• Title/Summary/Keyword: 임상적 진단법

Search Result 1,075, Processing Time 0.03 seconds

Application of Molecular Diagnostics Technology in the Development of a Companion Diagnostics for Malignant Solid Tumors (악성 고형암의 항암제 동반진단 기술에서 분자진단기술의 적용)

  • Kim, Jin-Hee
    • The Journal of the Korea Contents Association
    • /
    • v.19 no.3
    • /
    • pp.365-374
    • /
    • 2019
  • Unlike benign tumors, malignant tumors are capable of metastasis, easy to relapse, poor survival, and low quality of life. In Korea, here is a tendency to treat the tumors collectively according to the General Principles of Cancer Chemotherapy(GPCC) of the Health Insurance Review & Assessment Service (HIRA). But recently, companion diagnostics(CDx) is recommended rather than unilateral medication because biomarker-based molecular diagnostics is possible to predict the drug response of patients before drug treatment. Not only domestic but also overseas Food and Drug Administratio (FDA) recommends the development of the CDx system at the stage of drug development to ensure the responsiveness and safety of medicines. In this study, I focused on the necessity of CDx development direction as well as CDx development status through literature review. Furthermore I also discussed CDx types according to the molecular diagnostic technology such as immunohistochemistry (IHC), polymerase chain reaction (PCR), in situ hybridization (ISH), and next-generation sequencing (NGS) not only in the approved CDx but also in the developing one by US FDA. And I suggested the technology issue of CDx development process such as a selection of molecular diagnostics at the time of release, a clear understanding of the CDx mechanism, and a convergence of drug with CDx development. The necessity of social insurance system also was proposed for CDx development.

VR을 이용한 ADHD 진단을 위한 디지털 치료제

  • Son, Ha-Min;Lee, Jun-Hui;Choe, Jeong-Hun;Jeong, Tae-Myeong
    • Broadcasting and Media Magazine
    • /
    • v.27 no.1
    • /
    • pp.38-48
    • /
    • 2022
  • 해마다 정신 질환의 발병률은 높아지지만, 이를 위한 진단과 치료의 한계는 현재까지도 해결되지 않고 있다. 디지털 치료제(DTx)는 이러한 한계를 극복할 수 있는 새로운 해결법으로 화두되고 있다. 본 연구는 객관적인 ADHD 진단을 위한 Hippo T&C의 디지털 치료 솔루션인 AttnKare-D를 제안한다. AttnKare-D는 정신 질환의 진단 및 통계 편람(DSM-5)에 따라 통제된 환경에서 데이터를 정량화함으로써 진단을 객관화한다. 또한, ADHD의 세부적 증상에 대한 상세한 보고서를 만듦으로써, 넓은 분류보다는 특정한 증상들에 집중하여 치료를 개인화한다. 적절한 샘플 사이즈에 낮은 오류율을 보이므로 임상 환경에서 AttnKare-D는 긍정적인 가능성을 보여준다.

Diagnostic Efficacy of PET in Soft Tissue Tumors: Comparative Study with Conventional Methods (연부 조직 종양에서 PET의 유용성: 기존의 진단법과의 비교 연구)

  • Seo, Sung-Wook;Park, Sang-Min;Cho, Hwan-Seong
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.11 no.1
    • /
    • pp.32-39
    • /
    • 2005
  • Introduction: Currently, F-18 fluorodeoxyglucose positron emission tomography scans (FDG-PET) has been investigated in soft tissue tumor especially for tumor detection and noninvasive grading. However, the validity and the efficacy of FDG-PET are still unclear in clinical evaluation. The purpose of this study is to determine the efficacy of FDG-PET in compared to conventional diagnostic imaging studies currently used in the soft tissue tumor. Methods: Between March 2001 and March 2002, 29 patients (sixteen males, thirteen females, mean age, 47 years; a range from 4 to 73) diagnosed with soft tissue tumor were evaluated by both conventional diagnostic imaging and FDG-PET. Valid reference test of the local lesion was the histopathologic diagnosis, which was measured in all patients. The suspecting metastasis in the imaging studies was validated by pathology or follow up imaging for at least 6 months. Each imaging diagnosis was made independently. The accuracy of each diagnostic method was evaluated. The incremental cost accuracy ratio was determined in each diagnostic method. Results: For detection of local lesion, sensitivity, specificity, and accuracy for MRI and FDGPET scans were 91%, 57%, 83% and 95%, 43%, 83% respectively. For detection of distant lesion, sensitivity, specificity, accuracy for conventional diagnostic methods and FDG-PET scans were 77%, 89%, 87% and 92%, 94%, 93% respectively. The incremental cost accuracy ratio (ICAR) of FDG-PET for detection of distant lesion was 145,000won/%. According to ICAR for each tumor grade, PET strategy is most cost-effective at high grade tumors. Conclusions: For detection of local lesion such as recurrence or remnant tumor, FDG-PET scan was not more accurate than MRI. However, It was more accurate for detection of metastatic lesion than conventional methods. For detection of high grade tumor, PET was most costeffective than for detection of lower grade tumor.

  • PDF

Clinical Features of Thymic Epithelial Tumors (흉선 상피 종양의 임상적 고찰)

  • Mok, Jeong Ha;Seol, Hee Yun;Kim, Ji Eun;Kim, Ki Uk;Park, Hye-Kyung;Lee, Ho Seok;Kim, Young Dae;Kim, Yun Seong;Lee, Chang Hun;Lee, Min Ki;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
    • /
    • v.65 no.1
    • /
    • pp.23-28
    • /
    • 2008
  • Background: Thymic epithelial tumors are the most common tumors affecting the anterior mediastinum. The aim of this study is to investigate clinical features of the patients who were diagnosed with thymic epithelial tumors at Pusan National University Hospital. Methods: We retrospectively reviewed the records of thirty-seven patients who were diagnosed with thymic epithelial tumors from Jan. 1997 to Jan. 2007. The pathological classification and clinical stage of the thymic epithelial tumors were based on the WHO classification and Masaoka's staging system. A total 37 patients were enrolled: 23 were males and 14 were females, and their mean age was 51.3 years. Results: Thirty patients presented symptoms at the time of diagnosis and their symptoms were as follows: chest pain (53%), dyspnea (23%), and cough (17%). Myasthenia gravis was diagnosed in five patients. With respect to the tumor staging, three cases (8%) were stage I, 10 cases (28%) were stage II, 12 cases (32%) were stage III, 6 cases (16%) were stage IVA and 6 cases (16%) were stage IVB. Twenty-four cases (67%) displayed stage III or IV disease. The pathological types according to the WHO classification were as follows: B1 (32%), C (23%), B3 (20%), B2 (16%), AB (6%) and A (3%). Twenty-four patients underwent thymothymectomy and four of these patients relapsed. Stage III or type B3 was common in the relapsed patients. Five patientsexpired. Stage IV or type B3 and C were common in the expired patients. Conclusion: In this study, stage III or IV disease and type B3 or C were common at the time of diagnosis and these findings might contribute to postoperative recurrence and a poor outcome.

A Comparative Analysis on The Efficiency of Various Clinical Methods for Diagnosis of Tuberculosis (결핵 진단을 위한 검사 방법간의 효율성에 관한 비교 분석)

  • 최석철;정천환;성희경;김태운;이원재
    • Biomedical Science Letters
    • /
    • v.5 no.2
    • /
    • pp.191-200
    • /
    • 1999
  • In recent years continuously increasing number of tuberculosis (TB) cases due to the emergence of strains with multidrug resistance and AIDS is a significant global health problem. Therefore, more rapid and reliable diagnosis of TB may be one of the most urgent needs in efforts to eradicate the disease. The present study was designed to compare and assess the diagnostic values and efficiencies between the conventional methods (X-ray, AFB stain and culture) and PCR for pulmonary TB on 171 cases. Chest X-ray finding and clinical features revealed that 39 (22.8%) of 171 sputum specimens were pulmonary TB cases. The statistical data were taken on the basis of the definitive diagnosis: In X-ray, overall sensitivity, specificity, efficiency and false positive and false negative incidence was respectively 69.2%, 87.1%, 83.0%, 12.9%, and 30.8%; 79.5%, 95.5%, 91.8%,4.6% and 20.5% in AFB-stain; 56.4%, 99.2%,89.5%, 0.8% and 43.6% in culture; 82.1%, 96.2%, 93.0%, 3.8% and 17.9% in PCR. PCR got a highest sensitivity and efficiency as well as a lowest false negative incidence. Culture had a highest specificity with a lowest false positive incidence. These results imply that PCR assay is fast, sensitive and efficient method for diagnosis of pulmonary TB. However, combined use of the conventional methods with thorough quality control may offer more opportunities for detecting Mycobacterium tuberculosis and diagnosting TB although they have some limits.

  • PDF

A Cytogenetic Study in Patients with Sex Chromosome Abnormalities (성염색체이상증후군의 핵형 분석)

  • Seo, Hyun Ji;Lee, Ji Hye;Lee, Heung Kyo;Jung, Seung Hee;Lee, Kun Soo
    • Clinical and Experimental Pediatrics
    • /
    • v.48 no.12
    • /
    • pp.1317-1323
    • /
    • 2005
  • Purpose : This study was performed to evaluate the recent frequency of karyotypes in different sex chromosome abnormalities and to evaluate the age and clinical manifestations at diagnosis. Methods : Peripheral blood leukocytes were obtained from subjects who were clinically suspected to have sex chromosome abnormalities and referred to the cytogenetic laboratory in the Department of Pediatrics, Kyungpook National University Hospital from February 1981 to August 2001. Results : The relative frequencies of different sex chromosome abnormalities were Klinefelter(52 percent), Turner(42 percent), XXX syndrome(3 percent) and mixed gonadal dysgenesis(3 percent). The populations of different karyotypes in Klinefelter syndrome were 47,XXY(97 percent) and 46,XY/47,XYY(3 percent). The populations of different karyotypes in Turner syndrome were 45,X(67 percent,), mosaicism(23 percent), and structural aberrations(10 percent). The populations of different karyotypes in XXX syndrome were 47,XXX(67 percent,) and 46,XX/47,XXX(33 percent). All mixed gonadal dysgenesis were 45,X/46,XY. Eighty one percent of sex chromosome abnormalities was diagnosed after puberty. Patients diagnosed with Klinefelter and Turner syndrome in infancy showed nearly normal phenotypes or had minor congenital malformations. Conclusion : Early diagnoses of sex chromosome abnormalities is required to prevent associated morbidities and to maximize growth and development. We have to pay careful attention in diagnoses of Turner syndrome because of the high proportion of mosaicism and structural aberrations.

Systematic Diagnosis and Long-term Care of Cardiopulmonary Disease (심폐기 질환의 체계적인 진단과 장기-치료 관찰)

  • 김재웅
    • The Korean Journal of Food And Nutrition
    • /
    • v.11 no.2
    • /
    • pp.171-178
    • /
    • 1998
  • K14 patient with chronic dyspnea, who is senile female, early had suffered from radical mastectomy, radiotherapy, autoplastic transplantation, and knee arthritis. Abnormalities of cardiopulmonary function such as obesita, hypertension, mild left ventricular hypertrophy, and chronic pulmonary disease were found from K14 patient's clinical datas, which based on medical history and diagnosis, as well as evaluation of blood pressure, obesity, clinical diagnosis, chest PA, electrocardiogram, ultrasonocardiograph, and spirometery test. Diagnostic results were exactly analyzed, also long-term cares of K14 patient were discussed with related to the clinical literatures.

  • PDF

A CLINICAL EVALUATION OF 61 CASES VOCAL CORD PARALYSIS (성대마비 61례에 대한 임상적 분석)

  • 김상현;이원상;김동환;정덕희;김춘길
    • Proceedings of the KOR-BRONCHOESO Conference
    • /
    • 1991.06a
    • /
    • pp.30-30
    • /
    • 1991
  • 성대마비 이비인후과 영역에서는 비교적 빈번하게 관찰되는 질환으로 대부분은 미주신경과 그 분지인 반회신경이 경정맥공에서 후두까지의 주행중에 생긴 질환에 의하여 이차적으로 발생하거나, 드물게는 윤상갑상연골 관절의 고정에 의사여 발생하게 된다. 임상적인 진단은 간접후두경이나 화이버옵틱후두경 검사법에 의하여 간단하게 내려질 수 있으나, 그 발생원인은 다양하며, 임상적인 양상 및 그에 따른 치료 원칙도 다르게 나타난다. 이에 연자들은 1986년 1월 1일부터 1990년 12월 31일까지 5년간 국립의료원 이비인후과에 내원한 환자중 성대마비로 진단된 환자 61례에 대한 후향적 기록 분석에 의해 성별, 원인별, 측별, 성대의 위치, 및 그에 따른 치료방향에 대하여 비교 검토하여 다음과 같은 결과를 보였다. 1)성별은 남녀비가 3:2로 남자가 많았으며, 연령별 분포는 20대에서 70대까지 비교적 균등하였으나 50대(23.0%)에서 가장 많은 분포를 보였다. 2)원인으로는 원인불명이 16례(26.2%), 갑상선수술 8례(13.1%), 폐결핵과 기관내삽관후 각각 6례(9.8%), 폐암 5례(8.2%) 순이었다. 3)마비된 성대의 측별 분포는 편측성이 51례(83.6%), 양측성이 10례(16.4%)이며, 편측성중 좌측이 37례(60.6%)로 가장 많았다. 마비된 성대의 위치는 부정주위가 33례(54%)로 가장 많았다. 4)즉 증상은 단지 애성만 있었던 례가 31례(50.8%), 호흡곤란 혹은 기도흡인등을 동반한 애성이나, 애성을 동반하지 않은 례도 있었다(3례). 증상 발현후 병원 내원까지 기간은 2개월이내가 가장 많았다. 5)16례에서 수술적 처치가 시행되었거나(9례), 혹은 자연치유가 관찰되었는데(7례) 편측성마비때 갑상연골성형술 2례, 양측 마비때 후두외접근법에 의한 피열연골절제술 4례, 레이저를 이용한 피열연골절제술 2례, 승모판 협착증에 의한 편측성 성대마비에서 개심술후 성대마비 회복 1례, 자연 치유는 7례에서 관찰되었으며 6례에서는 증상발현후 6개월이내에 회복되었다.

  • PDF

Diagnosis and Prognosis of Sepsis (패혈증의 진단 및 예후예측)

  • Park, Chang-Eun
    • Korean Journal of Clinical Laboratory Science
    • /
    • v.53 no.4
    • /
    • pp.309-316
    • /
    • 2021
  • Sepsis is a physiological response to a source of infection that triggers mechanisms that compromise organ function, leading to death if not treated early. Biomarkers with high sensitivity, specificity, speed, and accuracy that could differentiate sepsis from non-infectious systemic inflammatory response syndrome (SIRS) could bring about a revolution in sepsis treatment. Given the limitations and time required for microbial verification of pathogens, the accurate diagnosis of infection before employing antibiotic therapy is important and clinically necessary. Procalcitonin (PCT), lactate, C-reactive protein (CRP), cytokines, and proadrenomedullin (ProADM) are the common biomarkers used for diagnosis. The procalcitonin (PCT)-guided antibiotic treatment in patients with acute respiratory infections effectively reduces antibiotic exposure and side effects while improving survival rates. The evidence regarding sepsis screening in hospitalized patients is limited. Clinicians, researchers, and healthcare decision-makers should consider these findings and limitations when implementing screening tools, future research, or policy on sepsis recognition in hospitalized patients. The use of biomarkers in pediatric sepsis is promising, although such use should always be correlated with clinical evaluation. Biomarkers may also improve the prediction of mortality, especially in the early phase of sepsis, when the levels of certain pro-inflammatory cytokines and proteins are elevated.

Study of Practical Method for International 10~20 Electrode System (국제적인 10~20 전극시스템의 실용적인 방법에 관한 연구)

  • Kim, Sung-Hee;Lee, Ok-Kyoung;Kim, Dae Jin
    • Korean Journal of Clinical Laboratory Science
    • /
    • v.53 no.1
    • /
    • pp.60-67
    • /
    • 2021
  • Electroencephalography (EEG) is used for the diagnosis of epilepsy and testing the brain function. Clinical technologists are responsible for recording EEG without artifacts in accordance with the international 10~20 electrode system. Training on these techniques requires practical education. In the case of EEG, however, it is difficult for trainees to find the correct location of the electrode. Therefore, this study compared the time spent to locate the electrode attachment between traditional tape and the newly developed band. The time spent for sitting position patients using the band (196.7±61.8s) was 1084.3 s faster than the tape (1,281.0±457.4s) (P<0.001). Furthermore, the spend time spent for lying position patients using the band (200.2±49.3s) was 1217.7s faster than the tape (1417.9±482.3s) (P<0.001). Measurements using the band showed fewer differences due to various factors, such as position, practical experience, and gender. The newly developed band can locate the correct electrode attachment position quickly and efficiently, which has been a difficult problem in EEG practical education. In addition, this band is expected to be applied widely by new clinical technologists in the clinical field. Nevertheless, more study will be required to verify the accuracy of the location of the attaching electrode.