• Title/Summary/Keyword: 발병 위험도

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Risk Factors of Catheter-related Bloodstream Infection Due to Methicillin-resistant Staphylococcus aureus in Very Low Birth Weight Infants (극소저체중 출생아에서 메티실린 내성 포도상구균으로 인한 카테터 연관 혈류감염의 위험인자)

  • Cho, Il-Hyun;Jung, Tae-Woong;Lee, Ju-Young;Moon, Se-Na;Bin, Joong-Hyun;Lee, Hyun-Seung;Lee, Jung-Hyun;Kim, So-Young;Sung, In-Kyung
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.288-292
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    • 2011
  • Purpose: The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection has increased in children and in neonates, and is particularly associated with frequent use of central venous catheter in very low birth weight (VLBW) infants. It is known that the morbidity and mortality of MRSA infection are low in neonates, as compared with adults. The objective of this study was to examine the difference in clinical characteristics between VLBW infants that survived and those that did not, a catheter-related bloodstream infection (CRBSI) of MRSA. Methods: Thirty-four VLBW infants had laboratory-confirmed bloodstream infection with S. aureus. We examined the incidence, mortality and morbidity of CRBSI, and predictive factors associated with mortality. Results: Twenty-six infants had same pathogen (24 MRSA, 2 Methicillin-sensitive Staphylococcus aureus) in the blood and in the catheter tip. Eight infants (25.8%) died in the CRBSI and they all had MRSA blood infections. Sex ratio, gestational age, duration between blood collection and identification of pathogens, and WBC and platelet count were not significantly different between patients that died from and patients that survived CRBSI of MRSA. C-reactive protein (CRP) was significantly higher in VLBW infants that died. Mean age of onset and hospital day was earlier (9.1${\pm}$6.6 vs. 26.9${\pm}$20.2; P=0.005) and shorter for patients that died (10.1${\pm}$7.0 vs. 73.0${\pm}$32.4; P=0.000). Two survivors had complications of pyogenic arthritis of the lower extremities and soft tissue infection, respectively. Conclusion: Mortality of CRBSI was likely to be high in VLBW infants and might be anticipated by CRP and early onset of disease.

Risk Factors for the First-Year Relapse in Children with Nephrotic Syndrome (신증후군 환아에서 1년내 재발과 관련된 위험 요인)

  • Shin, Hye Kyoung;Kim, Ji Hee;Yoo, Kee Hwan;Hong, Young Sook;Lee, Joo Won;Kim, Soon Kyum
    • Clinical and Experimental Pediatrics
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    • v.46 no.9
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    • pp.889-892
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    • 2003
  • Purpose : This study aimed to evaluate risk factors of the first year relapse in children with nephrotic syndrome(NS) without the need for biopsy. Methods : We reviewed, retrospectively, 78 children diagnosed with steroid responsive nephrotic syndrome between July 1997 and June 2002. Median years to follow up were 4.4 years(range : 1-5 years). We divided the patients into two groups(group I : primary responders with no relapse or with only two relapses in the first year after initial response; group II : initial steroid responders with three or more relapses within the first year). We retrospectively reviewed and compared variables - sex, onset age, serum albumin, serum cholesterol, 24 hours urinary protein, creatinine clearance(Ccr), presence of hematuria and hypertension(HTN), and days from initial attack to remission. Results : Of 78 patients(male : 61(78.2%), female : 17(21.8%), age range 1.1 years to 14 years, median $5.1{\pm}3.0years$), 47(60.3%) were in group I and 31(39.7%) were in group II. There were no statistically significant differences in sex, serum albumin, serum cholesterol, 24 hours urinary protein, Ccr, presence of hematuria or HTN. The median age of onset showed no statistical difference between the two groups. However, if the patients are dividing into two groups according to the age of onset of three-years, patients theree yrs old or less fit into group II, as opposed to patients older than three yrs in age(63.2% vs. 32.2%, P<0.05). The days from initial attack to remission was longer in group II($12.9{\pm}0.5$ vs. $16.2{\pm}1.1$, P<0.05). Conclusion : We may conclude that the age of onset of three yrs old or less, and the longer time remission to initial steroid therapy, are risk factors of the first year relapse.

Predictive indicators of coronary artery complications in Kawasaki disease (가와사키 병 환아에서 관상동맥 합병증의 예측인자)

  • Park, Min Jee;Jeon, In-sang;Tchah, Hann;Choi, Kang Ho;Jung, Mi-Jin;Choi, Deok Young
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1161-1166
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    • 2009
  • Purpose : Kawasaki disease—the most common cause of acquired heart disease in children—incidence is increasing yearly. Therefore, we evaluated the predictive indicators of coronary complications of Kawasaki disease based on clinical and laboratory data. Methods : Between January 2005 and March 2008, of the 201 children with Kawasaki disease treated at the Gil Hospital of Gachon University of Medicine and Science, 51 had coronary artery lesions (Group II) and 150 had no lesions (Group I). The reasons for coronary artery lesions were deduced from the clinical and laboratory data. Results : Analysis of the 2 groups revealed that fever duration and days of fever after and before initial intravenous gammaglobulin (IVIG) treatment were significantly longer in Group 2 than in Group I. IVIG infusions were statistically higher in Group II than in Group I. As per the laboratory data, C-reactive protein (CRP) value was significantly higher in Group II. Collectively, >10 days of fever duration, >48 h of fever duration after, and >10 days of fever before IVIG treatment increased the risk of coronary artery lesions 6-, 5-, and 3.5-fold, respectively. Furthermore, additional IVIG courses and higher CRP level increased the risk of coronary artery lesions 4-fold and 2-3-fold, respectively. Conclusion : The following 3 factors were responsible for increased risk of coronary artery lesions in children with Kawasaki disease: fever duration and days of fever after and before IVIG treatment. To identifythe predictive indicators of coronary complications, it is necessary to further elucidate the relationship between well-known forecasting factors.

The Underwriting of Cancer (악성종양의 언더라이팅)

  • Park, Ip-Sae;Park, Sung-Soo
    • The Journal of the Korean life insurance medical association
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    • v.25
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    • pp.9-24
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    • 2006
  • 지속적으로 증가 하고 있는 악성 종양 발병률의 증가, 생존률의 향상, 조기발견의 증가 등이 암 기왕자의 보험 수요 상승을 가져오고 있으며, 보험시장에서 더 이상 암 기왕자를 도외시하기 어렵게 만들고 있다. 그러나, 현재 국내에서는 암 기왕자를 인수할 수 있는 상품과 언더라이팅 인수 기법이 부족한 실정이다. 본 논문은 이러한 상황 하에서 기존에 거절체로 인식되었던 암 기왕자의 적극적인 인수를 위해 악성종양에 대한 보험 의학적인 고찰과 사망률, 위험도에 대해 분석하고, 국내에서 암 기왕자의 보험 인수 시 문제점과 그 해결방안을 모색해 보았다. 종양은 종양세포의 성장과 확산의 정도를 나타내는 병기와 조직학적 등급에 의해 그 예후와 경과가 예측 가능하며, 이 병기를 표준화하려는 국제적 시도로 1977년 American Joint Committee on Cancer(AJCC)는 TNM system 을 제시하였다. 병기를 기초로 치료의 결정도 함께 이루어지는데, 주요 치료법을 수술, 방사선치료, 항암치료, 면역요법이 있다. 이러한 치료법들은 후기 부작용을 일으키거나 이차성 암(Secondary malignant neoplasm)의 원인이 되기도 한다. 병기에 따른 암환자의 사망률을 살펴 보면, 암은 일정시기 동안 사망률이 급격히 증가하다가 이후에 점차 사망률이 감소하고, 그 이후에는 사망률에 영향을 미치지 않는다. 이러한 사망률 변화의 특성은 암 기왕자에게 평준식 정액 할증법(Per mille flat extra)의 적용이 적절함을 보여준다. 그러나, 현재 국내에서는 악성 종양 기왕자를 위한 상품이 전무한 상태이며, 암의 병리적 병기와 치료에 관련된 정보를 얻을 수 있는 도구도 부족하고, 명확한 인수 기법이 없다. 또한, 자체의 경험통계의 부족으로 위험에 대한 부담감이 큰 것이 현실이다. 하지만, 병기에 따른 사망률의 변화에서도 알 수 있듯이 평준식 정액 할증법의 도입이나, 악성종양의 병기(Stage)별 정액 할증률을 삭감법으로 전환하는 기준을 개발한다면, 종신보험은 충분히 인수가 가능하다. 또한, CI 보험도 암에 대한 부담보를 하는 선진사의 인수 기법을 도입하거나, 암 기왕자만을 위한 CI 상품을 개발하는 등 새로운 인수 기법을 모색한다면, 암기왕자 인수의 폭은 넓어질 것이다. 이와 같은 노력과 함께, 언더라이팅의 정보 획득을 위한 암 기왕자만의 고지서를 개발하고, 전문 언더라이터의 양성을 위한 노력을 게을리 하지 않는다면, 암기왕자를 적극적으로 인수할 수 있을 것이다. 앞으로 국내 보험사가 위와 같은 노력을 지속적으로 해 나가고, 비교적 예후와 경과가 양호한 0기와 1기 암 기왕자부터 단계적으로 종신보험의 인수를 시도한다면, 비교적 안전하게 경험치를 축적할 수 있을 것이다. 뿐만 아니라 국내 보험업계는 새로운 시장의 확보와 보험에 대한 대외 이미지 개선이라는 효과도 함께 얻게 될 것이다.

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Classification of Very High Concerns HRCT Images using Extended Bayesian Networks (확장 베이지안망을 적용한 고위험성 HRCT 영상 분류)

  • Lim, Chae-Gyun;Jung, Yong-Gyu
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.49 no.2
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    • pp.7-12
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    • 2012
  • Recently the medical field to efficiently process the vast amounts of information to decision trees, neural networks, Bayesian Networks, including the application method of various data mining techniques are investigated. In addition, the basic personal information or patient history, family history, in addition to information such as MRI, HRCT images and additional information to collect and leverage in the diagnosis of disease, improved diagnostic accuracy is to promote a common status. But in real world situations that affect the results much because of the variable exists for a particular data mining techniques to obtain information through the enemy can be seen fairly limited. Medical images were taken as well as a minor can not give a positive impact on the diagnosis, but the proportion increased subjective judgments by the automated system is to deal with difficult issues. As a result of a complex reality, the situation is more advantageous to deal with the relative probability of the multivariate model based on Bayesian network, or TAN in the K2 search algorithm improves due to expansion model has been proposed. At this point, depending on the type of search algorithm applied significantly influenced the performance characteristics of the extended Bayesian network, the performance and suitability of each technique for evaluation of the facts is required. In this paper, we extend the Bayesian network for diagnosis of diseases using the same data were carried out, K2, TAN and changes in search algorithms such as classification accuracy was measured. In the 10-fold cross-validation experiment was performed to compare the performance evaluation based on the analysis and the onset of high-risk classification for patients with HRCT images could be possible to identify high-risk data.

Distribution and clinical features of patients with degenerative change of the mandibular condyle (측두하악장애 환자 중 하악과두의 퇴행성 골 변화를 보이는 환자의 분포 및 임상적 특징)

  • Lim, Yong-Kyu;Kim, Min-Ji;Kim, Youn-Joong;Song, Yun-Heon;Lee, Dong-Yul
    • The korean journal of orthodontics
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    • v.36 no.6
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    • pp.402-411
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    • 2006
  • Objective: This study was carried out to evaluate the distribution and clinical features of patients with degenerative change of the mandibular condyle. Methods: Six thousand and seventy patients with TMD (temporomandibular cisorder) were selected for this study, who had complete initial clinical records and radiographs. Panorama and TMJ panorama radiographs were used to screen the degenerative change in the condyle, and the patients were divided into DJD (degenerative joint disease) and non-DJD groups. Results: The distribution. and clinical features of the two groups were compared. Out of the total number of patients, 31.7% were in the DJD group, and 68.3% were in the non-DJD group. The portion of females was larger in the DJD group (80.8%) than in the non-DJD group (67.5%), and the DJD group had high prevalence in the second and third decades. Lack of incisal contact, retrusive chin, facial asymmetry, and mouth opening limitation were the chief complaints of the patients who had positive relation to DJD. Conclusion: Patients with an orthodontic treatment history, CO-CR discrepancy and crepitation were at possible risk of having DJD.

A Case-Control Study on Attitudes to Dietary Life and Nutrient Intakes of Colorectal Cancer Patients in Daegu·Gyeongbuk Area (대구·경북지역 대장직장암 환자의 식생활 태도와 영양소 섭취에 관한 환자-대조군 연구)

  • Choi, Youngeun;Kim, Eunjung
    • The Journal of the Convergence on Culture Technology
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    • v.6 no.4
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    • pp.621-626
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    • 2020
  • The incidence of colorectal cancer (CRC) in Korea has been gradually increased and it has been reported that dietary life is highly associated with the development of CRC. To investigate dietary attitudes and nutritional risk factors for CRC, we analyzed food intake of 34 patients diagnosed with CRC within 1 year and 51 subjects without gastrointestinal diseases as a control reside in Daegu·Gyeongbuk Area using semi-quantitative food frequency questionnaire. The results showed that dietary regularity and variety of food intake in control subjects was better than CRC patients whereas, CRC patients eat more frequently animal and vegetable protein foods, fried foods, green and yellow vegetables, and fruits than control subjects. Nutrient intake analysis showed that Vitamin A, E, K, C, sodium, magnesium, iodine, and cholesterol intake of CRC patients was higher than control subjects. Especially, after adjusting age and sex, regression analysis showed that Vitamin K (OR = 1.022, 95% Cl 1.003-1.043, p = 0.026) and sodium (OR = 1.001, 95% Cl 1.000-1.002, p = 0.032) were identified as risk factors for CRC. In the future, verification of the relationship between these nutrients and CRC risk and appropriate nutrient education will be needed for the prevention of CRC.

Clinical Significance of Focal Breast Lesions Incidentally Identified by $^{18}F-FDG$ PET/CT ($^{18}F-FDG$ PET/CT에서 우연히 발견된 국소 유방 병변의 임상적 의의)

  • Cho, Young-Seok;Choi, Joon-Young;Lee, Su-Jin;Hyun, Seung-Hyup;Lee, Ji-Young;Choi, Yong;Choe, Yearn-Seong;Lee, Kyung-Han;Kim, Byung-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.6
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    • pp.456-463
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    • 2008
  • Purpose: We evaluated the incidence and malignant risk of focal breast lesions incidentally detected by $^{18}F-FDG$ PET/CT. Various PET/CT findings of the breast lesions were also analyzed to improve the differentiation between benign from malignant focal breast lesions. Materials & Methods: The subjects were 3,768 consecutive $^{18}F-FDG$ PET/CT exams performed in adult females without a history of breast cancer. A focal breast lesion was defined as a focal $^{18}F-FDG$ uptake or a focal nodular lesion on CT image irrespective of $^{18}F-FDG$ uptake in the breasts. The maximum SUV and CT pattern of focal breast lesions were evaluated, and were compared with final diagnosis. Results: The incidence of focal breast lesions on PET/CT in adult female subjects was 1.4% (58 lesions in 53 subjects). In finally confirmed 53 lesions of 48 subjects, 11 lesions of 8 subjects (20.8%) were proven to be malignant. When the PET/CT patterns suggesting benignancy (maximum attenuation value>75 HU or <30HU; standard deviation of mean attenuation > 20) were added as diagnostic criteria of PET/CT to differentiate benign from malignant breast lesions along with maximum SUV, the area under ROC curve of PET/CT was significantly increased compared with maximum SUV alone ($0.680{\pm}0.093$ vs. $0.786{\pm}0.076$, p<0.05). Conclusion: The malignant risk of focal breast lesions incidentally found on $^{18}F-FDG$ PET/CT is not low, deserving further diagnostic confirmation. Image interpretation considering both $^{18}F-FDG$ uptake and PET/CT pattern may be helpful to improve the differentiation from malignant and benign focal breast lesion.

Association between polymorphism of ALK receptor tyrosine kinase(ALK) gene and risk of intracerebral hemorrhage (ALK 유전자 다형성과 뇌출혈과의 상관성 연구)

  • Kim, Su-Kang
    • Journal of Internet of Things and Convergence
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    • v.4 no.2
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    • pp.21-28
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    • 2018
  • I investigated that ALK receptor tyrosine kinase (ALK) gene polymorphisms were contributed to susceptibility to ICH in Korean population. I recruited 156 ICH patients and 425 healthy controls for this study, respectively. rs1881421, rs1881420, rs3795850, and rs2246745 single nucleotide polymorphisms (SNPs) were genotyped. The genotype and allele distributions of tested four SNPs was analyzed using the SNPStats, SPSS 22.0, and the Haploview v.4.2 software. The Odd's ratios (OR), 95% confidence intervals (CI), and P values were calculated in allele and genotype models. I found that rs1881421, rs1881420, rs3795850, and rs2246745 SNPs of ALK gene (rs1881421, OR=2.02, 95% CI=1.54-2.64, p<0.001; rs1881420, OR=0.53, 95% CI=1.16-2.01, p=0.003; rs3795850, OR=1.54, 95% CI=1.17-2.02, p=0.002; rs2246745, OR=1.95, 95% CI=1.46-2.60, p<0.001 in each allele analysis). And distributions of CC, GT, and GC haplotypes between the ICH group and the control group also showed significant association with ICH (CC haplotype, p<0.001; GT haplotype, p=0.006; GC haplotype, p<0.001). These minor alleles of tested four SNPs in ALK gene were contributed to increased risk of development for ICH. Our findings suggested that the ALK gene may be a risk factor for susceptibility to ICH.The Korea Internet of Things Society.

A Study on Factors to Periodontal Diseases in Patients with Metabolic Syndrome in Health Examination Examinees (일부 건강검진 수검자에서 대사증후군 대상자의 치주질환 발생에 영향을 미치는 요인)

  • Lee, Jae-Sung;Kang, Hyun-Kyung
    • Journal of the Korea Convergence Society
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    • v.9 no.7
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    • pp.259-268
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    • 2018
  • The purpose of this study was to identify effective ways to prevent periodontal disease in adults with risk factors for metabolic syndrome based on health examination examinees of some area. The study participants included 9,902 subjects who had received health checks at the Korea Association of Health Promotion from January 1 to December 31, 2014. All data were analyzed by descriptive statistics, chi-square test, logistic regression using IBM SPSS 24.0 Ver. As a result, it was found that regular oral examination (0.579), use of oral products (0.499), and oral health education (0.358) are most likely to affect the incidence of periodontal diseases among those affected by metabolic syndrome. The odds ratio of periodontal disease increased 1.79 times without regular oral examination, 1.61 times without oral products, and 1.43 times without oral health education (p<0.001). In conclusion, the results suggest that people with metabolic syndrome have a high risk of periodontal disease and that regular checkups, use of oral products, and oral health education are very important to prevent periodontal disease.