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어레이 압저항 센서를 활용한 체질맥 임상연구 (Clinical Study on the Sasang Constitutional Pulse Using Array Piezoresistive Sensor)

  • 이시우;주종천;김경요;김종열
    • 사상체질의학회지
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    • 제18권1호
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    • pp.118-131
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    • 2006
  • 1. Objective Pulse diagnosis is generally applied to Traditional Oriental Medicine but not to Sasang Constitution diagnosis. Recently new pulse analyzer using array piezoresistive sensor and multi-channel robot arm developed. It reflects Oriental Medical Doctors' diagnostic processes, and its reproducibility test was done at Korea Institute of Oriental Medicine. We performed this study to set parameters diagnosing Sasang Constitution. 2. Methods One hundred thirty three subjects participated in this study. They are healty and approved this study. Before being tested with pulse analyzer, they had interview with Sasang Constitution Specialist to diagnose their Sasang Constitution. We established some useful parameters from parameters of pulse analyzer according to the Original Texts of Oriental Medicine and clinical experiences to analyze with clinical data of this study. 3. Results (I) There is a significant difference in pre-dicrotic notch time among all parameters of pulse analyzer in Sasang Constitution groups(P=0.047). (2) There is a significant difference in maximum pulse pressure in 33 to 48 year Sasang Constitution groups(P=0.010). (3) There is a significant difference in frequency width in 17 to 32 year Sasang Constitution groups(P=0.002). (4) There is a significant difference in CFS value in groups which OMD diagnoses; Floating & Sinking pulse(P=0.020). (5) There is a significant difference in pulse rate in groups which OMD diagnoses; Rapid & Slow pulse(P=0.000). (6) There is a significant difference in maximum pulse pressure in groups which OMD diagnoses; Deficient & Solid pulse(P=0.000). 4. Conclusions Analyzing parameters in each Sasang Constitution group, we found it shows significant difference in maximum pulse pressure and corresponding tendency in coefficient of floating & sinking pulse with theories of Sasang Consti-tutional Medicine. As we accumulate more clinical data, we will establish algorithm to diagnose Sasang Constitution using a pulse analyzer.

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Charlson 동반질환의 ICD-10 알고리즘 예측력 비교연구 (Comparative Study on Three Algorithms of the ICD-10 Charlson Comorbidity Index with Myocardial Infarction Patients)

  • 김경훈
    • Journal of Preventive Medicine and Public Health
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    • 제43권1호
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    • pp.42-49
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    • 2010
  • Objectives: To compare the performance of three International Statistical Classification of Diseases, 10th Revision translations of the Charlson comorbidities when predicting in-hospital among patients with myocardial infarction (MI). Methods: MI patients ${\geq}20$ years of age with the first admission during 2006 were identified(n=20,280). Charlson comorbidities were drawn from Heath Insurance Claims Data managed by Health Insurance Review and Assessment Service in Korea. Comparisions for various conditions included (a) three algorithms (Halfon, Sundararajan, and Quan algorithms), (b) lookback periods (1-, 3- and 5-years), (c) data range (admission data, admission and ambulatory data), and (d) diagnosis range (primary diagnosis and first secondary diagnoses, all diagnoses). The performance of each procedure was measured with the c-statistic derived from multiple logistic regression adjusted for age, sex, admission type and Charlson comorbidity index. A bootstrapping procedure was done to determine the approximate 95% confidence interval. Results: Among the 20,280 patients, the mean age was 63.3 years, 67.8% were men and 7.1% died while hospitalized. The Quan and Sundararajan algorithms produced higher prevalences than the Halfon algorithm. The c-statistic of the Quan algorithm was slightly higher, but not significantly different, than that of other two algorithms under all conditions. There was no evidence that on longer lookback periods, additional data, and diagnoses improved the predictive ability. Conclusions: In health services study of MI patients using Health Insurance Claims Data, the present results suggest that the Quan Algorithm using a 1-year lookback involving primary diagnosis and the first secondary diagnosis is adequate in predicting in-hospital mortality.

응급실을 경유하여 입원한 자살시도자들의 분석 -정신병력, 자살시도력 및 정신과적 진단을 중심으로- (Analyses of Suicide Victims Admitted via the Emergency Department -Based on Psychiatric Histories, Past Suicidal Attempts and Psychiatric Diagnoses-)

  • 허재민;전우찬;민영기;정윤석
    • 대한임상독성학회지
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    • 제2권2호
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    • pp.106-115
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    • 2004
  • Purpose: This study analyzed the general features, psychiatric histories, past suicidal attempts and psychiatric diagnoses of suicide victims admitted via the emergency department (ED). Methods: Reviewing the charts of 138 inpatients of suicide attempts admitted via the ED from January 2002 to December 2003, we analyzed various data, including sex, age, season, stressful events, psychiatric histories, previous suicidal attempts, and psychiatric diagnoses during admission, and we used a chi-square test to chart the statistical data. Results: A significant difference was found between 1 st attempts and repeated attempts as to the mechanical methods used for the suicide attempts, There was a significant difference in the kinds of drugs between patients with and without psychiatric histories. In the psychiatric diagnosis, there was a significant difference in AXIS I between patients with and without psychiatric histories. In AXIS II, there was a significant difference between patients with and without psychiatric histories, 1st attempts and repeated attempts. Conclusion: We emphasize the importance of psychiatric consults, treatments, and follow-ups for suicide victims and the emergency physicians' function in helping them to contact psychiatric doctors.

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수기 액상세포검사를 이용한 자궁목 세포진 검사의 임상적 효용성: 고식적 세포진 검사와의 비교 (Clinical Efficacy of Manual Liquid-Based Cervicovaginal Cytology Preparation: Comparative Study with Conventional Papanicolaou Test)

  • 박종명;이종기;서인수
    • 대한세포병리학회지
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    • 제16권1호
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    • pp.10-17
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    • 2005
  • This study was performed to compare manual liquid-based preparation with conventional Papanicolaou tests in view of the cytologic diagnoses and specimen adequacy. The specimens of 5,979 women from 33 local clinics and 1 general hospital were prepared by both manual liquid-based preparation and conventional Papanicolaou test. The cytologic diagnoses and specimen adequacy were evaluated in Department of Fathology in Kyoungpook National University School of Medicine. A conventional Papanicolaou test was always prepared first, after that residual material on the sampling device was rinsed into a liquid preservative, and then thin-layer slides were prepared using manual method of liquid-based cervicovaginal cytology. Conventional and liquid-based slides were read independently, and cytologic diagnoses and specimen adequacy were classified using the Bethesda System. Of the cases, 5,763 (96.3%,) had the same interpretation, and there was no significant diagnostic difference in 5,853 (97.8%) cases. When evaluating cases with more than one diagnostic class difference, the manual liquid-based preparation demonstrated a statistically significant overall improvement (2.1%) in the detection of squamous intraepithelial lesion and invasive cancer. Using manual method of liquid-based preparation, there was 14.1%, reduction in unsatisfactory slides through excellent cellular presentation. In conclusion, the manual liquid-based preparation produces standardized quality, superior sensitivity and improved adequacy as compared to the conventional method.

유방 병변 256례의 세침흡인 세포학적 진단 및 조직학적 진단과의 비교연구 (Comparison of Fine Needle Aspiration Cytologic Diagnoses and Histologic Diagnoses in 256 Breast Lesions)

  • 강미선;정수진;윤혜경
    • 대한세포병리학회지
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    • 제8권2호
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    • pp.120-128
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    • 1997
  • Fine needle aspiration cytology of breast lesion is well known as a simple, economic and effective diagnostic modality. For the evaluation of cytohistologic correlation, 256 cases of cytologic smears and subsequent histologic sections during 2-year period from Jan. 1995 to Dec. 1996 were reviewed. 1. Fifteen cases(5.9%) were proven as insufficient for evaluation, and 13 of them were fibrocystic change histologically. One case of carcinoma exhibiting sufficient amount of aspirates with no malignant cells on smear was regarded as inadequate. 2. Cytohistologic correlation of 240 cases revealed sensitivity 87.0%, specificity 100.0%, positive predictive value 100.0%, negative predictive value 97.0%, false positive rate 0.0% and false negative rate 13.0%. Total diagnostic accuracy is 95.7%. 3. Total 6 cases of negative were due to small amount of aspirates containing scantiness of malignant cells in two and underestimation in four. 4. Diagnostic concordance rates of fibrocystic change and fibroadenoma were 95.5% and 80.0%, respectively. Diagnostic discrepancies were noted in 7 cases of fibrocystic change and 6 cases of fibroadenoma, however, cytologic discrimination of two entities was not easy in seven of them. 5. In a case of phyllodes tumor and a case of duct ectasia, the discrepancy was due to targeting error. Other three cases(lymphoma, adenomyoepithelioma and granulomatous mastitis) were misinterpreted because of poor acquaintance with those entities. Diagnostic accuracy of fine needle aspiration cytology of breast lesions are relatively high. However, good technique on aspiration and adequate interpretation are necessary to reduce the false negative rate and the discrepancy between cytologic and histologic diagnoses.

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Assessment and Clinical Significance of Haematuria in Malaysian Patients - Relevance to Early Cancer Diagnosis

  • Ng, Keng Lim;Htun, Thi Ha;Dublin, Norman;Ong, Teng Aik;Razack, Azad Hassan
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권6호
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    • pp.2515-2518
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    • 2012
  • Aim: To study the causes and significance of both microscopic and macroscopic haematuria in adult patients and assess possible relevance to early detection of urological cancers. Methods: 417 patients presenting with haematuria were assessed in our Urology Unit. Following confirmation of haematuria, these patients were subjected to imaging techniques and flexible cystoscopy. Parameters analysed included clinical characteristics, imaging results, flexible cystoscopy findings, time delay to diagnoses and eventual treatment and final diagnoses of all cases. Results: 390 haematuria cases were analysed from 417 consecutive patients with haematuria. After 27 cases were excluded as they had previous history, 245 microscopic and 145 macroscopic. Age range was 17 to 95 years old with predominance of 152 females to 239 males. The racial distribution included 180 Chinese, 100 Indians,95 Malays and 15 other races. The final diagnoses were benign prostatic hyperplasia (22.6%), no cause found (22.3%), other causes (18.7%), urolithiasis (11.5%), urinary tract infection UTI (10.8%), non specific cystitis (10.3%), bladder tumours (2.8%) and other genitourinary tumours (1%). 11 new cases (2.8%) of bladder cancers were diagnosed, with a mean age of 59 years. Only 3 of 245 (1.2%) patients with microscopic haematuria had newly diagnosed bladder tumour compared with 8 of 145 (5.5%) patients with frank haematuria (p=0.016). Mean time taken from onset of symptoms to diagnosis of bladder cancer was 53.3 days with definitive treatment (TURBT) in 20.1 days from diagnosis. Conclusion:- This study has highlighted the common causes of haematuria in our local setting. We recommend that full and appropriate investigations be carried out on patients with frank haematuria especially those above 50 years old in order to provide earlier detection and prompt management of bladder diseases especially tumours.

소아정신과 입원환자의 공존질병(Comorbidity) (COMORBIDITY OF CHILD AND ADOLESCENT INPATIENTS)

  • 신윤오;조수철;홍강의;김자성
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제4권1호
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    • pp.91-97
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    • 1993
  • 본 논문의 목적은 소아정신과 입원환자에서 진단의 공존질병이 어느정도인지를 알아보기 위한 예비적 조사이다. 평균나이 12세인 56명의 입원환자를 대상으로 DSM-III-R에 의한 공존질병을 조사결과 64.3%에서 2개 이상의 진단이 있었으며 평균 2개의 진단이 있었다. 주의력결핍과잉운동장애, 품행장애, 반항장애, 정신분열증, 기분장애, 틱장애, 배설장애, 정신지체, 인격장애 9개의 진단군으로 나누어 조사하여 상당수에서 공존질병이 있었으며 특히 틱장애, 배설장애, 파탄적행동장애에서 평균진단 수 20개 보다 많았다. 앞으로의 연구에서 대상 군의 수를 늘려 공존질병을 조사하고 아울러 새로운 진단분류의 가능성에 대해서도 고려해야 될 것이다.

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일 시설노인에게 나타난 주요 간호진단의 관련요인 분석 (An Analysis of Related Factors for Major Nursing Diagnoses Identified for Instituionalized Elders)

  • 허혜경;박소미;김기연;신윤희;임은실
    • 성인간호학회지
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    • 제15권1호
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    • pp.126-136
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    • 2003
  • Purpose: The purpose of this study was to analyze related factors for major nursing diagnoses used in caring for institutionalized elders. Method: This study was a descriptive study. The participants were 92 residents in a long-term care facility in Wonju, selected by convenience sampling. The instrument was a checklist designed on the basis of the related factors suggested by NANDA (1997) and a literature review. Data was collected by chart review, observation, and interviews with the participants. Data was analyzed using descriptive statistics with the SPSS WIN program. Result: The most frequent nursing diagnosis was 'risk for injury', 'self-esteem disturbance', 'activity intolerance', 'impaired phyical mobility', and 'powerlessness'. The most frequent component for related factors for the five component for each nursing diagnosis was the physical component, followed by the social component. Common related factors for the nursing diagnoses were 'pain', 'change of emotional state/disorder', 'cognitive disorder', 'change of physical structure and function', and 'physical impairment', and 'immobility'. Conclusion: The results of this study can contribute to the development of appropriate nursing intervention programs for elders (eg. 'Injury Prevention Programs', 'Self-esteem Improvement Programs' etc.). Clinical guidelines that gerontological nurses can use to accurately assess health problems and select appropriate nursing interventions may be developed.

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