• Title/Summary/Keyword: 임상적 연관성

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Comparisons of HRV Parameters Among Anxiety Disorder, Depressive Disorder and Trauma·Stressor Related Disorder (불안장애, 우울장애, 외상 및 스트레스 관련 장애의 심박변이지표 비교 연구)

  • Kim, Ji-eun;Park, Do-won;Han, Ji-yeon;Lee, Jung Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.81-88
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    • 2020
  • Objectives : This study aimed to compare autonomic nervous system (ANS) dysregulation and differential relationships with clinical severities between anxiety disorder, depressive disorder, and trauma·stressor related disorder using heart rate variability (HRV) parameters. Methods : We conducted a retrospective chart review of outpatients from 2017 to 2018 in Stress Clinic of National Center for Mental Health. Total 473 patients were included; 166 anxiety disorder; 184 depressive disorder ; 123 trauma·stressor related disorder. Parameters of 5-min analysis of HRV were compared in three groups. Additionally, we investigated the differential association of each parameters with Clinical Global Impression-Severity Scale (CGI-S) across each group. Results : No significant differences were found in all HRV parameters between the three groups. However, significant group interactions by CGI-S were found in standard deviation of all RR intervals (SDNN) and the square root of the mean squared differences of successive normal-to-normal intervals (RMSSD) (SDNN, p=0.017 ; RMSSD, p=0.034). A negative relationship between CGI-S and SDNN, RMSSD has been found in anxiety disorder and depressive disorder. However, a positive relationship between CGI-S and SDNN, RMSSD has been found in trauma·stressor related disorder. Conclusions : Despite of no significant differences of each HRV parameter, our findings suggested the differential associations of HRV parameters with clinical severity among anxiety disorder, depressive disorder and trauma·stressor related disorder. In trauma·stressor related disorder, the clinical severity and degree of ANS dysregulation may differ, so more aggressive treatment is suggested.

Study on Correlation between Cognitive Impairment and Geriatric Depression or Geriatric Stress (인지기능과 노인성 우울, 노인성 스트레스의 연관성에 대한 연구)

  • Kim, Dae Jin;Cho, Soo-Young;Choi, Jeong Su;Lee, Min Woo;Cho, Eun-Kyung;Kang, Se-hee;Kim, Suhng Wook
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.1
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    • pp.105-113
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    • 2019
  • This study examined the effects of geriatric depression and geriatric stress on cognitive impairment. In particular, the dementia groups were divided into Alzheimer's disease and vascular dementia. A normal group was used as the control group. For each group, the geriatric depression using the geriatric depression scale (GDS) and geriatric stress using the geriatric stress scale (GSS) was compared with the regression and correlation results of cognitive impairment. Statistical tests, such as descriptive statistics, Kruskall-Wallis, correlation analysis, and multiple regression analysis, were performed. For the Alzheimer's group, the GDS and GSS correlated with the cognitive impairment, but only the GDS showed a cause-and-effect relationship with cognitive impairment. In particular, the male group with Alzheimer's disease showed clear confirmation. In addition, geriatric stress was found to be associated with geriatric depression. In conclusion, geriatric depression affects the cognitive impairment directly and geriatric stress affects the cognitive ability indirectly through geriatric depression. In this study, the Alzheimer's disease, vascular dementia, and control groups had a small sample size. Therefore, the external validity in future studies can be increased using a larger sample size for each group.

국소적 소인에 의한 구강내 출혈

  • Park, Gwang-Ho
    • The Journal of the Korean dental association
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    • v.27 no.7 s.242
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    • pp.609-610
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    • 1989
  • 국소적 소인에 의한 구강내 출혈은 구소적 감염이나 원인 혹은 외상등에 의해 야기되는 것으로 혈액응고에 관여하는 여러인자의 양적, 질적 이상으로 유발되는 출혈성 소인에 의한 출혈과는 구별되어 진다. 대부분의 치과의사가 접할 수 있는 가장 흔한 출혈은 국소적 소인에 의한 것이며, 명심해야 될 사항은 이런 국소적 소인에 전신적 출혈성 소인의 한 요소일 수도 있다는 점이다. 이에 치과의사들은 구강내에서 국소적 원인을 쉽게 발견 치료할 수도 있으나, 전신적 출혈성 소인에 대한 연관성 조사를 항시 염두에 두어야 하겠다. 출혈성 소인에 의한 출혈은 특별한 외상 없이도 되부, 점막, 관절등에 자연히 출혈이 일어나며, 가벼운 외상에 의해서도 쉽게 출혈하는 경향이 있는 점이 국소적 소인에 의한 출혈과의 감별사항이다. 가장 관찰하기 쉬운 곳이 피부 및 점막으로 출혈하여 피가 모인 것을 자반(Purpura)이라 하며, 크기 및 정도에 따라 모세혈관에서의 출혈은 점상출혈(Petechia), 세동맥 및 세정맥에서의 출혈은 반상출혈(Ecchymosis), 좀더 심부에서 출혈하여 촉지되는 혈종(Hematoma)으로 나눌 수 있다. 임상적으로 구별되는 이런 양상을 잘 관찰하고 주의해야 하겠다.

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An Investigation of Retirement Expectation among Medical Technologists in Korea (한국 임상병리사들의 은퇴 기대 조사)

  • Jo, Yoon-kyung;Lee, Duck-Hye;Sung, Hyun-Ho
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.2
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    • pp.171-179
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    • 2017
  • This study investigated the influence factors of retirement expectations among medical technologists at medical centers in Seoul and Gyeonggi area, Korea. Subjects were 158 medical technologists. Using a sampling survey method, data was analyzed between July 2015 and December 2016. There was a negative correlation between educational level and economic preparation, but gender and monthly income did not reach retirement expectation level. Conversely, we found no change in the trends with respect to gender, monthly income; nonetheless, we observed that frustration gradually increased with age and working duration. In conclusion, our findings show that there are four factors that significantly influence retirement expectation and preparation: age, level of education, working duration, and family condition. This study contributes to understanding retirement expectations and can be a reference for retirement preparation in medical technologists.

Correlation between Infiltrations of Tumor-associated Macrophages, Mast Cells, and Dendritic Cells with Clinicopathologic Factors in Advanced Gastric Cancer (진행성 위암에서 종양 연관성 대식세포, 비만세포, 가지세포의 침윤과 임상-병리학적 인자와의 연관성)

  • Lee, Seung-Bum;Chi, Kyong-Chon
    • Journal of Gastric Cancer
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    • v.5 no.3 s.19
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    • pp.206-212
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    • 2005
  • Purpose: Angiogenesis has a critical role in tumor proliferation, invasion, and metastasis. In gastric cancer, tumor-associated macrophages and mast cells produce angiogenic factors such as VEGF, that inhibit the functional maturation of dendritic cells. The aim of this study is to identify tumor-associated macrophages, mast cells, dendritic cell infiltrations, and microvessel densities (MVD) to investigate the relationship between them and the prognosis for gastric-cancer patients. Materials and Methods: The subjects were 79 patients selected from those who had undergone a curative gastric resection for stomach cancer. With them, Immune-histochemical staining was done using CD34 for the MVD, CD68 antigen for macrophages, and S-100 protein for dendritic cells, and toluidine blue staining was done for mast cells. Results: Macrophage infiltration showed a statistically significant positive correlation with histologic differentiation and a negative correlation with invasion depth, nodal metastasis, and stage. S-100 (+) dendritic cells and mast cells had no significant correlations with histologic differentiation, invasion depth, nodal metastasis, distant metastasis, stage, and MVD. As survival, no statistically significant differences were seen between the variables. Conclusion: Tumor-associated macrophages should be evaluated as possible prognostic markers in gastric-cancer patients.

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The Efficiency of Objective Structured Clinical Examination (OSCE) as a Method of Clinical Clerkship in the Korean Ophthalmology & Otolaryngology Department (한방안이비인후과에서 임상실습 한 방법으로서 Objective Structured Clinical Examination (OSCE)의 효용성)

  • Jang, Yu-Jin;Hong, Seug-Uk
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.27 no.4
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    • pp.121-130
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    • 2014
  • Objectives : 본 연구를 통하여 한방안이비인후과 임상실습에서 Objective Structured Clinical Examination (OSCE) 수업의 효용성을 알아보고자 한다. Methods : 2014학년도 한의과대학 본과 4학년 학생을 대상으로 안이비인후과 임상실습의 한 방법으로 OSCE를 시행한 후, 학생들은 OSCE 수업 만족도에 관한 설문지를 작성하고 레지던트는 학생들을 평가하였다. OSCE 평가 성적과 기타 임상실습 및 필기시험 성적과의 연관성을 분석하여 OSCE 성적의 학점 부여 타당도를 살펴보았다. Results : 만족도 관련 설문 결과 총 평균점수가 4.34점이 나왔다. OSCE성적과 기타 임상실습 및 필기시험 성적과의 상관성을 pearson correlation을 통하여 살펴본 결과, OSCE성적은 임상실습 성적 및 (r=0.210, p=0.056), 필기시험 성적과 통계적으로 유의한 상관성이 없었다 (r=0.064, p=0.567). Conclusions : 위의 결과로부터 임상실습에서 OSCE 시행은 학생들의 학습 만족도를 높인다는 것을 알 수 있었다. 임상실습에서 효율적으로 OSCE를 활용하는 방안을 모색하기 위해 더 많은 연구가 필요할 것으로 생각된다.

Analysis of Prognostic Factors according to WHO Classification for Thymic Epithelial Tumor (흉선종의 WHO 분류에 따른 예후인자의 임상적 고찰)

  • 서영준;금동윤;권건영;박창권
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.684-690
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    • 2004
  • Background: Primary thymic epithelial neoplasm is a type of mediastinal tumors that have various biologic and morphologic features. In this study, we reclassified 59 cases of thymic epithelial tumors by the new WHO classification. We inquired whether the new WHO classification has independent prognostic relevance by analyzing clinical characteristics of thymic epithelial tumors including Masaoka's clinical stage. Material and Method: From December 1986 to August 2003, 59. patients who underwent surgery in the Keimyung University Dongsan Medical Center with definite diagnosis of thymic epithelial tumor were studied. We analyzed the histologic subtype (WHO classification). clinical stage (Masaoka's clinical stage) and patient's characteristics (sex, age, myasthenia gravis, tumor size, invasion. recurrence, metastasis) as prognostic factors. We analyzed the relationship between histologic subtype and clinical stage. Result: 32 patients were male and 27 were female. Mean age was 50.1$\pm$14.2. From WHO A to C, all thymic epithelial tumors were reclassified by the new WHO classification. Six patients (10.2%) had Type A, 7 (11.9%) had Type AB, 7 (11.9%) had Type B$_1$, 10 (16.9%) had Type B$_2$ and 7 (11.9%) had Type B$_3$, 22 (37.3%) had Type C. Two factors were shown by multivariate analysis to be associated with a favorable prognosis: completeness of resection (p=0.003) and non-invasiveness (p=0.001). The overall 5-year survival of the 59 patients was 53%, subtype A and AB were 92.3%, B$_1$ and B$_2$ were 70.2%, and B$_3$ and C were 26.1%. The association between histologic subtype and invasive behavior (stage) was statistically significant (p<0.001). Conclusion: The WHO classfication is not only a histologic classfication of the thymic epithelial tumors but also a significant prognostic factor that influence the survival of thymic epithelial tumors.

Henoch-Schönlein purpura associated with Mycoplasma infection (마이코플라스마 감염증과 관련된 Henoch-Schönlein 자반증)

  • Kim, Hyung Wook;Kim, Young Dae;Kim, Woo Kyung;Lee, Chong Guk
    • Pediatric Infection and Vaccine
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    • v.14 no.1
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    • pp.62-68
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    • 2007
  • Purpose : The cause and pathogenesis of Henoch-Sch$\ddot{o}$nlein purpura (HSP) are unknown, but recently the hypothesis that immunoglobulin A may have an important role in the pathogenesis of HSP is being published and HSP associated with mycoplasma infection has been also reported. The aim of this study is to discover relation between HSP and mycoplsma infection. Methods : From Jan. 2002 to Dec. 2005, we retrospectively evaluated 98 children who were diagnosed as HSP at Ilsan Paik Hospital. 84 patients were not associated with mycoplasma infection (group A) and 14 patients were associated with mycoplasma infection (group B). We compared both groups about clinical features. Results : The ratio of male to female patients in group A and B were 1.21:1 and 1.80:1. The number of patients in group A was most in November and December, and in group B was most in November. All patients had non-thrombocytopenic purpura concentrated on the buttocks and lower extremities and joint involvement was most common on the feet and ankle in both groups. 57 (67.9%) cases in group A and 9 (64.3%) cases in group B complained of abdominal pain. And 21 (25.0%) cases in group A and 5 (35.7%) cases in group B had nephritis. Elevated mycoplasma antibody titer (${\geq}1:320$) or 4 fold-rise were noted in 14 of 98 patients (14.3%). In this study, there was one child with HSP preceded by typical mycoplasma pneumonia (mycoplasma antibody titer 1:1280). Conclusion : In this study, elevated mycoplasma antibody titer (${\geq}1:320$) or 4 fold-rise were noted in 14 of 98 patients and the difference of clinical features between group A and B was not specific. The role of mycoplasma infection in the etiology of HSP may have been implicated, so the association with mycoplasma infection should have to be proved by further controlled studies.

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Metabolic Complications Associated with HIV and Highly Active Antiretroviral Therapy : Overview & A Clinical Case Report (HIV와 HAART 요법과 관련된 대사합병증: 개요 및 임상증례보고)

  • Choi, Eun Joo;Graham, Kathleen K.
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.3
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    • pp.274-282
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    • 2012
  • 현재 HIV(human immunodeficiency virus) 감염에 대하여 보다 많은 효과적인 약물치료법이 가능하다. Highly active antiretroviral therapy (HAART)로 언급되는 이 치료법은 항 HIV치료제의 다양한 병용법으로 구성된다. 그러나, 최근에 이렇게 치료된 환자들에게 중요한 독성들(toxicities)로서 빈번하게 상당한 지질이상과 혈중당의 항상성 조절장애와 연관된 몸의 지방 분포 비정상으로서 나타나는, 광범위한 대사성 합병증(metabolic complications)이 출현해왔다. 이러한 합병증의 관리는 표준적인 치료 중재(interventions)와 연관하여 지질과 당 대사와 관련된 항 HIV치료제의 특성 있는 효과를 이해하면서, 항 HIV 약물들을 조절하는 것을 포함한다. 본 증례는 항HIV 약물요법과정에서 나타난 상당한 지질 이상, 매우 높은 LDL 수치와 높은 TG수치에 따르는 후속 약물요법을 보여주며, 개별화된 항 HIV 약물요법을 수행하면서, 대사성 합병증에 관련된 수치의 검사와 주기적인 약물치료과정의 모니터링을 권하여 HIV에 감염된 환자들의 효과적인 치료를 향상시키기 위한 것이다.

Changes in C-Reactive Protein and Complete Blood Cell Count According to Procalcitonin Levels (프로칼시토닌의 수준에 따른 C-반응성단백과 혈구산정검사의 변화)

  • Kim, Jin-San;Park, Chang-Eun
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.1
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    • pp.15-22
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    • 2022
  • Procalcitonin (PCT) can provide an experimental rationale and a diagnostic lead to distinguish between bacterial and viral infections. This study sought to investigate the clinical characteristics and prognosis of patients with high PCT levels, to improve clinical diagnosis, and to determine whether PCT levels were associated with the subsequent development of sepsis in the general population. This was a retrospective observational study conducted on outpatients (N=127) over a year. The general data and laboratory parameters studied were PCT, C-reactive protein (CRP), and complete blood count (CBC). The positive rates of CRP and white blood cells (WBCs) in the elevated PCT group were higher than those of the normal group (P<0.05); the specificity and sensitivity of the PCT levels were obviously higher than those of the CRP and WBC levels at diagnosis (P<0.05). The mean PCT levels in the low group were significantly higher than those in the high or moderate group (P<0.001). There was a significant positive correlation with CRP, total WBCs, and neutrophils (P<.001). The main finding of this study was the significant association between an elevated PCT level and CRP and WBC levels, signifying a high diagnostic value. This has important implications for the diagnosis of bacterial infections and therapeutic implications for the use of antibiotic treatment in specific patients.