• Title/Summary/Keyword: 환자 선별

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The Study of the Initial Presentations of Wilson Disease at Diagonosis (Wilson 병의 진단시 임상 발현 양상에 대한 고찰)

  • Yang, Tae-Jin;Ji, Geun-Ha;Song, Min-Seop;Hwang, Tae-Gyu
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.199-206
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    • 2001
  • Purpose: To review the clinical and laboratory features of patients with Wilson disease at diagnosis. Methods: In this retrospective study, records of all 20 patients, who were diagnosed as having Wilson disease at the Paik hospital in Busan from 1990 to 2000, were reviewed. Results: Out of 20 patients, 12 pateints (60%) have hepatic presentation alone, 2 patients (10%) have neurologic presentation, 4 patients (20%) have hepatic and neuropsychiatric presentation, and one patient (5%) has hematologic presentation at diagnosis. One patient (5%) has neither symptom nor laboratory finding of Wilson disease except very low serum ceruloplasmin level and positive family history. Family screening test revealed 3 cases of Wilson disease. 12 patients were revealed to be combined with liver cirrhosis at diagnosis. Conclusion: Early diagnosis and treatment is very important in patients with Wilson disease. Children or adolescents who manifest symptoms of hepatitis, who has prolonged elevation of liver enzymes, and has family history of hapatitis of unknown origin, with mild hematologic or urinary abnormalities must be suspected to have Wilson disease. Also, in adolescents with extrapyramidal symptoms or other neuropsychiatric symptoms, liver function test should be done.

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Childhood Trauma and Pharmacotherapy Retention among Outpatients with Panic Disorder (공황장애 외래 환자의 아동기 외상과 약물치료 유지)

  • Kim, Dong Joo;Kim, Daeho;Lee, Jinbok;Kim, Yaeseul;Sohn, Sujin
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.53-62
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    • 2020
  • Objectives : This study investigated lifetime experiences of trauma, treatment retention, and psychiatric symptoms among outpatients with panic disorder after initiation of pharmacotherapy. Our research hypothesis was that panic patients with childhood trauma would display more severe symptoms and less treatment retention compared to those without such history. Methods : A total of 135 first-visit outpatients with DSM-IV panic disorder were approached during the period from March 2012 to August 2016. Fifty-three patients (39%) either refused or returned incomplete questionnaires, leading to a final sample size of 82. Participants completed the Trauma History Screen, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results : The number of lifetime trauma was significantly correlated with treatment retention (rho=-0.269, p=0.015). Among subtypes of trauma, only childhood physical abuse was significantly correlated with treatment retention (rho=-0.298, p=0.007). Conclusions : Our results indicated that psychological trauma, particularly of an interpersonal nature from childhood, can affect pharmacotherapy treatment retention in panic disorder. This may be mediated by poor patient-doctor relationships originating from trust issues among childhood trauma survivors or lack of perceived improvement due to the more severe symptoms and unfavorable course experienced by those with childhood trauma. Further studies are needed to explore the reasons for poor treatment adherence in this population.

Correlations between Cognitive Function and Occupational Participation in Dementia Patients (치매 환자의 인지 기능과 작업 참여와의 상관관계)

  • Lee, Hyun-Jin;Kwon, Hyuk-Cheol;Kim, Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.4
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    • pp.472-480
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    • 2018
  • This study was conducted to examine cognitive function and the ability for occupational participation in patients with mild and moderate dementia and to identify correlations between these two variables. The study investigated 95 dementia patients who visited a day care center in Daegu between September and November, 2017. Their detailed cognitive functions were examined using the Mini-Mental State Examination-Korean (MMSE-K) and the Korean Version of the Loewenstein Occupational Therapy Cognitive Assessment Geriatric population: LOTCA-G. Their occupational participation was measured using the Model of Human Occupation Screening Tool (MOHOST). The subjects' cognitive functions and abilities for occupational participation were analyzed using the descriptive statistics produced by the SPSS 20.0 program. In addition, Pearson correlation coefficient was used to analyze the correlations between the cognitive functions of the subjects and their abilities for occupational participation. The results of the study showed positive correlations between cognitive function and the ability for occupational participation of patients with mild and moderate dementia. Based on the results of this study, the evaluation of the patients with dementia and ability for occupational participation related to the cognitive function in establishing the therapeutic goal should be considered.

Effect of Articulation Abilities on the Articulator Strength Training by IOPI of Spasticity Dysarthric Speech (IOPI를 활용한 조음기관 훈련 프로그램이 경직형 마비말장애의 조음 능력에 미치는 영향)

  • Lee, Jang-Shin;Lee, Ji-Yun;Kim, Sun-Hee
    • Therapeutic Science for Rehabilitation
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    • v.9 no.1
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    • pp.91-99
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    • 2020
  • Objective : The purpose of this study was to investigate the effects of the IOPI articulator strength training program on articulator(tongue and lip) muscle strength, numbers of /l, s, ʨ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy in the alternate motion rates, and sequential motion rate changes in patients with spastic dysarthria. Methods : Three cases of patients with spastic dysarthria living in Jeju, Korea, were included in this study. A single subject design was selected to study changes in articulator(tongue and lip) muscle strength, numbers of /ㄹ, ㅅ, ㅈ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy in the alternate motion rates and sequential motion rates. Results : After the articulator strength training program was conducted on patients with spastic dysarthria, there were positive changes in articulator(tongue and lip) muscle strength, numbers of /ㄹ, ㅅ, ㅈ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy on the alternate motion rates and sequential motion rates. Conclusion : Our findings suggest that IOPI articulator strength training program could be very useful for the most representative childeren with cerebral palsy if conducted in various subtypes of dysarthric patients and linked with articulatory function training with IOPI at home.

A Node2Vec-Based Gene Expression Image Representation Method for Effectively Predicting Cancer Prognosis (암 예후를 효과적으로 예측하기 위한 Node2Vec 기반의 유전자 발현량 이미지 표현기법)

  • Choi, Jonghwan;Park, Sanghyun
    • KIPS Transactions on Software and Data Engineering
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    • v.8 no.10
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    • pp.397-402
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    • 2019
  • Accurately predicting cancer prognosis to provide appropriate treatment strategies for patients is one of the critical challenges in bioinformatics. Many researches have suggested machine learning models to predict patients' outcomes based on their gene expression data. Gene expression data is high-dimensional numerical data containing about 17,000 genes, so traditional researches used feature selection or dimensionality reduction approaches to elevate the performance of prognostic prediction models. These approaches, however, have an issue of making it difficult for the predictive models to grasp any biological interaction between the selected genes because feature selection and model training stages are performed independently. In this paper, we propose a novel two-dimensional image formatting approach for gene expression data to achieve feature selection and prognostic prediction effectively. Node2Vec is exploited to integrate biological interaction network and gene expression data and a convolutional neural network learns the integrated two-dimensional gene expression image data and predicts cancer prognosis. We evaluated our proposed model through double cross-validation and confirmed superior prognostic prediction accuracy to traditional machine learning models based on raw gene expression data. As our proposed approach is able to improve prediction models without loss of information caused by feature selection steps, we expect this will contribute to development of personalized medicine.

Multidetector Computed Tomography in Patients with Femoral Neck Fracture for Assessing Osteoporosis: Comparison with Dual Energy X-Ray Absorptiometry (대퇴골 경부 골절 환자에서 골다공증 평가를 위한 다중검출 CT의 이용: 이중에너지 X-선 흡수계측법과의 비교)

  • Hyo Jeong Lee;Ji Young Hwang
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.173-181
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    • 2021
  • Purpose To evaluate the ability of the Hounsfield unit (HU) measurement of the femoral neck during multidetector computed tomography (MDCT) for assessing osteoporosis compared with dual-energy X-ray absorptiometry (DXA). Materials and Methods Forty-two patients with femoral neck fractures who underwent MDCT and DXA from July to December 2016 were included in this study. HU measurements were made of the cancellous portions of the normal contralateral femoral neck on MDCT. Bone mineral density (BMD) and T-scores were obtained at the femur DXA. Correlations of HU values with BMD and T-scores were analyzed using Spearman's correlation test. Results The mean BMD and T-score of the femoral neck were 0.650 g/cm2 and -2.4, respectively. The mean HU values for the normal, osteopenia, and osteoporosis groups were 131.9, 98.9, and 41.3, respectively. HU values at the femoral neck were positively correlated with BMD (r2 = 0.670; p < 0.001) and T-scores (r2 = 0.676; p < 0.001). Conclusion The HU values of the femoral neck on MDCT are significantly correlated with BMD and T-scores of femur DXA. The HU values may serve as a diagnostic tool for the screening of regional bone quality when MDCT is performed for other reasons.

Added Value of Structured Reporting for US of the Pediatric Appendix: Additional CT Examinations and Negative Appendectomy (소아 충수 초음파 검사에서 구조화 판독문의 부가가치: 추가 CT 검사 및 음성 충수절제술의 관점에서)

  • Keonwoo Choi;Ji Young Choi;Hyuk Jung Kim;Hyun Jin Kim;Suk Ki Jang
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.653-662
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    • 2023
  • Purpose This study aimed to determine the incremental value of using a structured report (SR) for US examinations of the pediatric appendix. Materials and Methods Between January 2009 and June 2016, 1150 pediatric patients with suspected appendicitis who underwent US examinations of the appendix were included retrospectively. In November 2012, we developed a five-point scale SR for appendix US examinations. The patients were divided into two groups according to the form of the US report: free-text or SR. The primary clinical outcomes were compared between the two groups, including the rate of CT imaging following US examinations, the negative appendectomy rate (NAR), and the appendiceal perforation rate (PR). Results In total, 550 patients were included in the free-text group and 600 patients in the SR group. The rate of additional CT examinations decreased by 5.3% in the SR group (8.2%, p = 0.003), and the NAR decreased by 8.4% in the SR group (7.8%, p = 0.028). There was no statistical difference in the appendiceal PR (37.6% vs. 48.0%, p = 0.078). Conclusion The use of an SR to evaluate US examinations for suspected pediatric appendicitis results in lower CT use and fewer negative appendectomies without an increase in appendiceal PR.

Clinical Significance of Nasal Peak Inspiratory Flow Rate in Patients with Chronic Cough (만성기침환자에서 비강최대흡기유속 측정의 의의)

  • An, Chang-Hyeok;Lee, Byung-Hun;Park, Yong-Bum;Choi, Jae-Chul;Jee, Hyun-Suk;Park, Sung-Jin;Kang, Sun-Bok;Kim, Jae-Yeol;Park, In-Won;Choi, Byung-Whi;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.654-661
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    • 1999
  • Background : The upper respiratory tract is the primary target organ of various airborne pollutants and is easily accessible part of the respiratory tract, and also is the predominant structure where chronic cough originates. The nasal peak inspiratory flow(PIFn), which is the peak inspiratory flow via nose with nasal mask and spirometry, could be a reliable parameter of nasal obstruction. The validity of PIFn has been evaluated in several studies by assessing the correlation between PIFn measurements and other parameters of nasal air flow. This study was designed to show the reproducibility of PIFn, the difference of PIFn between patients with chronic cough and normal subjects, and the usefulness of PIFn in the evaluation of nasal obstruction in patients with chronic cough. Methods : PIFn was measured by spirometry with nasal mask, twice a day for 3 consecutive days in 7 young normal subjects to evaluate validity of the test. In 32 patients with chronic cough and 25 age-matched normal subjects, PIFn and pulmonary function test($FEV_1$, $FEV_1%$ pred, FVC, and FVC% pred) were measured at first visiting. Results : Values of PIFn, $FEV_1$, and FVC were nearly constant in 7 young normal adults. Patients with chronic cough were 32 (14 males and 18 females) and the mean age was $41.4{\pm}15.9$ years. Normal subjects were 32(22 males and 10 females) and the mean age was $39.8{\pm}18.6$ years. There was no significant difference of age and pulmonary function test between patients with chronic cough and normal subjects(p<0.05). The PIFn values in patients with chronic cough was significantly lower than those of normal subjects($2.25{\pm}0.68\;L/sec$ vs. $2.75{\pm}1.00\;L/sec$ ; p=0.02). The postnasal drip syndrome(PNDS) comprised the majority of patients with chronic cough(27). The PIFn in patients with PNDS was significantly lower than that of normal subjects (mean$\pm$SD ; $2.18{\pm}0.66$ vs. $2.75{\pm}1.00\;L/sec$, p=0.006). Conclusion : There was a significant difference of PIFn between patients with chronic cough and normal subjects. Among the patients with chronic cough, patients with PNDS showed the most significant difference with normal subjects in PIFn. The PIFn could be a useful parameter of nasal obstruction in patients with chronic cough, especially in patients with PNDS.

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Relationship Between Tumor Angiogenesis, Stage and Prognosis in Non-Small Cell Lung Cancer (비소세포 폐암에서 종양 혈관신생과 병기 및 예후와의 관련성)

  • Lee, Won-Yeon;Kim, Chong-Ju;Shin, Pyo-Jin;Cho, Mee-Yon;Yong, Suk-Joong;Shin, Kye-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.557-567
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    • 2001
  • Background : Tumor angiogenesis is required for tumor growth and metastasis. In this study, we investigated the correlation between the intensity of angiogenesis and stage, nodal status, histologic type, metastasis and survival rate of non-small cell lung cancer. Method : Formalin fixed, paraffin embedded surgical specimens of 45 patients who had surgically resected primary non-small cell lung cancers without pre or post operative adjuvant chemotherapy or radiotherapy were examined. The microvessel count(MVC) was demonstrated by immunohistochemical staining for CD31(platelet endothelial cell adhesion molecule, PECAM). Results : Microvessel counts(MVCs) in stage IIIA and IIIB were higher than in stage I and II(p<0.05). The MVC in patients with lymph node metastasis was higher than that in patients without lymph node metastasis, although the difference was not statistically significant(p>0.05). However, in adenocarcinoma, the MVC in patients with lymph node metastasis was significantly higher than that seen in patients without lymph node metastasis(p<0.05). The MVC in adenocarcinoma was higher than that in squamous cell carcinoma(p<0.05). The difference between the MVCs of adenocarcinoma and squamous cell carcinoma was not statistically significant in stage I and II or N0 stage(p>0.05). However, in stage IIIA and IIIB or N1~3 stage, the MVC in adenocarcinoma was higher than that in squamous cell carcinoma(p<0.05). MVC was more increased when metastasis developed within 12 months. In the same histologic type and stage, the duration of survival time in patients with high MVC was shorter than in patients with low MVC, however the difference was not statistically significant(p>0.05). The survival rate in patients with high MVCs was lower than that in patients with low MVCs(P<0.05). Conclusion : In non-small cell lung cancer, MVC correlated relatively well with pathologic stage, nodal status(limited in patients with adenocarcinoma), histologic type, postoperative metastasis and survival rate. However, in the same histologic type and stage, MVC was not significantly related to the duration of survival. Therefore the assessment of the intensity of angiogenesis in non-small cell lung cancer may be helpful in predicting prognosis and in selecting patients for systemic adjuvant therapy of potential metastasis according to the results.

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Galactosemia Detected by Neonatal Screening Test (신생아 선별검사에 의해 발견된 갈락토스혈증에 대한 고찰)

  • Park, Il Sung;Cho, Hye Jung;Lee, Dong Hwan;Song, Jung Hwan
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.440-446
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    • 2003
  • Purpose : The genetic disturbance of galactosemia is expressed as a cellular deficiency of either galactose-1-phosphate uridyltransferase(GALT) or galactokinase(GALK) or UDP galactose 4-epimerase(GALE). To find-out the pattern of galactosemia in Korea, we retrospectively analyzed cases of galactosemia detected by neonatal screening program. Methods : We analyzed medical records of patients who visited Soonchunhyang University Hospital at age of 1 month after showing abnormalities in neonatal screening of galactosemia. For accurate diagnosis, galactose was measured by enzyme immunoassay(EIA) and fluorophotometer, also galactose-1-phosphate by fluorophotometer. Enzyme activities of GALK, GALT and GALE in RBC and galactose-1-phosphate were measured by radioisotope assay(RIA). Beutler test were done. Patients went on a lactose-free diet and follow-up tests for galactose, galactose-1-phosphate level and enzyme activity were performed. Results : 10 patients(male : 6, female : 4) were diagnosed as galactosemia. Two patients had GALK deficiency and two had GALT deficiency. Six were GALE deficient showing the largest number. In two patients with GALK deficiency, GALT and GALE activities were normal but GALK activities showed respectively reduced activity. For GALT deficiency, two patients had low GALT activity in RBC and showed genotype of Duarte 2/G(galactosemia) in DNA analysis. In one patient, GALT activity was normal. Three patients seemed to be heterozygote state of GALE deficiency according to GALE activity levels. Four patients showed GALK hyperactivity. Conclusion : GALE deficiency provided the highest number. After lactose-free diet, galactose and galactose-1-phosphate were normaly maintained. Neonatal screening on galactosemia is essential for preventing life-threatening symptoms and an accurate diagnosis is needed for finding out the type of galactosemia which is important for prognosis.