• Title/Summary/Keyword: Clinical usefulness

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Usefulness of pelvic ultrasonography for the diagnosis of central precocious puberty in girls

  • Yu, Jung;Shin, Ha Young;Lee, Sun Hee;Kim, You Sung;Kim, Jae Hyun
    • Clinical and Experimental Pediatrics
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    • v.58 no.8
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    • pp.294-300
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    • 2015
  • Purpose: It is difficult to differentiate between central precocious puberty (CPP) and premature thelarche (PT) in girls. The aim of this study was to investigate the diagnostic usefulness of pelvic ultrasonography to distinguish between CPP and PT in girls with early breast development. Methods: This study included girls with early breast development who visited the clinic between January 2012 and December 2013. Clinical, laboratory, and pelvic ultrasonographic data were evaluated. CPP and PT were confirmed using the gonadotropin-releasing hormone stimulation test. Results: A total of 248 girls aged 7-8 years were included, among whom 186 (75.0%) had CPP and 62 (25.0%) had PT. The uterine length, transverse diameter, fundus, volume, and cross-sectional area were significantly larger in the CPP group (uterine length, $2.45{\pm}0.50cm$ vs. $2.63{\pm}0.49cm$, P=0.015; uterine volume, $0.95{\pm}0.62cm^3$ vs. $1.35{\pm}0.76cm^3$, P<0.001). However, there were no differences in the fundus/cervix ratio and ovarian measurements. In receiver operating characteristic analysis, a uterine volume of at least $1.07cm^3$ was the most predictive parameter for CPP with an area under the curve of 0.670 (95% confidence interval, 0.593-0.747). Conclusion: Uterine measurements by pelvic ultrasonography in girls with early pubertal development were significantly larger in the CPP group. However, the diagnostic value of ultrasonographic parameters was not high because of a considerable overlap of values between the two groups. Therefore, pelvic ultrasonography in combination with clinical and laboratory tests may be useful to distinguish between CPP and PT in girls.

Usefulness of Clinical Performance Examination for Graduation Certification of Nursing Students (졸업인증 임상수행력평가의 유용성 평가)

  • Kim, Yun-Hee;Kang, Seo-Young;Kim, Mi-Won;Jang, Keum-Seong;Choi, Ja-Yun
    • Journal of Korean Academy of Nursing Administration
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    • v.14 no.3
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    • pp.344-351
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    • 2008
  • Purpose: The aim of this study was to testify whether clinical performance examination (CPX) was useful to evaluate comprehensive performance for nursing students just prior to graduation. Method: A cross-sectional descriptive study was designed to examine the usefulness. A total of 61 nursing students whose requirement credits were completed for graduation from a C University in G-city, at December, 5, 2007. Data were analyzed by Pearson's Correlation Coefficient and Spearman's rank Correlation Coefficient. Results: This study showed that both of the finals scores with paper and pens and the clinical practicum scores were not correlated with the CPX scores (r=-.031, p=.811; r=.028, p=.831). Consistency of scores between faculties and standardized patients was moderate (r=.752, p=.000). Conclusion: CPX was considered as a different and innovative evaluation from previous testing systems to test the various aspects of performance including knowledge, skill and attitude. Therefore, CPX under high raters' consistency was useful to test nursing students's final performance. Further study would be needed to develop the standard of CPX system.

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Clinical usefulness of serum procalcitonin level in distinguishing between Kawasaki disease and other infections in febrile children

  • Lee, Na Hyun;Choi, Hee Joung;Kim, Yeo Hyang
    • Clinical and Experimental Pediatrics
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    • v.60 no.4
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    • pp.112-117
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    • 2017
  • Purpose: The aims of this study were to compare serum procalcitonin (PCT) levels between febrile children with Kawasaki disease (KD) and those with bacterial or viral infections, and assess the clinical usefulness of PCT level in predicting KD. Methods: Serum PCT levels were examined in febrile pediatric patients admitted between August 2013 and August 2014. The patients were divided into 3 groups as follows: 49 with KD, 111 with viral infections, and 24 with bacterial infections. Results: The mean PCT level in the KD group was significantly lower than that in the bacterial infection group ($0.82{\pm}1.73ng/mL$ vs. $3.11{\pm}6.10ng/mL$, P=0.002) and insignificantly different from that in the viral infection group ($0.23{\pm}0.34ng/mL$, P=0.457). The mean erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level in the KD group were significantly higher than those in the viral and bacterial infection groups (P<0.001 and P<0.001 for ESR, P<0.001 and P=0.005 for CRP, respectively). The proportion of patients in the KD group with PCT levels of >1.0 ng/mL was significantly higher in the nonresponders to the initial intravenous immunoglobulin treatment than in the responders (36% vs. 8%, P=0.01). Conclusion: PCT levels may help to differentiate KD from bacterial infections. A combination of disease markers, including ESR, CRP, and PCT, may be useful for differentiating between KD and viral/bacterial infections.

Reconstruction of Myocardial Current Distribution Using Magnetocardiogram and its Clinical Use (심자도를 이용한 심근 전류분포 복원과 임상적 응용)

  • 권혁찬;정용석;이용호;김진목;김기웅;김기영;박기락;배장호
    • Journal of Biomedical Engineering Research
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    • v.24 no.5
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    • pp.459-464
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    • 2003
  • The source current distribution in a heart was reconstructed from the magnetocardiogram (MCG) and its clinical usefulness was demonstrated. MCG was measured using 40-channel superconducting quantum interference device (SQUID) gradiometers for a patient of Wolff-Parkinson-White (WPW) syndrome, which has an accessory pathway between the atria and the ventricles. Reconstruction of source current distribution in a plane below the chest surface was performed using minimum norm estimation (MNE) algorithm and truncated singular value decomposition (SVD), In the simulation, we confirmed that the current distributions. which were computed for the test dipoles, represented well the essential feature of the test current configurations, In the current map of WPW syndrome, we observed abnormal currents that would bypass the atrioventricular junction at a delta wave. However, we could not observe such currents any more after the surgery. These results showed that the obtained current distribution using MCG signals is consistent with the electrical activity in a heart and has clinical usefulness.

USEFULNESS OF $^{18}F$-FDG PET/CT IN THE EVALUATION OF CERVICAL LYMPH NODE METASTASIS IN PATIENTS WITH ORAL CANCER (구강암 환자에서 $^{18}F$ FDG-PET/CT의 경부 림프절 전이 평가 유용성)

  • Yu, Min-Gi;Ryu, Sun-Youl
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.4
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    • pp.213-220
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    • 2009
  • Purpose: The present study was aimed to examine the usefulness of 18F-FDG PET/CT in the evaluation of cervical lymph node metastasis in patients with oral cancer. Materials and methods: Twenty-two patients who underwent neck dissection to treat oral cancer were subjected for examination. The cervical node metastasis was evaluated by means of clinical examination, CT scan, PET, and histologic examination. By comparing the results of each examination modality with those of histologic examination, it's sensitivity, specificity, positive predictive value, and negative predictive value were determined. Results: The oral cancer was more frequent in males with a ratio of 2.14:1. The sixth decade showed the highest incidence in age distribution with mean of $56{\pm}16$. Histologic findings showed that squamous cell carcinoma was the most common (15 patients), and mucoepidermoid carcinoma (3), malignant melanoma (2), and adenoid cystic carcinoma and ghost cell odontogenic carcinoma (1 each), in order. In most cases, wide surgical excision of the primary cancer and neck dissection was performed, followed by reconstruction with free flaps when necessary. When comparing the results of each examination modality with those of the histologic examination, clinical examination showed sensitivity, specificity, positive predictive value, and negative predictive value at 11%, 85%, 33%, and 58%, respectively. CT scans showed at 67%, 77%, 67%, and 77%, while $^{18}F$-FDG PET/CT at 78%, 77%, 70%, and 83%, respectively. Conclusions: These results suggest that PET is more useful, compared with clinical examination and CT scans, in the evaluation of cervical lymph node metastasis in patients with oral cancer.

Clinical Usefulness of Circulating Antiendometrial Antibodies in Endometriosis (자궁내막증에서 순환 항자궁내막 항체의 유용성)

  • Kim, Jung-Gu;Park, Chang-Soo;Choi, Young-Min;Shin, Chang-Jae;Moon, Shin-Yong;Chang, Yoon-Seok;Lee, Jin-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.20 no.1
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    • pp.87-94
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    • 1993
  • Antiendometrial antibodies were tested by passive hemagglutination assay(PHA) and enzyme linked immunosorbent assay(ELISA) in sera of 45 patients with endometriosis and 21 controls for the evaluation of its clinical usefulness. Both titers(reciprocal) of serum antiendometrial antibody by PHA and ELISA reactivity against endometrial antigens at 405nm were significantly higher in patients with endometriosis than in the control group. Of 45 patients with endometriosis, twenty-six(57.8%) by PHA and twenty-three(51.1%) by ELISA were determined antiendometrial antibody positive but none of the controls were positive. Antiendometrial antibody titers were followed up by PHA and ELISA in 14 patients with high antiendometrial antibody titers before and after treatment with Decapeptyl. There was a decreasing tendency of antiendometrial antibody titers after treatment but there was no statistical significance. These data suggest that the measurement of circulating antiendometrial antibody may be useful for the diagnosis but not for the follow up of endometriosis.

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Pattern analysis of lower limb magnetic resonance images in Korean patients with distal myopathy

  • Park, Hyung Jun;Shin, Ha Young;Kim, Seung Min;Park, Kee Duk;Choi, Young-Chul
    • Annals of Clinical Neurophysiology
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    • v.21 no.2
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    • pp.79-86
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    • 2019
  • Background: Magnetic resonance (MR) images are useful for diagnosing myopathy. The purpose of this study was to determine the usefulness of lower-limb MR images in Korean patients with distal myopathy. Methods: We reviewed medical records in the myopathy database from January 2002 to October 2016. We selected 21 patients from 91 unrelated families with distal myopathy: four with GNE myopathy, 11 with dysferlinopathy, and six with ADSSL1 myopathy. Results: Ten (48%) of the 21 patients were men. The ages of the participants at symptom onset and imaging were $19.2{\pm}9.5$ and $30.4{\pm}9.0$ years (mean${\pm}$standard deviation), respectively. Their grade on the modified Gardner-Medwin and Walton grade was $3.3{\pm}1.7$. The strength grade of the knee extensors was not correlated with the Mercuri scale for the quadriceps (r = -0.247, p = 0.115). However, the Medical Research Council grades of the knee flexors, ankle dorsiflexors, and ankle plantar flexors were significantly correlated with the Mercuri scale ratings of the knee flexors (r = -0.497, p = 0.001), tibialis anterior (r = -0.727, p < 0.001), and ankle plantar flexors (r = -0.620, p < 0.001), respectively. T1-weighted MR images showed characteristic fatty replacement patterns that were consistent with the causative genes. Unsupervised hierarchical clustering of the Mercuri scale showed that the main factors contributing to the dichotomy were the causative gene and the clinical severity. Conclusions: This study is the first to reveal the usefulness of lower-limb MR images in the differential diagnosis of distal myopathy in Korea.

Virtual reality education program including three-dimensional individualized liver model and education videos: A pilot case report in a patient with hepatocellular carcinoma

  • Jinsoo Rhu;Soyoung Lim;Danbee Kang;Juhee Cho;Heesuk Lee;Gyu-Seong Choi;Jong Man Kim;Jae-Won Joh
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.3
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    • pp.285-288
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    • 2022
  • Three-dimensional (3D) modeling of the liver can be especially useful for both the surgeon and patient to understand the actual location of the tumor and planning the resection plane. Virtual reality (VR) can enhance the understanding of 3D structures and create an environment where the user can focus on contents provided. In the present study, a VR platform was developed using Unreal Engine 4 software (Epic Games, Potomac, MD, USA). Patient's liver based on magnetic resonance image was imported as a 3D model that could distinguish liver parenchyma, vascular structure, and cancer. Preoperative education videos for patients were developed. They could be viewed inside the VR platform. To evaluate the usefulness of VR education program for patients undergoing liver resection for hepatocellular carcinoma, a randomized clinical trial evaluating the knowledge and anxiety of the patient was designed. The case presented in this report was the first experience of performing the VR education program and examining the knowledge and anxiety using questionnaires. When the knowledge score increased, the anxiety score also increased after the education program. Based on findings of this pilot case study, the timing and place where the questionnaire will be answered can be modified for formal initiation of the randomized controlled study to examine the usefulness of VR in patient education.

Evaluation and Optimization of a Serum-based Minimum Inhibitory Concentration Assay to Caspofungin in Candida albicans Clinical Isolates

  • Yoo, Young Bin;Kim, Sung-Soon;Kim, Young Kwon;Kim, Sunghyun
    • Biomedical Science Letters
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    • v.22 no.4
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    • pp.174-183
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    • 2016
  • In the present study, a serum-based minimum inhibitory concentration (MIC) testing to caspofungin was optimized and evaluated to solve the limitations of the conventional Clinical and Laboratory Standards Institute (CLSI) guideline-based antifungal agent MIC test and the usefulness of this testing for clinical application was determined. A total of 105 Candida albicans clinical isolates were used for measuring MIC to caspofungin. Results showed that growth characteristics were different according to types of serum and the mouse serum was the most suitable for this assay. In order to measure the optimal concentration of mouse serum, 0 to 100% mouse serum were added to the media during fungal culture. The optimal concentration of serum was 50% when consideration of antifungal agent administration and inoculum size, serum components and ease of hyphae separated, and the consideration of the degree of growth. In comparison of the usefulness between the conventional Alamar-modified broth microdilution MIC assay and 50% mouse serum-based MIC testing, the range of $MIC_{80}$ of the Alamar-modified broth microdilution MIC assay was $0.13{\sim}2.0{\mu}g/mL$ (SD ${\pm}0.42{\mu}g/mL$) and that of the 50% mouse serum-based MIC assay was $2.0{\sim}32.0{\mu}g/mL$ (SD ${\pm}9.01{\mu}g/mL$). The range of $MIC_{50}$ of the Alamar-modified broth microdilution MIC assay was $0.13{\sim}2.0{\mu}g/mL$ (SD ${\pm}0.40{\mu}g/mL$) and that of the 50% mouse serum-based MIC assay was $1.0{\sim}16.0{\mu}g/mL$ (SD ${\pm}2.36{\mu}g/mL$). The MICs of 50% mouse serum-based MIC testing was increased by up to 4 to 64 times than Alamar-modified broth microdilution MIC assay. In conclusion, a 50% mouse serum-based MIC assay was more useful for measuring MIC in Candida albicans clinical isolates than conventional colorimetric broth microdilution MIC testing.

The Role of Bone Scans in Routine Preoperative Evaluations of Non-Small Cell Lung Cancer Patients. (비소세포 폐암의 병기에 있어 통상적인 골 스캔의 역할)

  • 김영태;홍장미;이재익;이정상;성숙환;김주현
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.659-663
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    • 2002
  • The objective of this study was to assess the usefulness of bone scans in routine preoperative examinations of patients with newly diagnosed non-small cell lung carcinoma. Material and Method: We reviewed the medical records of 258 patients who were newly diagnosed with non-small cell lung cancer in our hospital between January 2000 and December 2000. More than half of the patients (132) were deemed to be inoperable due to their advanced stage based on the CT scans. The remaining 126 patients were considered potentially operable. For these patients, clinical evaluation including the presence of bone pain, serum alkaline phosphatase, and calcium levels was used as clinical predictors of bone metastasis. All patients received bone scans. Bone X-rays, MRI or bone biopsy were performed to confirm the presence of bone metastasis. The usefulness of the bone scan was evaluated by comparing its power of predicting bone metastasis to that of the clinical information. Result: In all patients, the positive and negative predictive values of bone scans for the bone metastasis were 44%, and 99%, respectively. Those of the clinical information were 38% , and 94%. However, in potentially operable patients, the negative predictive value of the clinical information was as high as 99%. Conclusion: If newly diagnosed non-small cell lung cancer patients are presented as potentially operable on the basis of CT scan with no clinical evidence of distant metastases, curative resection could be considered without performing routine bone scans because of the low probability of bone metastasis. However, if there are positive clinical findings, further evaluations, including bone scan should be followed as metastasis will be documented in more than 30% of patients.