• Title/Summary/Keyword: 임상 결과 예측

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Association of Positive Ureaplasma in Gastric Fluid with Clinical Features in Preterm Infants

  • Jung, Yu-Jin
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.280-287
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    • 2011
  • Purpose: The purpose of the present study was to determine the association of positive Ureaplasma urealyticum in gastric fluid with clinical features and outcomes in preterm infants. Methods: Gastric fluid from the preterm infants was first aspirated within 30 minutes and cultured within 24 hours after birth to check for U. urealyticum. Infants were divided into two groups on the basis of the presence/absence of U. urealyticum. Results: U. urealyticum in gastric fluid was identified in 17 of 91 (19%) preterm infants. Compared with the negative U. urealyticum group, there were significantly higher percentage of infants with gestational age ${\leq}$30 weeks (P=0.020), higher Apgar score at 1 minute and 5 minutes (P=0.017 and P=0.048, respectively), and higher rate of vaginal delivery (P=0.000) in the positive U. urealyticum group. Although the incidence rate of bronchopulmonary dysplasia between the two groups was not different, the frequency of bronchopulmonary dysplasia without previous respiratory distress syndrome was significantly higher in the positive group (11%) than that in the negative group (1%) (P=0.030). Conclusion: The detection of U. urealyticum in gastric fluid is more frequent in infants with gestational age ${\leq}$30 weeks. It can be helpful to predict the development of bronchopulmonary dysplasia without previous respiratory distress syndrome in preterm infants.

Clinical Roles of Continuous Lumbar Drainage in Acute Hydrocephalus Patients (급성 수두증 환자에서 지속적 요추지주막하 배액의 임상적 역할)

  • Yang, Geun Jin;Kim, Mun Chul;Chung, Hoon;Lee, Sang Pyung;Choi, Gi Whan;Yeo, Hyung Tae
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.644-649
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    • 2000
  • Objective : Acute hydrocephalus can be caused by many pathologic conditions such as sub- arachnoid hemorrhage, intraventricular hemorrhage, inflammatory diseases. External ventricular drainage(EVD) through trephination of the skull is essential procedure for progressing or persistent symptomatic acute hydrocephalus. If the EVD can not be removed in short period, the chance of ventriculitis increases and periodic transposition of the draining catheter should be considered. Shunt procedure can not be performed in acute hemorrhage or infectious condition because of the risk of shunt malfunction or intra-abdominal spreading of the infection, respectively. The authors replaced EVD with continuous lumbar drainage(CLD) for the purpose of controlling acute hydrocephalus and preventing ventriculitis simultaneously, or treating ventriculitis more effectively in case of infection which had already broken out. CLD has many advantages over EVD, although, it can complicate disastrous downward brain herniation in patients with elevated intracranial pressure. The authors performed CLD with EVD maintained and then tested the possibility of the brain herniation with quite simple method. If the CLD was proven as safe through the test, EVD could be replaced with it without terrible herniation. Material and Method : Between September 1998 and April 1999, 10 patients underwent CLD in replacement of EVD. Among them, 5 were patients with aneurysmal subarachnoid hemorrhage, 2 were patients with thalamic hematoma and intraventricular hemorhage and 3 were patients with traumatic intracranial hemorrhage. Results : In eight of them the replacements were successfully done and one of them died on account of medical illness. In two of them the replacement could not be performed because of the risk of herniation and all expired owing to ventriculitis. Two patients required permanent shunt operation. Conclusion : This article provides a valuable alternative method of treatment for persistent symptomatic hydrocephalus which can not be managed with shunt operation immediately.

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Diagnostic value of various screening tests in neonatal sepsis (신생아 패혈증의 다양한 선별검사들의 진단적 가치)

  • Je, Hyun Gon;Jeoung, Young Mi;Jeong, Soo Jin
    • Clinical and Experimental Pediatrics
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    • v.49 no.11
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    • pp.1167-1173
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    • 2006
  • Purpose : To evaluate various sepsis screening tests, individually and in combination, to formulate a guideline for the diagnosis of neonatal sepsis. Methods : The study was a retrospective cohort study. It took place at the neonatal intensive care unit of the Paediatric Department, Il Sin Christian Hospital, Busan, Korea, over a period of 68 months from 1st, April, 2001 to 31st, December, 2005. This study evaluated 100 neonates having clinical features of sepsis and 100 normal asymptomatic neonates and used screening tests including C-reactive protein (CRP), total leukocyte count (TLC), absolute neutrophil count (ANC), immature neutrophils to total neutrophil count ratio (I/T ratio), thrombocytopenia, degenerative changes in the neutrophils and gastric aspirate cytology (GAC) for the diagnosis of neontal sepsis. Results : The sensitivity of CRP and ANC was high. CRP had 86 percent sensitivity for group-A (proven sepsis) and 74 percent sensitivity for group-B (probable sepsis) and 94 percent specificity for group-A, B. ANC had sensitivity of 72 percent for group-A and 62 percent for group-B and 86 percent specificity for group-A, B. For group-A, sensitivity, specificity of GAC for polymorphs was 74 percent and 94 percent respectively. As for sensitivity, specificity of platelet count for group-A was 64 percent and 89 percent respecively. The sensitivity, specificity and predictive values (PV) of the individual tests and different test combinations were also calculated for group-A and B. Conclusion : For the detection of culture negative cases in neonatal sepsis, screening tests including CRP, TLC, ANC, thrombocytopenia, cytoplasmic vacuolization in the neutrophils and GAC for polymorphs have high sensitivity. A combination of three tests has higher sensitivity.

Evaluation of the Risk Factors Predicting Morbidity and Mortality after Major Pulmonary Resection (주요 폐절제술시 이환율과 사망률을 예견하는 위험인자의 평가)

  • Choi, Ho;Lee, Cheol-Joo;Soh, Dong-Moon;Kim, Jung-Tae;Hong, Jun-Wha;Ryu, Han-Young;Park, Jae-Beom
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.549-555
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    • 1999
  • Background: Patients who are considered for major pulmonary resection are generally evaluated by spirometry and clinical assessment to predict morbidity and mortality. Despite this, none has yet proved to be a convenient and reliable estimate of risk. Material and Method: A retrospective analysis was performed in 167 patients who were diagnosed for lung cancer, bronchiectasis, pulmonary tuberculosis, and other benign pulmonary disease, and who underwent major lung resections. The relationship of 25 preoperative or postoperative variables to 19 postoperative events were classified into categories as operative mortality, pulmonary or cardiovascular morbidity, and other morbidity was assessed. Logistic regression analysis and $\chi$2 analysis were used to identify the relationship of the operative risk factors to the grouped postoperative complications. Result: The best single predictor of complications was the percent predicted postoperative diffusing capacity (pulmonary morbidity, p<0.009; cardiovascular morbidity, p<0.003: overall morbidity, p<0.004). Conclusion: The diffusing capacity of the lung for carbon monoxide was an important predictor of postoperative complications than the spirometry, and it usually should be a part of the evaluation of patients being considered for pulmonary resection.

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Correlation of Caries Experience and Activity between Mothers and Their Children Using a Colorimetric Test (비색법을 이용한 모자간 우식 경험 및 활성의 상관성)

  • Jang, So-young;Lee, Koeun;Song, Je Seon;Kim, Seong-Oh;Lee, Jaeho;Choi, Hyung-Jun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.2
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    • pp.162-169
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    • 2018
  • The purpose of this study was to compare the validity of $Cariview^{(R)}$, a new colorimetric caries activity test, with $CRT^{(R)}$ bacteria, a conventional bacterial culture method. In addition, this study assesses the correlation between the dental caries experience and activity between mothers and their children. 34 pairs of mothers and their children under the age of 6 years participated in this study with informed consent. After filling out a questionnaire and oral examination, the two caries activity tests above were performed on each subject. In the results, $Cariview^{(R)}$ scores were statistically significant with children's caries experience (r = 0.598, p < 0.01) and showed higher correlation than $CRT^{(R)}$ bacteria scores. $Cariview^{(R)}$ scores showed statistically significant correlation with the number of decayed teeth in both mothers and children (p < 0.05). In both $Cariview^{(R)}$ and $CRT^{(R)}$ bacteria tests, there was no statistically significant correlation between caries experience and caries activity (p > 0.05). $Cariview^{(R)}$ colorimetric test will be clinically useful for predicting future caries risk and establishing a preventative strategy in pediatric dentistry.

Clinical Significance of Measuring Levels of CEA, CA19-9 in Peritoneal Washing Fluid in Patients with Gastric Cancer (위암 환자에서 복강 세척액의 CEA, CA19-9 측정의 임상적 의의)

  • Shim, Gyu-Beom;Park, Ji-Hun;Koo, Tea-Young;Min, Hyun-Sik
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.125-131
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    • 2006
  • Purpose: Free cancer cells exfoliated from cancer-invaded serosa contribute to peritoneal dissemination, the most frequent pattern of recurrence in patients with gastric cancer. To detect free cancer cells, CEA and CA19-9 were introduced as the markers of gastric cancer, and many methods, such as cytology, immunoassay, and reverse transcription polymerase chain reaction (RT-PCR), exist for detecting them. The aim of this study is to define the clinical significance of using immunoassay to measure the levels of CEA and CA19-9 in the peritoneal washings in patients with gastric cancer. Materials and Methods: The peritoneal washing fluids were obtained from 130 patients with gastric cancer who received a curative gastrectomy, palliative gastrectomy or open and closure. The pCEA and pCA19-9 levels were measured by using immunoassay and cytology. The results were compared with the clinicopathological data. Results: The pCEA and pCA19-9 levels were correlated with tumor invasion, lymph-node metastasis, and stage (P<0.05). Conclusion: A correlation was found between elevated pCEA and pCA19-9 levels measured by immunoassay and the TNM stage. Therefore, a combined pCEA and pCA19-9 assay could be a sensitive detector of peritoneal dissemination, as well as a predictor of postoperative prognosis. pCEA and pCA19-9 may also determine the adjuvant management strategy.

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Clinical Consideration of Visual Fatigue on 3D Images (3D 영상 시청에 대한 시각적 피로도의 임상적 고찰)

  • Kim, Jung-Ho;Son, Jeong-Sik;Park, Sung-Jin;Kwon, Soon-Chul
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.38C no.11
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    • pp.990-999
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    • 2013
  • Previous studies based on the theoretical evidence and based on the empirical data have been constantly revealing related factors affecting visual fatigue in viewing 3D images. however, the measurement data coupled with the factors that affect the viewers to feel fatigue is insufficient. this study research that the viewers feel the visual functional data is based on subjective fatigue such as IPD, AC/A ratio, and the degree of phoria and the effects on variance in these data, is to examine the correlation between these data. based on the average score of subjective fatigue which is $6.00{\pm}3.88$, total fatigue points from 0 up to 6 is classified as a group not appealing for the fatigue and from 7 up to 16, they were classified as the fatigue appealing group. the results showed no difference in satisfaction of the images by each subjective fatigue, IPD and far phoria. AC/A ratio was higher from the fatigue not appealing group, near phoria was higher from the fatigue appealing group. after watching 3D images, the fatigue not appealing group showed a tendency of higher increase of exophoria. correlations appeared in this experiment showed that AC/A ratio and near phoria are closely related to level of subjective fatigue which feel when watching 3D images. when watching 3D images based on two data appear to be able to predict the fatigue, even during content production fatigue reduce the data dimensions to be used as the main basis is expected.

Assessment of Predicting Factors for Pediatric Sleep Disordered Breathing (소아 수면호흡장애의 예측 인자 평가)

  • Moon, Soyeon;Lee, Daewoo;Kim, Jaegon;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.4
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    • pp.377-388
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    • 2020
  • The aim of this study was to evaluate the association between various predicting tools and Apnea-Hypopnea Index (AHI) to identify children with sleep disordered breathing (SDB). From 5 to 10 years old who came for orthodontic counseling, 61 children, whom had lateral cephalograms, pediatric sleep questionnaire (PSQ) records, and portable sleep monitoring results, were included in this study. A total of 17 measurements (11 distances and 6 angles) were made on lateral cephalograms. The measurements of lateral cephalograms, PSQ scales and portable sleep monitoring results were statistically analyzed. 49 of 61 (80%) patients showed AHI > 1, which suspected to have SDB and their mean AHI was 2.75. In this study, adenoid size (A/N ratio), position of the hyoid bone from mandibular plane, gonial angle, and PSQ scale were related to a higher risk of pediatric SDB. Also, oxygen desaturation index (ODI) and snoring time from sleep monitoring results were statistically significant in children with SDB using Mann-Whitney test (p < 0.05). In conclusion, evaluation of hyoid bone position, adenoidal hypertrophy, gonial angle in lateral cephalogram, and PSQ scale was important to screen out potential SDB, especially in children with frequent snoring.

Macroscopic Serosal Invasion in Advanced Gastric Cancer (진행성 위암에서 육안적 장막침윤의 의의)

  • Yun, Woo-Sung;Kim, Tae-Bong;Yu, Wan-Sik
    • Journal of Gastric Cancer
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    • v.6 no.2
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    • pp.84-90
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    • 2006
  • Purpose: The macroscopic findings of tumors are not always identical with the microscopic findings. This study investigated the oncologic implications of macroscopic serosal invasion in advanced gastric cancer to find out how to improve the accuracy for the depth of invasion assessed by the surgeon during an operation. Materials and Methods: The medical records of 789 patients with advanced gastric cancer who underwent a gastrectomy at Kyungpook National University Hospital between 1995 and 1999 were reviewed. The prognoses and the recurrence patterns were analyzed according to macroscopic serosal invasion and microscopic serosal invasion, and the clinico-pathological factors of cT3/ss cancers were compared with those of cT3/se cancers. Results: Difference of survival rates according to macroscopic serosal invasion and microscopic serosal invasion revealed statistically significant. Recurrence rates were similar in patients with macroscopic and microscopic serosal invasion (42.2% and 41.4%, respectively). Peritoneal recurrence rates were also similar (19.8% and 21.9%, respectively). The sensitivity and the specificity of macroscopic assessment of serosal invasion were 70.3% and 77.8%, respectively, On univariate and multivariate analyses, Borrmann type I/II cancers and the absence of distant metastases revealed the risk factors for overestimating of serosal invasion. Conclusion: Macroscopic serosal invasion assessed by a surgeon intraoperatively can be used to give a prognosis and to predict the recurrence pattern precisely, although there is a risk for overestimation when the tumor is a Borrmann type I/II cancer or the tumor has no distant metastases. (J Korean Gastric Cancer Assoc 2006;6:84-90)

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Comparison of in Vivo, in Vitro 3T MR Spectroscopy and Proton NMR Spectroscopy for the Fluid from Cystic Tumor: Preliminary Study (낭성 종양의 체액에 대한 생체내, 생체외 3T 양성자 자기공명분 광법과 양성자 핵자기공명기법의 비교: Preliminary Study)

  • Lee, Hui-Joong;Kim, Jong-Yeol;Chang, Yong-Min
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.2
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    • pp.107-114
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    • 2008
  • Purpose : The aim of this study is to determine possibility of application of in vivo proton ($^1H$) magnetic resonance spectroscopy (MRS) in distinguishing cystic mass arising around pancreas by comparison of in vivo MRS, in vitro MRS using 3T MR machine, based on nuclear magnetic resonance (NMR). Materials and Methods : We obtained spectra of in vivo MRS, in vitro MRS and NMR from abdominal mass arising around pancreas (mucinous cystic neoplasm=5, intraductal papillary mucin producing tumor=5, pseudocyst=1, and lymphangioma=1). We estimated existence of peak of in vivo MRS, and in vitro MRS concordant to that of NMR. We also evaluated differential peak for predicting specific disease. Results : Correlation of presence of peak with NMR showed showed sensitivity of 29.6%, specificity of 82.6% and accuracy of 67.7% on in vivo MRS (p = 0.096, McNemar test), sensitivity of 57.1% and specificity of 92.6% and accuracy of 82.3% on in vitro MRS (p = 0.362, McNemar test). The spectra of NMR for IPMT showed more frequent peaks at 3.5-4.0 ppm (p=0.026). Conclusion : Although chemical analysis, using NMR could be regarded as possible tool to differentiate cystic masses, in vivo and in vitro MRS need further technical evolution for clinical application.

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