• Title/Summary/Keyword: 예후 예측

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A Study on Family Involvement in Therapeutic Process of the Mentally Ill (정신장애인 가족의 치료참여에 관한 연구)

  • Seo, Mi-Kyung
    • Korean Journal of Social Welfare
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    • v.51
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    • pp.119-140
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    • 2002
  • The main premise of this study is that family involvement which is based on professional-family collaborative partnership is very important for successful treatment and rehabilitation of the mentally ill. Accordingly, this study aims to find out factors which are related to family involvement in therapeutic process. This study conducted the survey with 275 service providers(i.e. mental health professionals) and with 124 service consumers(i.e. family members) in order to discover in what extent do related factors affect on the family involvement. The major findings of the study are; 1) From the service providers standpoint, using multiple regression, job characteristics, perception of family culpability, frequency of contact with family, functioning of their organization affect significantly on the family involvement by 33.0% of explanatory power. Using a step-wise multiple regression, the most powerful influenced factors on family involvement are frequency of contact with family, type of agency, type of profession, and their career. 2) From the service consumers standpoint, using multiple regression, socioeconomic level, attitudes of professionals, optimistic perception of prognosis, functioning of their family, diagnosis affect significantly on the family involvement by 40.9% of explanatory power. Using a step-wise multiple regression, the most powerful influenced factors on family involvement are economic level, attitudes of professionals, optimistic perception of prognosis, educational level. In conclusion, family accessibility to the therapeutic system must be allowed and further, politically encouraged by the related legislation. Also this study recommends clinician to use an empowerment model for the families with the mentally ill.

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Development of medical image quantification software in the abdominal diseases (복부질환 의료영상 분석 소프트웨어 개발)

  • Kim, Ji-Eon;Kim, Seung-Jin;No, Si-Hyeong;Jun, Hong-Yong;Lee, Chung Sub;Ryu, Jong-Hyun;Kim, Tae-Hoon;Jeong, Chang-Won
    • Proceedings of the Korea Information Processing Society Conference
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    • 2019.05a
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    • pp.348-349
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    • 2019
  • 의료영상은 진단을 목적으로 환자의 질환 부위별로 정밀하게 촬영하여 수집된 영상이다. 수집된 의료영상을 판독하여 진단하기 어려운 경우에는 조직검사를 통해 확진검사를 실시한다. 하지만 조직검사의 경우 환자에게 신체적, 경제적 부담을 줄 수 있다. 따라서 의료영상을 기반으로 정밀 진단하는데 도움을 줄 수 있는 정량분석 소프트웨어 개발이 중요하다. 현재 복부 간 질환의 경우 MELD(Model For End-Stage Liver Disease) 점수를 이용하여 간 질환의 중증도나 예후를 예측하는데 이용되고 있다. 하지만 MELD점수 산출에 있어서 의료영상 정보를 사용하지 않았기 때문에 질환 여부를 가늠하는데 에만 이용될 뿐 병변부위의 위치를 확인하는데 에는 어려움이 있다. 그러므로 본 논문은 다양한 의료영상장비에서 획득한 복부영상을 이용하여 복부질환의 중증도를 예측 및 분석함으로서 실제 임상진단에 도움을 줄 수 있는 시스템을 제안하고자 한다.

Conditional Variational Autoencoder-based Generative Model for Gene Expression Data Augmentation (유전자 발현량 데이터 증대를 위한 Conditional VAE 기반 생성 모델)

  • Hyunsu Bong;Minsik Oh
    • Journal of Broadcast Engineering
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    • v.28 no.3
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    • pp.275-284
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    • 2023
  • Gene expression data can be utilized in various studies, including the prediction of disease prognosis. However, there are challenges associated with collecting enough data due to cost constraints. In this paper, we propose a gene expression data generation model based on Conditional Variational Autoencoder. Our results demonstrate that the proposed model generates synthetic data with superior quality compared to two other state-of-the-art models for gene expression data generation, namely the Wasserstein Generative Adversarial Network with Gradient Penalty based model and the structured data generation models CTGAN and TVAE.

Clinical Characteristics of Patients with Traumatic Diaphragm Injury and Comparison of Scoring Systems as Predictors (외상성 횡격막 손상환자의 임상적 고찰과 예후 예측 인자의 유용성 비교)

  • Lee Sang Jin;Jung Jin Hee;Sohn Dong Suep;Cho Dai Yun
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.56-62
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    • 2005
  • Because of high morbidity and mortality, traumatic diaphragm injury remains a diagnostic challenge. In this study, we evaluate that some factors and scores can be used as predictors. Material and Method: From May 1995 to June 2003, 23 patients with traumatic diaphragm injury were enrolled. We examined the clinical features of patients. RTS, TRISS, ISS and APACHE II scores for each patient are calculated for analyzing the relationship of mortality and ICU duration. Result: The study identified 15 men $(65.2{\%})$ and 8women $(34.8{\%})$. There are right sided diaphragmatic injury in 11 patients $(47.8{\%})$, left sided in 11 $(47.8{\%})$, and both sided in 1 ($0.4{\%}$). Plain X-ray, CT, upper GI contrast study and esophagogastroscopy were used as diagnostic tools. Age, hemodynamic status, early diagnosis are not associated with outcome. As prognostic factor, RTS and ISS are associated with mortality and there was negative relationship between RTS and ICU duration (r=0.737, p=0.026). Conclusion: An early diagnosis of traumatic diaphragm injury can frequently be missed in the acute trauma setting. So high index of suspicion and a careful examination are important in multiple trauma patients. An RTS can probably be used effectively as a predictor for the severity and prognosis in patients with traumatic diaphragm injury.

The Optimal Time for Embryo Transfer in Fresh IVF: Comparison between Day 3 and Day 5 on Pregnancy Outcomes (체외수정술 후 난할단계 배아와 포배기단계 배아를 이식했을 때의 임신예후의 비교)

  • Lyu, Sang-Woo;Kim, A-Ri;Seok, Hyun-Ha;Kim, You-Shin;Lee, Woo-Sik;Yoon, Tae-Ki;Won, Hyung-Jae
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.2
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    • pp.143-151
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    • 2010
  • Objective: The aim of this study was to compare day 3 embryo transfer (D3ET) with day 5 ET (D5ET) in fresh in vitro fertilization (IVF) cycle on pregnancy outcomes. Methods: We conducted a retrospective matched case control study that included 90 women with D3ET and 90 women with D5ET from January 2007 to June 2009. Subjects were matched for reproductive profiles and IVF cycle characteristics. Two good quality embryos were transferred in both groups. Pregnancy rates (PR), implantation rate, and multiple PR were compared. Results: Demographics, stimulation parameters and embryological data were comparable in both groups. Main pregnancy outcomes with D3ET and D5ET groups were not statistically different: implantation rate (39.4% vs. 32.8%), positive PR (57.8% vs. 46.7%), clinical PR (53.3% vs. 45.6%), ongoing PR (50.0% vs. 42.2%), respectively. Both groups showed high multiple PR (37.5% vs. 34.1). Conclusion: D5ET may not be beneficial and necessary in comparison with D3ET on pregnancy outcomes, and elective single ET should be considered to decrease multiple pregnancies in women with favorable conditions and good quality embryos undergoing IVF.

Initial Plain Radiographs versus MR Imaging: Comparison of Prognostic Efficacy in Legg-Calve-Perthes Disease (초기의 단순 X선 촬영술 대 자기공명영상: 소아성 대퇴골두 무혈성 괴사증에서 예후 예측성 비교)

  • Lee, Sun-Jin;Jee, Won-Hee;Cho, Song-Mee;Jeong, Chang-Hoon;Ok, In-Young
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.2
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    • pp.153-160
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    • 2008
  • Purpose : To evaluate if at the time of diagnosis of Legg-Calve-Perthes disease, MR imaging is superior to radiographs for identifying patients with a favorable long term prognosis as determined by maintenance of a spherical configuration of the femoral head epiphysis on follow-up radiographs. Materials and Methods : We retrospectively analyzed plain radiographs and MR images of 48 femoral heads in 41 patients with Legg-Calve-Perthes disease at time of diagnosis. Femoral head involvement was estimated on initial plain radiographs and MR images using the Catterall classification. Prognosis as determined by maximum femoral head deformity was determined on follow-up radiographs evaluated according to Stulberg classification. Results: Catterall classification of greater than 1 at MR imaging had 100% sensitivity (14/14) for detecting patients with a poor prognosis as indicated by deformity of the femoral head on follow-up radiographs (Stulberg class > 2). Initial radiographs had a lower sensitivity of 57% (8/14) for detecting patients with poor prognosis. Specificity for MR imaging was 21% (7/34) which was not significantly different from 32% (11/34) specificity for initial radiographs. Conclusion: Catterall group 1 at initial MR imaging indicates favorable prognosis for Legg-Calve-Perthes disease. Patients with more extensive involvement of the femoral head can have a good outcome, however they are at risk for loss of spherical configuration of the femoral head and subsequent osteoarthritis in adulthood. MR imaging may be superior to radiographs for identifying a subgroup of patients with favorable prognosis.

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Prognostic Value of Normal Exercise $^{99m}Tc$-MIBI Myocardial Perfusion SPECT: Comparison with Exercise Electrocardiography and Coronary Angiography ($^{99m}Tc$-MIBI 운동부하 심근관류 SPECT에서 정상소견을 보인 환자의 예후: 운동부하 심전도와 관동맥 조영소견과의 비교)

  • Lee, Sang-Woo;Lee, Jae-Tae;Chun, Kyung-Ah;Kang, Do-Young;Kim, Dong-Hwan;Cho, Yong-Keun;Chae, Shung-Chull;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.3
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    • pp.199-206
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    • 2000
  • Purpose: Myocardial perfusion scintigraphy is a useful technique to diagnose and to predict prognosis in patients with suspected or known coronary artery disease. The purpose of the present study is to evaluate the prognostic value of normal exercise $^{99m}Tc$-MIBI myocardial perfusion single photon emission computed tomography (SPECT) and to analyze results with regard to those of exercise electrocardiography or coronary angiography. Materials and Methods: We evaluated 301 patients (mean age $52{\pm}10$ years, 166 males and 135 females) with normal exercise $^{99m}Tc$-MIBI myocardial perfusion SPECT performed for suspected coronary artery disease. Subject were evaluated for cardiac events and followed for 8-55 months (mean $19{\pm}10$ months) after imaging. Results: During the follow-up period, there was no cardiac death but only one non-fatal myocardial infarction (event rate 0.21% per year). In addition, only one patient underwent coronary revascularization. There was no significant difference in cardiac event rate between patients with positive (n=27) and negative (n=235) exercise electrocardiography (p:NS). There was no cardiac event in 17 patients who underwent coronary angiography (4 patients with >50% luminal narrowing, 2 patients with vasospasm and 11 patients with no significant lesion). Conclusion: Patients with normal exercise $^{99m}Tc$-MIBI myocardial perfusion SPECT has a very low risk for cardiac events regardless of exercise electrocardiographic and coronary angiographic findings.

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Relationship Between Tumor Angiogenesis, Stage and Prognosis in Non-Small Cell Lung Cancer (비소세포 폐암에서 종양 혈관신생과 병기 및 예후와의 관련성)

  • Lee, Won-Yeon;Kim, Chong-Ju;Shin, Pyo-Jin;Cho, Mee-Yon;Yong, Suk-Joong;Shin, Kye-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.557-567
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    • 2001
  • Background : Tumor angiogenesis is required for tumor growth and metastasis. In this study, we investigated the correlation between the intensity of angiogenesis and stage, nodal status, histologic type, metastasis and survival rate of non-small cell lung cancer. Method : Formalin fixed, paraffin embedded surgical specimens of 45 patients who had surgically resected primary non-small cell lung cancers without pre or post operative adjuvant chemotherapy or radiotherapy were examined. The microvessel count(MVC) was demonstrated by immunohistochemical staining for CD31(platelet endothelial cell adhesion molecule, PECAM). Results : Microvessel counts(MVCs) in stage IIIA and IIIB were higher than in stage I and II(p<0.05). The MVC in patients with lymph node metastasis was higher than that in patients without lymph node metastasis, although the difference was not statistically significant(p>0.05). However, in adenocarcinoma, the MVC in patients with lymph node metastasis was significantly higher than that seen in patients without lymph node metastasis(p<0.05). The MVC in adenocarcinoma was higher than that in squamous cell carcinoma(p<0.05). The difference between the MVCs of adenocarcinoma and squamous cell carcinoma was not statistically significant in stage I and II or N0 stage(p>0.05). However, in stage IIIA and IIIB or N1~3 stage, the MVC in adenocarcinoma was higher than that in squamous cell carcinoma(p<0.05). MVC was more increased when metastasis developed within 12 months. In the same histologic type and stage, the duration of survival time in patients with high MVC was shorter than in patients with low MVC, however the difference was not statistically significant(p>0.05). The survival rate in patients with high MVCs was lower than that in patients with low MVCs(P<0.05). Conclusion : In non-small cell lung cancer, MVC correlated relatively well with pathologic stage, nodal status(limited in patients with adenocarcinoma), histologic type, postoperative metastasis and survival rate. However, in the same histologic type and stage, MVC was not significantly related to the duration of survival. Therefore the assessment of the intensity of angiogenesis in non-small cell lung cancer may be helpful in predicting prognosis and in selecting patients for systemic adjuvant therapy of potential metastasis according to the results.

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The Utility of $^{18}F$-FDG PET/CT for Following Up Head and Neck Cancer (두경부암 환자의 추적관찰에서 $^{18}F$-FDG PET/CT의 유용성)

  • Chung, Eun-Jae;Baek, Seung-Kuk;Woo, Jeong-Soo;Kwon, Soon-Young;Jung, Kwang-Yoon
    • Korean Journal of Head & Neck Oncology
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    • v.26 no.2
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    • pp.178-182
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    • 2010
  • 서 론 : 두경부암의 예후에 가장 중요한 인자는 진단시 병기와 치료 후 재발의 유무이다. 따라서, 재발 병변을 조기에 발견하는 것이 매우 중요하다. 본 연구에서는 두경부암 환자의 추적 관찰에서 $^{18}F$-FDG PET/CT의 유용성에 대해 알아보고자 하였다. 대상 및 방법 : 2004년 4월부터 2008년 8월까지 고려대 안암병원에서 두경부암으로 치료를 완료한 후 추적관찰이 가능하였던 88 예의 환자를 대상으로 하였다. 환자는 본원의 두경부암 추적관찰 양식에 따라 술 후 6, 12개월째 $^{18}F$-FDG PET/CT를 시행하였으며, 원발부위 및 경부 재발, 원격전이와 중복암의 진단에 있어 $^{18}F$-FDG PET/CT의 민감도, 특이도, 양성예측율, 음성예측율을 평가하였고, 기존의 추적관찰 방법과 이를 비교하였다. 결 과 : 원발부위 재발의 진단에 있어 민감도, 특이도, 양성예측율, 음성예측율은 각각 95%, 97%, 90%, 98% 였다. 경부전이 재발의 진단에 있어서는 각각 94%, 98%, 83%, 99%였으며, 원격전이 및 이차암 진단에 있어서는 94%, 100%, 100%, 99%였다. 원발부위 재발은 고식적인 진단 방법, 원격전이와 이차암은 $^{18}F$-FDG PET/CT가 진단에 의미있게 유리하였다. 결 론 : $^{18}F$-FDG PET/CT는 두경부암의 추적관찰 과정에서 재발 여부를 판정하는데 있어 매우 유용하며, 특히 원격전이 및 이차암의 발견에 있어 유용하다. 그러나, 위양성 및 위음성의 가능성으로 고식적인 진단 방법과 병행해야 진단의 효과를 높힐 것으로 생각된다.

Prognostic Value of TNM Staging in Small Cell Lung Cancer (소세포폐암의 TNM 병기에 따른 예후)

  • Park, Jae-Yong;Kim, Kwan-Young;Chae, Sang-Cheol;Kim, Jeong-Seok;Kim, Kwon-Yeop;Park, Ki-Su;Cha, Seung-Ik;Kim, Chang-Ho;Kam, Sin;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.322-332
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    • 1998
  • Background: Accurate staging is important to determine treatment modalities and to predict prognosis for the patients with lung cancer. The simple two-stage system of the Veteran's Administration Lung Cancer study Group has been used for staging of small cell lung cancer(SCLC) because treatment usually consists of chemotherapy with or without radiotherapy. However, this system does not accurately reflect segregation of patients into homogenous prognostic groups. Therefore, a variety of new staging system have been proposed as more intensive treatments including either intensive radiotherapy or surgery enter clinical trials. We evaluate the prognostic importance of TNM staging, which has the advantage of providing a uniform detailed classification of tumor spread, in patients with SCLC. Methods: The medical records of 166 patients diagnosed with SCLC between January 1989 and December 1996 were reviewed retrospectively. The influence of TNM stage on survival was analyzed in 147 patients, among 166 patients, who had complete TNM staging data. Results: Three patients were classified in stage I / II, 15 in stage III a, 78 in stage IIIb and 48 in stage IV. Survival rate at 1 and 2 years for these patients were as follows: stage I / II, 75% and 37.5% ; stage IIIa, 46.7% and 25.0% ; stage III b, 34.3% and 11.3% ; and stage IV, 2.6% and 0%. The 2-year survival rates for 84 patients who received chemotherapy(more than 2 cycles) with or without radiotherapy were as follows: stage I / II, 37.5% ; stage rna, 31.3% ; stage IIIb 13.5% ; and stage IV 0%. Overall outcome according to TNM staging was significantly different whether or not received treatment. However, there was no significant difference between stage IIIa and stage IIIb though median survival and 2-year survival rate were higher in stage IIIa than stage IIIb. Conclusion: These results suggest that the TNM staging system may be helpful for predicting the prognosis of patients with SCLC.

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