• Title/Summary/Keyword: 환자 선별

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The Effect of Left Subclavian Artery Coverage During Endovascular Repair of the Thoracic Aortic Aneurysm on Cerebral Hemodynamics: Two Cases of Flow Measurement by using 2D Phase Contrast Magnetic Resonance Imaging (흉부대동맥류의 혈관내치료 도중 좌측 쇄골하동맥 폐색이 뇌혈류역동에 미치는 효과: 2차원 위상차 대조 자기공명영상을 이용한 혈류 측정 2례 보고)

  • Baek, Seung-Hoon;Youn, Sung-Won;Kim, Ho-Kyun;Kwon, Oh-Choon;Lee, Sub;Lee, Jong-Min
    • Investigative Magnetic Resonance Imaging
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    • v.16 no.2
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    • pp.159-168
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    • 2012
  • The proximity of thoracic aortic aneurysm to the left subclavian artery (LSA) has made the coverage of LSA during thoracic endovascular aortic repair (TEVAR) be essential. Despite controversy concerning the safety of LSA coverage and the indications for LSA revascularizations, the cerebral hemodynamic change after LSA coverage has not been demonstrated. We prospectively examined two patients who would undergo TEVAR with LSA coverage by using 2D cine phase contrast MR imaging. After LSA coverage, the left subclavian steal was properly compensated by the increased flow volumes of both carotid arteries and right vertebral artery, which is the major collateral supply. The total brain supply after TEVAR did not lessen, which showed good correlation with uneventful clinical outcome. Therefore, 2D phase contrast MR imaging can be recommended as a useful technique to evaluate the hemodynamic change of the LSA coverage during TEVAR and to triage the candidate for LSA revascularization.

Assessment of Detection Rate Applying the Digital Convergence Mammographic Imaging Methods(FFDM, DBT, BMRI): Based on Breast Density (디지털 융복합 유방 영상 검사기법(FFDM, DBT, BMRI)을 사용한 검출률 평가 : 유방밀도에 근거하여)

  • Jang, Eun-Hee;Goo, Eun-Hoe
    • Journal of Digital Convergence
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    • v.15 no.5
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    • pp.281-291
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    • 2017
  • This study aimed to assess detection rate applying the mammographic imaging methods. The evaluation of the shape and margin of tumor was conducted by score oriented to 180 patients who had undergone FFDM, DBT and BMRI scans among breast cancer patients, and the number of calcification was classified by size. There was no significant difference between DBT and BMRI for tumors larger than 1 cm in low-density breasts and for tumors larger than 2 cm in high-density breasts. Moreover, as for the detection rate of number of fine calcification, the highest rate was observed in FFDM followed by DBT and BMRI in the order named regardless of size. In conclusion, DBT was able to be detected even without BMRI if the mass was larger than 1 cm in the low-density breast and larger than 2 cm in the high-density breast. The detection rate of calcification turned out to be the highest in FFDM followed by DBT regardless of size, and calcification was not observed by BMRI. The appropriate use of FFDM, DBT and BMRI with respect to mass tumor will contribute to serving as a guide to examination methods of reducing burden of patients.

Diagnosis of Functional Gastrointestinal Disorders with Rome III Criteria in Korean Pediatric and Adolescent Patients: Clinical Usefulness of QPGS (한국 소아청소년에서 로마 III 기준을 이용한 기능성 위장관 질환의 진단: QPGS (Questionnaire on Pediatric Gastrointestinal Symptoms)의 유용성)

  • Kim, Dong-Soon;Nho, Han-Nae;Kim, Cu-Rie;Lee, Hee-Woo;Yoon, Ji-Hyun;Uhm, Ji-Hyun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.120-132
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    • 2009
  • Purpose: We diagnosed pediatric functional gastrointestinal disorders in Korean children and adolescents using Rome III criteria and investigated the clinical validity of QPGS-Rome III. Methods: Diagnosis based on QPGS was compared with the physician's diagnosis based on Rome III criteria. One hundred and thirty eight children and their parents completed the QPGS. Agreement rates were measured using Kappa method. Results: In physician's diagnoses, the most prevalent disorders were functional dyspepsia (39.1%), irritable bowel syndrome (38.4%), and functional abdominal pain (18.8%). Among QPGS based diagnoses, the most prevalent disorders were irritable bowel syndrome (39.1%), functional dyspepsia (29.7%), and functional abdominal pain (21.7%). The agreement rate was substantial (${\kappa}$=0.72, p=0.00). Diagnostic disagreements probably resulted from different patient responses to bowel movement form and bowel frequency. Conclusion: Functional dyspepsia, irritable bowel syndrome, and functional abdominal pain were the most common disorders by Rome III criteria in the Korean pediatric and adolescent patients. The agreement rate between physician's diagnoses and QPGS based diagnoses supported the validity of the QPGS-Rome III in Korean pediatric and adolescent patients. QPGS seems to be useful in diagnosis of patients with functional gastrointestinal disorders by Rome III criteria.

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Carpal Tunnel Syndrome among Packing Workers in A Rayon Manufacturing Factory (모 사업장 포장부서 근로자들에서 발생한 수근터널증후군에 대한 조사연구)

  • Lee, Won-Jin;Lee, Eun-Il;Cha, Chul-Whan
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.1 s.37
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    • pp.26-33
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    • 1992
  • The carpal tunnel syndrome is one of the most common peripheral nerve entrapment syndromes. The typical symptoms are pain, numbness and paresthesia in the median nerve territory of the hand. Recently, it is widely recognized that occupational factor is regarded as the important cause of the carpal tunnel syndrome. Clinical study is performed in the 42 female workers who is repetitively working at packing department in a rayon manufacturing factory from November 1991 till March 1992. The study included a questionnaire, physical examinations, and the neurophysiological test. The summary of the results obtained was as follows : 1. Among 42 packing workers, 9 workers(21.4%) were diagnosed as carpal tunnel syndrome by electromyography. The affected side was bilateral in 4 workers(9.5%), right in 4 workers(9.5%), and left in one worker(2.4%). 2. Among 42 subjects, 28 workers(66.7%) complained the clinical symptoms related to carpal tunnel syndrome, 11 workers(26.2%) showed positive Phalen sign, and 7 workers(16.7%) showed positive Tinel sign. 3. Researchers regard electromyographic finding as the gold standard for diagnosis of carpal tunnel syndrome. The sensitivity and specificity of the clinical symptoms to diagnose the carpal tunnel syndrome were 0.89, 0.39 respectively. If the carpal tunnel syndrome is diagnosed by the combination of the positive findings of the symptoms and the physical examinations, either Tinel or Phalen sign, the sensitivity and specificity were 0.67 and 0.76 respectively. Considering above results, though this small number of workers is not adequate for epidemiologic conclusions, carpal tunnel syndrome seems to be an important occupational disorder among packing workers in a rayon manufacturing factory.

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The Effectiveness of Electroglottographic Parameters in Differential Diagnosis of Laryngeal Cancer (후두암 감별진단에 있어 성문전도(Electroglottograph) 파라미터의 유용성)

  • 송인무;고의경;전경명;권순복;김기련;전계록;김광년;정동근;조철우
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.14 no.1
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    • pp.16-25
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    • 2003
  • Background and Objectives : Electroglottography(EGG) is a non-invasive method of monitoring the vocal cord vibration by measuring the variation of physiological impedance across the vocal folds through the neck skin. It reveals especially the vocal fold contact area and is widely used for basic laryngeal researches, voice analysis and synthesis. The purpose of this study is to investigate the effectiveness of EGG parameters in differential diagnosis of laryngeal cancer. Materials and Methods : The author investigated 10 laryngeal cancer and 25 benign laryngeal disease patients who visited at the Department of Otolaryngology, Pusan National University Hospital. The EGG equipment was devised in the author's Department. Among various parameters of EGG, closed quotient(CQ), speed quotient(SQ), speed index(SI), Jitter, Shimmer, Fo were determined by an analysis program made with MATLAB 6.5$^{\circledR}$(Mathwork, Inc.). In order to differentiate various laryngeal diseases from pathologic voice signals, the author has used the electroglottographic parameters using the neural network of multilayer perceptron structure. Results : SQ, SI, Jitter and Shimmer values except those of CQ and Fo showed remarkable differences between benign and malignant laryngeal disease groups. From the artificial neural network, the percentage of differentiating the laryngeal cancer was over 80% in SQ, SI, Jitter, Shimmer except for CQ and Fo. These results indicated that it is possible to discriminate the benign and malignant laryngeal diseases by EGG parameters using the artificial neural network. Conclusion : If parameters of EGG which can reveal for the pathology of laryngeal diseases are additionally developed and the current classification algorithm is improved, the discrimination of laryngeal cancer will become much more accurate.

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Risk factors and effect of screening for gastric cancer in a university hospital (한 대학병원 위암 환자의 위험요인과 조기검진 효과)

  • Lee, Tae-Yong;Min, Gyung Hun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.5
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    • pp.2914-2922
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    • 2014
  • To study the risk factors and effect of gastric cancer screening, case-control study was conducted. From June 2007 to December 2011, 580 newly diagnosed gastric cancer (342 advanced gastric cancer, 171 early gastric cancer) patients were enrolled at the department of general surgery in a university hospital. History of gastric examinations and possible risk factors were collected through interviews with structured questionnaire and reviewed medical chart. Comparing advanced cancer and early gastric cancer were analysed by chi-square test and logistic regression. The results showed that aged 70 and over (OR 2.393; 95%CI 1.329-4.310), Ex-smoker (OR 1.612; 95%CI 0.970-2.680), blood type A (OR 1.784; 95%CI 1.035-3.075), and H. pylori infection (OR 1.699; 95%CI 0.905-3.191) were important risk factors for advanced gastric cancer compared to early gastric cancer. Weight loss (OR 2.752; 95%CI 1.333-5.684) and indigestion (OR 1.574; 95%CI 1.069-2.319) were also important sign and symptom. Although the results cannot find effect of screening, national policies on early cancer detection must conduct.

Research Trends Regarding Primary Progressive Aphasia During the Last 10 Years (일차 진행성 실어증에 대한 최근 10년간 연구 동향)

  • Kim, Noheul;Kim, JungWan
    • 재활복지
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    • v.20 no.3
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    • pp.45-65
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    • 2016
  • The purposes of this study were to determine recent trends of domestic and international studies for primary progressive aphasia (PPA) patient group and to identify areas for future research. For these purposes, 171 studies on communication disorders of a PPA were chosen and sub-categories for research methods and contents were also analyzed. The sub-categories for research methods include types of research subject, research purpose and research field. As the research subject, 'agrammatism' was most frequently dealt with in both domestic and international studies; as the research purpose, 'characteristics study' accounted for the largest portion; and with respect to the research field, the international studies have covered evenly language, speech and others, while the domestic studies have handled only the field of 'language,' paying no attention to 'speech' and 'others.' In the international studies, apraxia of speech was added to the conventional three sub-types of PPA classification, so distinction between the four symptoms has been actively studied; however, patient cases were difficult to find in Korea, so the symptoms the patients had, although centering around communication disorders, have been rarely researched in the domestic studies. The results suggested that there have been extremely few studies related and their research field has lacked diversity. We suggested a direction for future research on communication disorders with PPA.

Detecting Potassium Imbalance: Whole Blood vs. Serum (전혈과 혈청에서의 칼륨 이상소견 검사의 차이)

  • Cho, Young-Duck;Choi, Sung-Hyuk;Yoon, Young-Hoon;Park, Sang-Min;Kim, Jung-Youn;Lim, Chae-Seung
    • The Korean Journal of Blood Transfusion
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    • v.23 no.2
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    • pp.162-168
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    • 2012
  • Background: Potassium, the most common cation in the intracellular space, plays a critical role in our physiology. Potassium imbalance may cause life-threatening problems, ranging from general weakness to cardiac arrest due to ventricular fibrillation. For emergency physicians, detection of such derangement within a short period of time is of critical importance. In this study, we wanted to determine whether analysis of whole blood samples can be used as a screening tool for potassium imbalance by comparative analysis of whole blood and serum samples. Methods: Two samples were drawn from 227 patients. The whole blood sample was taken from the radial artery and contained in a commercially available arterial blood collection syringe with a lithium-heparin coating. The serum sample was contained in a commercially available vacuum bottle in a non-additive silicone coated tube and transported to the laboratory. The study population was divided into three groups, patients with normal whole blood potassium, patients with decreased whole blood potassium, and patients with elevated whole blood potassium. Potassium levels for each group were coupled with serum potassium levels and compared. Results: No significant difference in potassium values was observed between whole blood and serum samples (P<0.05). Strong associations were observed among the three groups (normal range, hypokalemia, and hyperkalemia group). Compared to the normal group (r=0.851), the hyperkalemia group showed a stronger association between variables (r=0.897), and the hypokalemia group showed a weaker association (r=0.760). Their correlation coefficients were highly significant (P<0.05). Conclusion: Our study illustrates that point-of-care testing using whole blood with whole blood can be a reliable screening tool when treating patients with suspicious potassium abnormality, especially in hyperkalemia patients.

Study on the Effect of Bloodletting on Back-Shu Points and Sabonghyeul with Ryodoraku (양도락을 이용한 사봉혈과 배수혈의 사혈요법 효과 연구)

  • Koo, Jin Suk
    • Journal of Convergence for Information Technology
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    • v.11 no.9
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    • pp.173-181
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    • 2021
  • The purpose of this study is to prove the existence of the meridians by analyzing the effect of bloodletting cupping on Back-Shu Points and venesection on sabonghyeul, which are treatments for gastrointestinal and circulatory diseases with Ryodoraku. We selected the charts of 30 patients who received the treatment such as bloodletting cupping on Back-Shu Points and venesection on sabonghyeul for gastrointestinal and circulatory diseases. First, the Ryodoraku test was conducted in a stable state. After taking a rest on the bed, he performed a venesection on sabonghyeul. And bloodletting cupping on Back-Shu Points was performed with prone position. After all the procedures were completed, Ryodoraku test was performed again. And the result was compared with previous test status. By bloodletting cupping on Back-Shu Points and venesection on sabonghyeul, the deviation between the current value of the right F5 (gallbladder)· H4 (small intestine)· H6 (large intestine) (p<.05, p<.05, p<.001), left H5 (triple energizer) (p<.05) and the average current of 24 source points was significantly decreased. The difference between the left and right currents at the site of F3 (kidney) showed a significant increase (p<.005). It can be proved the existence of meridians that Bloodletting cupping on Back-Shu Points and venesection on sabonghyeul showed significant changes in the F5 (gallbladder), H4 (small intestine), H6 (large intestine), F3 (kidney), H5 (triple energizer) in digestive and circulatory symptoms by Ryodoraku test.

The Association Between Cancer and Network Structure of Depressive Symptoms (암과 우울증상 네트워크 구조의 연관성)

  • Hwang, Hwijin;Lee, Kyung Kyu;Lee, Seok Bum;Lee, Jung Jae;Kim, Kyoung Min;Kim, Dohyun
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.121-127
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    • 2021
  • Objectives : The characteristics of depressive symptoms in patients with cancer is different from those in control group. However, few research has focused on the association between depressive symptoms in cancer patients. The aim of this study was to compare the network structure of depressive symptoms between patients with cancer and normal control. Methods : This study was based on cohort data from Korea National Health and Nutrition Examination Survey in 2016-2018. The Patient health Quetionnaire-9 (PHQ-9) was used to assess depressive symptoms in 599 patients with cancer and 599 age-sex matched controls. We estimated network structure of depressive symptom using Isingfit model. Results : There was no significant difference of each PHQ-9 item score. There were strong associations between symptoms were concentration problem-psychomotor activity, anhedonia-depressed mood, and depressed mood-suicidal ideation in both groups. Strength centrality of worthlessness was significantly higher in patients with cancer. Conclusions : These results suggest that worthless is associated with other depressive symptoms more tightly in patients with cancer. Worthless can serve as important treatment targets for intervention of depression in patients with cancer.