• The Korean Journal of Nuclear Medicine
• /
• v.35 no.6
• /
• pp.371-377
• /
• 2001

Purpose: One or more abnormal vertebrae detected on bone scintigraphy is a common finding in clinical practice, and it could pose a diagnostic dilemma especially in cancer patients. as either metastasis or benign disease may cause scintigraphic abnormality. The purpose of this study was to determine whether additional spine SPECT has a role in differentiating malignant from benign lesions in patients with back pain. Materials and Methods: We reviewed spine SPECT studios obtained over a three-year period in 108 patients. Among them, forty-five patients with abnormal SPECT and clinically followed records were evaluated (20 cancer patients were included). Uptake patterns were classified as follows: 1. Body: diffusely increased uptake, linear increased uptake of end plate, segmental increased uptake, and cold defect, 2. Posterior element: posterior to body (pedicle), posterior to Intervertebral disc space (facet joint), and spinous process. Lesions were correlated with radiological findings and with final diagnosis. Results: Sixty-nine bone lesions were detected on SFECT images, including 18 metastases, 28 degenerative diseases and 21 compression fractures. Cold defect (6) and segmental increased uptake (5) were dominant findings in metastasis; linear increased uptake (12), and facet joint uptake (15) were in degenerative change; and diffuse increased uptake (9), and linear increased uptake (9) were in compression fracture. Conclusion: Cold defect and segmental increased uptake of body were characteristic findings of metastasis, but care should be taken because compression fracture also shows segmental increased uptake in some cases. Degenerative disease was easily diagnosed because of the typical finding of linear increased uptake of end plate and facet joint. Therefore, additional bone SPECT after planar bone scan would be helpful for differentiating metastasis from benign condition in cancer patients.

• Health Policy and Management
• /
• v.12 no.2
• /
• pp.23-42
• /
• 2002

The purpose of this study was to analyze the results of 133 studies related to patient compliance published between 1980 and 2001 and to assess the effectiveness of intervention on compliance by using meta-analysis. We collected the existing literatures by using web and manual search 'patient compliance', 'sick role behavior', 'major clinical disease', and 'intervention' as key words and by reviewing content of journals related to medicine, nursing and public health. The compliance interventions were classified by theoretical focus into educational, behavioral, and affective categories within which specific intervention strategies were further distinguished. The compliance indicators broadly represent five classes of compliance-related assessments: (1) health outcomes (eg, blood pressure and hospitalization), (2) direct indicators (eg, urine and blood tracers and weight change), (3) indirect indicators (eg, pill count and refill records), (4) subjective report (eg, patients' or others' reports), (5) utilization (appointment making and keeping, use of preventive services). Quantitative meta-analysis was performed by MetaKorea program which was developed for meta-analysis in Korea. Among the 133 articles, 10 studies were selected through the qualitative meta-analysis process, and then only 6 studies were selected for the quantitative meta-analysis finally. The interventions produced significant effects for all the compliance indicators with the magnitude of common effect size (4.1192) than the non-intervention group in a random effect model. The largest effects were each study for patient of hypertension using health outcome such as blood pressure (0.4679) and diabetes mellitus using direct indicator such as glucose level in blood and urine (0.7753). These results suggest that strategic interventions showed clear advantage for improvement of patient compliance compared with non-intervention group.

• Journal of Veterinary Clinics
• /
• v.29 no.2
• /
• pp.134-140
• /
• 2012

This retrospective study was performed to describe and evaluate ultrasonographic characteristics of splenic disorders and to pursue any relationship with cytologic or histopathologic diagnoses. Medical records were reviewed for patients that had undergone both abdominal ultrasonographic procedures and ultrasound-guided fine-needle aspiration (FNA) or surgical biopsy of splenic lesions or necropsy from January 2002 to July 2011 at Seoul National University Hospital for Animals. Total 124 dogs, 76 cases with FNA and 48 cases with biopsy, were available for this investigation. The age of dogs ranged from 2 to 17 years ($mean{\pm}SD$ = $9.54{\pm}3.34$ years), with the gender distribution of 61 females (26 spayed) and 63 males (40 neutered). In breed distribution, 114 were purebred dogs and 10 were mixed breed dogs. The dogs represented 26 breeds, with 113 dogs categorized into small-sized breeds. The ultrasonographic appearances of splenic disorders could be classified into 10 types including normal appearance, depending on the distribution and echogenicity of splenic lesions as well as the increase in spleen size and diffuse parenchymal changes. Among 124 cases, 44 (35.4%) had hypoechoic nodules/masses with the highest frequency, followed by 23 (18.5%) with multiple small hypoechoic nodules. Of 124 cases, 70 (56.5%) were benign and 54 (43.5%) were malignant lesions at cytologic or histopathologic results. Each ultrasonographic appearance had variable cytologic or histopathologic diagnoses. However, diffuse heterogenicity and diffuse hypoechogenicity were significantly associated with malignancy (p < 0.05), whereas hyperechoic nodules/masses were more often associated with benignity (p < 0.05). Based on our results, it may be considered that the ultrasonographic examination for spleen could be able to provide the least information necessary for benign and malignant lesions in prioritizing differential diagnoses.

• Clinical and Experimental Pediatrics
• /
• v.45 no.5
• /
• pp.646-653
• /
• 2002

Purpose : The incidence of type 2 diabetes mellitus in children has been increasing worldwide recently, which is thought to be related to the increasing prevalence of obesity. We investigated to evaluate the incidence and the characteristics of type 2 diabetes mellitus in children and also analysed the relationship between intrauterine growth retardation and type 2 diabetes mellitus. Methods : We investigated 25 children diagnosed as type 2 diabetes mellitus between March 1990 and December 2000. The analysis was performed retrospectively with medical records based on the clinical characteristics and laborotory findings. Results : Incidence of type 1 and type 2 diabetes mellitus in children has been increasing since 1990. We demonstrated an increase in the percentage of type 2 diabetes mellitus children from 5.3% in 1990 to 21.0% in 2000. Sixty eight percent of patients(17/25) were classified as obese group. Initial symptoms at first visit were polyuria, polydipsia and polyphagia 48%(12/25), asymptomatic glycosuria 40% (10/25), weight loss 8%(2/25) and obesity 4%(1/25). The mean age at diagnosis was $12.9{\pm}1.8$ years. 64%(16/25) of patients had positive family history of type 2 diabetes mellitus. Autoanti-bodies were positive in 18.1%(4/22) of patients. Twenty eight percent (7/25) of patients had an associated disease and two patients had fatty liver in association with obesity. Treatment consisted of diet, exercise, education and oral hypoglycemic agents. Three patients were treated with insulin as well as oral hypoglycemic agents because of poor blood glucose control. Long-term diabetic complications occurred in 4 patients. Intrauterine growth retardtion was found in 34.6%(9/25); 88.9% (8/9) of these patients were non-obese group. Conclusion : The increase in the incidence of type 2 diabetes mellitus in children is thought to be related to the increasing prevalence of obesity. The non-obese group of patients might be associated with intrauterine growth retardation.

• Journal of Acupuncture Research
• /
• v.30 no.4
• /
• pp.55-68
• /
• 2013

Objectives : The purpose of this study is to analyze the distribution, relationship, prognosis and improvement score of idiopathic facial palsy inpatients according to constitutional differentiation ; Sasang constition, Hyungsang classification, Sasang constition combined with Hyungsang classification. Methods : A study was done on 102 patients who were diagnosed and treated as idiopathic facial palsy from April 2012 to Nomember 2012 at the Department of Acupuncture and Moxibution Medicine, Dong-eui Oriental University Hospital. Medical records of inpatinets who underwent facial ENoG, NET test were analyzed. Changes of HBGS grade and Yanagihara's score were also evaluated. We classified inpaients acording to Sasang constitution by consulting to Department of Sasang constitutinal medicine, and to Hyungsang classification(Dam-body, Bangkwang-body) by measuring under medical system of 3D facial shapes(RS-400FL). The constitutional differentiation and general characteristics were initially analyzed, and valuse on ENoG, NET were correlated with constitutinal differentiation. Results of HBGS and Yanagihara's score were also correlated with constitutinal differentiation. Results : 1. Each 39.2 percent of idiopathic facial palsy inpatients were the Taeeumin and Soyangin, 21.6 percent were the Soeumin. 2. 75.5 percent of idiopathic facial palsy inpatients were the Bangkwang-body, 24.5 percent were the Dam-body. 3. 34.3 percent of idiopathic facial palsy inpatinets were the Taeeum-Bangkwang, 21.6 percent were the Soyang-Bangkwang, 19.6 percent were the Soeum-Bangkwang, 17.6 percent were the Soyang-Dam, 4.9 percent were the Taeem-Dam, 2 percent were the Soeum-Dam. 4. By sex, the each ratio of Taeeumin, Soeumin, Bangkwang-body, Taeeum-Bangkwang, Soeum-Bangkwang, Soyang-Bangkwang was higher in female, that of Dam-body, Taeeum-Dam, Soyang-Dam was higher in male. 5. By relations between Sasang constitution and Hyungsang classification, the each ratio of Taeeumin and Soeumin was higher in Bangkwang-body. 6. By values on ENoG and NET, evaluations of HBGS's grade and Yanagihara's score, there were no significant difference. Conclusions : In idiopathic facial palsy inpatients, the proportion of Taeeum and Soyang among the Sasang constitution was higher, that of Dam among the Hyungsang classification was higher, that of Taeeum-Bangkwang among the Sasang combined with Hyungsang was the highest. It would seem that Bangkwang-body, female were closely related to Taeeumin, Soeumin. Also, Dam-body were closely related to male. But when comparing groups, there was no statistically significant difference in prognosis and improvement.

• Sleep Medicine and Psychophysiology
• /
• v.12 no.1
• /
• pp.58-63
• /
• 2005

Objectives: REM sleep behavior disorder (RBD), characterized by excessive motor activity during REM sleep, is associated with loss of muscle atonia. In recent years, it has been reported that RBD has high co-morbidity with CNS disorders (especially, Parkinson's disease, dementia, multiple system atrophy, etc.). We aimed to assess differences in clinical and polysomnographic findings among RBD patients, depending on the presence or absence of central nervous system (CNS) disorders. Methods: The medical records and polysomnographic data of 81 patients who had been diagnosed as having RBD were reviewed. The patients were classified into two groups: associated RBD (aRBD, i.e., with a clinical history and/or brain MRI evidence of CNS disorder) and idiopathic RBD (iRBD, i.e., without a clinical history and/or brain MRI evidence of CNS disorder) groups. Twenty-one patients (25.9%) belonged to the aRBD group and 60 patients (74.1%) belonged to the iRBD group. The clinical characteristics and polysomnographic findings of the two groups were compared. Results: Periodic limb movement disorder (PLMD), i.e., PLMI (periodic limb movement index)>5, was observed more frequently in the aRBD group than in the iRBD group (p<0.001, Fisher's exact test). Also, obstructive sleep apnea syndrome (OSAS), i.e., RDI (respiratory disturbance index)>5, was found more frequently in the aRBD group (p=0.0042, Fisher's exact test). The percentages for slow wave sleep and sleep efficiency were significantly lower in the aRBD group than in the iRBD group. Conclusion: We found that 1 out of 4 RBD patients had associated CNS disorders, warranting more careful neurological evaluation and follow-up in this category of RBD. In this category of RBD patients, we also found more frequent PLMD and OSAS. These patients were also found to have lower slow wave sleep and sleep efficiency. In summary, RBD patients with associated CNS disorders suffer from more disturbed sleep than those without them.

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.4
• /
• pp.465-473
• /
• 1995

Background: The prevalence of pulmonary tuberculosis has decreased progressively after the control of the tuberculosis began as national control. But as diabetes, malignancy, immunodeficiency disease recently tend to be increased, the tuberculosis become to the important national health problem. So, this study was designed to observe the state and the change of the prevalence and the clinical status of pulmonary tuberculosis for recent 10 years at one women's university. Method: We retrospectively investigated the epidemiology and the clinical status of 612 patients who were registered at the Ewha Womans University Health Center by analyzing records from 1983 to 1992. Results: 1) The prevalence rate had been steadily decreased from 0.63% in 1983 to 0.11 % in 1992. The prevalence of freshman and the incidence rate according to the entrance year while in the university significantly decreased since 1989. 2) In classifying by registered source, 45.6% of students were detected by annual periodical health examination, 34.5% by entrance physical examination, 12.0% by hospital, 5.4% by health center clinic, 2.5% by reentrance physical examination, sequentially. 3) The students with past history of tuberculosis were 70(11.4%) and 61(10%) suffered from pulmonary tuberculosis. The patients with family history of tuberculosis were 142(23.3%). 4) There were 530(86.6%) with minimal disease, 79(12.9%) with moderate and only 3(0.5%) with far advanced, when classified by the severity of disease. 5) The initial symptoms were mild breathing difficulty in 30.1%, sweating in 14.9%, fatigue in 14.3%, febrile sense in 11.7%, hemoptysis in 8.2%, sequentially. 6) The duration of treatment was $10.6{\pm}3.6$ months in mild group, $14.9{\pm}5.2$ months in the moderate group(P<0.05). 7) The side reactions of the drug were GI trouble in 7.2%, hepatitis in 1.8%, skin rash in 0.8% and streptomycin side in used patients in 9.1%. Conclusion: The prevalence of pulmonary tuberculosis among the students in one women's university was significantly lower than that of university students and 20-24 year-old age group announced in tuberculosis survey on a national scale, and significantly decreased since 1989. The treatment effect was desirable in student's group managed by university health center.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.5
• /
• pp.953-961
• /
• 1998

Background : In recent years, lung cancer has been one of most common cause of death in Korea. Despite many physician's high degree of pessimism about the gains made in treatment, progressive improvement in the survival of lung cancer by treatment has occurred, particulary in the early stages of the disease. However, a lot of patients refuse treatment or give up in the fight against the disease. This study was done to evaluate factors influencing the compliance to therapy and to lead in the establishment of special programs to enhance compliance in patients with lung cancer. Methods: The medical records of 903 patients, whose ECOG(Eastern Cooperative Oncology Group) performance status was 3 or less and whose medical record was relatively satisfactory, among 1141 patients diagnosed with lung cancer between January 1989 and December 1996 were reviewed retrospectively. Compliance was classified into three groups based on the degree of compliance with physicians practice guideline: (a) compliants; (b) patients who initially complied but gave up of themselves midway during the course of treatment; (c) noncompliants who refused the treatment. Results: The overall compliance rate was 63.9%, which was progressively increased from 57.3-61.3% in 1989 and 1990 to 64.2-67.5% in 1995 and 1996. Age, education level and occupation of patients bore statistically significant relationship with the compliance but sex, marital status and smoking history did not. The compliance was significantly higher in patients without symptoms than with, and was also significantly higher in patients with good performance status. The compliance was significantly high in patients with NSCLC(non-small cell lung cancer) compared to SCLC(small cell lung cancer), but after exclusion of stage I and II, among NSCLC, which had higher compliance to surgery there was no significant difference of compliance by histology. The compliance was significantly lower in advanced stage. Conclusion: To enhance the compliance, special care including education programs about therapy including complication and prognosis are necessary, especially for educationally and economically disadvantaged patients.

• Journal of Intelligence and Information Systems
• /
• v.16 no.3
• /
• pp.147-161
• /
• 2010

As broadcasting and communication are converged recently, communication is jointed to TV. TV viewing has brought about many changes. The IPTV (Internet Protocol Television) provides information service, movie contents, broadcast, etc. through internet with live programs + VOD (Video on demand) jointed. Using communication network, it becomes an issue of new business. In addition, new technical issues have been created by imaging technology for the service, networking technology without video cuts, security technologies to protect copyright, etc. Through this IPTV network, users can watch their desired programs when they want. However, IPTV has difficulties in search approach, menu approach, or finding programs. Menu approach spends a lot of time in approaching programs desired. Search approach can't be found when title, genre, name of actors, etc. are not known. In addition, inserting letters through remote control have problems. However, the bigger problem is that many times users are not usually ware of the services they use. Thus, to resolve difficulties when selecting VOD service in IPTV, a personalized service is recommended, which enhance users' satisfaction and use your time, efficiently. This paper provides appropriate programs which are fit to individuals not to save time in order to solve IPTV's shortcomings through filtering and recommendation-related system. The proposed recommendation system collects TV program information, the user's preferred program genres and detailed genre, channel, watching program, and information on viewing time based on individual records of watching IPTV. To look for these kinds of similarities, similarities can be compared by using ontology for TV programs. The reason to use these is because the distance of program can be measured by the similarity comparison. TV program ontology we are using is one extracted from TV-Anytime metadata which represents semantic nature. Also, ontology expresses the contents and features in figures. Through world net, vocabulary similarity is determined. All the words described on the programs are expanded into upper and lower classes for word similarity decision. The average of described key words was measured. The criterion of distance calculated ties similar programs through K-medoids dividing method. K-medoids dividing method is a dividing way to divide classified groups into ones with similar characteristics. This K-medoids method sets K-unit representative objects. Here, distance from representative object sets temporary distance and colonize it. Through algorithm, when the initial n-unit objects are tried to be divided into K-units. The optimal object must be found through repeated trials after selecting representative object temporarily. Through this course, similar programs must be colonized. Selecting programs through group analysis, weight should be given to the recommendation. The way to provide weight with recommendation is as the follows. When each group recommends programs, similar programs near representative objects will be recommended to users. The formula to calculate the distance is same as measure similar distance. It will be a basic figure which determines the rankings of recommended programs. Weight is used to calculate the number of watching lists. As the more programs are, the higher weight will be loaded. This is defined as cluster weight. Through this, sub-TV programs which are representative of the groups must be selected. The final TV programs ranks must be determined. However, the group-representative TV programs include errors. Therefore, weights must be added to TV program viewing preference. They must determine the finalranks.Based on this, our customers prefer proposed to recommend contents. So, based on the proposed method this paper suggested, experiment was carried out in controlled environment. Through experiment, the superiority of the proposed method is shown, compared to existing ways.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.9 no.1
• /
• pp.39-47
• /
• 2006

Purpose: We proposed a new classification of pediatric intussusception based on clinical and radiologic findings. Methods: Data from 88 consecutive patients with intussusception were reviewed. We retrospectively analyzed six factors; patient age, sites of intussusception, symptoms, therapeutic methods, existence of enlarged mesenteric lymph nodes, and ultrasonographic (US) findings from clinical records. Results: 1) There was one neonatal case (1.1%), the others (98.9%) were infants and children. 2) These 87 infant and child cases consisted of 14 cases (16.1%) of small bowel intussusception (SBI) and 73 cases (83.9%) of ileo-colic intussusception (ICI). Of the 14 SBI cases, 12 cases were symptomatic and 2 cases were asymptomatic. The symptomatic group comprised 8 transient cases (66.7%), 3 operative cases (25.0%), and 1 enema-reduction case (8.3%). Two asymptomatic cases were incidentally captured by computed tomography. Of the 73 ICI cases, 19 cases (26.0%) required operation, and 54 (74.0%) enema-reduction. 3) When transient SBI cases were compared with operated SBI cases, enema-reduced and operated ICI cases, the age ($38.0{\pm}22.9$ months) of transient SBI cases were significantly higher than those of the others (p=0.003). Mean mass size ($20.8{\pm}2.7mm$) in transient SBI was significantly smaller than in the others (p=0.0001). 4) No correlation was found between the existence of enlarged mesenteric lymph nodes and therapeutic method or concomitant illness. 5) Most of the target types observed by US were in transient SBI cases, the remainder were in the enema-reduced ICI cases. In terms of the doughnuts type, all 8 cases (34.8%) with an external hypoechoic rim thickness of >8.9mm were treated surgically. Conclusion: Pediatric intussusception may be classified based on clinical and radiologic findings, which are likely to indicate appropriate therapies.