• Title/Summary/Keyword: 임상추론

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Future Medical Screening: A Challenge to the Insurance Industry (보험업계(保險業界)의 과제(課題))

  • Yoon, Byong-Hak;Kraus, H.K.
    • The Journal of the Korean life insurance medical association
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    • v.12
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    • pp.50-55
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    • 1993
  • After a short historical resume, screening is discussed on the basis of the current philosophy of Life insurance compaines in leading countries. This is followed by considerations with regard to the future in areas of major bearing on Life insurance screening which have emerged as important within the last decade. HIV-antibody testing is dealt with from the screening point of view followed by aspects regarding the applicability of tumour marker use in Life insurance medicine. Last but not least genetic testing will be addressed, taking into account prospects for the future, as well as the resulting responsibility in medical and underwriting terms. The major considerations and suggested guidelines can be summarized as follows: 1) Screening in Life insurance is a prerequisite for underwriting and is a well-functioning selection instrument. 2) Screening technologies are medically well defined and have to follow general clinical rules, also in the future. 3) Screening parameters should follow the patterns of diseases according to age and risk groups. 4) Screening parameters for prognostic use are legitimate as long as they are considered in conjuction with clinical medical observations and rules. 5) Screening technologies of a sensitive nature require very special rules for handling in the sense of "consequential ethies". 6) Screening parameters like HIV-antibody testing require ongoing scientific feedback in their new testing dimensions. 7) Screening in the form of genetic testing is as yet not used in Life insurance; its potential future role in Life insurfance medicine must, however, be discussed responsibly and in time. 8) Screening enables the insurance industry to rule out possible antiselection and provide for equal knowledge on the part of the insurance applicant and the insurer about impairements which shorten life expectancy. 9) Screening, informed consent, counselling and confidentiality must go hand in hand both now and to an even greater extent in the future.

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Evaluation of Diagnostic Performance of a Polymerase Chain Reaction for Detection of Canine Dirofilaria immitis (개 심장사상충을 진단하기 위한 중합연쇄반응검사 (PCR)의 진단적 특성 평가)

  • Pak, Son-Il;Kim, Doo
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.77-81
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    • 2007
  • Diagnostic performance of polymerase chain reaction (PCR) for detecting Dirofilaria immitis in dogs was evaluated when no gold standard test was employed. An enzyme-linked immunosorbent assay test kit (SnapTM, IDEXX, USA) with unknown parameters was also employed. The sensitivity and specificity of the PCR from two-population model were estimated by using both maximum likelihood using expectation-maximization (EM) algorithm and Bayesian method, assuming conditional independence between the two tests. A total of 266 samples, 133 samples in each trial, were randomly retrieved from the heartworm database records during the year 2002-2004 in a university animal hospital. These data originated from the test results of military dogs which were brought for routine medical check-up or testing for heartworm infection. When combined 2 trials, sensitivity and specificity of the PCR was 96.4-96.7% and 97.6-98.8% in EM and 94.4-94.8% and 97.1-98% in Bayesian. There were no statistical differences between estimates. This finding indicates that the PCR assay could be useful screening tool for detecting heartworm antigen in dogs. This study was provided further evidences that Bayesian approach is an alternative approach to draw better inference about the performance of a new diagnostic test in case when either gold test is not available.

Exploring the Thalamus of the Human Brain using Tractography Analysis at 3Tesla MRI (3 Tesla MRI에서 트랙토그래피 분석을 이용한 시상 탐색)

  • Im, Sang-Jin;Kim, Joo-Yeon;Baek, Hyeon-Man
    • Journal of the Korean Society of Radiology
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    • v.15 no.4
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    • pp.555-564
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    • 2021
  • Thalamus is known to play an important role in the regulation of nerve function. Thalamus, located in the center of the brain, is involved in sleep, arousal, and emotional regulation, and has been reported to be associated with multiple sclerosis, essential tremors, and neurodegenerative diseases such as Parkinson's disease. In addition, it has been reported that iron deposits in the thalamus can cause depressive symptoms with age. Although there are discrepancies between studies, it can be deduced that the thalamus region has a clear effect on neurological disorders due to a strong relationship between the thalamus and neurological functions such as emotional control and processing. Through tractography analysis, the connectivity between the detailed areas of each subcortical region was investigated in the form of a matrix, showing strong connectivity and weak interhemispheric connectivity. In the 59> group, the WM connectivity of thalamus was found to be weaker than those of the two groups. Comparisons between the two groups showed that the young groups (10-39 and 40-59) had higher connection intensity than the 59> group and that statistically significant differences in 3 connection pathways were found in each hemisphere. A decrease in thalamus-related connection strength in aging has shown that it can affect emotional and neurological disorders such as anxiety and depression, and network measurements can help assess cognitive impairment across clinical conditions.

Export Control System based on Case Based Reasoning: Design and Evaluation (사례 기반 지능형 수출통제 시스템 : 설계와 평가)

  • Hong, Woneui;Kim, Uihyun;Cho, Sinhee;Kim, Sansung;Yi, Mun Yong;Shin, Donghoon
    • Journal of Intelligence and Information Systems
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    • v.20 no.3
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    • pp.109-131
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    • 2014
  • As the demand of nuclear power plant equipment is continuously growing worldwide, the importance of handling nuclear strategic materials is also increasing. While the number of cases submitted for the exports of nuclear-power commodity and technology is dramatically increasing, preadjudication (or prescreening to be simple) of strategic materials has been done so far by experts of a long-time experience and extensive field knowledge. However, there is severe shortage of experts in this domain, not to mention that it takes a long time to develop an expert. Because human experts must manually evaluate all the documents submitted for export permission, the current practice of nuclear material export is neither time-efficient nor cost-effective. Toward alleviating the problem of relying on costly human experts only, our research proposes a new system designed to help field experts make their decisions more effectively and efficiently. The proposed system is built upon case-based reasoning, which in essence extracts key features from the existing cases, compares the features with the features of a new case, and derives a solution for the new case by referencing similar cases and their solutions. Our research proposes a framework of case-based reasoning system, designs a case-based reasoning system for the control of nuclear material exports, and evaluates the performance of alternative keyword extraction methods (full automatic, full manual, and semi-automatic). A keyword extraction method is an essential component of the case-based reasoning system as it is used to extract key features of the cases. The full automatic method was conducted using TF-IDF, which is a widely used de facto standard method for representative keyword extraction in text mining. TF (Term Frequency) is based on the frequency count of the term within a document, showing how important the term is within a document while IDF (Inverted Document Frequency) is based on the infrequency of the term within a document set, showing how uniquely the term represents the document. The results show that the semi-automatic approach, which is based on the collaboration of machine and human, is the most effective solution regardless of whether the human is a field expert or a student who majors in nuclear engineering. Moreover, we propose a new approach of computing nuclear document similarity along with a new framework of document analysis. The proposed algorithm of nuclear document similarity considers both document-to-document similarity (${\alpha}$) and document-to-nuclear system similarity (${\beta}$), in order to derive the final score (${\gamma}$) for the decision of whether the presented case is of strategic material or not. The final score (${\gamma}$) represents a document similarity between the past cases and the new case. The score is induced by not only exploiting conventional TF-IDF, but utilizing a nuclear system similarity score, which takes the context of nuclear system domain into account. Finally, the system retrieves top-3 documents stored in the case base that are considered as the most similar cases with regard to the new case, and provides them with the degree of credibility. With this final score and the credibility score, it becomes easier for a user to see which documents in the case base are more worthy of looking up so that the user can make a proper decision with relatively lower cost. The evaluation of the system has been conducted by developing a prototype and testing with field data. The system workflows and outcomes have been verified by the field experts. This research is expected to contribute the growth of knowledge service industry by proposing a new system that can effectively reduce the burden of relying on costly human experts for the export control of nuclear materials and that can be considered as a meaningful example of knowledge service application.

IMMUNOHISTOCHEMICAL ASSAYS FOR THE EXPRESSION OF EPIDERMAL GROWTH FACTOR-SIGNALING PROTEINS IN ADENOID CYSTIC CARCINOMAS OF HUMAN SALIVARY GLANDS (타액선 선양낭성암종에서 상피성장인자 신호전달 단백의 발현에 관한 면역조직화학적 연구)

  • Park, Young-Wook;Kim, Jung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.6
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    • pp.499-510
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    • 2006
  • Malignant tumors of the human salivary glands may arise from major or minor salivary glands. Adenoid cystic carcinoma (ACC) is the second most common malignant neoplasm in the salivary glands. ACC is occasionally highly aggressive tumor that readily invades adjacent tissues and metastasize to distant organs at early stages of the disease. Although ACC tends to grow slowly, treatment outcome may be poor due to wide local infiltration, perineural or intraneural spread and a propensity for hematogenous metastasis. Therefore, knowledge of cellular and molecular characteristics that influence the growth, survival and metastasis of tumor cells, is important for new treatment strategies of salivary ACC. I determined expressions of epiderma growth factor (EGF)-signaling molecules using surgical specimens of human ACCs. Protein expressions of EGF, transforming growth $factor(TGF)-{\alpha}$, EGF receptor (EGFR), phosphorylated EGFR (pEGFR), and human EGF receptor (HER)-2 were assessed in 18 cases of salivary ACC by immunohistochemical staining. Adjacent normal salivary tissues and mucosal tissues, uninvolved by the malignant tumor, served as internal controls. Most of the tumors, especially ACC with a tubulocribriform pattern, were positive for EGF signaling molecules. The overall percentages of the 18 specimens expressing EGF, $TGF-{\alpha}$, EGFR, pEGFR, and HER2 were 50, 89, 61, 61 and 83% respectively. Moreover, tumor-associated endothelial cells and infiltrating immune-related cells in the stroma of ACC, also expressed these biomarkers. Taken together, EGF-signaling molecules are actively expressed in salivary ACC. Therefore, we suggest that these biomarkers can be molecular targets for new treatment strategies of salivary tumors.

The Relationship between Burning Mouth Syndrome and Helicobacter pylori in the Oral Cavity (구강작열감증후군과 구강 내 Helicobacter pylori의 상호관련성)

  • Kim, Jun-Ho;Ryu, Ji-Won;Yoon, Chang-Lyuk;Ahn, Jong-Mo
    • Journal of Oral Medicine and Pain
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    • v.36 no.2
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    • pp.91-97
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    • 2011
  • Helicobacter pylori (H. pylori) is bacterial infection, with more than half of the world population infected and relates to many oral disease such oral lichen planus, recurrent aphthous ulceration, periodontal disease and halitosis and so on. Burning mouth syndrome(BMS) is defined as a burning sensation of the oral mucosa, lips, and/or tongue, in the absence of specific oral lesions. The etiology of BMS is suggested local, systemic and psychological factors and researchs related BMS and to infection of H. pyloir in the oral cavity are few. The purpose of this study was to evaluate relationship between burning mouth syndrome and H. pylori in the oral cavity. We recruited 21 subjects with burning mouth syndrome and 21 subjects as control group. Samples in the oral cavity were taken area of buccal mucosa, dorsum of the tongue and saliva. We analysed samples by nested polymerase chain reaction(PCR). The results were as follows: 1. Among 21 patients with burning mouth sydrome and 21 subjects of control group, 6(29%) and 3(14%) were positive respectively(P>0.05). 2. In detection rate of H. pylori in area taken sample, 3(14%), 2(10%) and 4(19%) were positive in buccal mucosa, dorsum of the tongue and saliva of patient and 2(10%) and 1(5%) were positive in dorsum of the tongue and saliva of control group(P>0.05). Conclusively, we can guess that H. pylori in the oral cavity is not related with burning mouth syndrome.

Investigation of the Korean Traditional Hobun(Oyster shell W.) Manufacturing Technique : Centering on Calcination Method (전통 호분(합분) 제조기술 연구 : 소성방법을 중심으로)

  • Lee, Han-Hyoung;Kim, Soon-Kwan;Kim, Ho-Jeong;Jeong, Hye-Young
    • Journal of Conservation Science
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    • v.23
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    • pp.103-118
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    • 2008
  • Hobun(Oyster shell W.) is a traditional material used as extender and white pigment from ancient times. The production method of it, however, has been discontinued. We have studied the traditional production method of Hobun through calcination of oyster shell, which is one of the traditional ways for preparing Hobun. Our work has the important meaning in that we can reproduce the manufacturing method of the discontinued traditional material and also it provides a solid background knowledge to stabilize the production and supply of Hobun for the cultural asset repairing materials. The result can be summarized as followings: The production processes of Hobun by calcination method are divided into 4 steps - calcination ${\rightarrow}$ slaking(pulverization) ${\rightarrow}$ separating fine powder by submergence in water ${\rightarrow}$ drying. In calcination step, the temperature is required to exceed $700^{\circ}$ to get pure white color of Hobun, since organic materials in the shell cause the final powder to be less white below $600^{\circ}$. And the calcination methods produce significant amount of calcium hydroxide, which is incongruent for pigment materials without additional treatments. The experimental study also demonstrated that the additional treatment process introduced in traditional paintings can be a probable process since the calcium of potassium hydroxide is observed to be promoted by this treatment. It is also concluded that, the calcination method of Hobun is appropriate for a small amount and high quality production.

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The Processing of Irregular Verbals in Korean : Shown in Aphasics (한국어 불규칙 용언의 형태 정보 : 실어증 환자를 중심으로)

  • 김윤정;김수정;김희정;남기춘
    • Proceedings of the Korean Society for Cognitive Science Conference
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    • 2000.05a
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    • pp.303-308
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    • 2000
  • 용언은 그 어간이 여러 문법소와 결합하면서 자동적 음운 변동을 제외한 형태 변동이 있는가, 없는가에 의해 규칙 용언/불규칙 용언으로 구분할 수 있다. 이러한 불규칙 용언은 심성 어휘집에 어떤 형태로 저장되어 있으며, 규칙 용언과는 어떠한 관계가 있는지, 나아가 실어증 환자의 경우에는 정상인에 비해 어떤 행동장애를 보이며, 장애가 있다면 어느 경로의 손상으로 인한 장애인지를 알아보는 것이 본 연구의 목적이다. 이를 위해 이해성 실어증 환자 한 명과 음어적 실행증 현상을 동반한 경미한 정도의 실어증 환자를 피험자로 하였다. 실험 과제는 단어 채워 넣기 과제(word completion task)를 사용하였다. 즉 주어진 기본형 용언을 검사 문장의 문맥에 맞게 활용하여 채워 넣는 것이다. 실험 결과에 의하면 환자들은 규칙용언의 활용(예. 먹다/먹는)과 불규칙 용언 중 형태를 유지한 채로 활용하는 경우(예. 줍다/줍고)에는 거의 오류가 없었으나, 불규칙 용언이 형태 변화를 겪어야 할 경우(예. 줍다/주워)에는 대부분 오류를 보였다. 또 이때는 기본형(basic form)을 그대로 유지하는 오류 방향성을 관찰할 수 있었다. 이는 그간 문법으로 구분되어 오던 규칙 용언/불규칙 용언의 정보 처리보다는 형태 유지/형태 변화 정보 처리의 영향이 크다는 것을 알 수 있다. 특히 이해성 실어증 환자는 전체적인 오류율이 매우 높았는데, 규칙 용언의 경우에도 오류를 보였다. 이때, 용언의 어간에 해당하는 부분에는 오류가 없고, 뒤에 따르는 내용과의 관계를 파악해야 하는 문법 기능소, 즉 연결 어미에서 오류를 보여 정보의 유지, 통합에 문제가 있다는 기존의 연구와도 일치하는 결과를 나타냈다.환자는 시제 선어말 어미를 선택하는데도 어려움을 보임이 확인되었다. 실험 3 역시 실험 1과 실험2에서와 동일하게 처리의 어려움을 보였다. 이러한 실험 결과들은 국어의 존칭과 시제 선어말 어미가 통사부에서 구(XP)와 결합하여 새로운 구를 형성하는 통사적 접사로 해석할 수 있으며 Grodzinsky의 가설을 지지하는 결과를 보여 줌으로서 국어에서도 AgrP, TP, CP 사이의 통사적 위계가 있음을 뒷받침하는 증거가 된다.전처리한 Group 3에서는 IL-2와 IL-4의 수준이 유의성있게 억제되어 발현되었다 (p < 0.05). 이러한 결과를 통하여 T. denticola에서 추출된 면역억제 단백질이 Th1과 Th2의 cytokine 분비 기능을 억제하는 것으로 확인 되었으며 이 기전이 감염 근관에서 발견되는 T. denticola의 치수 및 치근단 질환에 대한 병인기전과 관련이 있는 것으로 사료된다.을 보였다. 본 실험 결과, $Depulpin^{\circledR}은{\;}Tempcanal^{\circledR}와{\;}Vitapex^{\circledR}$에 비해 높은 세포 독성을 보여주공 있으나, 좀 더 많은 임상적 검증이 필요할 것으로 사료된다.중요한 역할을 하는 것으로 추론할 수 있다.근관벽을 처리하는 것이 필요하다고 사료된다.크기에 의존하며, 또한 이러한 영향은 $(Ti_{1-x}AI_{x})N$ 피막에 존재하는 AI의 함량이 높고, 초기에 증착된 막의 업자 크기가 작을 수록 클 것으로 여겨진다. 그리고 환경의 의미의 차이에 따라 경관의 미학적 평가가 달라진 것으로 나타났다.corner$적 의도에 의한 경관구성의 일면을 확인

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The Analysis of Professional Education Needs for the Competencies of Occupational Therapists in Cognitive Rehabilitation: Focusing on the Professors in Occupational Therapy Departments of Universities/Colleges in Korea (작업치료사의 인지재활 직무역량에 대한 교육요구도 분석: 국내 대학 작업치료(학)과 교수자를 중심으로)

  • Hong, Seung-Pyo;Lee, Hee-Ryoung;Han, Dae-Sung;Ju, Yu-Mi;Kim, Young-Geun
    • Therapeutic Science for Rehabilitation
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    • v.12 no.3
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    • pp.45-59
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    • 2023
  • Objective : This study aims to identify the status of education in cognitive rehabilitation (CR) in occupational therapy departments of Korean universities/colleges and to analyze the educational needs for professional competencies. Methods : This study was conducted by distributing a questionnaire to professors. The questionnaire extracted items related to professional competencies from the results of a previous Delphi study. A total of 39 respondents from 32 (51.6%) of 62 universities/colleges were analyzed. The questionnaire analysis was conducted using Excel 2010 and SPSS 18.0 to analyze the Borich requirements and the priority of education through the Locus for focus model. Results : The priority of competency in CR was followed by "clinical reasoning ability to explain cognitive problems from the occupational performance perspective", "ability to manage insurance billing for CR", "ability to establish a CR plan based on outcome evaluation", "ability to perform occupation-oriented CR", and "ability to solve problems that occur during CR evaluation and intervention". In the Locus for focus model, items such as occupation-based cognitive assessment, intervention, and skills for documentation were high priorities for education. Conclusion : This study is expected to reflect educational competencies for CR and establish a plan for CR specialists through continuing education.

A Study on the Development of a Competency-Based Intervention Course Curriculum of the Korean Academy of Sensory Integration (대한감각통합치료학회 역량기반 중재과정 교육커리큘럼 개발연구)

  • Namkung, Young;Kim, Kyeong-Mi;Kim, Misun;Lee, Jiyoung
    • The Journal of Korean Academy of Sensory Integration
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    • v.17 no.3
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    • pp.26-45
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    • 2019
  • Objective : The purpose of this study is to develop educational goals, training content, and training methods for the intervention course of the Korean Academy of Sensory Integration (KASI) and to conduct competency-based intervention courses based on the competency model for sensory integration intervention. Methods : This study was conducted on work therapists who participated in the 2019 intervention course of KASI. In the first phase, educational needs were analyzed to set goals for the interventional course. In the second phase, a meeting of researchers drafted the intervention course education program and the methods of education, and the intervention course was conducted. In the third phase, the changes in educational satisfaction and performance level pre- and post-intervention course for each competency index were investigated. Results : The educational goals of "learning and applying the clinical reasoning process of sensory integration intervention" and "intervention by applying the principle of sensory integration intervention" were set after reflecting on the results of the analysis of the educational requirements. The length of the competency-based intervention course was 42 hours. The average education satisfaction level of participants in the arbitration process was 4.48±0.73, and the average education satisfaction level of the supervisor was 3.92±0.71. In both groups, the most satisfying curriculums were the data-driven decision-making process and the intervention goal-setting lecture. But the satisfaction level of was the lowest. Before and after the intervention course, there were significant changes in the performance of the two behavioral indicators of the analytic skills in the expertise competency cluster of the competency model. Conclusion : This study is meaningful in that it conducted a survey of educational needs, the development and implementation of an educational curriculum, and an education satisfaction survey through systematic courses necessary for education development.