• Title/Summary/Keyword: 임상 결과 예측

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Clinical Observations on 12 Children with Alport Syndrome (Alport 증후군 환아 12명의 임상적 고찰)

  • Bae Young-Min;Kim Seoung-Do;Kang Hyeon-Ho;Cho Byoung-Soo
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.48-56
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    • 2000
  • Purpose: Alport SD., the most common herectitary rephriris, is a renal disease with rapid progression. Deafness, ocular abnormalities and a specific EM finding may be associated in addition to a family history. We have aralyged retrospectively. Methods: We observed 12 children with Alport syndrome who were diagnosed at Dept. of pediatrics in Kyunghee Univ., College of Medicine, from Apr. 1991 until Jun. 1999. We used four criteria for diagnosis: renal disease, family history, deafness or eye abnormalities, and a specific finding in electron microscopy Results: 2 of 12 patients had all features of the four diagnostic criteria. We could not trace an exact family history in 3 patients, and 6 patients did not exhibit deafness or eye abnormality. One could not have renal biopsy because offer chronic renal failure. Other three criteria were observed in her. The ratio of male to female observed was 1:2 respectively and the mean age of initial renal symptom was 5.6 years. 9 of 12 patients had a family history of renal disease. In the audiogram and ocular examination for 11 of 12 cases, sensorineural hearing loss was observed in 6 and ocular abnormality in 2 cases. In electron microscopic finding, irregular thickness of the capillary basement membranes with lamination of lamina densa and foot process obliteration was noted in 9 of 11 and thin basement membrane with splitting and foot process obliteration was noted in the other 2. The mean period of follow-up was 3 6/12 years. And one patient developed the chronic renal failure until now and had kidney transplantation. Conclusion: For the diagnosis of Alport syndrome, the following four diagnostic criteria are very important : renal disease, family history, deafness or eye abnormalities, and a specific finding on electron microscopy. We expect that more patients can be detected through the analysis of these characteristics.

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A Clinical Usefulness of Korean Version of Strengths and Difficulties Questionnaire (강점.난점설문지의(SDQ-Kr)의 임상 활용도)

  • Shin, Jong-Soo;Ahn, Joung-Sook;Choi, Young-Hun;Kim, Hae-Ji
    • Korean Journal of Psychosomatic Medicine
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    • v.17 no.2
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    • pp.75-81
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    • 2009
  • Objectives : This study aimed to evaluate the clinical usefulness of Korean version of Strengths and Difficulties Questionnaire(SDQ-Kr) by comparing with Korean version of Childhood Behavior Checklist (K-CBCL). Methods : The parent version of SDQ-Kr and K-CBCL were administered to parents of 313 children in psychiatric clinic, 91 children referred for psychiatric consultation from pediatric clinic and 93 control children in pediatric clinic. All children aged 4-11 years old. Children in psychiatric clinic were diagnosed with one of followings;ADHD, emotional disorders and oppositional/conduct disorder. Mean scores were compared among three groups by gender. Coefficients were calculated for corresponding problem scales and total scores of both questionnaires. ROC analysis was performed for discriminant validity to distinguish psychiatry and pediatrics samples, and also to distinguish diagnostic groups of psychiatry sample. Results : The psychiatry sample showed highest means of problem scales and total scores, followed by consultation and control sample of pediatrics. SDQ-Kr and K-CBCL were significantly correlated, and equally able to distinguish those samples with SDQ-Kr showing better results. Within the psychiatry sample, SDQ-Kr had higher predictive power for all diagnostic groups. Conclusion : This study supports clinical usefulness of SDQ-Kr. We suggest that SDQ-Kr could be used not only as a diagnostic tool for children in psychiatric clinic but also as an effective and efficient screening instrument for children in need for psychiatric evaluation in pediatric clinic.

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Usefulness of Automated PCR Test for the Detection of Mycobacterium Tuberculosis in Fresh Biopsy Tissues (신선조직 검체에서 결핵균 검출을 위한 자동화 중합효소연쇄반응 검사의 유용성)

  • Choi, Woo Soon;Shin, So Young;Kim, Jong Ok;Kim, Myung Sook;Lee, Hye Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.54-59
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    • 2006
  • Background: Although there have been several studies regarding the clinical value of an automated TB-PCR study using sputum, bronchial washing, and other body fluid samples for the detection of pulmonary tuberculosis, there are only a few reports on the use of fresh tissue samples. Materials and methods: The acid-fast bacilli stain(AFB), tuberculosis culture, automated TB-PCR study, and histopathology examination were performed in 42 fresh tissue samples. Results: Among the 42 cases, 18 cases were diagnosed with tuberculosis based on the clinical findings. Sixteen of the 18 cases were TB-PCR positive and of these 16 cases, only 2 cases were positive in the AFB stain or culture study. However, all 18 cases showed the histopathology findings of chronic granulomatous inflammation that was compatible with tuberculosis. Based on the clinical findings, the sensitivity, specificity, positive predictability, and negative predictability of the automated TB-PCR study were 88.9%, 100%, 100%, and 92.3% respectively. Conclusion: An automated TB-PCR assay is an important diagnostic tool for diagnosing tuberculosis in fresh tissue samples.

Prediction of Life-expectancy for Patients with Hepatocellular Carcinoma Based on Prognostic Factors (간암 환자에서 예후인자를 통한 생존기간의 예측)

  • Yeom, Chang-Hwan;Shim, Jae-Yong;Lee, Hye-Ree;Hong, Young-Sun
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.30-38
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    • 1998
  • Background : Hepatocellular carcinomoma is the 3rd most common malignancy and the 2nd most common cause of death in Korea. The prediction of life-expectancy in terminal cancer patients is a major problem for patients, families, and physicians. We would like to investigate the prognostic factors of hepatocellular carcinoma, and therefore contribute to the prediction of the survival time of patients with hepatocellular carcinoma. Methods : A total of 91 patients(male 73, female 18) with hepatocellular carcinoma who were admitted to the hospital between January and lune 1995 were entered into the study, and data were collected prospectively on 28 clinical parameters through medical obligation record. We surveyed an obligation and local district office records, and confirmed the surivival of patients till July, 1996. Using Cox-proportional hazard model, give the significant variables related to survival. These determined prognostic factors. Life regressional analysis was used, there were calculated predicted survival day based on combinations of the significant prognostic factors. Results : 1) Out of 91 patients, 73 were male, and 18 were female. The mean age was $56.7{\pm}10.6$ ears. During the study, except for 16 patients who could not follow up, out of 75 patients, the number of deaths was 57(76%) and the number of survivals was 18(24%). 2) Out of the 28 clinical parameters, the prognostic factors related to reduced survival rate were prothrombin time<40%(relative risk:10.8), weight loss(RR:4.4), past history of hypertension (RR:3.2), ascites(RR:2.8), hypocalcemia(RR:2.5)(P<0.001). 3) Out of five factors, the survival day is 1.7 in all of five, $4.2{\sim}10.0$ in four, $10.4{\sim}41.9$ in three, $29.5{\sim}118.1$ in two, $124.0{\sim}296.6$ in one, 724.0 in none. Conclusion : In hepatocellular carcinoma we found that the prognostic factors related to reduce survival rate were prolonged prothrombin time(<40%), weight loss, past history of hypertension, ascites, and hypocalcemia(<8.7mg/dl). The five prognostic factors enabled the prediction of life-expectancy in patients with hepatocellular carcinoma and may assist in managing patients with hepatocellular carcinomal.

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A Pediatric Fall-Risk Assessment Tool for Hospitalized Children (입원 아동의 낙상 위험 예측 도구)

  • Shin, Hyeon Ju;Kim, Young Nam;Kim, Ju Hee;Son, In Sook;Bang, Kyung-Sook
    • Child Health Nursing Research
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    • v.20 no.3
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    • pp.215-224
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    • 2014
  • Purpose: This study was conducted to identify risk factors in hospitalized children, and to develop and validate a fall-risk assessment tool for hospitalized children. Methods: A retrospective chart review was performed at one university children's hospital, and an analysis was done of the characteristics of all patients who fell during a 44-month period (n=48). These patients were compared with another 149 hospitalized children who did not fall. Results: Significant predictors of falls as identified in a multivariate logistic regression analyses were age of less than 3 years old, neurological diagnosis including epilepsy, children's dependency of ADL, physical developmental delay, multiple usage of fall-risk-increasing drugs. The respective odds ratios ranged from 2.4 to 7.1 with 95% confidence interval (p<0.05). Accordingly, defining patients with either 5 risk factors as fall-prone hospitalized children provided a sensitivity of 93.6% and specificity of 16.2%. Conclusion: The results show that this tool has an acceptable level of sensitivity to assess the risk factors of fall in hospitalized children even though the specificity was low, suggesting that this tool may enable nurses to predict the risk level of childhood falls, and develop preventive strategies against pediatric falls in children's units.

The effects of Pre-briefing Team-based Learning in Standardized Patients Simulation (표준화 환자 시뮬레이션 실습교육기반의 간호교육에서 사전브리핑을 활용한 팀 기반 학습 효과)

  • Kim, Hyun-Ju
    • Journal of Digital Convergence
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    • v.18 no.8
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    • pp.271-279
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    • 2020
  • Simulation practice training is used in nursing education as an education method to improve the adaptability to the clinical field, but responds to unpredictable situations and negatively affects practice satisfaction. This study applied a team-based learning utilizing a pre-briefing inequality controls ago to investigate the effect of self-efficacy, simulation practice satisfaction and clinical performance of the nursing college in the simulation based nursing education and after quasi-experimental study. Data collection in the fourth grade and P University Nursing 72 peoples, the study period is from November 15 from October 14, 2019. As a result, the experimental group that applied team-based learning using pre-briefing showed higher self-efficacy, simulation practice satisfaction, and clinical performance than the control group. Therefore, applying team-based learning to the pre-briefing process can be an important learning strategy for simulation practice training, and suggests a follow-up study to confirm the effectiveness by standardizing the pre-briefing step later.

A Study of Impeller's Design and CFD Analysis for Axial Flow Blood Pump (축류형 혈액펌프 개발을 위한 임펠러의 설계 및 해석에 대한 연구)

  • 임상필;김동욱
    • Proceedings of the KAIS Fall Conference
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    • 2002.11a
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    • pp.193-196
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    • 2002
  • 완전인공심장은 크게 정상류형과 박동류형이 있다. 정상류형 인공심장중 축류형 혈액펌프는 기구가 간단하고 비용적형이기 때문에 소형화가 가능한 장점이 있지만, 가동중 발생하는 난류로 인해 용혈현상이 따른다는 단점이 있다. 이 용혈의 형성과정은 실제와 가까운 모의실험을 하지 않고서는 알 수가 없다. 따라서 본 연구에서는 모의 실험단계를 거치지 않고 유한요소해석에 의한 난류평가를 통하여 용혈지수가 가장 낮은 임펠러의 형상을 연구하였다. 난류해석 결과, vane매수가 적을 경우 상대적으로 용혈지수가 낮게 나타나는 것을 알 수 있었으나 vane매수가 적을 경우에는 일정한 출구유량을 얻기 위해 임펠러의 고속회전 이 필요하며 이에 따른 난류에너지가 발생, 높은 용혈지수가 예상되므로 본 논문에서는 vane매수 4매-6매 중 6000-7000rpm의 회전속도사이의 조건으로 설계된 임펠러의 모델이 적당한 것으로 예측할 수 있었다.

액체 램제트 엔진의 3차원 분무 및 연소 반응 해석

  • 오대환;임상규;손창현;이충원
    • Proceedings of the Korean Society of Propulsion Engineers Conference
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    • 1999.04a
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    • pp.11-11
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    • 1999
  • 액체 램제트 연소기는 흡입공기와 분무, 혼합 그리고 이에 따른 연소 등 일련의 과정에 따라 다수의 복잡한 현상들이 상호 밀접하게 관련되어 있다. 본 연구에서는 액체 램제트 연소기내의 유동특성을 파악하기 위해서 2차원 및 3차원 연소기 형상에 대해서 수치적 실험을 수행하였으며, 격자구성은 연소기에 공기를 공급하고 연료를 분무하는 공기 유입관 영역과 연소실 영역, 그리고 출구 대기 영역으로 나누어 독자적으로 격자를 생성시켰다. 2차원과 3차원 유동해석을 비교하였고 분무모델의 적용에 따른 연소특성 및 분사위치에 따른 연소특성을 비교하였다. 유동해석 결과 2차원과 3차원의 유동특성은 달랐으며, 분무모델을 적용해야 정확한 연소 유동 현상을 예측할 수 있음을 알 수 있었다. 그리고 유입관의 안쪽에 연료의 분사위치를 준 경우가 연소의 안정화에 필요한 재순환영역으로의 연료의 혼합이 잘 되어 유입관 바깥쪽에 연료를 분사시키는 것보다 좋은 분사위치임을 알 수 있었다.

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Analysis of Using and Gathering of Distribution ERP in Massfeeding (집단급식사업에서의 유통 ERP 사용과 집계 분석)

  • Lim, Sang-Sun;Park, Dea-Woo
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2011.06a
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    • pp.143-147
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    • 2011
  • 집단급식사업을 할 때 재료의 신선한 공급을 위한 신속성, 음식의 매출액과 재료비, 인건비, 경비 등의 관련비용 집계에 대한 정확성과 기업회계 결산에 대한 어려움이 있다. 집단급식사업은 통신과 컴퓨터를 이용하여 유통 ERP를 구축하고, 사업장을 여러 군데로 확장하여 정확한 정보의 집계와 전달에 관한 연구가 필요하다. 본 논문에서는 집단급식사업의 유통 ERP를 연구하고, 구축 운영하여 급식 매출과 원가의 요소를 집계한다. 또한 집단급식사업장 단위의 매출액에 대한 재료비, 인건비, 경비 등 요소를 집계하고, 급식 자재의 유통을 위한 구매 발주와 낙찰된 식자재의 계약과 결과 값으로 예측 Simulation하여 본다. 집단급식 사업장 단위에서 마감되면 시도 단위와 전국 단위의 자산 및 손익 계산을 하는 ERP를 연구한다. 본 논문 연구를 통하여 집단급식사업의 ERP 발전과 물류 유통 산업 발전에 기여하게 될 것이다.

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Relationships between Integration, Clinical Practice Stress, Department Satisfaction in Nursing Students (일 간호대학생의 통합성과 임상실습 스트레스가 학과만족도에 미치는 영향)

  • Baek, Myung-Wha;Lee, Mi-Suk;Kim, Ji-Youn
    • Journal of Digital Convergence
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    • v.20 no.2
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    • pp.543-551
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    • 2022
  • The purpose of this study was to understand the integration and clinical practice stress of nursing students and to understand the relationship with department satisfaction. Data collection was from June to July 2021. Data were collected through questionnaires consisting of scales of integration, clinical practice stress, and departmental satisfaction, targeting 3rd and 4th grade nursing students who have had more than one clinical practice experience. A total of 394 copies were analyzed using the SPSS program to analyze the data. As a result of the study, integration showed a positive correlation with department satisfaction (r=.412, p<.01) and a negative correlation with clinical practice stress (r=-.193, p<.01). The predictive factors affecting the department satisfaction of nursing students were integration (β=.406, p<.001) and admission motivation (β=.166, p=.006), which accounted for 20% of the total variance. Integration Performance It was confirmed that the motivation for entering the nursing department affects department satisfaction. In order to increase the department satisfaction of nursing students, it is thought that it is necessary to operate an integration promotion program and department adaptation program from the early stage of admission.