• Title/Summary/Keyword: 환자 선별

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Plasma Amino Acid and Urine Organic Acid in Diagnosis of MELAS (멜라스 증후군 진단에서의 혈장 아미노산과 소변 유기산 분석)

  • Ji-Hoon Na;Young-Mock Lee
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.23 no.1
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    • pp.17-24
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    • 2023
  • Purpose: In the past, detection of metabolic abnormalities in plasma amino acid (PAA) and urine organic acid (UOA) has been widely used to diagnose clinical mitochondrial diseases, such as mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS). In this study, the diagnostic values of PAA and UOA were reviewed, and their effectiveness in the diagnosis of MELAS was examined retrospectively. Methods: Blood and urine samples at the time of diagnosis were collected from all clinically diagnosed MELAS patients (n=31), and PAA and UOA tests were performed. All samples were collected in a fasting state to minimize artifacts in the results. The difference in the ratio of abnormal metabolites of PAA and UOA at initial diagnosis was statistically compared between the MELAS with genetic confirmation (n=19, m.3243A>G mutation) and MELAS without genetic confirmation (n=12) groups. The MELAS without genetic confirmation group was used as control. Results: Comparison of PAA and UOA between the two groups revealed that no abnormal metabolites showed characteristic differences between gene-confirmed MELAS patients with and those without genetic confirmation. Conclusions: Abnormal values of metabolites in PAA or UOA might be useful as a screening test but are not sufficient to diagnose MELAS patients.

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Post Traumatic Stress Disorder (PTSD) in Medical Accident Patients: The Interaction Effect of Clinicians' Explanation and Attitude and Social Support (의료사고 환자들의 외상후 스트레스 장애(PTSD) 실태: 의료진의 설명 및 태도와 사회적 지지의 상호작용)

  • Nayeon Kim;Suran Lee;Yaeun Choi;Young Woo Sohn
    • Korean Journal of Culture and Social Issue
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    • v.23 no.2
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    • pp.215-237
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    • 2017
  • Most research on medical accidents is related to medical disputes and malpractice of relief system. Therefore, there is a lack of research which explores the psychological experiences of patients injured by medical accidents. The purpose of this study was to investigate Post Traumatic Stress Disorder (PTSD) of patients harmed by medical accidents and to examine the moderating role of social support on the relationship between clinicians' explanation and attitude and PTSD symptoms. A total of 180 patients were drawn from a medical accident organization and online communities related to medical accidents. Results showed that 171 (95%) of the subjects experienced full PTSD symptoms and their severity of the PTSD Symptoms was as high as those who experienced other severe traumatic events. Though the main effect of clinician's explanation and attitude on PTSD symptoms was not significant, the moderating effect of social support was significant in the relationship between clinicians' explanation and attitude and PTSD symptoms. In other words, when the level of social support was low, the poorer the explanation and attitude of clinicians, the more severe the symptoms of PTSD. Drawing from these results, psychological, social, and institutional strategies were suggested to alleviate and prevent PTSD symptoms of patients injured by medical accidents. Finally, limitations of this study and suggestions for future research were discussed.

Evaluation of the Automated Immunohematology Analyzer DAYMATE M (혈액은행 자동화 검사장비 DAYMATE M의 수행능 평가)

  • Yoo, Jaeeun;Yu, Hain;Choi, Hyunyu;Lee, Gyoo Whung;Song, Young-Sun;Lee, Seungok;Jekarl, Dong Wook;Kim, Yonggoo
    • Laboratory Medicine Online
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    • v.7 no.4
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    • pp.163-169
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    • 2017
  • Background: An automated immunohematology analyzer, DAYMATE M (DAY Medical, Switzerland), has been recently developed. The potential of this analyzer to improve test results has been evaluated. Methods: A total of 300 blood samples from Seoul St. Mary's hospital and Incheon St. Mary's hospital were tested for ABO and RhD typing. In addition, 336 antibody screening test (AST) samples and 82 patients treated with hematopoietic stem cell transplantation (HSCT) were included. AST results by DAYMATE M were compared with those obtained by a manual method using DS-Screening II (Bio-Rad Laboratories, Switzerland) and red blood cells from Selectogen (Ortho-Clinical diagnostics Inc., USA). Results: Of the 300 patients enrolled, 87, 73, 79, and 61 had type A, B, O, and AB blood, respectively. The concordance rate was 99.9% for cell typing and 97.0% for serum typing. One discordant case was classified as type B instead of AB, and six discordant serum-typing cases were type A, but classified as type AB. Among the 336 AST samples, the concordance rate was 93.2%. From 136 positive cases, six were discordant. Within the 82 HSCT-treated patients, the concordance rate for ABO blood typing was 92.2%. Among the six discordant cases, DAYMATE M typed four cases as donor type where the standard method typed them as the recipient blood type. Conclusions: The DAYMATE M automated immunohematology analyzer performs reliably for ABO and RhD typing, as well as for ASTs and on samples from patients treated with HSCT.

The value of Dedicated Tc-99m MIBI Scintimammography in the Evaluation of Patients with Palpable Breast Lesions in Comparison with Mammography: Preliminary Result (만져지는 유방 병소를 평가하는데 있어 Tc-99m MIBI 유방스캔과 유방촬영 술의 비교: 예비 결과)

  • Cho, Arthur;Cho, Ho-Jin;Yun, Mi-Jin;Park, Byeong-Woo;Kim, Min-Jung;Kim, Eun-Kyung;Kang, Won-Jun;Lee, Jong-Doo
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.1
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    • pp.48-54
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    • 2009
  • Purpose: There are few studies evaluating the usefulness of dedicated high-resolution scintimammography and no studies using delayed washout with this dedicated high resolution scintimammography for the evaluation of breast lesions. We underwent this study to evaluate the clinical usefulness of Tc-99m MIBI in evaluating patients with palpable breast lesions using dedicated high-resolution scintimammography. Materials and Methods: This study included 19 patients with 23 palpable breast lesions who underwent mammography. Tc-99m MIBI was taken to further characterize these lesions. Scintimammography images were acquired with standard craniocaudal and mediolateral oblique views and delayed images were additionally taken. Final conclusions were based on histopathology, either by biopsy or mastectomy results. Results: Eighteen lesions were malignant and five were benign. Mammography was indeterminate for thirteen lesions, nine of those were malignant. Mammography also categorized one lesion as benign in a dense breast, but scintimammography and pathology results showed malignancy. Of the five benign lesions, two were visible on scintimammography, but delayed images showed washout. Conclusion: Based on our preliminary results, dedicated high resolution scintimammography seems to be very useful in characterizing palpable lesions that were indeterminate or negative on mammography.

Study on the Characteristics and Quality Level of Single Subject Researches in the Stroke Patients : The Field of health care ~ (뇌졸중 환자를 대상으로 한 단일대상연구의 특성과 질적 수준에 관한 연구: 보건의료 분야를 대상으로)

  • Sim, Kyoung-Bo
    • The Journal of Korean society of community based occupational therapy
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    • v.8 no.2
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    • pp.15-28
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    • 2018
  • Objective : This study sought to characterize and determine the qualitative level of a single target study for stroke patients. Methods : The National Science and Technology Information Center (NDSL), DBpia (DBpia), RISS (Radical Research Information Service), Korea Research Information (KISS), and the National Assembly Library's original case study from 2002 to 2017. A total of 24 single target research papers were selected through the screening process to analyze the quality level of research methods and research design. Results : ABA design was th most common study design method. One person was the most with 12(50%). and three were the second with 8(33.3%). Imagination was the most used as an independent lawyer. Dependent variables had the highest level of situability and one-sidedness. The study was also conducted with a variety of target behaviors, including 'memory', 'visual attention', 'dysphagia', 'visual-motor coordination', 'balance', 'activity of daily life' and 'edema' behaviors. It also showed a positive effect on all dependent variables. The Qualitative level was found to be above the intermediate level except for one study. Conclusion : It is academic significance that this study analyzes the items to be prepared for in the performance of a single target study and further studies may require the establishment of a weak but good-quality single target study for researchers conducting research in local communities and clinical sites.

Comparison of cephalometric norms between Mongolian and Korean adults with normal occlusions and well-balanced profiles (조화로운 측모를 가진 몽골인과 한국인 성인 정상교합자의 측모두부계측방사선학적 비교 연구)

  • Kim, Ji-Hwan;Gansukh, Odontuya;Amarsaikhan, Bazar;Lee, Sin-Jae;Kim, Tae-Woo
    • The korean journal of orthodontics
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    • v.41 no.1
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    • pp.42-50
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    • 2011
  • Objective: The purposes of this study were to establish cephalometric norms of Mongolian adults, which have not previously been reported in orthodontic journals, and to compare them with cephalometric norms of Korean adults. Methods: Lateral cephalometric radiographs of 74 Mongolian adults (35 men, 39 women) and 95 Korean adults (52 men, 43 women) with normal occlusions and well-balanced lateral profiles were obtained. The subjects were chosen by orthodontists of the same ethnic background. Forty craniofacial variables were measured, and groups were compared by analysis of covariance. Results: The cephalometric norms for male and female Mongolian and Korean adults with normal occlusions and well-balanced lateral profiles were established. Sexual dimorphism was found in linear skeletal measurements and vertical skeletal relationships. Compared with Korean adults, Mongolian adults had shorter anterior facial height, more prominent chins, and more upright upper incisors. There were few differences in soft tissue measurements. The differences were statistically significant, but their clinical importance may be limited. Conclusions: Cephalometric differences can be considered, but little difference may exist in the orthodontic diagnosis and treatment planning of Mongolian and Korean adults.

Spontaneous Pneumomediastinum: Clinical Investigation (자연성 종격동 기종의 임상적 고찰)

  • Park Jae Hong;Chei Chang Seck;Hwang Sang Won;Kim Han Yong;Yoo Byung Ha;Kim Dae Hwan
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.220-225
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    • 2006
  • Background: Spontaneous pneumomediastinum is an uncommon, benign, self-limited disorders that usually occurs in young adults without any apparent precipitating factors or disease. The purpose of this study was to review our experience in dealing with this entity and describe a reasonable course of assessment and management. Material and Method: A retrospective case series was conducted to identify adults patients with SPM who were diagnosed and treated in a single institution between 2001 and 2005. Result: Fifteen patients were identified who included 14 men and 1 women with a mean age of 26 years. Presenting symptoms were chest pain in 12 patients ($80\%$), dyspnea in 5 patients ($33\%$), and throat discomfort in 4 patients ($26\%$). Two cases were associated with use of inhalational drugs and 3 cases were associated with exercise. The predisposing factors were asthma, excessive exercise, and vomiting in spontaneous pneumomediastinum. The physical findings were subcutaneous emphysema in 10 patients ($77\%$). Chest radiography and computerized tomography were the diagnostic methods in all cases with CT scan revealing six cases with associated pulmonary abnormalities. Esophagogram and flexible bronchoscopy were selectively used. Fifteen patients ($100\%$) were admitted to the hospital. Their mean hospital stay was 3 days. All patients were conservatively treated. In a follow-up of 3 years no complications or recurrences were observed. Conclusion: Most simple spontaneous pneumomediastinum cases were benign diseases and most of them ($77\%$) had shown typical chest pain, dyspnea and subcutaneous emphysema. Inhalational drug use was not a major cause of SPM; however, increased use of bronchoinhalers was a suspicious cause of SPM.

Usefulness of Ultrasonographic Examination by a Pediatrician in Children with Abdominal Pain (소아 복통에서 소아과 의사에 의한 초음파 검사의 유용성)

  • Park, Hyun-Seok;We, Ju-Hee;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.2
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    • pp.141-147
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    • 2011
  • Purpose: Ultrasonography (US) is widely used as a screening test in patients with abdominal pain (AP). We investigated the usefulness of US by a pediatrician in children with AP. Methods: We retrospectively analysed the medical records of children with AP who undertook US from December, 2008 to July, 2010. Results: A total of 628 patients (325 male, 303 female) were enrolled in this study. The mean age of patients was $8.08{\pm}4.61$ years. Duration of AP was acute in 427 and chronic in 201 patients. Localization of AP was diffuse (36.9%), periumbilical (24.4%), epigastric (21.0%), and right lower quadrant (8.1%). On the examination, there were no abnormal findings in 327 patients (52.1%). Abnormal ultrasonographic findings were mesenteric lymphadenitis (27.1%), intestinal mural thickening (10.0%), intussusception (3.0%), appendicitis (2.6%), choledochal cyst (1.6%), and pancreatitis (0.3%). We performed additional imaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI) in 39 patients who showed obscure findings on the US. In 33 patients (84.6%), the same results were obtained from CT or MRI. Two cases of appendicitis, one case of pancreatitis and one case of Henoch-Sh$\ddot{o}$nlein purpura were diagnosed by the CT examination. However, there were two cases of appendicitis diagnosed by US thathad no evidence of appendicitis on the CT. Diagnostic accuracy of initial US in children with abdominal pain was 99.4%. Conclusion: US by a pediatrician as a screening test in children with AP provides a rapid and accurate diagnostic indication and has non-invasive and radiation-free advantages.

Clinical Results of ACL Reconstruction in the Immature Adolescent via Transphyseal Approach in Tibia Based on a New Indication Paradigm (새로운 수술적응증에 의한 골 미성숙 전방십자인대 손상 환자에서의 성장판을 통과하는 전방십자인대 재건술의 결과)

  • Lee, Dong Chul;Shon, Oog Jin;Park, Chul-Hyun;Kwon, Moon Soo
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.1-8
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    • 2012
  • Purpose: To evaluate clinical and radiologic outcomes of transphyseal anterior cruciate ligament (ACL) reconstruction in patients with open physes who were selected with authors' new operative indications. Materials and Methods: We evaluated 15 patients with open physes who underwent a transtibial ACL reconstruction and were followed up for 4~6 years after surgery. Our operative indications involved 1) choronologic age of ${\geq}$ 16 in male and ${\geq}$ 14 in female, 2) open physes of ${\leq}$ 2 mm width, and 3) Risser sign and Tanner stage of ${\geq}$ 3. Tibialis anterior tendon allograft was used in all patients, and endobutton and bioscrew were used for femoral and tibial fixations, respectively. Functional outcomes were evaluated using Lysholm Knee Scoring scale, Tegner activity scale, and International Knee Documentation Committee (IKDC) 2000 subjective score. Physical examinations to evaluate stability involved Lachman and pivot shift tests. For radiographic results, we evaluated side to side differences of anterior displacement in stress views. In addition, with use of scannograms taken at last follow-up, we examined side to side differences of femorotibial angles, anatomical and mechanical lateral distal femoral angles, mechanical medial proximal tibial angles and leg lengths. Results: The mean Lysholm Knee score was 51(40-61) points preoperatively and 97(94-100) points at last follow up. The mean Tegner activity score was 2.6 points preoperatively and 7.1 points at last follow up. The mean IKDC score was 32.6 points preoperatively and 88.3 points at last follow up. The mean anterior displacement of the tibia was improved from 6.7(${\pm}1.0$) mm to 1.9(${\pm}0.9$) mm. There were no leg length discrepancies over 5 mm and no statistically significant differences in all the radiographic variables representing growth disturbance. Conclusion: This study suggests that patients with open physes who selected by authors' new indication would safely undergo transphyseal ACL reconstruction with successful outcomes.

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Usefulness and Limitations of Fine Needle Aspiration Cytology in Adult Cervical Lymph Node Enlargement Patients: An analysis of 342 cases (성인 경부 림프절 비대 환자들에서 미세침 흡인 세포검사법의 유용성과 문제점: 342 증례의 분석)

  • Lee, Jaeho
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.1
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    • pp.18-28
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    • 2004
  • Background : Many diseases like lung cancer and tuberculosis can involve cervical lymph node. Fine needle aspiration cytology(FNAC) was known as a useful screening test for the evaluation of enlarged lymph node. But the usefulness and limitations of FNAC according to disease category or physical characteristics of lymph node were not yet fully established. Methods : Retrospective analysis of three hundred forty two adult patients who performed FNAC due to enlarged cervical lymph nodes at the Seoul Municipal Boramae Hospital during the period from January 1999 to December 2002 and final diagnosis could be made by surgical biopsy, microbiology or clinical observation. Results : Among the 342 cases, 176(51.5 %) were finally diagnosed as benign nature ncluding reactive hyperplasia, Kikuchi's disease and acute suppuration. Eighty eight(25.7 %) were diagnosed as tuberculous lymphadenitis, 66(19.3 %) as metastasis, and 12(3.5 %) as lymphoma. Tuberculosis, metastasis, and lymphoma all showed significantly larger diameter, longer duration of lymph node enlargement. There were higher frequency of supraclavicular involvement in the cases of tuberculosis and metastasis. The overall diagnostic sensitivity of FNAC was 88.0 %, and 88.6 % in benign nature lesion, 77.3 % in tuberculosis, 90.1% in metastasis and 58.3 % in lymphoma. The diagnosis of tuberculosis was made by FNAC in 68 cases (77.3 %) among 88 cases. Lung cancer(43.9 percent) was most frequent cause of cervical lymph node metastasis. Diagnostic sensitivity of FNAC was significantly lower in the supraclavicular than other cervical lymph node(80 % vs. 91.3 %) and not correlated with disease nature, node size or number. Conclusion : Though FNAC was a reliable screening test for enlarged cervical lymph node enlargement, the diagnostic sensitivity was low in the case of lymphoma or when the enlarged lymph node was located at the supraclavicular area.