• Title/Summary/Keyword: 환자 선별

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Lung Cancer Screening (폐암 조기 진단)

  • Kim, Ju Ock
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.207-213
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    • 2006
  • 기존의 폐암 발생의 고위험군(나이. 흡연력, $FEV_1$, 가족력, 직업적 발암물질의 노출력, 기존의 폐암 및 두경부 종양)에 대한 저선량 나선식 CT와 기관지 내시경 검사로 선별 검사 시 폐암의 유병률은 높아야 2%내외이고 대부분 그보다 낮은 것으로 알려져 있다. 특이도는 49-90%, 양성예측률은 10%이하로 선별검사 시 불필요한 검사를 초래하고 그에 따른 이환률과 사망률을 증가시키며 비용적인 문제를 야기하는 것으로 알려져 있다. 이에 기존의 고위험군에 대해 대상 환자를 더욱 더 좁힐 필요가 있으며, 이는 실제 임상적으로 이용 가능한 생물학적 표지자의 개발의 필요성이 있다고 하겠다. 그러나 현재까지 알려진 폐암조기검진에 대한 각종 진단 수기 중애서 상기의 3가지 방법(저선량 MDCT, 자가형광기관지경 및 객담내 MAGE)을 한꺼번에 시행하는 program은 비용적인 문제는 있지만 시도해 볼 만한 방법이라고 생각된다.

다양한 특징 파라미터와 선형변별분석을 이용한 후두암의 선별검사

  • 이원범;왕수건;권순복;전경명;전계록;김수미;김형순;양병곤;조철우
    • Proceedings of the KSLP Conference
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    • 2003.11a
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    • pp.149-149
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    • 2003
  • 후두질환 감별용 음성 분석방법인 multi-dimensional voice program (MDVP)으로 분석이 불가능할 정도로 주기성이 크게 훼손된 후두암 말기의 음성 에 대하여 효과적인 감별을 하기 위하여, 몇 가지 켑스트럼(cepstrum) 파라미터를 비롯하여, 주기성 및 그 동요 정도, 영교차율(zero-crossing rate, ZCR), 스텍트럼 중심 (spectral centroid, SC) 등 다양한 특징 파라미터를 이용한 감별 실험을 수행하였다. 후두암 감별 실험을 위해 부산대학교 병원 이비인후과에서 수집한 정상 남자 음성 데이터 50개, 양성 후두질환 남자 음성 데이터 50개 및 남성 후두암 환자 음성 데이터 105개를 사용하였다. 음성 데이터는 단모음 /아/ 발성만을 사용하였고, 정상인과 양성후두질환 환자, 그리고 MDVP 분석이 가능한 후두암 환자 음성 데이터 중 2/3는 학습에, 나머지 113은 감별실험에 사용하였다. 후두암 감별을 위한 분류기로는 Gaussian Mixture Model(GMM) 분류기를 사용하였으며, 이때 모델의 복잡도를 표현하는 mixture 수는 1에서 10까지 가변시키면서 가장 좋은 성능을 나타내는 값으로 결정하였다. 또한 모든 실험에서 켑스트럼 분석의 차수는 동일하게 12차로 고정시켰다. (중략)

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A case with 3-Methylcrotonyl-CoA carboxylase deficiency with MCCC2 mutations (MCCC2 유전자 돌연변이로 진단된 3-Methylcrotonyl-CoA carboxylase deficiency)

  • Lee, Beom-Hui;Jin, Hye-Yeong;Kim, Gu-Hwan;Choe, Jin-Ho;Yu, Han-Uk
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.10 no.1
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    • pp.27-30
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    • 2010
  • 3-Methylcrotonyl-CoA carboxylase deficiency (3-MCCD) is an autosomal-recessive inborn error of leucine catabolism caused by the deficiency of 3-methylcrotonyl-CoA carboxylase (3-MCC). With the introduction of tandem mass spectrometry in newborn screening, this disorder has been identified with unexpectedly high prevalence. The clinical manifestations of 3-MCCD are highly variable ranging from asymptomatic to severe neurological manifestations. 3-MCC is an heteromeric enzyme consisting of ${\alpha}$ - and ${\beta}$ - subunits, encoded by the MCCC1 and the MCCC2 gene, respectively. In the currentreport, a Korean patient with 3-MCCD is described. She was identified by newborn screening test, and has been asymptomatic with normal development and intelligence up to 3.8 years of age. She carries p.[D280Y]+[D280Y] mutations in the MCCC2 gene.

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Differences in Verbal Fluencies and Discourse Comprehension Abilities associated with Working Memory in Alzheimer's Disease and Vascular Dementia (알츠하이머와 혈관성 치매 환자 선별에서의 작업기억 능력 관련 구어유창성 및 이야기이해 능력의 차이)

  • Yeo, Hangyeol;Kim, Choong-Myung
    • Journal of the Korea Convergence Society
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    • v.11 no.12
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    • pp.383-390
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    • 2020
  • The present study was conducted to examine the differences and correlations between verbal fluency and story comprehension according to the working memory(WM) capacity, and to find out what WM factors influence the linguistic competence in Alzheimer's disease(AD) and vascular dementia(VaD) groups each consisting of 15 patients. The results of their performance produced firstly significant differences in phonemic fluency, story comprehension, delayed recall and recognition task between the two groups. Further analysis shows that VaD group had significant correlations between the scores of story comprehension and the recognition test scores additionally. These findings suggest that it is possible to differentiate the two groups even by story comprehension tasks and WM. In conclusion, the clinical application of the results is likely to contribute to appropriate treatment plans and effective interventions for elderly with AD and VaD as well as to improve the classification criteria for both types of dementia.

A Diagnostic Algorithm after Newborn Screening for Hypermethioninemia (고메티오닌혈증의 신생아 선별 검사 후 진단 알고리즘)

  • Kim, Yoo-Mi
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.1
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    • pp.1-9
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    • 2016
  • Newborn screening (NBS) is important if early intervention is effective in a disorder and if there are sensitive and specific biochemical markers to detect disorder. Methionine is a useful marker to detect abnormal methionine-homocysteine metabolism, especially homocystinuria which needs urgent medical intervention. However, hypermethioninemia could occur in other metabolic disorder including liver disease, tyrosinemia type I, methionine adenosyltransferase (MAT) I/III deficiency, glycine N-methyltransferase (GNMT) deficiency, or adenosylhomocysteine hydrolase deficiency. However, experience with NBS for homocystinurias and methylation disorders is limited. Especially, MAT I/III deficiency which is the most common cause of persistent hypermethioninemia have two inheritance, autosomal recessive (AR) and autosomal dominant (AD), and their clinical manifestation is different between AR and AD. Here, author reviewed recent articles of guideline and proposed guideline for homocystinuria and methylation disorder.

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Design and Implementation of an IoT Device for the Effective Screening of Dementia and Mild Cognitive Impairment

  • Kim, Hansoo
    • Journal of the Korea Society of Computer and Information
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    • v.24 no.12
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    • pp.119-126
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    • 2019
  • Korea is rapidly becoming an aging society due to lower birth rate and longer life expectancy. As elderly diseases are of a serious concern, the number of patients with dementia has been increasing significantly. For now, it has become a nationwide problem, as dementia is difficult to manage and requires a lot of social costs. To solve this, an IoT device has been devised that efficiently screens Mild Cognitive Impairment(MCI), the early stage of dementia. To design and implement the device, the latest IoT technology is introduced, the optimized Korean Version of Hasegawa Dementia Scale Revised(K-HDS) is utilized, and convenient service scenario with user-friendly design is applied. As a result, the symptoms of MCI have been screened quickly with convenient operation, which lead to the healthier society by the prevention of dementia.

The Methicillin - Resistant Rate of Staphylococcus Aureus Isolated from the Nares and Throat of Patients Admitted to Medical Intensive Care Unit (내과계 중환자실 입원환자의 비,인후 배양에서 메치실린내성 황색포도구균의 빈도)

  • Kim, Hi Gu;Cho, Jae Hwa;Ahn, In Sun;Yoon, Byoung Gap;Lee, Keum Ho;Ryu, Jeong Sun;Kwak, Seung Min;Lee, Hong Lyeol;Kim, Jin Joo
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.2
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    • pp.151-156
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    • 2005
  • Background : Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in hospital-acquired infection, and is prevalent in intensive care units (ICU). The MRSA colonization rates of the nares and throat were examined in both the ICU and general ward. This study was performed to investigate the MRSA rate and necessity for MRSA screening cultures in patients admitted to ICU. Methods : Between June and September 2004, those patients admitted to both the medical ICU and general ward participated in this study. Bacterial cultures were performed on swabs of the nares and throat taken within 24 hours of admission. Clinical data were also collected. Results : One hundred and twenty one patients and 84 patients, admitted to the medical ICU and medical general ward, respectively, were investigated. The numbers of nasal MRSA colonization in the ICU and general ward were 3 (2.5%) and 3 (3.6%), respectively. There were 2 (1.7%) cases of throat MRSA colonization in the ICU, but none in the general ward. The MRSA colonization rates of the nares and throat were no different between the ICU and general ward. There were no significant differences in the previous admission, operation history and admission route between the ICU and general ward groups. Conclusion : The MRSA colonization rates of the nares and throat were 3.3 and 3.6% in the ICU and the general ward, respectively. The MRSA screening test does not appear to be required in all patients admitted to the ICU, but further studies, including high-risk patients, are recommended.

Hospice and Palliative Care in End Stage Liver Disease (말기 간질환 환자에서의 호스피스 완화의료)

  • Kim, Moon Young
    • Journal of Hospice and Palliative Care
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    • v.20 no.3
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    • pp.167-172
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    • 2017
  • End-stage liver disease (ESLD) is a terminal condition of cirrhosis which cannot be treated without liver transplantation. Thus, it is natural for patients to consider hospice/palliative care (HPC). Since the recent legislation of the Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life (Act No. 14013) in Korea, the practicality of this law has become an issue. The criteria for HPC should be defined with consideration to how the severity of each ESLD complication may vary by individual patients. Generally, patients qualify if they have an intractable condition despite aggressive treatment such as the hepatorenal syndrome, hepatic encephalopathy or variceal hemorrhage. However, the option of liver transplantation should be sufficiently discussed with patients and their families before making a decision on HPC. The evaluation of which ESLD patients should receive HPC should be based on a long-term doctor-patient relationship and sufficient objective data. Therefore, a multidisciplinary approach and mutual consultation among cirrhosis specialists and doctors with other expertise are essential to offer optimal and balanced treatments between liver-specific treatment and HPC. Discussed in this review are adequate criteria for HPC and special considerations for ESLD at the point of HPC.

The Assessment of Blood Glucose Distribution according to the Fasting State and Glycemic Control Indicators for Diabetes Screening (금식 여부에 따른 혈당치 분포와 당뇨병 선별을 위한 혈당조절지표의 평가)

  • Kwon, Pil Seung;Rheem, Insoo
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.4
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    • pp.312-320
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    • 2016
  • This study analyzed the distribution of the blood glucose level according to the fasting status. Moreover, a relationship was analyzed between fasting blood glucose level and glycemic control indicators. A total of 707 outpatients, who visited Dankook University Hospital, were included and classified into either the fasting group and the non-fasting group. The mean blood glucose level of each group was calculated and analyzed by sex, age, and clinic. In addition, blood glucose, HbA1c, fructosamine, and 1,5-AG were measured in 153 fasting health check-up patients, and the correlation between the blood glucose level and glycemic control indicators was evaluated. Blood glucose averages between the two groups (non-fasting 111.9 vs. fasting 103.6 mg/dL) were different (p<0.05); and the mean difference was lower in women (4.8 mg/dL) than in men (12.2 mg/dL). A significant difference of the median glucose values among the age groups was only observed in the non-fasting group (Kruskal-Wallis test, p<0.01), and not in the fasting group. A 1,5-Anhydroglucitol was estimated to be significantly correlated with the fast blood glucose level in the range of the criteria of impaired fasting glucose (IFG). We presented an assessment of the distribution of blood glucose level in accordance with the fasting status among outpatients, and estimated that 1,5-anhydroglucitol was well correlated with the fasting blood glucose than fructosamine and HbA1c, through the analysis of results of health screening subjects. It is suggested that the use of glycemic indicators that reflect short-term blood glucose control can be used together with the blood glucose measurement in the screening of diabetes mellitus.

Music for Pediatric Patients in Medical Settings: A Systematic Review of Randomized Controlled Trials (소아환자를 위한 음악: 무작위 임상연구의 체계적인 문헌고찰)

  • Lee, Jin Hyung
    • Journal of Music and Human Behavior
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    • v.10 no.2
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    • pp.1-33
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    • 2013
  • The aim of this study was to systematically review the latest clinical trials in music medicine and medical music therapy for pediatric patients. Thirteen databases were searched to obtain randomized controlled/crossover design studies published between the year 2000 and 2012 in English language. Out of 1012 articles retrieved in the initial search, fifteen studies were identified based on an exclusion criteria. Overall, selected articles involved children 1 month to 18 years, sample size of 11 to 150, and total participants of 987. Studies were classified and compared as music medicine or music therapy studies through a systematic synthesis assessing general characteristics, methodological quality, measured outcomes, types of interventions and the study results. Seven music medicine and eight music therapy studies measured seven dependent variables using thirty-six different measurement tools with a large heterogeneity in the selection, type, and method of music interventions. Evaluation of the methodological quality revealed that many studies did not provide a full report of the research method, and did not meet some or most methodological standards, such as randomization, allocation concealment, double or partial blinding, and intention to treat analysis. Although overall research results were positive if not significant, poor methodological quality and heterogeneity in design and intervention strategies raise the question of research bias and trustworthiness issues. The systematic review concluded that music may have a valuable clinical effect in addressing the physical and psychosocial needs of hospitalized children, although more rigorous, homogeneous and replicable studies are greatly needed.