• Title/Summary/Keyword: 임상 결과 예측

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Characteristics of Sham/Placebo Acupuncture Controlled Trials for Headache (두통에 대한 Sham/Placebo 침술 대조군 연구의 특성에 대한 연구)

  • Jung, Su-Hyung;Seo, Jung-Chul;Yang, Angela;Xue, Charlie
    • Journal of Acupuncture Research
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    • v.26 no.1
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    • pp.99-109
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    • 2009
  • 목적 : 두통의 침술효과에 대한 연구가 꾸준히 이루어지고 있다. 하지만 많은 연구들에서 서로 상충되는 결과를 내놓고 있다. 이에 저자는 대조군 집단 시술의 역할과 시험의 특성에 대해 연구하는 데 있어 몇 가지 유형의 두통, 특히 긴장성 두통(Tension-type headache, TTH)과 편두통에 대한 침술의 대조군 시험에서 나타나는 일관성 없는 발견 사항들의 원인이 무엇인지에 대해 밝히려고 하였다. 방법 : 두통의 침술효과에 대해 보고하고 있는 11개의 임의대조군 시험(Randomized controlled trials, RCTs)을 대상으로 하여 위약 침술과 방법론적 특성 범주 III과 IV를 중심으로 위약 시술 분석, 비교를 실시하였다. 결과 : 임상적 유효성과의 상관관계에 있어 범주 III과 IV 사이에는 유의한 차이가 없었다. 표본 크기 계산, 표본 전체 크기, 진짜 집단과 위약 집단에 속한 피험자의 수에는 긍정적 결과와 중립적 결과 사이에 유의한 차이가 없었다. 결론 : 두통의 임의대조군 시험에 대한 다양한 유형의 위약 대조군과 침술의 방법론적 특성이 임상적 효과를 예측해 주는지의 여부에 대해 추가 연구가 이루어져야 하겠다.

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Rapid Detection of Mycobacterium tuberculosis Complex in Tissues by Using the Nested PCR (Nested PCR을 이용하여 조직으로부터 Mycobacterium tuberculosis Complex 신속검출)

  • Park, Jung-Yeon;Yang, Byoung-Seon
    • Korean Journal of Clinical Laboratory Science
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    • v.47 no.4
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    • pp.313-317
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    • 2015
  • Due to the increase in incidence of infection of Mycobacterium tuberculosis complex (MTC), it is imperative that a rapid diagnosis accompanies the handling of MTC. This is due to the three to eight weeks it takes to culture Mycobacteria, and the lack of sensitivity of microscopic examination of AFB. Recently, nested PCR has been used to detect and diagnose mycobacteria. It is especially useful in complementing diagnosis by histological extra pulmonary. After culturing all the specimens and practicing the nested PCR, we did comparison analysis between nested PCR and culture. There were 76 specimens, 31 of which were positive. Of the 31 positive specimens in culturing, only 22 were positive in nested PCR. Of the 45 negative specimens, 36 were negative in nested PCR. As a result, Sensitivity was 71% and specificity was 80%. Furthermore, the positive predictive value was 71% and negative predictive value was 80%. These results indicate that nested PCR based techniques are sensitive, specific, and rapid methods for the detection of MTC.

Pharmacogenomics in Cancer Research

  • Rha Sun-Young
    • Proceedings of the Korean Society for Bioinformatics Conference
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    • 2006.02a
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    • pp.91-96
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    • 2006
  • 현대의학의 발전으로 많은 질병들의 치료율이 개선되고 있으나, 암은 여전히 낮은 치료율과 약제 내성 및 부작용으로 많은 환자들이 의학적 고통 뿐 아니라 정신적, 경제적 문제점들을 호소하고있다. 이와같은 문제점은 동일한 병리학적 특성을 가지는 종양이라도 사람마다 그 생물학적 특성이 다르며, 동일한 환자안에서도 종양의 시기에 따라 다양한 특성의 세포들이 공존하며 다양한 문제를 발생하는 tumor heterogeneity에서 기인하게된다. 다행히 최근의 분자생물학의 발전과 인간유전체연구들의 활성화로 이와같은 다양한 암의 특성과 환자들의 특성을 이해하는 연구 방법들의 개발로 환자의 특성에 맞는 항암제를 효율적으로 투여하는 맞춤치료를 향한 노력을 지속하고 있다. 이와같은 맞춤치료의 일환으로 약제의 환자에서의 반응과 부작용을 예측하고자 최신의 high-throughput 기법을 도입한 것이 Pharmacogenomics이다. 즉, 지금까지의 항암치료는 암의 종류에 따라 임상연구 결과에 근거한 항암제를 선택하고 있다. 그러나 앞서 설명한 것처럼 암의 특성과 환자 반응의 다양화로 실제 항암효과는 기대에 미치지 못하여 많은 수의 환자들이 치료에 내성을 보일 뿐 아니라 치명적인 부작용으로 새로운 문제에 대면하게 되었다. 따라서 각 항암제011 최대의 효과를 보이며 최소의 부작용을 나타내는 최선의 치료책을 선정하는 것이 중요한 과제이다. 이를 위해서 암환자의 치료 단계에서 정확한 진단 및 병기 설정, 생물학적 특성 이해 뿐 아니라, 치료 반응을 예측할 수 있는 생물학적 표지자를 찾고자 하는 노력의 결과로 현재 임상에 사용되는 몇 가지 종양표지자를 포함하여 다양한 유전자 칩들이 연구단계에 있다. 특히 다양한 생물학적 현상이 많은 유전자들의 변화에 의한다는 근거하여 약제의 효과와 부작용을 예측할 수 있는 표지자 발굴도 DNA chip 등의 high-throughput technology를 사용하여 그 특이도와 민감도가 향상된 표지자 발굴이 시도되고 있다. 아직은 시작단계이고 많은 검증이 필요하나 여러 가지 가능성의 증거들로 멀지않은 시기에 맞춤치료가 가능하리라 기대하며, 암 연구에 있어서 pharmacogenomics의 현황을 소개하고자 한다.

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Effect of Wearing a Compression Stocking on Electromyogram of the Legs (동일인에서 한쪽 다리에만 압박스타킹을 착용했을 때 유발되는 다리 근육의 근전도 변화에 대한 정량적 분석)

  • Lee, Ji-Youn;Yuk, So-Hee;Yoo, Hyo-Gyung;Hong, Nam-Ju;Jeon, In-Cheol;Jung, Dongju
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.2
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    • pp.185-190
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    • 2019
  • Compression stockings are widely used for prevention of varicose vein. Depending on manufacture, there are diverse types of compression stockings available. Most common type of compression stocking might be the one cover calf of a lower leg which has 20~30 mmHg pressure. Despite being widely used, possible side effects that may occur by wearing compression stockings have not been studied much. We analyzed for a long wearing effect of compression stocking. Participants wore the compression stocking over one leg for 7 days. During the period, all the participants did their ordinary works wearing the compression stocking. Electrocardiogram (ECG), ankle-brachial index (ABI), blood pressure (BP), and electromyogram (EMG) were measured at 0 day, 3rd day and 7th day. There was no effect of wearing compression stockings from ECG, ABI or BP. Only EMG that was measured on the covered muscle increased proportionally to the wearing time. Interestingly, EMG from the opposite leg that had never been covered by compression stocking decreased in proportion to the wearing date. These results suggest wearing a compression stocking for varicose vein may cause unintentional increase or decrease of EMG from the wearing or non-wearing legs, respectively.

Surgical Planning in Deformity Correction Osteotomies using Forward Kinematics and Inverse Kinematics (정기구학 및 역기구학을이용한하지 교정절골술 계획 생성)

  • Jeong, Jiwon;Lee, Seung Yeol;Youn, Kibeom;Park, Moon Seok;Lee, Jehee
    • Journal of the Korea Computer Graphics Society
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    • v.20 no.1
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    • pp.1-11
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    • 2014
  • Patients with cerebral palsy or arthritis have deformities in lower limb which cause unstable gait or posture and pains. Surgeons perform a deformity correction osteotomy with surgical plan. But sometimes they find the unexpected angular or rotational deformation after surgery. The problems are that there is no method to predict the result of a surgical plan and also there are so many factors to must consider in surgical planning step such as clinical measurements, rotation angle, wedge angle, morphology of lower limb, etc. This paper presents new methods for planning the deformity correction osteotomy efficiently. There are two approaches based on the 3D mesh model and the accurate assessment of the patient's lower limb. One is the manual pre-simulation of surgery using forward kinematics. And the other is the automatic surgical planning using inverse kinematics and nonlinear optimization. Using these methods, we can predict and verify the results of various surgical treatments and also we can find a more effective surgical plan easily compared to conventional methods.

What is the Prognosis for Early Gastric Cancer with pN Stage 2 or 3 at the Time of Pre-operation and Operation (pN2 이상인 조기위암 환자의 수술 전과 수술 중의 평가)

  • Kim, Chan-Young;Lee, Se-Yul;Yang, Doo-Hyun
    • Journal of Gastric Cancer
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    • v.6 no.2
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    • pp.114-119
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    • 2006
  • Purpose: The purpose of this study is to determine whether it is possible to evaluate patients with pN2 or pN3 early gastric cancer (EGC) as being in an advanced stage before and during the operation. Materials and Methods: 4,430 patients underwent a gastrectomy for cancer from 1990 to 2003. Eight of the 552 patients with EGC included pN2 or pN3. The estimated clinical and surgical stage before and during the operation were compared to the pathological results, and a follow-up of progression was done. Results: The patients were evenly distributed among all age groups with seven men and one woman. The pre-operative estimate of T1 by CT was 25% (2/8). In the main, the cT stage was over estimated. The estimate of over N2 was 50% (4/8). One patient was preoperatively staged as la sT1 during operation was 57.1% (4/7), and the estimate of over N2 was 67% (4/6). Two patients were intraoperatively evaluated as Ia. Only one patient survived over 5 years, and the mean survival of these patients was 15 months $(95%\;Cl:\;0{\sim}35.5)$. Conclusion: It was generally possible to evaluate patients with EGC of over pN2 as being in an advanced stage before and during the operation. Although very rare (2/552, 0.04%), there were EGC patients whose stages were not predictable at all. Therefore, more precise preoperative and intraoperative staging methods are warranted.

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Average rainfall estimation method of electromagnetic wave rain gauge (전파강수계 평균 강우 추정 기법)

  • Lim, Sanghun;Kim, Won;Lee, Chanjoo;Choi, Jeongho
    • Proceedings of the Korea Water Resources Association Conference
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    • 2021.06a
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    • pp.376-376
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    • 2021
  • 홍수와 같은 수문 재해를 예측하고 예방하기 위해서는 강우량을 정확하게 예측하는 것이 중요하다. 신뢰할 수 있는 수문재해 예보 시스템은 기존의 포인트 기반 우량계를 사용하여 달성 할 수 있는 것보다 강우량의 공간 분포를 관측할 수 있는 보다 효과적인 방법이 필요하다. 본 연구에서는 전파강수계 시스템과 다중 고도 관측 데이터를 이용하여 평균 강우를 추정하는 방법을 제시한다. 전파강수계는 K 밴드 이중 편파 기술을 사용하여 초단거리 관측을 수행하는 소형전파강수관측시스템이다. 평균 강우량을 추정하는 방법은 매우 짧은 관측 범위와 이중 편파 정보의 다중고도 평균 관측 개념을 기반으로 하며 관측 지역의 반사도와 비차등위상차의 고도별 평균값을 이용하여 추정한다. 제안 된 방법은 전파강수계의 관측 범위와 스캔 시간이 매우 짧기 때문에 강우 분포의 시공간적 변화가 낮다는 가정하에 개발되었다. 제안된 방법의 평가를 위해 핏게이지, 우량계 및 Parsivel disdrometer를 포함한 지상 장비와 비교하였다. 시험적용 결과 제안된 강우 추정 기법이 다양한 강우사상에 대해 강우강도를 잘 추정하는 것으로 확인되었다

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Predictive factors for severe infection among febrile infants younger than three months of age (발열을 주소로 내원한 3개월 미만의 영아에서 중증 감염의 예측 인자)

  • Cho, Eun-Young;Song, Hwa;Kim, Ae-Suk;Lee, Sun-Ju;Lee, Dong-Seok;Kim, Doo-Kwun;Choi, Sung-Min;Lee, Kwan;Park, Byoung-Chan
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.898-903
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    • 2009
  • Purpose : This study investigated the predictive factors for identifying infection-prone febrile infants younger than three months. Methods : We conducted a retrospective study of 167 infants younger than three months with an axillary temperature >$38^{\circ}C$ who were hospitalized between 2006 and 2008. If they met any of the following criteria, positive blood culture, CSF WBC ${\geq}11/mm^3$ or positive CSF culture, urinalysis WBC ${\geq}6$/HPF and positive urine culture, WBC ${\geq}6$/HPF on microscopic stool examination or positive stool culture, they were considered at high risk for severe infection. Infants with focal infection, respiratory infection or antibiotic administration prior to admission to the hospital were excluded. We evaluated the symptoms, physical examination findings, laboratory data, and the clinical course between the high risk and low risk groups for severe infection. Results : The high-risk group included 77(46.1%) infants, and the most common diagnosis was urinary tract infection (51.9%). Factors, such as male sex, ESR and CRP were statistically different between the two groups. But, a multilinear regression analysis for severe infection showed that male and ESR factors are significant. Conclusion : We did not find the distinguishing symptoms and laboratory findings for identifying severe infection-prone febrile infants younger than three months. However, the high-risk group was male and ESR-dominated, and these can possibly be used as predictive factors for severe infection.

Clinical characteristics of acute renal failure of rhabdomyolysis in children (소아에서 횡문근융해증을 동반한 급성신부전의 임상양상)

  • Kim, Jae Hui;Goo, Min Ji;Yeom, Jung Sook;Park, Eun Sil;Seo, Ji Hyun;Lim, Jae Young;Park, Chan Hoo;Woo, Hyang Ok;Youn, Hee Shang
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.277-283
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    • 2007
  • Purpose : Acute renal failure (ARF) is an important complication of rhabdomyolysis. The purpose of this study was to identify the major causes of rhabdomyolysis in children and to identify the factors associated with the developmet of ARF. Methods : A retrospective chart review between January 1997 to June 2005 was conducted of 60 patients with a diagnosis of rhabdomyolysis. Rhabdomyolysis was defined by an elevation of serum creatine phosphokinase (CK) greater than 1,000 IU/L with a MM fraction more than 95% or serum myoglobin>300 mg/dL or positive urine myoglobin. Patients were excluded if they had evidence of myocardial ischemia, or cerebrovascular insufficiency. Results : Sixty patients (37 males, 23 females) were enrolled, with the median age of 4.25 year. The most common causes of rhabdomyolysis were repiratory tract infection (9), seizure (7), hypoxia or asphyxia (6). Fifteen patients (25.0%) developed ARF and ten of them (66.0%) died. The initial serum creatinine, uric acid, potassium, pH and peak serum creatinine, initial systolic blood pressure, and mental status were statistically correlated with the development of ARF. The peak serum CK was associated with mortality of rhabdomyolysis. Conclusion : Acute renal failure was significant complication of rhabdomyolysis in children. Several clinical and laboratory factors were statistically associated with the development of ARF and death.

Future Prospects of Forest Type Change Determined from National Forest Inventory Time-series Data (시계열 국가산림자원조사 자료를 이용한 전국 산림의 임상 변화 특성 분석과 미래 전망)

  • Eun-Sook, Kim;Byung-Heon, Jung;Jae-Soo, Bae;Jong-Hwan, Lim
    • Journal of Korean Society of Forest Science
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    • v.111 no.4
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    • pp.461-472
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    • 2022
  • Natural and anthropogenic factors cause forest types to continuously change. Since the ratio of forest area by forest type is important information for identifying the characteristics of national forest resources, an accurate understanding of the prospect of forest type change is required. The study aim was to use National Forest Inventory (NFI) time-series data to understand the characteristics of forest type change and to estimate future prospects of nationwide forest type change. We used forest type change information from the fifth and seventh NFI datasets, climate, topography, forest stand, and disturbance variables related to forest type change to analyze trends and characteristics of forest type change. The results showed that the forests in Korea are changing in the direction of decreasing coniferous forests and increasing mixed and broadleaf forests. The forest sites that were changing from coniferous to mixed forests or from mixed to broadleaf forests were mainly located in wet topographic environments and climatic conditions. The forest type changes occurred more frequently in sites with high disturbance potential (high temperature, young or sparse forest stands, and non-forest areas). We used a climate change scenario (RCP 8.5) to establish a forest type change model (SVM) to predict future changes. During the 40-year period from 2015 to 2055, the SVM predicted that coniferous forests will decrease from 38.1% to 28.5%, broadleaf forests will increase from 34.2% to 38.8%, and mixed forests will increase from 27.7% to 32.7%. These results can be used as basic data for establishing future forest management strategies.