• 제목/요약/키워드: Primary screening test

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Genetic testing in clinical pediatric practice

  • Yoo, Han Wook
    • Clinical and Experimental Pediatrics
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    • 제53권3호
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    • pp.273-285
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    • 2010
  • Completion of the human genome project has allowed a deeper understanding of molecular pathophysiology and has provided invaluable genomic information for the diagnosis of genetic disorders. Advent of new technologies has lead to an explosion in genetic testing. However, this overwhelming stream of genetic information often misleads physicians and patients into a misguided faith in the power of genetic testing. Moreover, genetic testing raises a number of ethical, legal, and social issues. Diagnostic genetic tests can be divided into three primary but overlapping categories: cytogenetic studies (including routine karyotyping, high-resolution karyotyping, and fluorescent in situ hybridization studies), biochemical tests, and DNA-based diagnostic tests. DNA-based testing has grown rapidly over the past decade and includes preandpostnatal testing for the diagnosis of genetic diseases, testing for carriers of genetic diseases, genetic testing for susceptibility to common non-genetic diseases, and screening for common genetic diseases in a particular population. Theoretically, once a gene's structure, function, and association with a disease are well established, the clinical application of genetic testing should be feasible. However, for routine applications in a clinical setting, such tests must satisfy a number of criteria. These criteria include an acceptable degree of clinical and analytical validity, support of a quality assurance program, possibility of modifying the course of the diagnosed disease with treatment, inclusion of pre-and postnatal genetic counseling, and determination of whether the proposed test satisfies cost-benefit criteria and should replace or complement traditional tests. In the near future, the application of genetic testing to common diseases is expected to expand and will likely be extended to include individual pharmacogenetic assessments.

2020년 한국 보건의료의 상대적 위치와 추이: 경제협력개발기구 국가와 비교 (Position Value for Relative Comparison of Healthcare Status of Korea in 2020)

  • 박유신;박민아;박은철
    • 보건행정학회지
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    • 제33권2호
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    • pp.203-213
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    • 2023
  • This study examined the trend of healthcare status and compared the status of South Korea and other member of the Organization for Economic Cooperation and Development (OECD) using the OECD health statistics 2022. We used the OECD health statistics from 2022 and a position value for relative comparison (PARC) index to compare the five elements of the healthcare system. The study also used a Mann-Kendall test to analyze the trend of the PARC values from 2000 to the present year. The findings of the study indicate that many South Korea's PARC values were higher than the OECD median. But practicing physician in supply part and medical cost were lower than OECD median but the trend significantly increased. Medical accessibility part and quality of care part except primary care, and mental health had a high relative position but the trend did not increased significantly. After outbreak of coronavirus disease 2019, there were changes in medical accessibility. Health screening and vaccinations showed an overall decline in 2020 compared to 2019. These results suggest that policymakers need to take necessary steps for a sustainable healthcare system in the country.

Creatine Kinase (CK)-MB-to-Total-CK Ratio: a Laboratory Indicator for Primary Cancer Screening

  • Chang, Chih-Chun;Liou, Ching-Biau;Su, Ming-Jang;Lee, Yi-Chen;Liang, Chai-Ting;Ho, Jung-Li;Tsai, Huang-Wen;Yen, Tzung-Hai;Chu, Fang-Yeh
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6599-6603
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    • 2015
  • Background: For the determination of creatine kinase (CK)-MB, the immunoinhibition method is utilized most commonly. However, the estimated CK-MB activity may be influenced by the presence of CK isoenzymes in some conditions like cancer. Thus, a CK-MB-to-total-CK ratio more than 1.0 could be found in such a situation. The study aimed to explore the relationship of cancer to high CK-MB-to-total-CK ratio. Materials and Methods: From January 2011 to December 2014, laboratory data on all CK-MB and total CK test requests were extracted at Far Eastern Memorial Hospital (88,415 requests). Patients with a CK-MB-to-total-CK ratio more than 1.0 were registered in this study. Clinical data including tumor location, tumor TNM stage and metastatic status were also collected. Results: A total of 846 patients were identified with a CK-MB-to-total-CK ratio more than 1.0. Of these, 339 (40.1%) were diagnosed with malignancies. The mean CK-MB-to-total-CK ratio was significantly higher in malignancy than in non-malignancy ($1.35{\pm}0.28$ vs $1.25{\pm}0.23$, p<0.001) groups. The most frequent malignancy with a CK-MB-to-total-CK ratio more than 1.0 was colorectal cancer ($1.42{\pm}0.28$, 16.5%, n=56), followed by lung cancer ($1.38{\pm}0.24$, 15.9%, n=54) and hepatocellular carcinoma (14.5%, n=49). Higher CK-MB-to-total-CK ratios in hematological malignancies ($1.44{\pm}0.41$)were also noted. Additionally, the CK-MB-to-total-CK ratio was markedly higher in advanced stage malignancy than in early stage ($1.37{\pm}0.26$ vs. $1.29{\pm}0.31$, p=0.014) and significantly higher in liver metastasis than in non-liver metastasis ($1.48{\pm}0.30$ vs. $1.30{\pm}0.21$, p<0.001). Conclusions: The CK-MB-to-total-CK ratio is an easily available indicator and could be clinically utilized as a primary screening tool for cancer. Higher ratio of CK-MB-to-total-CK was specifically associated with certain malignancies, like colorectal cancer, lung cancer and hepatocellular carcinoma, as well as some cancer-associated status factors such as advanced stage and liver metastasis.

Fluorescence-in-situ-hybridization in the Surveillance of Urothelial Cancers: Can Use of Cystoscopy or Ureteroscopy be Deferred?

  • Ho, Christopher Chee Kong;Tan, Wei Phin;Pathmanathan, Rajadurai;Tan, Wei Keith;Tan, Hui Meng
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권7호
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    • pp.4057-4059
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    • 2013
  • Background: Fluorescence in situ hybridization (FISH) testing may be useful to screen for bladder carcinoma or dysplasia by detecting aneuploidy chromosomes 3, 7, 17 and deletion of the chromosome 9p21 locus in urine specimens. This study aimed to assess the sensitivity, specificity, positive and negative predictive value of FISH in a multi-ethnic population in Asia. Materials and Methods: Patients with haematuria and/or past history of urothelial cancer on follow-up had their voided urine tested with FISH. Patients then underwent cystoscopy/ureteroscopy and any lesions seen were biopsied. The histopathological reports of the bladder or ureteroscopic mucosal biopsies were then compared with the FISH test results. Results: Two hundred sixty patients were recruited. The sensitivity and specificity of the FISH test was 89.2% and 83.4% respectively. The positive (PPV) and negative predictive values (NPV) were 47.1% and 97.9%. By excluding patients who had positive deletion of chromosome 9, the overall results of the screening test improved: sensitivity 84.6%; specificity 96.4%; PPV 75.9% and NPV 97.9%. Conclusions: UroVysion FISH has a high specificity of detecting urothelial cancer or dysplasia when deletion of chromosome 9 is excluded. Negative UroVysion FISH-tests may allow us to conserve health resources and minimize trauma by deferring cystoscopic or ureteroscopic examination.

Development of a Risk Index for Prediction of Abnormal Pap Test Results in Serbia

  • Vukovic, Dejana;Antic, Ljiljana;Vasiljevic, Mladenko;Antic, Dragan;Matejic, Bojana
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권8호
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    • pp.3527-3531
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    • 2015
  • Background: Serbia is one of the countries with highest incidence and mortality rates for cervical cancer in Central and South Eastern Europe. Introducing a risk index could provide a powerful means for targeting groups at high likelihood of having an abnormal cervical smear and increase efficiency of screening. The aim of the present study was to create and assess validity ofa index for prediction of an abnormal Pap test result. Materials and Methods: The study population was drawn from patients attending Departments for Women's Health in two primary health care centers in Serbia. Out of 525 respondents 350 were randomly selected and data obtained from them were used as the index creation dataset. Data obtained from the remaining 175 were used as an index validation data set. Results: Age at first intercourse under 18, more than 4 sexual partners, history of STD and multiparity were attributed statistical weights 16, 15, 14 and 13, respectively. The distribution of index scores in index-creation data set showed that most respondents had a score 0 (54.9%). In the index-creation dataset mean index score was 10.3 (SD-13.8), and in the validation dataset the mean was 9.1 (SD=13.2). Conclusions: The advantage of such scoring system is that it is simple, consisting of only four elements, so it could be applied to identify women with high risk for cervical cancer that would be referred for further examination.

탄력밴드저항운동이 노인의 균형 능력 향상에 미치는 영향 (Effects of Elastic Band Resistance Exercise on Improving the Balance Ability in the Elderly)

  • 김건;김수현;서삼기;윤희종;김태열
    • The Journal of Korean Physical Therapy
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    • 제20권2호
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    • pp.1-10
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    • 2008
  • Purpose: This study examines the effects of elastic band of resistance exercise for balance control of the elderly. Methods: Thirty of eighty participants in experiment subjects who demonstrated balance-impairment through the use of primary screening tests including the one leg standing test (OLST), functional reach test (FRT) and timed up and go (TUG) were selected as subjects. Fifteen subjects that underwent muscle-strengthening exercise using an elastic band were selected as the exercise group and fifteen subjects were selected as a control group. Subjects undertook a home-based exercise program three times per week for 9 weeks. Muscle strength, functional assessment and a balance test were quantitatively measured before and after the exercise regimen. Results: After muscle strengthening exercises, changes in maximal voluntary isometric contraction (MVIC) showed a significant increase in all of the lower extremity muscles of the exercise group subjects. There were statistically significant differences between the exercise and control groups for changes in the OLST, FRT and TUG, which are functional assessments of balance ability, and changes of the unit path length and circumference area, measurement items of quantitative analysis. In addition, from examining correlations between MVIC, balance ability, it was found that an increase of muscle strength in the hip joint group of muscles among the lower extremity muscles had greater improvement in correlation with balance ability in this elderly population. Conclusion: Resistance exercise using elastic bands had significant effects on muscle strengthening in elderly subjects, with a resultant increase of lower extremity muscle strength with significant improvement of balance ability.

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Screening of Endophytic Fungal Isolates Against Raffaelea quercus-mongolicae Causing Oak Wilt Disease in Korea

  • Nguyen, Manh Ha;Yong, Joo Hyun;Sung, Han Jung;Lee, Jong Kyu
    • Mycobiology
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    • 제48권6호
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    • pp.484-494
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    • 2020
  • Oak wilt disease caused by Raffaelea quercus-mongolicae has emerged obviously in Korea. We selected antifungal isolates against R. quercus-mongolicae among 368 endophytic fungal isolates from different parts of oak and pine trees. The experiment was conducted in the primary and secondary screenings by dual culture test. The antifungal activity of the selected isolates was assessed in culture filtrate test based on the inhibition rates in mycelial growth, sporulation, and spore germination of oak wilt fungus. Five isolates, E089, E199, E282, E409 and E415, showed strong antifungal activity in culture filtrate test, and their antifungal activity decreased on the culture media supplemented with heated culture filtrate. Higher mycelial growth inhibitions on the unheated media were recorded in E409 (Colletotrichum acutatum), E089 (Daldinia childiae), E415 (Alternaria alternata) and E199 (Daldinia childiae) with the inhibition rates of 79.0%, 70.1%, 68.9% and 64.5%, respectively. These isolates also had the higher sporulation inhibitions on unheated media with the rates of 96.8%, 84.2%, 82.8% and 80.5%, respectively. The spore germination of the oak wilt fungus was completely inhibited by E282 (Nectria balsamea) on both unheated and heated media. These results showed that a higher number of potent antifungal isolates against oak wilt fungus was isolated from the petiole compared to the other parts. This study could contribute to the development of biological control approaches for the management of oak wilt disease caused by R. quercus-mongolicae.

Survival Rates of Cervical Cancer Patients in Malaysia

  • Muhamad, Nor Asiah;Kamaluddin, Muhammad Amir;Adon, Mohd Yusoff;Noh, Mohamed Asyraf;Bakhtiar, Mohammed Faizal;Tamim, Nor Saleha Ibrahim;Mahmud, Siti Haniza;Aris, Tahir
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권7호
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    • pp.3067-3072
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    • 2015
  • Cervical cancer is the most common malignant cancer of the female reproductive organs worldwide. Currently, cervical cancer can be prevented by vaccination and detected at an early stage via various screening methods. Malaysia, as a developing country faces a heavy disease burden of cervical cancer as it is the second most common cancer among Malaysian women. This population based study was carried out to fulfil the primary aim of determining the survival rates of Malaysian women with cervical cancer and associated factors. Data were obtained from two different sources namely, the Malaysian National Cancer Registry (MNCR) and National Health Informatics Centre (NHIC) from 1st January 2000 to 31st December 2005. Kaplan Meier analyses were conducted to identify the overall survival rates and median survival time. Differences in survival among different ethnic and age group were compared using the log-rank test. A total of 5,859 patients were included. The median survival time for cervical cancer in this study was 65.8 months and the 5-year survival rate was 71.1%. The overall observed survival rates at 1, 3 and 5 years were 94.1%, 79.3% and 71.1% respectively. The log-rank test finding also showed that there were significant differences in the 5-year survival rate among different ethnic groups. Malays had the lowest survival rate of 59.2% followed by Indians (69.5%) and Chinese (73.8%). The overall 5-year survival rate among patients with cervical cancer in Malaysia is relatively good. Age and ethnic groups remain as significant determining factors for cervical cancer survival rate.

국민학교(國民學校) 과학영재(科學英才) 선발(選拔) 준거(準據)에 관(關)한 연구(硏究) (A Study on the Selection Criteria of Science Gifted Children)

  • 서형두;정완호
    • 한국과학교육학회지
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    • 제13권2호
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    • pp.172-186
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    • 1993
  • This stady was carried out to define Gifted student for science, model for selection, the tools and methods and related theory for the selection of the Gifted students for the science in primary school level. Also the developed tools and materials are applied to student and analysed the results to generalize the methods for the selection of Gifted students for science. The definition of Gifted students for science was carried out by the three-ring conception model by Renzulli(1982) and Lee long-Sung which defined the characteristics as three parts such as above average ability, creativity and tesk comitment. The Gifted students for science upper 2 percent which have three characteristics at the same times, namely overlapping three characteristics. The model for the selection of Gifted students consist of four step; such as screeing, selection,differentiation, judgement. The materials for the selection are input at each stage, analysed the results and standard for the selection are made. In the first stage screening, 202 students are selected from the 5060 of 4th and 5th graders according to their achievment, intellecture ability and observation of students activity. In second selection and third differentiation stage, 65 students are seletted according to their achievement In this study it is approved that the Gifted students in science have to be selection by various test such as achievement, intellectual ability, aptitude in science, inquiry activity, manual skill etc, rather rather then simple test such as achievement and intellecture ability. Also it is important to select upper 2 percent who have general abilites overlapping three characteristics mentioned in definition of Gifted students in science and selections model

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항경련제 Vigabatrin이 시야에 미치는 영향 (Assessment of the Relationship between Vigabatrin and Visual Field Defect in Children)

  • 정사준;정용환;조의현
    • Clinical and Experimental Pediatrics
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    • 제45권12호
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    • pp.1546-1550
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    • 2002
  • 목 적: 본 저자들은 VGB과 시야결손과의 관련성을 알기 위해 본 연구를 시행하였다. 방 법: 간질로 진단 받고 VGB을 추가 복용으로 치료를 시행한 환아 중 발달 연령이나 인지 연령이 8세 이상인 환아 78명을 대상으로 하였다. 시야검사는 Humphrey 자동 시야측정계로 시행한 후 결과가 의심이 되면 Goldman 시야측정계로 검사를 즉시 다시 시행하였으며, 이들은 다시 6개월 후에 재검을 실시하였다. 결 과 : 본 연구에서는 78명 중 5명에게 의증이 있었으나 재검시 다시 정상으로 나와 시야결손이 있는 환아는 없었다. 결 론: 본 조사에서 VGB은 시야결손을 일으키는 약물로 나타나지는 않았다. VGB의 시야결손으로 사용에 제한을 두기보다 다른 약으로 조절이 되지 않는 부분발작과 영아연축의 치료에 초기 선택 약물로 조심스럽게 사용하면 무방할 것으로 생각되어진다. 이와 함께 시야결손의 선별검사가 추천되며, VGB을 복용하는 소아에게 있어 정기적인 검사가 필요하겠다.