• 동의신경정신과학회지
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• 제28권3호
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• pp.263-274
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• 2017

Objectives: To identify the current status of Korean medical practice pattern, diagnosis and treatment of dementia through recognition survey, and to use it as a preliminary data for various dementia research. Methods: Questionnaires were developed through expert meetings. The disease was defined as dementia and mild cognitive impairment, and areas were designated to practice pattern, diagnosis and treatment. From December 18, 2016-January 18, 2017, 221 respondents, including 36 neuropsychiatrists of Korean Medicine and 185 general physicians (including other medical specialists) were included. Results: 1. In both groups, the most commonly used KCD (Korean standard classification of disease and cause of death) were in the order of Unspecified Alzheimer's Dementia (F00.9), Mild Cognitive Impairment (F06.7), and Unspecified Dementia (F03). 2. The most commonly used pattern identification were zang-fu and qi-blood-yin-yang in both groups. 3. Diagnostic evaluation tools were mainly conducted by MMSE, radiologic examination, K-DRS, GDS and CDR in both groups. 4. Both groups reported using acupuncture and herbal medicine mainly. 5. In both groups, the acupuncture method was used extensively in the order of Body, Scalp, and Sa-Am. 6. Neuropsychiatrists used a variety of herbal medicines such as Wonjiseokchangpo-san (Yuanzhushichangpu-san), Yukmijihwang-tang (Liuweidihuang-tang), Palmijihwang-won (Baweidihuang-won), Sunghyangjungki-san (Xingxiang Zhengqi-san) and Ondam-tanggami (Wendan-tangjiawei). General physicians used a variety of herbal medicines such as Ondam-tanggami (Wendan-tangjiawei), Bojungikgi-tang (Buzhongyiqi-tang), Yukmijihwang-tang (Liuweidihuang-tang). 7. Neuropsychiatrists used a variety of Korean herbal preparation products (benefit and non-benefit) such as Ekgan-sangajinpibanha (Yigan-sanjiachenpibanxia), Yukmijihwang-tang (Liuweidihuang-tang), Jodeung-san (houteng-san), Palmijihwang-won (Baweidihuang-won). General physicians used a variety of Korean herbal preparation products such as Bojungikgi-tang (Buzhongyiqi-tang), Banhabaegchulcheonma-tang (banxiabaizhutianma-tang), Yukmijihwang-tang (Liuweidihuang-tang), Ekgan-sangajinpibanha (Yigan-sanjiachenpibanxia), Palmijihwang-won (Baweidihuang-won). Conclusions: By confirming awareness of Korean medical doctors treating dementia in clinical fields and understanding differences between neuropsychiatrists of Korean medicine and general physicians, it can be used to understand guideline users' needs and confirm clinical questions during development of future clinical practice guidelines for dementia.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2015년도 춘계학술대회
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• pp.383-387
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• 2015

현대인들의 불규칙한 생활과 서구화된 식습관에 의해 대장 및 직장 질환이 증가하고 있는 추세로, 특히 직장암은 전체 대장암의 50%를 차지하고 있다. 초기 직장암의 경우 표면으로 돌출되는 부분이 없으므로 초음파로 조직 내부를 보지 않으면 직장 농양으로 오진하는 오류를 범하기도 한다. 그러나 초음파 진단을 하더라도 직장암의 병기에 따라 농양과 육안으로 구별이 어려운 경우가 있기 때문에 보다 정확한 진단이 필요하다. 그러므로 본 연구에서는 직장암과 농양 영상에 대한 컴퓨터 알고리즘을 이용하여 정량적인 분석을 하였다. GLCM을 적용하여 정상 20증례와 농양, 직장암 각 20증례를 분석영역($50{\times}50$ 픽셀)으로 설정하고, 각 영상에서 Autocorrelation, Max probability, Sum average, Sum variance 4가지 파라미터를 비교하여 분석하였다. 결과적으로 Autocorrelation, Max probability, Sum variance 3개의 파라미터에서는 100%, Sum average 파라미터에서는 암 95%, 농양에서 90% 이상의 높은 병변 질감 검출 효율이 나타났다. 이러한 파라미터들이 직장에서의 정상조직, 농양조직, 암조직 간의 판별의 기준으로 가치가 있다고 사료된다. 임상에서의 활용정도에 따라 컴퓨터 보조진단으로서의 충분한 유용성을 볼 수 있을 것이다.

• 대한족부족관절학회지
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• 제7권2호
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• pp.208-217
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• 2003

Introduction: Soft-tissue impingement syndrome is now increasingly recognized as a significant cause of the chronic ankle pain. As a method to detect soft-tissue ankle impingement, a characteristic history and physical examination, routine MR imaging, and direct MR arthrography were used. The efficacy of routine MR imaging has been controversial for usefulness because of low sensitivity and specificity. Direct MR artrhography was recommaned for diagnosis because of the highest sensitivity, specificity and accuracy, but it requires an invasive procedure. The purpose of this study is to investigate the diagnostic accuracy of Fat suppressed, contrast enhanced, three-dimensional fast gradient recalled acquisition in the steady state with rediofrequency spoiling magnetic resonance imaging(CE 3D-FSPGR MRI) and to evaluate the clinical outcome of the arthroscopic treatment in assessing soft-tissue impingement associated with trauma of the ankle. Materials and Methods: We reviewed 38 patients who had arthroscopic evaluations and preoperative magnetic resonance imaging studies(3D-FSPGR MRI) for post-traumatic chronic ankle pain between January 2000 and August 2002. Among them, 24 patients had osteochondral lesion, lateral instability, loose body, malunion of lateral malleoli, and peroneal tendon dislocation. The patient group consisted of 23 men and 15 women with the average age of 34 years(16-81 years). The mean time interval from the initial trauma to the operation was 15.5 months(3 to 40 months), The mean follow-up duration of the assessment was 15.6months(12-48 months). MRI was simultaneously reviewed by two radiologists blinded to the clinical diagnosis. The sensitivity, specificity and accuracy of MRI was obtained from radiologic and arthroscopic finding. Arthroscopic debridement and additional operation for associated disease were performed. We used a standard protocol to evaluate patients before the operation and at follow-up which includes American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score. Results: For the assessment of the synovitis and soft tissue impingement, fat suppressed CE 3D-FSPGR MR imaging had the sensitivity of 91.9%, the specificity of 84.4 and the accuracy of 87.5%. AOFAS Ankle-Hindfoot Score of preoperative state was 69.2, and the mean score of the last follow-up was 89.1. These were assessed as having 50% excellent(90-100) and 50% good(75-89). The presence of other associated disease didn't show the statistically significant difference(>0.05). Conclusion: Fat suppressed CE 3D-FSPGR MR imaging is useful method comparable to MR arthrography for diagnosis of synovitis or soft-tissue impingement, and arthroscopic debridement results in good clinical outcome.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3611-3615
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• 2012

Objective: The objective of this study was to establish the diagnostic accuracy, specificity and sensitivity of fine needle aspiration cytology(FNAC) for intra-oral tumors, comparing with histopathology as the gold standard. Materials and methods: Forty cases of FNA cytology from intraoral tumors was performed in AFID along with the demographic data and clinical information and then diagnosed at AFIP, Rawalpindi. Then the cytology results obtained per FNAC were compared with the histopathological biopsy results of the same lesions. The following variables were recorded for each patient: Age, gender, site of biopsy, diagnosis. The data were entered and analyzed using Open-epi version 2.0. Diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value were calculated. Cohen Kappa was further applied to compare the agreement between the biopsy and FNAC diagnoses. A p-value of < 0.05 was considered as statistically significant. Results: Among the total patients included in the study there were 24 males and 16 females, with a ratio of 1.5:1. Age of the patients ranged from 24 to 80 years with a mean of 52 years. A total of six sites were aspirated from the oral cavity with maximum (11) aspirates taken from alveolar ridge. The results of FNAC revealed that there were 32 malignant and 8 benign aspirates. Confirmation through histopathological analysis came for 31/32 malignant cases while one was falsely given positive for malignancy on FNAC. Among a total of 40 cases, 31(77%) cases diagnosed were found to be malignant and remaining 9(23%) were benign. The FNAC results revealed 32 malignant and 8 benign lesions. Histopathology of the subsequent surgically excised specimen showed malignant lesions in 31(77%) and benign in 9(23%) patients. As a whole, it was found that the absolute sensitivity for introral FNAC was 100% and specificity 89% with positive predictive value of 97% and negative predictive value of 100%. Conclusion: Cytological diagnosis was almost corroborative with final histopathological diagnosis in all cases, with very few exceptions, exhibiting high diagnostic accuracy.

• 동의생리병리학회지
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• 제28권1호
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• pp.76-81
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• 2014

The aim of this study was to build the diagnosis criteria of Qi deficiency using distribution of sum of 11 items for Qi deficiency in stroke patients. Between September 2006 and December 2010, 2,994 patients from 11 Korean medical hospitals were asked to complete the Korean Standard Pattern Identification for Stroke (K-SPI-Stroke) questionnaire as a part of project 'Fundamental study for the standardization and objectification of pattern identification in traditional Korean medicine for stroke (SOPI-Stroke). Each patient was independently diagnosed by two experts (traditional Korean medicine physicians) from the same site according to one of five patterns. 2,994 patients were divided modeling and testing in 70:30 ratio by stratification of pattern identification. We calculated the sensitivity, specificity, accuracy and odds ratio (OR) using distribution of sum of 11 items (signs and symptoms) for Qi deficiency. More than four from 11 items of Qi deficiency in modeling dataset, sensitivity, specificity, accuracy and OR was 70.07%, 74.94%, 73.92% and 7.00, respectively. In testing dataset, 78.31%, 73.45%, 74.47% and 9.98, respectively. Although this values are not high, after values of sensitivity, specificity, accuracy and OR should be more than current value, and then we should be able to suggest as objective diagnosing criteria.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2297-2301
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• 2015

Background: Despite widely adopted standard methods for follow-up including cystoscopy plus cytology, recurrence rates of non muscle-invasive bladder cancer (NMIBC) have not improved over the past decades, still ranging from 60% through 70%. Hence, widely acceptable surveillance strategies with excellent sensitivity are needed. Early recurrence has led to the development of a novel cystoscopy technique utilizing photodynamic diagnosis (PDD). Although, no studies have evaluated the efficacy of PDD for patients of MIBC, BCG failure or 2nd-transurethelial resection (TUR). Materials and Methods: The present study was performed from October 2012 through May 2013. IRB approved 25 patients initially underwent a cystoscopy examination of white light and blue light followed by the resection of tumors identified. Resections were performed from bladder mucosa areas considered suspicious at PDD, along with PDD negative normal bladder mucosa area resected by random biopsy. Specimens were divided into two groups, PDD positive and negative. Primary endpoints were sensitivity and specificity. Results: A total of 147 specimens extracted from 25 patients were included in the analysis. Some 45 out of 92 PDD-positive specimens were confirmed to have bladder cancer, and 51 out of PDD-negative 55 specimens were confirmed to be cancer negative. The sensitivity of PDD was 91.8% (45/49) and specificity was 52.0% (51/98). The sensitivity:specificity was 89.5% (17/19) : 47.6% (30/63) in 12 2nd-TUR patients, 90.5% (19/21) : 61.1% (11/18) in seven MIBC patients, and 95.0% (19/20) : 48.5% (16/33) in eight failed BCG cases. Conclusions: PDD-TURBT has high sensitivity to diagnose BC even for 2nd-TUR, MIBC or BCG failure cases.

• 동의생리병리학회지
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• 제23권3호
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• pp.540-547
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• 2009

There needs disease-predictable signs in order to enable preventive diagnosis and therapy. Then traditional Chinese medicine applies various medical diagnostic equipments used in western medicine to diagnosing sub-healthy state. But such data are not originated from inherent oriental medicine, and not obtained easily in ordinary clinical practice. This paper is to provide synopsis of the ante-disease diagno-therapeutics partly and to show predictable data based on the facial shapes and signs, especially of gall bladder's versus bladder's body and masculine versus feminine shape. Ante-disease means not only the complete healthy state, but also the state unseen any symptoms in macrographically in the course of outbreak of disease. It contains two stages, first one is the former state of disease and second one is untransmitted state of disease. The patterns of ante-disease consist of latent disease, pre-disease, transmission type like senescent syndrome, abnormal reactive syndrome(變證), syndrome of transmission and transmutation. The classification with gall bladder and bladder type manifests the differences of shape, color and size of each organ in comparison of the universal and standard figures of the human being. On the other hand, the classification with masculine and feminine shape contrasts the innate sexual difference and the shape, characteristics originated from in itself. These two classification theories have their own pathologic types and syndrome types with each disease so that disease-predictable data can be constructed based on such a relationship. In addition, this diagnostic method by facial shapes and signs is able to be applied to whole stages from prenatal to present state of disease even if the cause and inducement are not clear. Ante-disease diagno-theraputic system by Gall Bladder's versus Bladder's Body and Masculine versus Feminine Shape is getting more important in the chronic and internal disease in comparison of the acute and traumatic disease. So this study is able to make up for the limit of diagnosis on ante-disease in the field of oriental medicine clinic.

• 동의생리병리학회지
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• 제21권6호
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• pp.1581-1585
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• 2007

To report Sensitivity and specificity about utility as diagnosis criteria for deficiency of Qi in stroke. Korean medicine doctor surveyed deficiency of Qi of the symptoms for the Stroke case report form in stroke patients within 1 month of onset. We analyzed 643 patients have diagnosed stroke, neurological deficit continued over twenty-four hours and within one month of onset, except traumatic cerebrovascular attack (EDH, SDH) using the result by medical specialist and residents diagnosed differentiation and written CRF(Case Report Forms) which based on 'Korean Standard Differentiation of the Symptoms and Signs II' in twenty multi centers. The sensitivity of "more 1/5 in major sings and 1/5 in helpful signs", "more 1/5 in major signs and 2/5 in helpful signs", "more 2/5 in major signs and 1/5 in helpful signs", "more 2/5 in major signs and 2/5 in helpful signs""more 3/5 in major signs and 1/5 in helpful signs""more 3/5 in major signs and 2/5 in helpful signs" are respectively 83%, 50%, 72%, 46%, 47%, 32%. The specificity are respectively 28%, 59%, 55%, 74%, 80%, 89%. The sensitivity(72%) and specificity(55%) of "more 2/5 in major signs and 1/5 in helpful signs" that to be implanted. Although this values are not high, after values of sensitivity and specificity should be more than current value, and then we should be able to suggest as objective diagnosing criteria.

• 대한임상독성학회지
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• 제17권2호
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• pp.108-117
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• 2019

Purpose: The study examined the poisoned patients' characteristics nationwide in Korea by using data from the National Emergency Department Information System (NEDIS). Methods: Among the patients' information sent to NEDIS from January 1, 2013 to December 31, 2015, the included subjects' main diagnosis in ED showed poisoning according to the 7th edition of the Korean Standard Disease Classification (KCD-7). We analyzed the patients' gender, age, initial vital signs, visit time, stay time of staying in ED, results of ED care, main diagnosis in ED, length of hospitalization, and results of hospitalization. Results: A total of 106,779 ED visits were included in the analysis. There were 55,878 males (52.3%), which was more than the number of females. The number of intentional poisoning was 49,805 (59.6%). 75,499 cases (70.8%) were discharged, and 25,858 cases (24.2%) were hospitalized. The numbers of poisoning patients per 1,000 ED visits were 14 in Chungnam and 11.9 in Jeonbuk. The most common cause of poisoning, according to the main diagnosis, was venomous animals. It was the same for hospitalized patients, and pesticide was next. Pesticide was the most common cause of mortality in ED (228 cases, 46.1%) and after hospitalization (584 cases, 54.9%). The incidence of poisoning by age group was frequent for patients in their 30s to 50s, and mortality in ED and post-hospitalization were frequent for patients in their 60s to 80s. Conclusion: This study investigated the characteristics of poisoning patients reported in the past 3 years. Pesticide poisoning had a high mortality rate for patients in ED and in-hospital. For mortality, there was a high proportion of elderly people over 60. Thus, policy and medical measures are needed to reduce this problem. Since it is difficult to identify the poison substance in detail due to nature of this study, it is necessary to build a database and monitoring system for monitoring the causative substance and enacting countermeasures.

• Tuberculosis and Respiratory Diseases
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• 제60권4호
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• pp.412-418
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• 2006

연구배경 : 클라미디아 감염의 진단은 혈청검사로 이루어진다. 현재 표준 방법은 MIF(microimmunofluorescence)이나 이 방법은 주관적이고 시간이 많이 걸리는 단점이 있다. 최근을 SPR(surface plasmon resonance) 센서를 이용한 단백질 칩이 감염의 새로운 진단 방법으로 제시되고 있다. 클라미디아 감염의 진단을 위한 단백질 칩 개발을 위하여 금 칩 표면에 세균을 고정하고 클라미디아 균에 대한 항체와 표면 위 세균과의 반응을 SPR 센서를 이용하여 측정하고자 하였다. 방법 : 표면 항원으로 배양한 Chlamydophila pneumoniae LKK1의 EB를 정제하였다. 양전하를 띤 PDDA (polydiallyldimethylammonium chloride)를 이용하여 전하를 이용한 단백질 칩을 제작하였다. 클라미디아 균을 고정시킨 후에 atomic force microscopy를 이용하여 표면을 관찰하였다. 클라미디아 균에 대한 항체를 투여하고 나서 자체 제작한 SPR 센서를 이용하여 항원 항체 반응을 SPR 파장 변화로 측정하였다. 결과 : 양전하를 띤 PDDA 표면위에서 클라미디아 균이 고정되었음을 확인 하였다. 그리고, 항체를 투여한 후에 SPR 파장의 증가를 확인하였다. 파장 변화는 항원의 농도와 관련이 있었다. 결론 : 전하를 이용하여 클라미디아 폐렴균의 EB를 단백질 칩에 고정하였고, 단백질 칩 위에서의 항원 항체 반응을 확인하였다. 비정형 폐렴의 진단에 SPR 센서가 기여할 수 있을 것으로 사료되나, 실제 임상 시료에의 적용을 위해서는 좀더 연구가 필요할 것으로 사료된다.