• 제목/요약/키워드: Medical Screening

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Community-based Helicobacter pylori Screening and its Effects on Eradication in Patients with Dyspepsia (지역사회에서 소화불량 환자의 Helicobacter pylori 감염에 대한 집단검진 및 치료효과)

  • Kim, Seong-Ho;Hong, Dae-Yong;Lee, Kyeong-Soo;Kim, Seok-Beom;Kim, Sang-Kyu;Suh, Jeong-Ill;Kim, Mee-Kyung;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.3
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    • pp.285-298
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    • 2000
  • Objectives : To investigate the positive rate of Helicobacter pylori in patients with dyspepsia; medical compliance and related factors; the eradication rate a year after screening and related factors; the relationship between the eradication of Helicobacter pylori and the improvement of symptoms; and the estimated cost of three alternative approaches to treat Helicobacter pylori in the community. Methods : A total of 510 subjects with dyspeptic symptoms were selected and given the serological test in March 1998. The subjects were all adults over 30 years of age residing in Kyongju city. Results : Of the 510 selected subjects, 375 (73.5%) subjects proved positive for Helicobacter pylori on serological testing. Of these 304 (81.1%) who consented to an endoscopic examination, underwent a Campylobacter-like organism (CLO) test. Of these 304 subjects, 204 (67.1%), who had positive CLO test results, were given the triple therapy - tripotassium dicitrato bismuthate, amoxicillin, and metronidazole. To determine the eradication rate of Helicobacter pylori, 181 (88.1%) out of the 204 subjects who were given the triple therapy completed a follow-up urea breath test one year later. Of these, the Helicobacter pylori of 87(48.1%) subjects was eradicated. Among the 122 subjects who were medication compliant, the Helicobacter pylori eradication rate was 57.4% (70 subjects), while the eradication rates was only 28.8% (17subjects) in the non-compliant group. The Helicobacter pylori eradication was significantly related to compliance (p<0.01), but not to other characteristics and habits. The symptom improvement rate tended to be higher 62.1%), in the Helicobacter pylori eradicated group than in the non-eradicated group (59.6%). Conclusions : When the advantages and disadvantages of each alternative treatment were considered in the light of cost, antibiotic tolerance and the number of patients to be treated, alternative II was favorable in terms of cost. Alternative III was favorable in terms of the number of patients to be treated, antibiotic tolerance and early detection of gastric cancer. Further long-term research analyzing the cost-benefit and cost-effectiveness of each treatment will be needed as supporting material in creating new policies.

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Values of Alpha-fetoprotein of Maternal Serum in Normal Pregnancy (정상 임산부의 혈청 Alpha-fetoprotein치의 임상적 이용)

  • Kim, Mok-Jin;Han, Kuk-Sun;An, Jae-Hong;Suh, Jeung-Ho;Lee, Young-Gi;Park, Yoon-Kee;Lee, Tae-Hyung
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.168-174
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    • 1997
  • Alphafetoprotein(AFP) is a glycoprotein synthesized by the fetus early in gestation by the yolk sac and later by the gastrointestinal tract and liver. The concentration of AFP is highest in fetal serum and amniotic fluid around 13th week, and 32nd week in maternal serum. Some conditions are associated with abnormal maternal serum AFP concentration. For examples, neural tube defects, omphalocele, renal anomalies are associated with elevated maternal serum AFP and fetal death, chromosomal trisomies are associated with low level of maternal serum AFP. So maternal serum AFP screening plays a significant role in assessing candidates for prenatal diagnosis and prenatal counselling in pregnant women. This study evaluates the normal ranges of AFP using enzyme immunoassay in normal pregnant women. We studied 500 normal pregnant women who visited the Department of Obstetrics & Gynecology, Yeungnam Medical Center, Yeungnam University during the period through January, 1993 to September, 1996. The group of the study were selected randomly at various gestational ages from 8 to 41 weeks. The results were summarized as follows: 1. The lowest level of AFP in our study group was 2.1ng/ml at 8 weeks of gestation. Thereafter serum alpha-fetoprotein concentrations rose rapidly to reach a peak value at 32nd week. 2. The mean levels of AFP in the primipara and multipara were $166.37{\pm}12.06ng/ml$, and $223.78{\pm}14.00ng/ml$, respectively, showing stastiscally significant difference between these two groups(p<0.01). 3. The mean levels of AFP between mothers who delivered male and female babies were $192.96{\pm}13.00ng/ml$, and $194.29{\pm}13.84ng/ml$, respectively, without statistically significant difference(p>0.05). 4. The normal ranges of maternal serum AFP according to each gestational week were evaluated.

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A Method to Quantify Breast MRI for Predicting Tumor Invasion in Patients with Preoperative Biopsy- Proven Ductal Carcinoma in Situ (DCIS) (유방 자기공명영상법을 이용한 수술 전 관상피내암으로 진단된 환자의 침윤성 유방암을 예측하는 정량적 분석법)

  • Ko, Myung-Su;Kim, Sung Hun;Kang, Bong Joo;Choi, Byung Gil;Song, Byung Joo;Cha, Eun Suk;Kiraly, Atilla Peter;Kim, In Seong
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.2
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    • pp.73-82
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    • 2013
  • Purpose : To determine the quantitative parameters of breast MRI that predict tumor invasion in biopsy-proven DCIS. Materials and Methods: From January 2009 to March 2010, 42 MRI examinations of 41 patients with biopsy-proven DCIS were included. The quantitative parameters, which include the initial percentage enhancement ($E_1$), peak percentage enhancement ($E_{peak}$), time to peak enhancement (TTP), signal enhancement ratio (SER), arterial enhancement fraction (AEF), apparent diffusion coefficient (ADC) value, long diameter and the volume of the lesion, were calculated as parameters that might predict invasion. Univariate and multivariate analyses were used to identify the parameters associated with invasion. Results: Out of 42 lesions, 23 lesions were confirmed to be invasive ductal carcinoma (IDC) and 19 lesions were confirmed to be pure DCIS. Tumor size (p = 0.003; $6.5{\pm}3.2$ cm vs. $3.6{\pm}2.6$ cm, respectively) and SER (p = 0.036; $1.1{\pm}0.3$ vs. $0.9{\pm}0.3$, respectively) showed statistically significant high in IDC. In contrast, E1, Epeak, TTP, ADC, AEF and volume of the lesion were not statistically significant. Tumor size and SER had statistically significant associations with invasion, with an odds ratio of 1.04 and 22.93, respectively. Conclusion: Of quantitative parameters analyzed, SER and the long diameter of the lesion could be specific parameter for predicting invasion in the biopsy-proven DCIS.

Screening of conjugated linoleic acid (CLA) producing Lactobacillus plantarum and production of CLA on soy-powder milk by these stains (공액리놀레산 생성 Lactobacillus plantarum 선발 및 이를 이용한 콩-분말 두유에서 공액리놀레산 생산)

  • Kim, Baolo;Lee, Byong Won;Hwang, Chung Eun;Lee, Yu-Young;Lee, Choonwo;Kim, Byung Joo;Park, Ji-Yong;Sim, Eun-Yeong;Haque, Md. Azizul;Lee, Dong Hoon;Lee, Jin Hwan;Ahn, Min Ju;Lee, Hee Yul;Ko, Jong Min;Kim, Hyun Tae;Cho, Kye Man
    • Korean Journal of Microbiology
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    • v.51 no.3
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    • pp.231-240
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    • 2015
  • In this study, a total of 16 conjugated linoleic acid (CLA) producing lactic acid bacteria (LAB) were isolated from fermented foods. Among those strains, the S48 and P1201 strains were capable of producing higher CLA contents than other LABs. The two strains were classified as Lactobacillus plantarum based on morphological, physiological, chemotaxonomic, and molecular-genetic properties. The survival rates of these strain appeared to be 59.57% and 62.22% under artificial gastric conditions after 4 h at pH 2.5, respectively. These strains produced the cis-9, trans-11, and trans-10, cis-12 CLA isomers from 8% skim milk medium supplemented with the different free LA concentration at $37^{\circ}C$ for 48 h and the production of two CLA isomers constantly increased in the growth until 48 h of incubation. After 48 h of fermentation, the levels of CLA appeared highest in steamed soy-powder milk than fresh and roasted soy-powder milks. In particular, the CLA contents were produced $183.57{\mu}g/ml$ and $198.72{\mu}g/ml$ from steamed soy-powder milk after fermentation (48 h) with S48 and P1201 strains, respectively.

A Study on the Risk Factors for Maternal and Child Health Care Program with Emphasis on Developing the Risk Score System (모자건강관리를 위한 위험요인별 감별평점분류기준 개발에 관한 연구)

  • 이광옥
    • Journal of Korean Academy of Nursing
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    • v.13 no.1
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    • pp.7-21
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    • 1983
  • For the flexible and rational distribution of limited existing health resources based on measurements of individual risk, the socalled Risk Approach is being proposed by the World Health Organization as a managerial tool in maternal and child health care program. This approach, in principle, puts us under the necessity of developing a technique by which we will be able to measure the degree of risk or to discriminate the future outcomes of pregnancy on the basis of prior information obtainable at prenatal care delivery settings. Numerous recent studies have focussed on the identification of relevant risk factors as the Prior infer mation and on defining the adverse outcomes of pregnancy to be dicriminated, and also have tried on how to develope scoring system of risk factors for the quantitative assessment of the factors as the determinant of pregnancy outcomes. Once the scoring system is established the technique of classifying the patients into with normal and with adverse outcomes will be easily de veloped. The scoring system should be developed to meet the following four basic requirements. 1) Easy to construct 2) Easy to use 3) To be theoretically sound 4) To be valid In searching for a feasible methodology which will meet these requirements, the author has attempted to apply the“Likelihood Method”, one of the well known principles in statistical analysis, to develop such scoring system according to the process as follows. Step 1. Classify the patients into four groups: Group $A_1$: With adverse outcomes on fetal (neonatal) side only. Group $A_2$: With adverse outcomes on maternal side only. Group $A_3$: With adverse outcome on both maternal and fetal (neonatal) sides. Group B: With normal outcomes. Step 2. Construct the marginal tabulation on the distribution of risk factors for each group. Step 3. For the calculation of risk score, take logarithmic transformation of relative proport-ions of the distribution and round them off to integers. Step 4. Test the validity of the score chart. h total of 2, 282 maternity records registered during the period of January 1, 1982-December 31, 1982 at Ewha Womans University Hospital were used for this study and the“Questionnaire for Maternity Record for Prenatal and Intrapartum High Risk Screening”developed by the Korean Institute for Population and Health was used to rearrange the information on the records into an easy analytic form. The findings of the study are summarized as follows. 1) The risk score chart constructed on the basis of“Likelihood Method”ispresented in Table 4 in the main text. 2) From the analysis of the risk score chart it was observed that a total of 24 risk factors could be identified as having significant predicting power for the discrimination of pregnancy outcomes into four groups as defined above. They are: (1) age (2) marital status (3) age at first pregnancy (4) medical insurance (5) number of pregnancies (6) history of Cesarean sections (7). number of living child (8) history of premature infants (9) history of over weighted new born (10) history of congenital anomalies (11) history of multiple pregnancies (12) history of abnormal presentation (13) history of obstetric abnormalities (14) past illness (15) hemoglobin level (16) blood pressure (17) heart status (18) general appearance (19) edema status (20) result of abdominal examination (21) cervix status (22) pelvis status (23) chief complaints (24) Reasons for examination 3) The validity of the score chart turned out to be as follows: a) Sensitivity: Group $A_1$: 0.75 Group $A_2$: 0.78 Group $A_3$: 0.92 All combined : 0.85 b) Specificity : 0.68 4) The diagnosabilities of the“score chart”for a set of hypothetical prevalence of adverse outcomes were calculated as follows (the sensitivity“for all combined”was used). Hypothetidal Prevalence : 5% 10% 20% 30% 40% 50% 60% Diagnosability : 12% 23% 40% 53% 64% 75% 80%.

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Change of RBC Indices with Serum Iron, TIBC Level in Iron Deficiency Anemia Patients Who Treated Oriental Medicine (철결핍성 빈혈 환자에서 한약 투여에 따른 혈청철, 철포합능 및 적혈구 지표의 변화)

  • Kim, Dong-Woung;Shin, Jin-Bong;Park, Bo-Ra;Won, Jin-Hee;O, Kwang-Woo;Moon, Goo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.6
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    • pp.1579-1584
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    • 2008
  • Anemia are often detected among many patients who are treated in oriental traditional medicine hospitals in Korea through blood tests which are taken to diagnose the patients' general state, and most of them are diagnosed to have iron deficiency anemia. This study amis the effect of herbal medicine on the RBC count, hemoglobin, hematocrits and indices of red blood cells such as mean corpuscular volume(MCV), mean corpuscular hemoglobin(MCH), mean corpuscular hemoglobin concentration(MCHC), serum iron, and total iron binding capacity(TIBC) among patients who were treated in oriental medical hospital and diagnosed to have anemia through blood tests other than main symptoms. The subjects of this study were 29 patients(male 7, female 22, mean age: 56.24${\pm}$19.11years) who were chosen ones, they has below hemoglobin 12 gm/dL, serum iron 70 IU/L, MCV 80 fL on laboratory screening test when they first visits our hospital. As a result, the volume of red blood cell(RBC), hematocrit(HCT), and hemoglobin(Hb) in peripheral blood increased from $348.27{\pm}8.95{\times}10^5$ /UL, 28.82${\pm}$0.56%, 9.24${\pm}$0.22 g/dL to $375.62{\pm}9.11{\times}10^5$ /UL, 31.36${\pm}$0.68%, 10.31${\pm}$0.25 g/dL comparing before and after oriental medicine treatment. After the treatment, MCH, MCHC, and MCV also increased from 26.98${\pm}$0.84 Pg, 32.62${\pm}$0.45 g/dl, 79.26${\pm}$0.17 fL to 27.74${\pm}$0.74 Pg, 32.84${\pm}$0.33 g/dl, 84.15${\pm}$1.67 fL. There was statistically significant increase in MCH, MCV(P<0.05); however, there was no significant change in MCHC(P>0.05). The amount of iron in blood increased from 32.96${\pm}$4.20 ug/dL to 67.22${\pm}$7.18 ug/dL, which showed a statistically significant increase(P<0.05). On the other hand, TIBC decreased from 325.08${\pm}$13.97 ug/dL to 315.61${\pm}$18.79 ug/dL, which was not a statistically significant change(P>0.05). Like this, all the patients showed favorable results in anemia based on the measurements of indices of red blood cells except MCHC. According to the classification of herbal medicines, in strengthening energy group(補氣), replenishing blood group(補血), and replenishing both energy and blood group(補氣血), the volume of RBC, HCT, and hemoglobin showed significant increases. Furthermore, in herbal medicines strengthening blood(補血) and replenishing both energy and blood group(補氣血), serum iron also relatively increased compare to strengthening energy group(補氣).

DEVELOPMENT OF SCALE FOR MEASURING DELINQUENT BEHAVIOR (청소년 비행행동 측정도구 개발)

  • Kim, Hyun-Sil;Kim, Hun-Soo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.79-90
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    • 2000
  • Objective:This study was performed in order to develop a measuring instrument for assessing and predicting delinquent behavior of the adolescents in Korea. Methods:This study was methodological research for developing a questionnaire for measuring delinquent behavior. Through the relevant literature review and personal interview using open-ended question with 12 adolescents in schools, outpatient basis and the juvenile corrective institutions, the author developed a pre-questionnaire with 31 items for assessing delinquent behavior among delinquentprone adolescents. Statistical method employed were test-retest reliability and Cronbach's alpha coefficient for testing reliability and factor analysis for testing validity of this questionnaire, and t-test for mean difference between student adolescents and delinquent adolescents, using SAS program. Subject served for this study consisted of 2,177 adolescents including 1,206 students and 971 delinquent adolescents by proportional stratified random sampling method. Results:1) Three stable factors were emerged and these contributed 52.2% of the variance in the total score. All 31 items loaded above .40 on each factor. 2) Factor I was named as antisocial delinquent behavior(17 items), factor II was named as aggressive delinquent behavior(8 items), and factor III was named as psychopathic delinquent behavior(6 items). 3) Comparison of these 3 factors between student adolescents and delinquent adolescents showed that there was a significant difference in factor Ⅰ(t=-42.91(student), -41.71(delinquent), p=.0001), factor II(t=-34.10(student), -35.72(delinquent), p=.0001), factor III(t=-14.24(student), -14.26 (delinquent), p=.0000), and total score(t=37.02(student), -36.38(delinquent), p=.0001). 4) Internal consistency reliability was tested by Cronbach's ${\alpha}$. Cronbach's ${\alpha}$ was .952 for total 31 items and .950, .866 and .721 for each 3 factors related to delinquent behavior. Conclusions:The author confirmed that this scale can use for measuring delinquent behavior, and hope to make a contribution to screening test and prevention of juvenile delinquency in Korea.

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Mechanisms of Insulinotropic Effect of YHB-2017 [Genistein] Isolated from fermentation Broths of Streptomyces sp. (방선균에서 유래한 YHB-2017 [Genistein]의 인슐린 분비 촉진 작용 기전)

  • Kwag, Won-Jae;Park, You-Hoi;Park, Jun-Chul;Lee, Byung-Kyu;Kang, Yup;Choe, Tae-Boo
    • KSBB Journal
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    • v.21 no.6 s.101
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    • pp.466-473
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    • 2006
  • Impaired insulin secretion from pancreatic beta-cells in response to glucose is an important feature in the pathology of non-insulin-dependent diabetes mellitus (NIDDM). In the course of screening for useful insulin secretagogues, we have isolated and identified YHB-2017 (Genistein) as a insulin secretion potentiator from fermentation broths of our in-house microbial library. The insulinotropic activity of YHB-2017 in isolated rat pancreatic islets was exerted only at high concentration of glucose (8.3-16 mM) but not at low concentration of glucose (3.3-5.5 mM). Also, in perifusion study with isolated rat pancreatic islets, YHB-2017 stimulated insulin secretion in a time-dependent manner when YHB-2017 was added to KRB buffer containing 16 mM glucose. In the presence of $200\;{\mu}M$ diazoxide and 35 mM KCI, which stimulates maximum $Ca^{2+}$ influx independently of KATP channel, YHB-2017 enhanced KATP channel-independent insulin secretion at high concentration glucose (16 mM). To elucidate the mechanisms of the glucose-dependent potentiation effect of YHB-2017, pharmacologic inhibitors for protein kinase A, protein kinase C and calcium/calmodulin kinase II were pre-treated and then the potentiation effect of YHB-2017 on insulin secretion was investigated. Pre-treatment of H89 as a PKA inhibitor had a significant inhibitory effect on YHB-2017-induced potentiation effect. Furthermore, western immunoblotting analyses revealed that YHB-2017 increased phosphorylation of PKA substrates and cAMP response element-binding protein (CREB) under high concentration of glucose. These results demonstrated that the insulinotropic effect of YHB-2017 is mediated through PKA signal pathway and activated amplifying $K_{ATP}$ channel-independent insulin secretion pathway.

Standardization and Reliability and Validity of the Korean Edition of Profile of Mood States(K-POMS) (한국판 기분상태척도(K-POMS)의 표준화와 신뢰도와 타당도 평가)

  • Kim, Eui-Joong;Lee, Sang-Ick;Jeong, Do-Un;Shin, Min-Sup;Yoon, In-Young
    • Sleep Medicine and Psychophysiology
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    • v.10 no.1
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    • pp.39-51
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    • 2003
  • Objectives: The Profile of Mood States (POMS) has been used broadly and frequently in various medical studies with various subjects. For the development and application of the Korean edition of POMS, called K-POMS, we translated POMS into Korean and then evaluated the reliability and validity of K-POMS. Methods: The subjects were 161 male students with a mean age of 18.1 years (15-30) and 244 female students with a mean age of 16.6 years (14-23). They were requested to perform K-POMS and SCL-90-R (Korean version) at the same time. Means, reliability coefficients, and test-retest correlations of K-POMS were calculated. Content validities, correlations with SCL-90-R, and discrimination validities in comparison with 76 depressive patients were obtained, and factor analyses were carried out. Results: Mean scores of Total Mood Disturbance (TMD) and some subscales (T, F, C, V factor) showed a significant difference between male and female students. The internal consistency coefficient ($\alpha$) of the total 65 items was 0.93, and ranged from 0.67 to 0.90 for subscales. Test-retest correlations of 43 subjects ranged from 0.27 to 0.63. Seven psychiatrists rated the properness of the content of each item as more than moderate degree (mean scale points=2.66, in the range of 0 to 4). Every subscale of KPOMS exhibited significant correlation with the matching subscale of SCL-90-R. Mean scores of K-POMS of the total 405 subjects were significantly different from those of the 76 depressive subjects after age correction. Six factors were extracted, accounting for 51.2% of total variance. Factor 6 consisted of 6 items which came from various subscales of POMS and represented "uncertainty and helplessness," which may be somewhat different to depression or sadness proper. Conclusion: The validity and reliability of K-POMS could be confirmed. The significant difference in K-POMS scores between depressive subjects and normal subjects suggests that K-POMS can be used clinically for the evaluation and screening of depression. The main structure of K-POMS is very similar to that of POMS, except the Confusion-Bewilderment factor which shows weak factor consistency in K-POMS. This may reflect some emotional characteristic of Koreans such as an undifferentiated aspect of cognitive efficiency. The sixth factor newly extracted from K-POMS also may be indicative of an unique emotional aspect of young Koreans.

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Clinical Features of Adolescent Tuberculosis: A Single Institute Study (단일기관에서 진단받은 청소년 결핵의 임상적 특징)

  • Hong, Sung Wan;Hong, Chan Eui;Lee, Dong Jean;Roh, Byung Hak
    • Pediatric Infection and Vaccine
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    • v.15 no.2
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    • pp.174-179
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    • 2008
  • Purpose : The purpose of this study was to investigate the clinical features of adolescent TB. Methods : We retrospectively reviewed the medical records of the adolescents aged 12 to 18 years and who are hospitalized with the diagnosis of TB at Dong Kang General Hospital between January 2003 and December 2007. Results : Of the 29 patients who were identified, 65.5% were male. The median age at diagnosis was 16.9 years (range: 12.1-18.9 years). A tuberculin skin test (TST) was performed for 6 patients (20.7%). Among them, 5 (5 of 8[62.5%]) in the 12-15 years age group (Group A) and 1 (1 of 21[4.8%]) in the 16-18 years of age group (Group B) were TST positive, which showed that the TST performing rate decreased with age (P<0.01). Twenty-five patients (86.2%) were detected by evaluating the clinical symptoms that suggested TB and 4 patients (13.8%) were detected by screening, but no cases were detected by contact tracing. Twenty patients (69.0%) had isolated pulmonary disease. Seven patients (24.1%) had pulmonary and extrapulmonary disease and 2 patients (6.9%) had exclusively extrapulmonary disease. Most patients presented with multiple symptoms, and the most common were cough (79.3%), fever (75.9%), sputum (65.8%) and chest pain (34.5%). M. tuberculosis was isolated from the sputum of 20 patients (69.0%). The culture-positive rate increased with age (range: 62.5% in Group A to 71.4% in Group B), but the difference between the groups was not significant. Cavitary lesions were found 13 patients (44.8%). The cavitary lesion rate increased with age (range: 25.0% in Group A to 52.4% in Group B), but the difference between the groups was not significant. Four patients (13.8%) were lost during follow-up. One patient (6.9%) relapsed. Conclusion : Clinicians need to be aware of the unique features of adolescent TB, and they also need awareness of the importance of TST and contact investigation for an adult suspected of having TB for making the diagnosis of TB.

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