• Title/Summary/Keyword: 임상적 연관성

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Operative Treatment of Distal Clavicle Fracture with Acromioclavicular Joint Injury (견봉 쇄골 관절의 손상을 동반한 원위 쇄골 골절의 수술적 치료)

  • Kang, Ho-Jung;Koh, Il-Hyun;Joo, Jong-Hwan;Chun, Yong-Min;Kim, Hyung-Sik
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.59-66
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    • 2011
  • Purpose: We wanted to evaluate the clinical and radiological outcomes and the prognosis of various surgical treatments for the distal clavicle fracture with an acromioclavicular joint injury. Materials and Methods: A retrospective study of 21 patients with a minimum of 12 months follow up was done. We classified acromioclavicular (AC) injury into type I (only intra-articular fracture (IAF), 5 cases), type II (IAF with widening of the AC joint > 7 mm, 9 cases) and type III (IAF with AC joint superior subluxation > 50%, 7 cases). The distal clavicle fractures were fixed using plate (9 cases), mini screws (1 case), K wire and tension band wiring (10 cases) and transarticular pinning (1 case). Acromioclavicular or coracoacromial ligament reconstruction was not done in all the cases. Results: In 20 of 21 cases, bone union was achieved at an average of 8.4 weeks. Traumatic arthritis (5 cases), AC joint widening (4 cases) and AC joint subluxation (2 cases) were noted at the last follow up. The average UCLA score was 32.6 in the type I AC joint injuries, 34 in type II and 34.1 in type III. There was no relationship between the clinical outcomes and the preoperative AC joint injury pattern, postoperative traumatic arthritis, AC joint widening or AC joint subluxation (p>0.05). Conclusion: Satisfactory results were achieved by acute reduction and firm fixation of the distal clavicle fracture with AC joint injury. There was no relationship between the pattern of AC joint injury, the residual radiologic findings and the functional outcome.

Genetic Variations of Candida albicans Isolated from Clinical Specimens Using Multi-locus Sequence Typing Analysis (임상 검체에서 분리된 Candida albicans의 MLST를 이용한 유전적 변이 특성)

  • Kim, Hee-Jin;Kim, Sang-Ha;Kim, Sunghyun;Yu, Young-Bin;Kim, Young-Kwon
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.3
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    • pp.331-336
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    • 2018
  • In this study, multi-locus sequence typing (MLST) analysis of 40 clinically isolated Candida albicans in tertiary hospitals in Daejeon, Korea, confirmed the nucleotide sequence and phylogenetic relationships of the strains collected from different specimen sources. The general variations found in seven different housekeeping genes of C. albicans, collected from urine and sputum, peripheral blood, central line blood, and other specimens, were analyzed. The phylogenetic tree was divided into 18 sub-clusters (1), a central line blood (2), others (5), sputum (1), peripheral blood (6), sputum (1), and urine (1), and the isolates at the same site were confirmed to have genetic similarity. Consequently, genetic similarity and the potential relevance were found in the strains collected from the same specimen sources. MLST analysis of C. albicans suggests that persistent data accumulation of phylogenetic gene variations of C. albicans may help establish infectious disease studies and epidemiological surveillance systems.

Clinical significance of loss of p16 protein by immunohistochemical staining in acute lymphoblastic leukemia (급성림프구성백혈병에서 면역조직화학염색에 의한 p16 단백질 소실의 의의)

  • Jin, Hye Young;Kang, Kyoung In;Kim, Sun Young;Youn, You Sook;Kang, Joon Won;Jo, Deog Yeon;Kwon, Kye Chul;Park, Kyung Duk
    • Clinical and Experimental Pediatrics
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    • v.51 no.1
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    • pp.73-77
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    • 2008
  • Purpose : p16 gene, mapped to the 9p21 chromosomal region, has emerged as a candidate tumor suppressor gene in human neoplasm. It is an inhibitor of cyclin-dependent kinase and inhibits Rb phosphorylation. In a variety of tumors including childhood acute lymphoblastic leukemia (ALL), deletion and/or mutation of the p16 gene has been found. Despite their high frequency, the prognostic importance of p16 alterations is still controversial in ALL and has been reported to be either unfavorable or similar to that of other patients. We studied the correlation between loss of p16 protein confirmed by immunohistochemical staining and clinical outcomes of patients diagnosed as ALL. Methods : We performed an immunohistochemical staining for p16 protein in 74 cases of bone marrow biopsy slide initially diagnosed as ALL between January 1998 and December 2006. We reviewed the clinical manifestations, laboratory findings, treatment outcomes retrospectively. Results : Of 74 slides, 12 were negative for p16 protein. Seven were males and 5 were females with a median age at diagnosis was 5.8 (1.3-18.8) years. Initial WBC were 17,225 $(500-403,300)/{\mu}L$. By immunologic surface marker analysis, 7 patients were early pre-B CALLA (+) and 5 patients were T-cell ALL. Two patients of intermediate risk group had relapsed and died. Three patients had family history of breast cancer. Four patients died and overall survival rates were $53.5{\pm}18.7%$. Conclusion : Loss of p16 protein is supposed to be an independent risk factor of childhood ALL associated with poor outcomes. In clinical setting, the clinician must take into account p16 status, not only at the genomic but also at the protein level. Further clinical experience on thoroughly investigated cases will help a better understanding between p16 status and clinical outcomes.

Clinical Analysis of Polymicrobial Bloodstream Infections in Pediatric Patients: Epidemiology, Clinical Features, Organisms, and Risk Factors (소아 환자에서 다균혈증에 대한 임상적 고찰)

  • Kim, Jung Min;Park, Hye Jin;Kim, Ki Hwan;Kim, Dong Soo
    • Pediatric Infection and Vaccine
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    • v.17 no.2
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    • pp.83-90
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    • 2010
  • Purpose : Although the incidence of polymicrobial bloodstream infection (PBSI) has increased, only a few studies have so far focused on children. Therefore, in an effort to prevent more serious situations in pediatric patients, we analyzed the clinical features, organisms, and laboratory results of PBSI. Methods : We performed a retrospective review of the case records of 97 patients with polymicrobial bloodstream infection in the Severance hospital, from 2001 to 2008. Using t-test and chi-square test, we analyzed the underlying medical conditions, clinical characteristics, organisms, and laboratory results of those patients. Results : Annual incidence of polymicrobial bloodstream infection increased from 1.4 % in 2001 to 10.9% in 2008 in pediatric patients. Immunocompromised hemato-oncological malignancy was found in 31 (31.9%) patients, and was the most common underlying medical condition; cardiovascular disease was found in 15 patients (15.4%), neurologic disease in 10 patients (10.3%), and so on. Gram positive organisms were recovered in 143 cases and gram negative organisms were recovered in 101 cases of PBSI. Staphylococcus epidermidis was the most common organism. Factors affecting mortality included underlying medical disease, immune status, nosocomial infection, and central catheter-related infection, for which the rate of mortality showed a greater increase (P<0.05). Conclusion : Due to the close connection between PBSI and fatal conditions or high mortality, it requires more aggressive management. Compared with previous studies, we discovered that immunocompromised hemato-oncological malignancy was the most common underlying medical condition and that frequency of gram-positive bacteria and fungus isolated has increased.

Atypical Correlation between CTG Repeat Size Variation and Clinical Manifestation in Brothers of Myotonic Dystrophy (임상양상과 유전자수가 비전형적인 연관관계를 갖는 근긴장성 이영양증 형제 1례)

  • Kim, Jung-Mee;Cho, Eun-Kyoung;Cho, Jeong-Seon;Choi, Yong-Suk;Han, Young-Su;Han, Jeong-Ho;Kim, Doo-Eung
    • Annals of Clinical Neurophysiology
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    • v.6 no.1
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    • pp.61-63
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    • 2004
  • The copy numbers of the CTG repeats are known to relate to the severity of clinical symptoms for myotonic dystrophy. The positive correlation between clinical manifestations and CTG repeat size has been demonstrated previously. A genetically confirmed myotonic dystrophy patient with 90 CTG repeat number had more severe clinical manifestation than brother with 120 CTG repeats, in adulthood.

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The Immunohistochemical Analysis for the Expression of Survivin, HSP, and Bcl-2 in Non-small Cell Lung Carcinoma (비소세포폐암에서 Survivin, HSP 및 Bcl-2 발현에 관한 면역조직화학적 분석)

  • Hong, Hyun-Ju;Hong, Seok-Gyun;Lee, Kye-Young;Kim, Woo-Ho;Lee, Choon-Taek;Yoo, Chul-Gyu;Han, Sung-Koo;Shim, Young-Soo;Kim, Young-Whan
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.5
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    • pp.441-452
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    • 2002
  • Background : Anti-apoptotic proteins may be involved in tumor development, progression and the response to treatment, Bcl-2 is by far the most studied anti-apoptotic protein. A novel inhibitor of apoptosis, designated survivin, and the heat shock proteins (HSPs) have recently been found in many human cancers. Immunohistochemical methods were used to determine the expression level of survivin, HSP70 and bcl-2 in non-small cell lung cancer (NSCLC) to evaluate their clinical significance. Materials and Methods : Tissue array slides were obtained from 99 surgically resected NSCLCs. Immunohistochemical staining was performed by an immuno-peroxidase technique using an avidin-biotinylated horseradish peroxidase complex. Anti-survivin rabbit polyclonal antibodies, anti-HSP70 mouse monoclonal antibodies and anti-bcl-2 mouse monoclonal antibodies were used as the primary antibodies. Results : Positive staining of survivin was detected in 33.3% of the cases. Survivin positivity is associated with to females and recurrence. A nonstatistically significant trend toward increased survivin expression was observed in non-smokers, and its expression inversely correlated with the number of cigarettes smoked in smokers. HSP70 was detected in 84.8% but this did not correlated with the clinicopathologic characteristics. Bcl-2 was detected in 18.2% and its expression correlated to tumor recurrence. No significant difference in the median survival time was noted in a comparison of all cases with survivin expression and those without. There was no association between HSP70 or bcl-2 expression and survival. Conclusion : Survivin expression was significantly associated with females and tumor recurrence. In addition its expression was inversely associated with the number of cigarettes smoked. However, HSP70 and bcl-2 expression were not associated with the clinical parameters or survival. This suggests that measuring the survivin levels may be useful in identifying patients at high risk for disease recurrence. Therefore, survivin might be a new diagnostic/therapeutic target in cancer.

Clinical Features and Associated Factors of Macrolide-Unresponsive Mycoplasma pneumonia and Efficacy Comparison Between Doxycycline, Tosufloxacin and Corticostreoid as a Second-Line Treatment (마크로라이드 불응성 마이코플라즈마 폐렴의 임상 양상 및 연관 인자와 2차 치료제로서 doxycycline, tosufloxacin 및 corticosteroid의 효능 비교)

  • Han Byeol Kang;Youngmin Ahn;Byung Wook Eun;Seungman Park
    • Pediatric Infection and Vaccine
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    • v.31 no.1
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    • pp.37-45
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    • 2024
  • Purpose: This study aimed to examine the clinical features and determinants of macrolide-unresponsive Mycoplasma pneumoniae pneumonia (MUMP) and to assess the differences in the time to fever resolution between doxycycline (DXC), tosufloxacin (TFX) and corticosteroid (CST) as second-line treatment. Methods: We retrospectively analyzed the medical records of patients under the age of 18 who were admitted to Nowon Eulji University Hospital between July 2018 and February 2020, diagnosed with mycoplasma pneumonia. Macrolide resistance was confirmed by detecting point mutations in the 23S rRNA gene. MUMP was clinically defined by persistent fever (≥38.0℃) lasting for 72 hours or more after the initiation of macrolide treatment. In cases of MUMP, patients were treated with an addition of CST, or the initial macrolide was replaced either DXC or TFX. Results: Out of 157 cases of mycoplasma pneumonia, 83 cases (52.9%) did not respond to macrolides. Patients with MUMP exhibited significantly higher C-reactive protein (CRP) levels (3.2±3.0 vs. 2.4±2.2 mg/dL, P=0.047), more frequent lobar/segmental infiltrations or pleural effusions (56.6% vs. 27.0%, P<0.001; 6.0% vs. 0.0%, P=0.032), and a higher prevalence of 23S rRNA gene mutations (96.4% vs. 64.6%, P<0.001) when compared to those with macrolide-susceptible M. pneumoniae pneumonia. In terms of second-line treatment, 15 patients (18.1%) responded to CST, 30 (36.1%) to DXC, and 38 (45.8%) to TFX. The time to defervescence (TTD) after initiation second-line treatment was significantly shorter in the CST group compared to the DXC (10.3±12.7 vs. 19.4±17.2 hours, P=0.003) and TFX groups (10.3±12.7 vs. 25.0±20.1 hours, P=0.043), with no significant difference observed between the DXC and TFX groups (19.4±17.2 vs. 25.0±20.1 hours, P=0.262). Conclusions: High CRP levels, the presence of positive 23S rRNA gene mutation, lobar or segmental lung infiltration, and pleural effusion observed in chest X-ray findings were significant factors associated with macrolide unresponsiveness. In this study, CST demonstrated a shorter TTD compared to DXC or TFX. Further, larger-scale prospective studies are needed to determine the optimal second-line treatment for MUMP.

Application of DNA microarry : Comparative functional genomic approach

  • Chu In-Sun
    • Proceedings of the Korean Society for Bioinformatics Conference
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    • 2006.02a
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    • pp.109-114
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    • 2006
  • 최근 Human 지놈 프로젝트를 포함한 다양한 종의 지놈 프로젝트가 수행되고 수많은 지놈정보가 생산되고 있으며 이를 해석하고 서로 연관성를 찾기 위한 다양한 연구가 진행되고 있다. 즉 최신 생명공학과 관련된 연구방향이 DNA의 구조적 해석에서 기능 해석과 유전자들의 상호연관성을 규명하는 방향으로 변화하고 있으며 이를 위한 강력한 도구로서 DNA microarray (DNA chip)는 방대한 양의 지놈 정보를 이용하여 단시간에 대량으로 고속처리하여 효율적으로 유전자 기능을 분석할 수 있는 주목받고 있는 방법이다. DNA microarray 실험과 분석에 있어 데이터분석, 재현성, 종간의 비교, 확인실험 및 비용 등의 문제가 있지만 유전자발현양상 데이터로부터 정확한 환자의 예후를 예측할 수 있는 비교적 적은 유전자 그룹의 진단마커를 찾거나, 하나의 유전자가 아니라 mouse 전체 지놈의 유전자발현 패턴을 인간의 암을 위시한 각종 질병 연구를 위한 발현 신호나 변화 등을 발견하여 신약개발 등에 활용하고자 하는 시도가 활발히 진행되고 있다. 서로 다른 종간에 비슷한 phenotype의 유전자발현도 진화적으로 보존되었다는 전제 하에서 지놈 sequence의 비교연구가 가능하고 DNA microarray 발현 데이터에 근거하여 독립적으로 각 종간의 유전자발현패턴을 비교함으로써 난치병 등을 새롭게 분류할 수 있다. 즉, 암세포 등에서 유전자발현 양상은 유전학적, 환경적 alteration들이 잘 반영되어 있다고 간주하고, 이러한 양상을 바탕으로 인간의 암을 위시한 다양한 질병 연구를 위한 최적의 mouse 모델을 찾을 수 있고, 이는 결국 새로운 치료 방법 개발이나 맞춤의학 실현에 중요한 역할을 할 것으로 기대된다. 특히 pathway 타겟으로 하는 치료를 위해서는 Human-mouse 비교를 통한 발현 신호를 찾는 것이 진단에서는 매우 유용한 방법이다. 이를 위한 고성능의 분석방법이나 시스템의 개발이 중요하게 된다.. 관류의 정도와 조영증강정도를 중심으로 관류 MR 영상소견과 조직학적 소견을 관련지어 분석하였다. 결과: 조영증강 T1강조MR영상에서 환상조영증강을 보이는 다형성 교보세포종 2예에서는 변연부 외륜이 고관류를, 중심부의 괴사부위는 저관류로 나타났다. 저등급 교종은 경계가 불분명한 저관류부위로 보였다. 뇌농양 2예는 변연부 외륜이 경도의 고관류를, 중심부는 저관류로 나타났다. 뇌수막종은 미만성의 균일한 중등도 혹은 고도의 고관류로 보였으며, 임파종과 배아종은 경계가 명확한 저관류부위로 나타났다. 신경세포종은 종괴\ulcorner 일부에 중등도 혹은 고도의 고관류부위가 관찰되었고, 전이암은 다수병변중 일부에서 중등도의 고관류를 보였다. 방사선괴사는 저관류부위내에 국소적 고관류부위를 보였다. 결론: 관류 MR영상은 뇌종양의 관류상태를 비교적 잘 반영하며, 조직학적 특성을 예측하는데에 도움을 주 수 있을 것으로 기대된다. 뇌종야에서의 관류MR영상의 분명한 역할을 규명하기 위해서는 앞으로 더 많은 임상적 연구가 필요할 것으로 생각된다.조증 환자의 자극성 전타액내 lactobacilli양은 peroxidase system을 함유한 세치제를 사용한 군에서 대조군에 비해 상대적으로 낮게 나타났으나(p = 0.067) 통계학적 유의성은 없었다.같은 예에서 찾아 볼 수 있다. 첫째, 발음상으로 동사의 변화형에서 "porte[$p{\jmath}rte$](들다: 현재형), porte[$p{\jmath}rte$](과거분사형), porta[$p{\jmath}rte$](단순과거형)"등이 대립되며, 이휘 "Porto[$p{\jmath}rte$](포르토)"와도 대립된다. 둘째, 어휘적 대립 "le haut[$l{\partial}o$](위)/l'eau[lo](물)"와 형태론적 대립 "le[$l{\partial}$](정관사, 남성단수)/l

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Analysis of research trends on mobile health intervention for Korean patients with chronic disease using text mining (텍스트마이닝을 이용한 국내 만성질환자 대상 모바일 헬스 중재연구 동향 분석)

  • Son, Youn-Jung;Lee, Soo-Kyoung
    • Journal of Digital Convergence
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    • v.17 no.4
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    • pp.211-217
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    • 2019
  • As the widespread use of mobile health intervention among Korean patients with chronic disease, it is needed to identify research trends in mobile health intervention on chronic care using text mining technique. This secondary data analysis was conducted to investigate characteristics and main research topics in intervention studies from 2005 to 2018 with a total of 20 peer reviewed articles. Microsoft Excel and Text Analyzer were used for data analysis. Mobile health interventions were mainly applied to hypertension, diabetes, stroke, and coronary artery disease. The most common type of intervention was to develop mobile application. Lately, 'feasibility', 'mobile health', and 'outcome measure' were frequently presented. Future larger studies are needed to identify the relationships among key terms and the effectiveness of mobile health intervention using social network analysis.

Imaging Features of Various Benign and Malignant Tumors and Tumorlike Conditions of the Pleura: A Pictorial Review (흉막의 여러 가지 양성 및 악성 종양 혹은 종양 같은 질환들의 영상 소견: 임상 화보)

  • June Young Bae;Yookyung Kim;Hyun Ji Kang;Hyeyoung Kwon;Sung Shine Shim
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1109-1120
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    • 2020
  • Pleural masses may be caused by various conditions, including benign and malignant neoplasms and non-neoplastic tumorlike conditions. Primary pleural neoplasms include solitary fibrous tumor, malignant mesothelioma, and primary pleural non-Hodgkin's lymphoma. Metastatic disease is the most common neoplasm of the pleura and may uncommonly occur in patients with hematologic malignancy, including lymphoma, leukemia, and multiple myeloma. Pleural effusion is usually associated with pleural malignancy. Rarely, pleural malignancy may arise from chronic empyema, and the most common cell type is non-Hodgkin's lymphoma (pyothorax-associated lymphoma). Non-neoplastic pleural masses may be observed in several benign conditions, including tuberculosis, pleural plaques caused by asbestos exposure, and pleural loose body. Herein, we present a review of benign and malignant pleural neoplasms and tumorlike conditions with illustrations of their computed tomographic images.