• The Korean Society of Law and Medicine
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• v.17 no.2
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• pp.85-124
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• 2016

The Human gene testing act (GenDG) in Germany starts from the characteristic features of gene testing, i.e. dualisting structure consisted of anlaysis on the one side and the interpretation on the other side. The linguistic distincion of 'testing', 'anlaysis' and 'judgment' in the act is a fine example. Another important basis of the regulation is the ideological purpose of the law, that is information autonomy. The normative texts as such and the founding principle are the basis of the classification of testing types. Especially in the case of gene testing for medical purpose is classified into testing for diagnostic purpose and predictive purpose. However, those two types are not always clearly differentiated because the predictive value of testing is common in both types. In the legal regulation of gene testing it is therefore important to manage the uncertainty and subjectivity which are inherent in the gene-analysis and the judgment. In GenDG the system ensuring the quality of analysis is set up and GEKO(Commity for gene tisting) based on the section 23 of GenDG concretes the criterium of validity through guidelines. It is also very important in the case of gene testing for medical purpose to set up the system for ensurement of procedural rationality of the interpretation. The interpretation of the results of analysis has a wide spectrum because of the consistent development of technology on the one side and different understandings of different subjects who performs gene testings. Therefore the process should include the communication process for patients in oder that he or she could understand the meaning of gene testing and make plans of life. In GenDG the process of genetic counselling and GEKO concretes the regulation very precisely. The regulation as such in GenDG seems to be very suggestive to Korean legal polic concerning the gene testing.

• The Korean Journal of Nuclear Medicine
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• v.32 no.2
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• pp.143-150
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• 1998

Purpose: T1-201 SPECT has been used in differentiating benign and malignant pulmonary lesions. While its sensitivity may be high, the specificity and predictive values are reported to be variable depending on the type of benign lung lesion. The purpose of this study was to prospectively assess the efficacy of T1-201 SPECT for differentiating benign and malignant single pulmonary lesion in a population with a high prevalence of benign pulmonary lesion, especially, tuberculosis. Materials and Methods: One-hundred thirty-three patients, having 89 malignant and 44 benign lesions(23 active tuberculosis, 5 inactive tuberculosis, 3 aspergil-loma, 3 focal pneumonia, 2 thymoma, and 8 others), were imaged using a dual-headed system at 15 minute(early) and 3 hour (delayed) following administration of 111MBq T1-201. The images were read visually and lesion-to-background ratios(L/B) were obtained from transverse tomographic slices. Retention index was expressed as [(delayed L/B- early L/B) $\div$ early L/B]. Results: 82/89(92%) and 83/89(93%) of the malignant lesions were visually positive on the early and delayed images, and 27/44(61%) and 26/44(59%) of the benign lesions were also visually positive on both images. Although a statistically significant difference was found between the mean L/B's of the malignant and benign lesions, L/B was not useful for differentiating the two due to a large overlap. There was no difference in retention indices. Conclusion: Despite of its high sensitivity, the specificity of T1-201 SPECT was unacceptably low in patients with active benign lesions. The positive and negative predictive values for lung cancer in a population with a high prevalence of the benign single pulmonary lesion was only marginal.

• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.368-380
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• 1999

Purpose: The purpose of this study was to evaluate and compare the scintigraphic findings and diagnostic accuracy of double-phase Tc-99m sestamibi scan in primary and secondary hyperparathyroidism (HPT). Materials and Methods: We retrospectively reviewed 16 cases of primary (18 lesions) and 11 cases of secondary HPT (44 lesions) who underwent Tc-99m-sestamibi scan before the surgical intervention. Scan was performed using LEM camera (Siemens, Germany) after the injection of 740MBq of Tc-99m sestamibi. Routine image consisted of baseline and 3-hour delayed images and each image was obtained using both parallel and pine hole collimator. The study population was 27 patients (male/female=5/22, age: $49.1{\pm}10.8$). Results: Eighteen lesions of primary HPT consisted of 13 adenomas and S hyperplasias, while all lesions of secondary HPT were hyperplasias. Among the case of primary HPT, we could detect all the lesions of 13 adenomas but only 2 lesions of 5 hyperplasias (40%) could be detected by double phase scintigraphy. Three cases of primary lesion showed decreased uptake in delayed images compared with baseline. The sensitivity, specificity, positive predictive value and accuracy of primary and secondary HPT were 58.8% (10/17), 83.3% (10/12), 83.3% (10/12), 75.9% (22/29), and 37.5% (15/40), 50% (2/4), 88.2% (15/17), 38.6% (17/44), respectively. Overall sensitivity, specificity, positive predictive value and accuracy were 43.9% (25/57), 75% (12/16), 86.2% (25/29), and 53.4% (39/73). There were no statistical difference between the weight of primary and secondary HPT lesion (p>0.05). Conclusion: Tc-99m sestamibi scan is fairly good modality to detect parathyroid lesion in patient with primary HPT before the surgical intervention. However, since some of cases may reveal decreased uptake in delayed image, a careful attention to the findings of baseline images may be helpful. Still the low accuracy of sestamibi scan in diagnosis of secondary HPT prohibits routine use of it for this disease.

• Pediatric Infection and Vaccine
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• v.26 no.2
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• pp.81-88
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• 2019

Purpose: Early detection of Mycoplasma pneumoniae is important for appropriate antimicrobial therapy in children with pneumonia. This study aimed to evaluate the diagnostic value of a rapid antigen test kit in detecting M. pneumoniae from respiratory specimens in children with lower respiratory tract infection (LRTI). Methods: A total of 215 nasopharyngeal aspirates (NPAs) were selected from a pool of NPAs that had been obtained from children admitted for LRTI from August 2010 to August 2018. The specimens had been tested for M. pneumoniae by culture and stored at $-70^{\circ}C$ until use. Tests with Ribotest $Mycoplasma^{(R)}$ were performed and interpreted independently by two investigators who were blinded to the culture results. Results: Among the 215 NPAs, 119 were culture positive for M. pneumoniae and 96 were culture negative. Of the culture-positive specimens, 74 (62.2%) were positive for M. pneumoniae by Ribotest $Mycoplasma^{(R)}$, and 92 of the 96 (95.8%) culture-negative specimens were negative for M. pneumoniae by Ribotest $Mycoplasma^{(R)}$. When culture was used as the standard test, the sensitivity and specificity of Ribotest $Mycoplasma^{(R)}$ were 62.2% and 95.8%, respectively. Additionally, the positive predictive value, negative predictive value, and overall agreement rates with Ribotest $Mycoplasma^{(R)}$ were 94.9%, 67.2%, and 77.2%, respectively. Conclusions: A positive test result of Ribotest $Mycoplasma^{(R)}$ suggests a high likelihood of culture-positive M. pneumoniae infection. However, a negative test result should be interpreted with caution because nearly one-third of negative test results reveal culture-positive M. pneumoniae infections.

• Parasites, Hosts and Diseases
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• v.54 no.1
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• pp.75-80
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• 2016

This study explored epidemiological trends in trichomoniasis in Daegu, South Korea. Wet mount microscopy, PCR, and multiplex PCR were used to test for Trichomonas vaginalis in vaginal swab samples obtained from 621 women visiting 2 clinics in Daegu. Of the 621 women tested, microscopy detected T. vaginalis in 4 (0.6%) patients, PCR detected T. vaginalis in 19 (3.0%) patients, and multiplex PCR detected T. vaginalis in 12 (1.9%) patients. Testing via PCR demonstrated high sensitivity and high negative predictive value for T. vaginalis. Among the 19 women who tested positive for T. vaginalis according to PCR, 94.7% (18/19) reported vaginal signs and symptoms. Notably, more than 50% of T. vaginalis infections occurred in females younger than 30 years old, and 58% were unmarried. Multiplex PCR, which simultaneously detects pathogens from various sexually transmitted infections, revealed that 91.7% (11/12) of patients were infected with 2 or more pathogens. Mycoplasma hominis was the most prevalent co-infection pathogen with T. vaginalis, followed by Ureaplasma urealyticum and Chlamydia trachomatis. Our results indicate that PCR and multiplex PCR are the most sensitive tools for T. vaginalis diagnosis, rather than microscopy which has been routinely used to detect T. vaginalis infections in South Korea. Therefore, clinicians should take note of the high prevalence of T. vaginalis infections among adolescent and young women in order to prevent persistent infection and transmission of this disease.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.9
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• pp.3829-3849
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• 2014

Continued advances in the field of histo pathology (and cyto pathology) over the past two decades have resulted in dramatic changes in the manner in which these disciplines are now practiced. This is especially true in the setting of a large university hospital where the role of pathologists as clinicians (diagnosticians), undergraduate and postgraduate educators, and researchers has evolved considerably. The world around us has changed significantly during this period bringing about a considerable change in our lifestyles and the way we live. This is the world of the internet and the world-wide web, the world of Google and Wikipedia, of Youtube and Facebook where anyone can obtain any information one desires at the push of a button. The practice of histo (and cyto) pathology has also evolved in line with these changes. For those practicing this discipline in a poor, developing country these changes have been breathtaking. This is an attempt to document these changes as experienced by histo (and cyto) pathologists practicing in the biggest center for Histopathology in Pakistan, a developing country in South Asia with a large (180 million) and ever growing population. The Section of Histopathology, Department of Pathology and Microbiology at the Aga Khan University Hospital (AKUH) in Karachi, Pakistan's largest city has since its inception in the mid-1980s transformed the way histopathology is practiced in Pakistan by incorporating modern methods and rescuing histopathology in Pakistan from the primitive and outdated groove in which it was stuck for decades. It set histopathology in Pakistan firmly on the path of modernity and change which are essential for better patient management and care through accurate and complete diagnosis and more recently prognostic and predictive information as well.

• Journal of the Korea Society of Computer and Information
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• v.25 no.9
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• pp.37-44
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• 2020

AI technology has developed in the form of decision support technology in law, patent, finance and national defense and is applied to disease diagnosis and legal judgment. To search real-time information with Deep Learning, Big data Analysis and Deep Learning Algorithm are required. In this paper, we try to predict the entrance rate to high-ranking universities using a Deep Learning model, RNN(Recurrent Neural Network). First, we analyzed the current status of private academies in administrative districts and the number of students by age in administrative districts, and established a socially accepted hypothesis that students residing in areas with a high educational fever have a high rate of enrollment in high-ranking universities. This is to verify based on the data analyzed using the predicted hypothesis and the government's public data. The predictive model uses data from 2015 to 2017 to learn to predict the top enrollment rate, and the trained model predicts the top enrollment rate in 2018. A prediction experiment was performed using RNN, a Deep Learning model, for the high-ranking enrollment rate in the special education zone. In this paper, we define the correlation between the high-ranking enrollment rate by analyzing the household income and the participation rate of private education about the current status of private institutes in regions with high education fever and the effect on the number of students by age.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.1
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• pp.29-35
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• 2020

Objectives : Evidence regarding the association between untreated depression in adolescence and suicidal risk in male young adults is scarce. We aimed to assess the effect of untreated illness during adolescence on the suicidal risk and attempt after that first episode. Methods : As part of a cross-sectional study, between May 2017 and April 2018, a total of 260 patients with currently unipolar or bipolar depression were included in the final analysis. Multiple linear and logistic regression analysis were performed to evaluate the association between untreated mood disorder in adolescence and its effect on the suicidal risk and attempt. Results : In total 260 patients, 189 were classified as untreated group. The proportion of suicide attempts, total depression score, suicidal risk and number of suicide attempts were significantly higher in the untreated group. The most predictive factors of suicide attempts were history of untreated depression [Adjusted Odds Ratio (AOR)=4.19, 95% Confidence Interval (CI)=2.25-7.81, p<0.001] and diagnosis of bipolar depression (AOR=2.60, 95% CI=1.52-4.46, p<0.001). Conclusions : Although the untreated depression suggests higher rates of suicidality, a significant proportion (86.7%) of adolescent depression in this study did not receive psychiatric treatment. Future research should be needed to find better ways to decrease barriers in using mental health treatment and its contribution to reduction and prevention of adverse outcome.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.18 no.2
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• pp.75-84
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• 2014

Objectives Eyes, one of visual inspection regions, present important clues to pathological patterns including deficiency and excess patterns to the clinicians. The purpose of this study was to develop Eyes Inspection Questionnaire (EIQ) and to examine which items among the EIQ were more predictive of clinicians' determination for the deficiency and excess patterns. Methods Nine questionnaire items for Visual Inspection of Eyes were extracted through the literature review. These items were presented to the 4 Korean medical doctors who are specialized in visual inspection to conduct the Delphi method. The Korean medical doctors were asked to rate the importance of each items for the corresponding Visual Inspection of Eyes, using a Likert 5-point scale(the 3 points of importance as a cut-off point). Then, out of 75 photographs submitted to the Society of HyungSang Medicine in 2009, 30 portrait pictures were selected as samples. The samples were copied to make 60 sample pictures, and then randomly assigned to 4 clinicians. The 4 clinicians evaluated the 60 samples for excess and deficiency of the eyes and were asked to check the 6 questionnaire items. The results were recorded as 5-points-scale, and their average and standard deviations were calculated. Intra- class reliability test and multi regression test were performed using SPSS 13. Results Intra-class correlation coefficient (ICC) was between 0.750 to 0.841 (P<0.05). Indices for visual inspection of the eyes were: endowment of the bone structure around the eyes; brightness of the eyes; upward deviation of the eyes; eye shapes; and definition of iris. 76.92% of deficiency symptom patterns and 86.42% of the excess symptom patterns matched the patterns predicted by the visual inspection of the eyes, according to the frequency analysis. According to the multiple regression analysis, were significantly related to the excessive symptoms, and to the deficiency symptoms. Conclusion This study is the first attempt of development for checklist of excess and deficiency of Visual Inspection of Eyes and quantitative measurement of excess and deficiency using the Visual Inspection of Eyes by the visual inspection experts. Still, additional studies are needed regarding the relationship visual inspection methods have with existing standards of diagnosis.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.4
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• pp.304-311
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• 2016

The study was performed to examine the metabolic syndrome risk factors in accordance with the obesity types based on body mass index (BMI) and waist circumference cutoffs. The diagnosis of metabolic syndrome closely adhered to the NCEP-ATP III criteria, and obesity was defined using the WHO Asian-Pacific criteria. We used the data from 591 elderly women, all aged over 65 years. They were divided into four groups: The normal group (n=272), the obesity group (n=124), abdominal obesity group (n=19), and obesity-abdominal obesity group (n=176). The obesity-abdominal obesity group was the most prevalent group of low HDL-cholesterol (p=0.009), hypertriglyceridemia (p=0.025), abdominal obesity (p<0.001), and metabolic syndrome (p<0.001). Logistic regression analysis demonstrated that the obesity-abdominal obesity group had the highest odds ratio in predicting metabolic syndrome (OR: 10.638, 95% CI: 6.053~18.697). Therefore, the obesity-abdominal obesity group was the strongest predictive factor of metabolic syndrome risk in Korean elderly women.