• Title/Summary/Keyword: Clinical patterns

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Study on Assessment and Treatment Patterns of Speech-Language Pathologists in Pediatric Vocal Problem Through Multicenter Survey (다기관 설문조사를 통한 국내 소아 음성질환 환자의 검사 및 치료 유형 연구)

  • Lee, Jong-Geun;Bang, Seung-Hwan;Jeon, Jae-Min;Lee, Jung-Kyu;Kim, Angela Yun;Woo, Jeong-Soo;Cho, Jae-Gu
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.1
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    • pp.39-47
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    • 2019
  • Background and Objectives : Pediatric vocal health problems are relatively common. However, it is not yet well studied whether uniform diagnosis and treatment is done properly in South Korea. The purpose of this study was to investigate the methods that the Korean speech therapists use to diagnose and treat pediatric voice problem. Materials and Method : An anonymous online questionnaire was administered to 32 speech language therapists registered at the Korean laryngeal speech linguistics society detailing demographics, employment institution, general management of pediatric patients with vocal problem including assessment and treatment procedures. Results : Current practice patterns were analyzed on 32 speech language therapists providing services in South Korea mostly working at tertiary university hospital. One third of pediatric patients were assessed without proceeding to treatment. One fifth of patients were treated without assessment. Perceptual assessment was the main pretreatment assessment methods used. Treatment was done in the following order : Voice rest, SOVT, yawn-sigh and resonant voice. Post-treatment evaluation was used in the following order : Instrumental assessment, clinical judgment, and recording comparison. Conclusion : Speech language therapists practice in South Korea mostly follows the ASHA practice guidelines. However, there are still great amount of cases in which only the evaluation was done without appropriate treatment. Further research is needed to make SPLs more systematic and efficient for evaluating and treating pediatric vocal patients.

Development of Pattern Identification Questionnaire for Attention-Deficit/Hyperactivity Disorder (ADHD) in Korean Medicine (주의력결핍 과잉행동장애(ADHD) 한의 변증 설문지 개발 연구)

  • An, Yunyoung;Jeong, Minjeong;Kim, Miyeon;Kim, Lakhyung
    • Journal of Oriental Neuropsychiatry
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    • v.30 no.1
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    • pp.1-11
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    • 2019
  • Objectives: Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by a persistent pattern of inattention and/or hyperactivity impulsivity that interferes with function or development in children. In traditional Korean medicine (TKM) and traditional Chinese medicine (TCM), ADHD is classified by several patterns based on symptoms and signs. However, currently, there is no objective diagnostic tool for ADHD in traditional medicine. The objective of this study was to develop the Pattern Identification Questionnaire for ADHD (parents-survey style) to be used in Korean medicine, through a literature review and consultation with groups of experts. Methods: The types of pattern identifications of ADHD mentioned in 13 pieces of Korean and Chinese literatures and their symptoms and signs were analyzed. The advisory committee (15 Neuropsychiatrist and 11 Pediatrist in Korean Medicine) assessed the appropriateness of the literature selection and the types of pattern identification selection and their symptoms and signs, and weighed the significance of the symptoms and signs. The Pattern Identification Questionnaire for ADHD was developed using the calculated weights by evaluated significance. The translation of symptoms and signs to the Korean language was achieved through consultation with expert translators. Results: 1. Four pattern identification types and their symptoms and signs were selected according to frequency of appearance in the Korean and Chinese literatures, and were reviewed by the advisory committee: Kidney yin deficiency and liver yang ascendant hyperactivity (腎虛肝亢), Dual deficiencies in the heart and spleen (心脾兩虛), Phlegm-fire harassing the heart (痰火擾心), and Spleen weakness and liver energy preponderance (脾虛肝旺). 2. The weights of all the symptoms and signs in the four patterns were calculated using the means and standard deviations of the symptoms and signs' importance that were obtained from specialists' significance weighting. 3. The Pattern Identification Questionnaire for ADHD (parents-survey style) in Korean medicine composed of 38 questions was suggested. Conclusions: Using a review of the literature and expert advice, Pattern Identification Questionnaire for ADHD (parents-survey style) in Korean medicine was developed. Further clinical study is required to develop a final version of the questionnaire through the evaluation of reliability and validity.

Evaluation of the Appropriateness of Empirical Antibiotic Prescription after Implementation of Antibiotic Treatment Guidelines for Pneumonia in a Hospital (원내 폐렴 진료 지침 수립 후 경험 항생제 선택의 적절성 평가)

  • Kang, Jiyoung;Kim, Hyungsook;Jeong, Youngmi;Namgung, Hyungwook;Lee, Eunsook;Lee, Euni;Hwang, Joohee;Song, Kyoungho;Kim, Eusuk;Kim, Hongbin
    • Journal of Korean Society of Health-System Pharmacists
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    • v.35 no.4
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    • pp.391-399
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    • 2018
  • Background : The Antimicrobial Stewardship Program promotes interdisciplinary interventions and targeted recommendations for the proper utilization of antibiotics. In particular, the aim of the program is to avoid indiscriminate use of broad-spectrum antibiotics based on the documented literature on the significant impact of unsystematic usage of antibiotics on the distribution of antibiotic-resistant microorganisms. To improve the care process for pneumonia treatment using antimicrobial agents, institution-level guidelines were established and disseminated at the Seoul National University Bundang Hospital in April 2016. In this study, we evaluated changes in the physicians'antibiotic prescribing patterns both before-and after-the implementation of the guidelines. Methods : The electronic medical records of inpatients who were prescribed with one or more antibiotics in May 2014 (Group A) and May 2016 (Group B) were reviewed. Data on demographic characteristics, clinical outcomes, and antibiotic prescriptions were collected and the prescription records were compared both before- and after- the implementation of the guidelines. Results : A total of 180 patients were included in the study: 77 patients in group A and 103 patients in group B. The baseline characteristics of the patients were not significantly different between the two groups. Community-acquired pneumonia was the most common diagnosis in both the groups and the difference was not significant (68.8% vs. 67.9%; p=0.67). The type of antibiotic prescriptions used for empirical treatment was not different between the two groups. The most commonly prescribed empirical antibiotics were cephalosporins, with no significant difference (p=0.31). One of the most inappropriately used antibiotics was piperacillin/tazobactam and the rate of prescription was similar in both the groups (p=0.68). The rates of appropriate empirical selection of antibiotics remained unaltered between the two groups (67.5% vs. 71.8%; p=0.53). Conclusions : Implementation of the guidelines only exhibited no significant effect on the antibiotic prescribing patterns of physicians for the treatment of pneumonia. To improve the adequate use of empiric antibiotics, more active interventions and closer monitoring of the feedbacks should be additionally considered and evaluated in future studies.

Projection of Cancer Incidence and Mortality From 2020 to 2035 in the Korean Population Aged 20 Years and Older

  • Youjin, Hong;Sangjun, Lee;Sungji, Moon;Soseul, Sung;Woojin, Lim;Kyungsik, Kim;Seokyung, An;Jeoungbin, Choi;Kwang-Pil, Ko;Inah, Kim;Jung Eun, Lee;Sue K., Park
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.6
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    • pp.529-538
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    • 2022
  • Objectives: This study aimed to identify the current patterns of cancer incidence and estimate the projected cancer incidence and mortality between 2020 and 2035 in Korea. Methods: Data on cancer incidence cases were extracted from the Korean Statistical Information Service from 2000 to 2017, and data on cancer-related deaths were extracted from the National Cancer Center from 2000 to 2018. Cancer cases and deaths were classified according to the International Classification of Diseases, 10th edition. For the current patterns of cancer incidence, age-standardized incidence rates (ASIRs) and age-standardized mortality rates were investigated using the 2000 mid-year estimated population aged over 20 years and older. A joinpoint regression model was used to determine the 2020 to 2035 trends in cancer. Results: Overall, cancer cases were predicted to increase from 265 299 in 2020 to 474 085 in 2035 (growth rate: 1.8%). The greatest increase in the ASIR was projected for prostate cancer among male (7.84 vs. 189.53 per 100 000 people) and breast cancer among female (34.17 vs. 238.45 per 100 000 people) from 2000 to 2035. Overall cancer deaths were projected to increase from 81 717 in 2020 to 95 845 in 2035 (average annual growth rate: 1.2%). Although most cancer mortality rates were projected to decrease, those of breast, pancreatic, and ovarian cancer among female were projected to increase until 2035. Conclusions: These up-to-date projections of cancer incidence and mortality in the Korean population may be a significant resource for implementing cancer-related regulations or developing cancer treatments.

Association of Korean Medicine Pattern Identifications and Liver Blood Markers with the Severity of Cognitive Impairment in an Elderly Population (경도인지장애와 경도치매 단계에서의 한의 변증 및 간 혈액지표 연관성 탐색 연구)

  • Kahye Kim;Jiyun Cha;Seul Gee Kim;Hyung-Won Kang;Yeoung-Su Lyu;In Chul Jung;Jaeuk U. Ki
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.3
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    • pp.141-150
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    • 2023
  • Objectives: This study aimed to comprehend the characteristics of Korean medicine patterns in relation to varying degrees of cognitive impairment in an elderly population. Methods: The dataset included 127 elderly individuals with cognitive impairment obtained from three Korean medicine hospitals between 2018 and 2021. The participants were categorized into two groups based on Clinical Dementia Rating-Sum of Boxes (CDR-SB) scores: those with questionable impairment (QI) and those with very mild dementia (VMD). A diagnostic framework for Korean medicine patterns encompassing Qi deficiency, Yin deficiency, Phlegm dampness, and Heat-fire was employed. Liver blood markers, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), and the AST/ALT ratio, were also analyzed. Results: The scores of the cognitive assessment tools (MoCA-K, MMSE-DS, and K-IADL) of the QI group significantly differed from those of the VMD group. CDR-SB exhibited a positive correlation with the scores of each pattern of Qi deficiency, Yin deficiency, Phlegm dampness, and Heat-fire, whereas ALT and AST values displayed negative correlations. Binomial logistic analysis, controlling for potential confounders, such as age, education years, body mass index, the presence of chronic disease, and the presence of medication, verified that the VMD group showed higher pattern scores and lower ALT and AST values than the QI group. Conclusions: Increases in pattern scores along with decreased AST and ALT levels might be indicative of more severe cognitive impairment.

Latent Profile Analysis of PTSD symptoms and PTG among Adults in South Korea: the Differences in Binge Eating, Non-Suicidal Self-Injury, and Problem Drinking Behaviors (잠재프로파일분석(LPA)을 활용한 PTSD 증상과 외상 후 성장 수준의 양상: 폭식, 비자살적 자해, 문제성 음주행동에서의 차이)

  • DeokHee Lee;DongHun Lee;HayoungJung
    • Korean Journal of Culture and Social Issue
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    • v.25 no.4
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    • pp.325-351
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    • 2019
  • The present study examined patterns of co-occurrence between DSM-5 posttraumatic stress disorder(PTSD) symptoms and posttraumatic growth(PTG) among Korean populations(n= 860). Latent profile analysis was used to identify subclasses and suggested that the 3-class model fit best: (1) Low PTSD/Mild PTG group (2) Low PTSD/High PTG group; (3) High PTSD/High PTG group. Class membership was predicted by demographic variables, social isolation, and frequency of traumatic experiences. Classes also differed with respect to self-destructive behaviors(binge eating, non-suicidal self-injury, and problem drinking). These findings contribute to future research about the coexisting patterns of PTSD and PTG, and to identify high-risk individuals who suffer from trauma-related problems in clinical practice.

Gamma Irradiation Induces a Caspase-dependent Apoptotic Mechanism in Human Prostate Cancer PC-3 Cells (인간 남성호르몬 비의존형 전립선 PC-3 암세포에서 감마선의 Caspase-의존성 세포자멸사 유도 효과)

  • Chang, Jeong-Hyun;Kim, Dong-Hyun;Jeon, Gye-Rok;Kwon, Heun-Young
    • Journal of Life Science
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    • v.18 no.8
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    • pp.1042-1048
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    • 2008
  • Prostate cancer is the most predominant cancer in men and related death rate increases every year. Till date, there is no effective therapy for androgen independent prostate cancer. To investigate the mechanism for cell growth inhibition or apoptosis in human androgen independent prostate cancer PC-3 cells after gamma irradiation. The aim of this study was to examine the potential of gamma irradiation to induce apoptosis in PC-3 cells and to assess the mechanism of gamma irradiation-induced apoptosis. Five different assays were employed in this study: cell proliferation assay, morphological assessments of apoptotic cells, DNA fragmentation analysis, quantification of apoptosis by annexin V (AV) and propidium iodide (PI) staning, and western blot analysis. Cell viability was inversely related to radiation dose. DAPI-positive cells were detected 48 hr after 40 Gy radiation exposure. And nuclear morphological changes of cells were observed by gamma irradiation. DNA ladder patterns in the cells exposed to gamma-radiation were appeared at 24 hr. Also, gamma irradiation induces apoptosis of PC-3 cells via Caspase3, Bax and PARP-dependent fashion.

Interferon-gamma susceptibility of HL-60 cells, mononuclear cells of umbilical cord blood and bone marrow (HL-60 세포주, 제대혈 및 골수 단핵구 세포의 interferon-gamma에 대한 감수성에 관한 연구)

  • Cheong, Hee Jeong;Hong, Dae Sik;Kim, Sook Ja;Cheong, Jae Hwa;Lee, Joo Young;Lee, Nam Su;Park, Sung Kyu;Won, Jong Ho;Park, Hee Sook;Kim, Sung Il
    • IMMUNE NETWORK
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    • v.1 no.3
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    • pp.230-235
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    • 2001
  • Background: Finding of the regulation of various gene expression by cytokine including $IFN-{\gamma}$ in hematopoietic stem cell will light up the understanding of pathogenesis of aplastic anemia in various aspects. To study on aplastic anemia, however, we have to circumvent the difficulty of directly obtaining bone marrow stem cells from the patient. Therefore, we tried to find out a cell can replace the bone marrow stem cells for study on cell signaling pathway and regulation of gene expression by $IFN-{\gamma}$. Materials and Methods: HL-60 cells, of 20 ng/mL of $IFN-{\gamma}$. Total RNA was isolated from the cells and RT-PCR of the indoleamine 2,3-dioxygenase (IDO), $IFN-{\gamma}$, TNF-${\alpha}$, $MIP-1{\alpha}$, and $TGF-{\beta}2$ was carried out for the estimation of the gene expression. Results: $IFN-{\gamma}$ induced IDO gene expression of mononuclear cells from umbilical cord blood showed similar pattern as compared to that of bone marrow. Whether $INF-{\gamma}$ was treated or not, $TNF-{\alpha}$ was expressed in both mononuclear cells from umbilical cord blood and bone marrow. However, HL-60 cells showed different expression patterns. HL-60 cells would express neither IDO nor $TNF-{\alpha}$ even under the culture with 20ng/mL of $IFN-{\gamma}$. Conclusion: Our results showed bone marrow can be replaced with mononuclear cells from umbilical cord blood in the study on the relation between aplastic anemia and $IFN-{\gamma}$ including $IFN-{\gamma}$ cell signaling pathway.

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THE THREE DIMENSIONAL FINITE ELEMENT ANALYSIS OF STRESS ACCORDING TO IMPLANT THREAD DESIGN UNDER THE AXIAL LOAD (수직력하에서 임프란트 나사형태에 따른 응력의 3차원 유한요소법적 분석)

  • Kim, Woo-Taek;Cha, Yong-Doo;Oh, Se-Jong;Park, Sang-Soo;Kim, Hyun-Woo;Park, Yang-Ho;Park, Jun-Woo;Rhee, Gun-Joo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.2
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    • pp.111-117
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    • 2001
  • There are three designs of thread form in screw type implants: V-thread, Reverse buttress thread and Square thread. The purpose of this study was to find out how thread form designs have an influence on the equivalent stress, equivalent strain, maximum shear stress and maximum shear strain and which design of thread form generates more maximum equivalent stress and strain. 3-D finite element analysis was used to evaluate the stress and strain patterns of three tread types. The results of this study were as follow. 1. Under the 200N of axial load, the value of maximum equivalent stress is smallest in square thread and there is no significant difference between that of V thread and reverse buttress thread. 2. Under the 200N of axial load, the value of maximum equivalent strain is largest in V thread and smallest in square thread. 3. Under the 200N of axial load, the value of maximum shear stress is smallest in square thread and there is no significant difference between that of V thread and reverse buttress thread. 4. Under the 200N of axial load, the value of maximum equivalent strain is largest in V thread and there is no significant difference between that of square thread and reverse buttress thread. 5. Above results show that the square thread has special advantages in stress and strain compared with other thread types, especially in shear stess which is most determinant to implant-bone interface. Considering the superior biomechanical properties of square form implant, we presume that square form implant has better clinical results than the other types of implants in the same clinical conditions.

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Relations between Normal Serum Gamma-glutamyltransferase and Risk Factors of Coronary Heart Diseases according to Age and Gender (연령과 성별에 따른 정상 혈청 Gamma-glutamyltransferase와 관상동맥질환 위험인자와의 관계)

  • Kwon, Se Young;Na, Young Ak
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.1
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    • pp.22-29
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    • 2016
  • Serum gamma-glutamyltransferase (GGT) has been widely used as a marker of alcohol intake and liver failure. Recently, the relativity between GGT and various diseases has been identified with growing interest. In this study, we examined relativity between GGT value and risk factors of coronary heart diseases among those with normal GGT value, excluding heavy drinkers. Specifically, we compared the differences based on age and gender. Data from the 2011 KNHNES were used (N=3,619). When the subjects were categorized according to quartile based on the serum GGT levels, there was 10~20, 21~27, 28~38, 39~71 IU/L in men, and 6~12, 13~16, 17~22, 23~42 IU/L in women. The mean of most variables was the highest in the $4^{th}$ quartile (Q4), however age and LDL Cholesterol were the highest in the $2^{nd}$ quartile (Q2) in men. The FRS and 10-year CHD risk was the highest in the $2^{nd}$ quartile in men, and the highest in the $4^{th}$ quartile in women. Increased GGT was correspondingly linked with age in women but age was the highest in GGT in the $2^{nd}$ quartile in men. In the 70's, the highest Q1 and Q2 was in men and the highest Q3 and Q4 in women. Although GGT value was within the normal range, increased GGT showed correlation with various risk factors. The FRS and 10-year CHD risk showed different patterns according to age and gender along with increased GGT value.