of Pulmonary Tuberculosis in Teenagers According to the Involved Lung (소아청소년기 폐결핵의 방사선상 침범위치에 따른 배양 양성률과 임상양상에 대한 연구)

  • Im, Bong Chil;Kim, Young;Kim, Kyoung Sim;Kim, Yong Wook;Kim, Eun Young;You, Eun Jung;You, Ju Hee;Cho, Hyoung Min
    • Pediatric Infection and Vaccine
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    • v.17 no.2
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    • pp.148-155
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    • 2010
  • Purpose : The purpose of this study was to investigate clinical features and culture-positive rates according to the involved lung in adolescent pulmonary tuberculosis (TB). Methods : We retrospectively reviewed the medical records of adolescents who ranged in age from 10 to 20 years and who had been hospitalized with a diagnosis of TB at Kwangju Christian Hospital from 2000 to 2008. Results : Sixty-six patients were identified with pulmonary TB: median age 16.82 years; 48.5% males. Among them, 90.9% of patients were between 15 and 20 years of age. Most patients presented with multiple symptoms, and the most common included cough (74.2%), sputum (60.6%), fever (39.5%), and night sweating (18.2%). Sputum samples were smear-positive in 28 (42.4%), culture-positive in 40 (60.6%), and PCR-positive in 46 (69.7%). The most common radiological patterns included cavitation in 18 (27.3%), pleural effusion in 18 (27.3%), lymphadenopathy in 10 (15.2%), and tuberculoma in 5 (7.6%). The prevalence of smear, culture, and PCR positive rates increased as the number of involved lobes increased (P<0.05, P<0.01, P<0.05). The median treatment duration was 7 months. Twelve patients (18.2%) had lower lung field TB (Group A) and forty-four patients (66.7%) had other areas involving TB, except for Group A (Group B), and ten patients (15.1%) had only TB pleurisy (Group C). The difference of clinical characteristics and culture rates between group A and group B was not significant. Conclusion : Pulmonary TB toward late adolescence is increasing. We need to pay more attention to lower lung field TB, which is difficult to detect with specific radiographic findings.

Comparison of C-reactive Protein between Capillary and Venous Blood in Children (소아에 있어서 C-반응성 단백의 모세혈 및 정맥혈 검사의 비교평가)

  • Jin, Ji Hoon;Jung, Soo Ho;Hong, Young Jin;Son, Byong Kwan;Kim, Soon Ki
    • Pediatric Infection and Vaccine
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    • v.17 no.2
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    • pp.101-107
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    • 2010
  • Purpose : In evaluation of patients, laboratory results are crucial in determination of a treatment plan. Obtaining venous blood from infants and children is a difficult procedure. Substitution of a capillary blood sample for a venous blood sample has been suggested. However, there are few studies showing mutual correlation between C-reactive protein (CRP) results in capillary and venous blood. This study was designed to determine whether the result of the capillary sample is the same as the result of the venous blood sample. Methods : After informed consent, a pair of venous and fingertip capillary blood samples were simultaneously collected from 100 children. The LC-178CRPTM was used for analysis of capillary blood and the Hitachi 7180 automatic hematology analyzer was used for analysis of venous blood. We compared CRP of both venous and capillary blood samples. Results were analyzed by crosstabulation analysis, simple regression analysis and the Bland Altman Plot method. Results : A close correlation (90.63%) was observed between capillary and venous blood analyzed by crosstabulation analysis. CRP results were similar between the two groups and showed a high coefficient correlation ($\beta$=1.3434, $R^2$=0.9888, P<0.0001) when analyzed by a simple regression model. The average value in venous blood was also higher compared to capillary blood. According to Bland Altman Plot analysis, lab results were measured at a 95% confidence interval. Conclusion : CRP results from capillary blood showed close correlation with venous blood sampling. At present, venous blood sampling is the preferred method. However, due to difficulty in venous blood sampling, capillary sampling could be considered as an alternative technique for use with children.