• Title/Summary/Keyword: 임상적 연관성

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Surgical Management of Obsructive Slepp Apnea Syndrom: latest tendency (임상가를 위한 특집 2 - 폐쇄성 수면 무호흡증의 외과적 치료: 최신 경향)

  • Song, Seung Il;Lee, Ho Kyung
    • The Journal of the Korean dental association
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    • v.52 no.10
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    • pp.602-614
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    • 2014
  • Obstructive sleep apnea syndrom(OSAS) is defined by total or partial collapse of the upper airway during sleep. In the presence of specific anatomic features, OSAS is potentially amenable to surgical treatment. Initially, the only treatment available for these patients was a tracheotomy that bypassed the obstruction and resulted in a 100% cure. However, this was not readily accepted by most patients, and surgical methods other than tracheotomy were developed to successfully maintain adequate upper airway patency during sleep by comparing to postoperative polysomnography(AHI,RDI etc). In this paper, I would like to provide an overview of some of the multilevel surgical techniques available for treating OSAS as well as the necessary preoperative considerations.

Polymorphisms of the NR3C1 gene in Korean children with nephrotic syndrome (한국 신증후군 환아에서 NR3C1 유전자 다형성 분석)

  • Cho, Hee Yeon;Choi, Hyun Jin;Lee, So Hee;Lee, Hyun Kyung;Kang, Hee Kyung;Ha, Il Soo;Choi, Yong;Cheong, Hae Il
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1260-1266
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    • 2009
  • Purpose : Idiopathic nephrotic syndrome (NS) can be clinically classified as steroid-sensitive and steroid-resistant. The detailed mechanism of glucocorticoid action in NS is currently unknown. Methods : In this study, we investigated 3 known single nucleotide polymorphisms (SNPs) (ER22/23EK, N363S, and BclI) of the glucocorticoid receptor gene (the NR3C1 gene) in 190 children with NS using polymerase chain reaction-restriction fragment length polymorphism and analyzed the correlation between the genotypes and clinicopathologic features of the patients. Results : Eighty patients (42.1%) were initial steroid nonresponders, of which 31 (16.3% of the total) developed end-stage renal disease during follow-up. Renal biopsy findings of 133 patients were available, of which 36 (31.9%) showed minimal changes in NS and 77 (68.1%) had focal segmental glomerulosclerosis. The distribution of the BclI genotypes was comparable between the patient and control groups, and the G allele frequencies in both the groups were almost the same. The ER22/23EK and N363S genotypes were homogenous as ER/ER and NN, respectively, in all the patients and in 100 control subjects. The BclI genotype showed no correlation with the NS onset age, initial steroid responsiveness, renal pathologic findings, or progression to end-stage renal disease. Conclusion : These data suggested that the ER22/23EK, N363S, and BclI SNPs in the NR3C1 gene do not affect the development of NS, initial steroid responsiveness, renal pathologic lesion, and progression to end-stage renal disease in Korean children with NS.

MNNG-Regulated Differentially Expressed Genes that Contribute to Cancer Development in Stomach Cells (MNNG 처리에 의해 조절되는 암발생 유발 유전자의 조사)

  • Kim, Tae-Jin;Kim, Myeong-Kwan;Jung, Dongju
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.4
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    • pp.353-362
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    • 2021
  • Cancer is a global health problem. There are diverse types of cancers, but there are several common pathways which lead to the development of cancer. Changes in gene expression might be the most common similarity found in almost all cancers. An understanding of the underlying changes in gene expression during cancer progression could lay a valuable foundation for the development of cancer therapeutics and even cancer vaccines. In this study, a well-known carcinogen, N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), was employed to induce changes in gene expression in normal stomach cells. MNNG is known to cause cancer by inducing damage to DNA in MNNG-treated mammalian cells and animals fed with this carcinogen. An analysis was performed by comparing the differentially expressed genes (DEGs) caused by MNNG treatment with DEGs in stomach cancer cell lines. To this end, methods of analysis for functional categorization and protein-protein interaction networks, such as gene ontology (GO), the database for annotation, visualization, and integrated discovery (DAVID), Kyoto encyclopedia of genes and genomics (KEGG) and search tool for the retrieval of interacting genes/proteins (STRING), were used. As a result of these analyses, MNNG-regulated specific genes and interaction networks of their protein products that contributed to stomach cancer were identified.

Differentiation of Malignant from Benign Soft-Tissue Solid Tumors: Clinical and MR Finding Complex (연조직고형종양의 악성과 양성 감별: 임상과 자기공명영상 복합소견)

  • Moon, Tae-Yong;Kim, Jung-Il;Shin, Su-Mi;Choo, Hye-Jeung;Choi, Hyun-Wook;Kim, Soo-Jin
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.79-87
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    • 2004
  • Purpose: The recent development of MR has made to possible radiological diagnosis in various soft tssue tumors. But multifarious components within soft tissue tumors and their periodic change have made to difficult even differentiation of malignant from benign soft tissue tumors solely on the MR. So authors retry to differentiate malignant from benign soft tissue tumors with clinical and MR finding complex. Materials and methods: We were analysed 82 pathologically confirmed soft tissue solid tumors (37 cases as malignancy including intermediate tumors and 45 cases as benign including inflammatory masses) which are correlated with clinical findings such as age, size, and location, MR findings such as tumor border, texture on T2 and contrast-T1 images, and enhancement area retrospectively. Many typical lipoma and cysts including of ganglion and abscess are rejected in the benign soft tissue tumor group because not difficult to diagnose on MR. Results: Malignant soft tissue tumors were more frequent in 21~40 and 61~80 years old of the age, above 3.0 cm of the size, trunk-pelvis-lower extremities of the location, and MR findings with irregular border and above 50% of the enhancement area than those of benign soft tissue tumors. Conclusion: The clinical finding that divided to two locations as trunk-pelvis-lower extremities and upper extremities-shoulder-spine was statistically significant to differentiate malignant from benign soft tissue solid tumors. However, the others would provide some useful informations to differentiate them never specific.

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Effect of Untreated Depression in Adolescence on the Suicide Risk and Attempt in Male Young Adults (청소년기 치료받지 못한 우울증이 젊은 성인 남성의 자살 위험성 및 자살 시도에 미치는 영향)

  • Yang, Chan-Mo;Lee, Sang-Yeol
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.29-35
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    • 2020
  • Objectives : Evidence regarding the association between untreated depression in adolescence and suicidal risk in male young adults is scarce. We aimed to assess the effect of untreated illness during adolescence on the suicidal risk and attempt after that first episode. Methods : As part of a cross-sectional study, between May 2017 and April 2018, a total of 260 patients with currently unipolar or bipolar depression were included in the final analysis. Multiple linear and logistic regression analysis were performed to evaluate the association between untreated mood disorder in adolescence and its effect on the suicidal risk and attempt. Results : In total 260 patients, 189 were classified as untreated group. The proportion of suicide attempts, total depression score, suicidal risk and number of suicide attempts were significantly higher in the untreated group. The most predictive factors of suicide attempts were history of untreated depression [Adjusted Odds Ratio (AOR)=4.19, 95% Confidence Interval (CI)=2.25-7.81, p<0.001] and diagnosis of bipolar depression (AOR=2.60, 95% CI=1.52-4.46, p<0.001). Conclusions : Although the untreated depression suggests higher rates of suicidality, a significant proportion (86.7%) of adolescent depression in this study did not receive psychiatric treatment. Future research should be needed to find better ways to decrease barriers in using mental health treatment and its contribution to reduction and prevention of adverse outcome.

Clinical Significance of Antibodies Against Platelet HLA Class I in Children with Idiopathic Thrombocytopenic Purpura (소아 특발성 혈소판 감소증에서 항-HLA Class I항체의 임상적 의미)

  • Lee, Hong Jun;Yeom, Jung-Sook;Park, Ji Sook;Park, Eun Sil;Seo, Ji-Hyun;Lim, Jae Young;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang
    • The Korean Journal of Blood Transfusion
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    • v.24 no.3
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    • pp.233-240
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    • 2013
  • Background: A previous history of transfusion has been known to be associated with production of anti-HLA class I antibodies. However, platelet glycoproteins are the main target of idiopathic thrombocytopenic purpura (ITP). The mechanism of antibody production is known to differ significantly between glycoproteins and anti-HLA class I. The aim of this study was to evaluate the clinical significance of anti-HLA class I antibodies in childhood ITP. Methods: Enrollment for the normal control group targeted 48 people who visited Gyeongsang National University Hospital from 1990 to 2010, and 48 young children with ITP. Anti-glycoproteins and anti-HLA class I antibodies were tested using the Modified Antigen Capture Enzyme-linked immunosorbent assay (MACE) kit. Results: The positive rate of anti-HLA antibodies was significantly different [36/39 (92.3%) vs 29/46 (63%)] [ITP group vs normal control group] (P=0.002). The mean positive S/C ratio of anti-HLA antibodies was also significantly different (3.55 vs 1.51) [ITP group vs normal control group] (P=0.0000). The positive rate of anti-HLA did not differ significantly between the transfused group and the non-transfused group [12/12 (100%) vs 24/27 (88%)] [transfused ITP vs non-transfused ITP]. The mean positive S/C ratio of anti-HLA antibodies did not differ significantly between the transfused ITP group and the non-transfused ITP group (4.30 vs 3.25) [transfused ITP vs non-transfused ITP]. Consecutive testing showed that positive rate and positive S/C ratio of anti-HLA antibodies did not change significantly between sampling times in both groups [transfused ITP vs non-transfused ITP] (P=1.00 and P=0.15). Conclusion: Anti-HLA class I antibodies may be involved in childhood ITP. Transfusion did not affect the course of childhood ITP.

Study on Infrared Thermography (적외석 체열촬영에 관한 고찰)

  • Kim, Ho-Bong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.1 no.1
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    • pp.9-14
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    • 1995
  • Thermography is a diagnostic procedures that measures infrared energy emitted by the skin. Thermography detects body temperature change which are controlled by the autonomic nervous system. It does show the thermal dysfunction that correlates closely with pain syndromes as well as normalization when the healing process takes place. Experienced clinical interpretation of the thermal pattern is necessary to diagnose and establish causation. Thermography is useful in the diagnosis of painful conditions such as herniated disc diseases, myofascial syndrome, myositis, musculoligamentous injury, reflex sympathetic dystrophy, athretic injuries, vascular diseases, arthritis, inflammation and breast tumors.

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Association of Sleep Perception With Objective and Subjective Sleep Variables in Insomnia Patients (불면증 환자의 수면인식과 객관적, 주관적 수면변수의 연관성에 대한 연구)

  • Yoon, Gahui;Oh, Seong Min;Seo, Min Cheol;Lee, Mi Hyun;Yoon, So Young;Lee, Yu Jin
    • Sleep Medicine and Psychophysiology
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    • v.28 no.2
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    • pp.70-77
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    • 2021
  • Objectives: Our study aims to investigate the clinical and polysomnographic variables associated with subjective sleep perception. Methods: Among the patients who underwent nocturnal polysomnography (PSG) at the Center for Sleep and Chronobiology of Seoul National University Hospital from May 2018 to July 2019, 109 diagnosed with insomnia disorder based on DSM-5 were recruited for the study, and their medical records were retrospectively analyzed. Self-report questionnaires about clinical characteristics including Pittsburgh sleep quality index (PSQI), Beck depression inventory (BDI), and Epworth sleepiness scale (ESS) were completed. Subjective sleep quality was measured using variables of subjective total sleep time (subjective TST), subjective sleep onset latency (subjective SOL), subjective number of awakenings, morning feeling after awakening, and sleep discrepancy (subjective TST-objective TST) the morning after PSG. Pearson and Spearman correlation analyses were used to determine the factors associated with subjective sleep perception. Results: In patients with insomnia, subjective TST was negatively correlated with Wake After Sleep Onset (WASO) (p = 0.001) and N1 sleep (p = 0.039) parameters on polysomnography. Also, it was negatively correlated with PSQI (p < 0.001) and BDI (p = 0.014) scores. Sleep discrepancy was negatively correlated with PSQI score (p = 0.018). Morning feeling was negatively correlated with PSQI (p = 0.019) and BDI (p < 0.001) scores. Conclusion: Our results demonstrated that subjective sleep perception is associated with PSG variables (WASO and N1 sleep) and with PSQI and BDI scores. In clinical practice, it is helpful to assess and manage insomnia patients in consideration of objective sleep variables, subjective sleep quality, and depressed mood, which can influence subjective sleep perception.

Heart Rate Variability and Parenting Stress Index in Children with Attention-Deficit/Hyperactivity Disorder (주의력결핍 과잉행동장애 아동에서의 심박 변이도와 양육 스트레스)

  • Kim, Soo-Young;Lee, Moon-Soo;Yang, Jae-Won;Jung, In-Kwa
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.2
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    • pp.74-82
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    • 2011
  • Objective:The aim of this study was to evaluate the relationship between sustained attention deficits in Attention-Deficit/Hyperactivity Disorder(ADHD) children and short-term Heart Rate Variability(HRV) parameters. In addition, we evaluate the relationship between The ADHD rating scale(ARS), the computerized ADHD diagnostic system(ADS) and Parenting stress index- short form(PSI-SF). Methods:This study was performed in the department of children and Adolescent psychiatry, Korea university Guro hospital from august 2008 to January 2009. We evaluated HRV parameters by short-term recordings of 5 minutes. K-ARS and ADS are used for screening and identifying ADHD children. Intelligence was measured using Korean educational Developmental Institute-wechsler Intelligence Scale for Children. The caregivers Complete Parenting Stress Index scale for evaluation parent stress. Results:The low frequency(LF) was significantly correlated with response variability of ADS. However, the other variables of ARS and ADS were not significantly correlated with LF. Hyperactivity subscale of ARS was significantly correlated with parental distress subscale and difficult child subscale of PSI-SF and inattention subscale of ARS was also significantly correlated with dysfunctional interaction and difficult child subscale of PSI-SF. Conclusion:The LF, 0.10-Hz component of HRV is known to measure effort allocation. This study shows that the LF component of HRV is significantly correlated with the response variability of ADS. This means that more severe symptoms of ADHD were correlated with the increase in the LF that means decreased effort allocation. These results also support the clinical usability of HRV in the assessment of ADHD. Furthermore, PSI-SF is correlated with hyperactivity and inattention variables of ARS.

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Clinical Role of Interventional Radiology in Abdominal Solid Organ Trauma (복부 고형 장기 외상에 대한 인터벤션의 임상적 역할)

  • Hyun Seok Jung;Chang Ho Jeon;Sang Hyun Seo
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.824-834
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    • 2023
  • Interventional management is commonly used for traumatic injuries to the abdominal solid organs. The American Association for the Surgery of Trauma (AAST) and the World Society of Emergency Surgery (WSES) recently published guidelines for the management and treatment of liver, spleen, and kidney injuries, emphasizing the importance of interventions. Here, we discuss the characteristics of each organ and the procedure method for each organ that interventional radiologists need to know when treating trauma patients.