• Title/Summary/Keyword: Clinical identification

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Application of Matrix-assisted Laser Desorption/Ionization Time-of-flight Mass Spectrometry (Matrix-assisted Laser Desorption/Ionization Time-of-flight Mass Spectrometry의 활용)

  • Pil Seung KWON
    • Korean Journal of Clinical Laboratory Science
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    • v.55 no.4
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    • pp.244-252
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    • 2023
  • The timeliness and accuracy of test results are crucial factors for clinicians to decide and promptly administer effective and targeted antimicrobial therapy, especially in life-threatening infections or when vital organs and functions, such as sight, are at risk. Further research is needed to refine and optimize matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS)-based assays to obtain accurate and reliable results in the shortest time possible. MALDI-TOF MS-based bacterial identification focuses primarily on techniques for isolating and purifying pathogens from clinical samples, the expansion of spectral libraries, and the upgrading of software. As technology advances, many MALDI-based microbial identification databases and systems have been licensed and put into clinical use. Nevertheless, it is still necessary to develop MALDI-TOF MS-based antimicrobial-resistance analysis for comprehensive clinical microbiology characterization. The important applications of MALDI-TOF MS in clinical research include specific application categories, common analytes, main methods, limitations, and solutions. In order to utilize clinical microbiology laboratories, it is essential to secure expertise through education and training of clinical laboratory scientists, and database construction and experience must be maximized. In the future, MALDI-TOF mass spectrometry is expected to be applied in various fields through the use of more powerful databases.

Study on the Relationship between Korean Standard of Pattern Identification (II) and Pattern Identification of Cold-Heat and Deficiency-Excess (한국형 중풍 변증 표준안 - II와 한열허실 변증지표의 연관성 연구)

  • Kim, So-Yeon;Lee, Jung-Sup;Oh, Dal-Seok;Kang, Byoung-Kab;Ko, Mi-Mi;Kim, Jeong-Cheol;Kwon, Se-Hyug;Bang, Ok-Sun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.1
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    • pp.15-21
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    • 2010
  • Previously standardization study for identifying 5 types of pattern identification of stroke patients has been performed and the Korean standard of pattern identification (II) was developed. In the present study we investigated the interactions between total indices designated by the Korean standard of pattern identification(KSPI II) and indices for PI of Cold-Heat and Deficiency-Excess. Indicators for Cold-Heat and Deficiency-Excess are isolated from 58 indices through the survey of oriental medicine doctors and their relationship with KSPI-II indices was analyzed by corresponding analysis method using data of 1581 stroke patients. Means and standard deviations indicated that 2 Cold indices, 14 Heat indices, 12 Deficiency indices, and 5 Excess indices were included for Cold-Heat and Deficiency-Excess pattern identification. The results of corresponding analysis shows the relationship of 57 indices and 4 types of pattern identification (excluding 1 index and 1 pattern among 58 indices and 5 patterns) using the cross-tabulation which was obtained from the clinical data. Most of Cold and Heat index were divided to dimension 1(inertia 51.9%) obtained from the result of corresponding analysis. Deficiency and Excess index were partially associated with dimension 2(inertia 31.7%). These data suggest that pattern identification of Cold-Heat plays an role in the standardization of pattern identification in stroke, although further studies are required by various trials such as analysis of surveys and clinical data.

Serotyping of Cryptococcus neoformans Strains Isolated in Korea

  • Hwang, Soo-Myung
    • Journal of Microbiology
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    • v.40 no.2
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    • pp.166-169
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    • 2002
  • Twenty strains of Cryptococcus neoformams isolated from environmental and clinical sources in Korea were examined for their serotypes. Two environmental isolates from pigeon excreta belonged to C. neoformans var. neoformans serotypes A. Of the 18 isolates from clinical specimens, 17 belonged to C. neoformans vats, neoiomans (serotype A : 16, serotype D : 1) and one belonged to C. neoformans vats, gattii serotype B, which was culturally unusual, producing mucous colonies. This is the first report of the identification of C. neoformans roar, gattii serotype B from a patient in Korea.

The Clinical Interchange between Western Medicine and Oriental Medicine: with the Stroke Patient Outcomes Research (일부 한.양방병원 뇌혈관질환 환자의 진료결과 및 만족도의 비교연구 -한양방협진 진료프로토콜의 적용을 중심으로-)

  • Park, Jong-Ku;Kang, Myung-Guen;Lee, Seong-Soo;Kim, Dal-Rae;Choi, Seo-Young;Han, Chang-Ho;Yoo, Jun-Sang;Kim, Min-Gi;Kim, Chun-Bae
    • The Journal of Internal Korean Medicine
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    • v.22 no.4
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    • pp.691-702
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    • 2001
  • Objectives : This study was done to assess the effects of the clinical interchange between the Western Medicine and the Oriental Medicine for ischemic stroke patients. The patient outcomes include changes in neurologic function by modified NIH stoke scale, stroke pattern identification scale, and patient satisfaction, Methods : For the assessment of effects, this study was performed with 178 inpatients who had undergone the stroke care at three hospitals (W Hospital adopted western therapy, S Oriental Hospital adopted Sasang constitution medicine therapy, and H Oriental Hospital adopted mixed therapy according to a joint protocol on Western Oriental medical care) from November 1997 to December 1998. Patients were interviewed or written with self-entered questionnaire forms, and clinical data were obtained, Physicians or oriental doctors wrote clinical questionnaire forms according to the care process. Results : The patient outcomes within three hospitals at 2 stages (at admission and discharge in the modified NIH stroke scale. at admission and second weeks during admission in the stroke pattern identification scale) were found to be decreased, Especially in the results of hierarchical multiple regression analysis, the degree of improvement of modified NIH stroke scale of the stroke patients at W Hospital was significant large than it at S Oriental Hospital. Also, the degree of improvement of stroke pattern identification scale at W Hospital was significantly large than it at other two hospitals. However, the patient's satisfaction score at three hospitals wasn't significantly different. Conclusions : The result of this study suggested that the joint clinical research of Western & Oriental medical practitioners was possible even if there was a conflict between Western Medicine and Oriental Medicine. Therefore Western & Oriental medical practitioners share a mutual responsibility to apply evidence-based practice, to seek scientific empirical proof through randomized clinical trials between the multicenter.

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Clinical and Bacteriological Evaluation of the Patients with Anaerobic Bacteria Isolation from Blood (혈액에서 혐기성 세균이 분리된 환자의 임상 및 세균학적 검토)

  • Kim, Jin-Ju;Chong, Yun-Sop;Lee, Samuel Y.
    • The Journal of the Korean Society for Microbiology
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    • v.20 no.1
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    • pp.35-44
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    • 1985
  • Isolation and identification of anaerobic bacteria from blood cultures are still technically demanding procedures. Recently, with the use of gas liquid chromatography, the accuracy of identification is much improved. However, there has never been a satisfactory data analysis on anaerobic bacteremia in Korea. The authors evaluated both the clinical and the bacteriological data of 129 anaerobic bacteremias found at the Yonsei Medical Center during the period of 1973 to 1984. The most frequently isolated anaerobic bacteria were Bacteroides (52.7%), among which the major species was B. fragilis (38.7%). Incidence of anaerobic bacteremia by sex was 57% in male and 43% in female. Mortality was higg in groups below 1-year old and above 50-year old. The cause of death seemed closely correlated with the patient's age, general condition and the severity of the underlying disease. Various neoplasms were the most common (20%) underlying diseases predisposing the anaerobic bacteremia. Biliary tract was considered the most frequent route of infection in anaerobic bacteremia. The frequent clinical signs in anaerobic bacteremia were fever (65%), followed by liver function abnormality (29%), jaundice (20%) and hypotention(18%). When analysis of positive rate of blood culture was made on the patients from whom 4 cultures were done within 24 hours, it was found that 33% of the samples were positive. Isolation rate of anaerobic bacteria in thioglycollate medium was 83.8%, while it was 44% in Tryptic soy broth. Among the anaerobic bacteremia, 25.4% were polymicrobial infections with aerobic bacteria (92.5%), such as E. coli(33.3%). From these studies, it is concluded that B. fragilis is the most important causative organism in anaerobic bacteremia, with high fatality, particularly in those who have underlying diseases. The ports of entry are mainly biliary, gastrointestinal and female genital tract. Fever is the most frequent clinical sign. Single blood culture is not sufficient to detect all anaerobic bacteremia, therefore more cultures with optimal time interval are needed. The incidence of polymicrobial infection in anaerobic bacteremia is higher than that in overall bacteremia.

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The Principle of Acupoint Selection Based on Branch and Root Treatment (표치와 본치의 측면에서 경혈 선혈의 원리)

  • Lee, In-Seon;Ryu, Yeonhee;Chae, Younbyoung
    • Korean Journal of Acupuncture
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    • v.37 no.3
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    • pp.203-208
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    • 2020
  • Objectives : Since there are complex associations between diseases/symptoms and acupoints, one-to-one correspondence may not be the proper approach. Pattern identification has been being used as a clinical framework to make treatment decisions by extracting and synthesizing clinical data including patients' signs and symptoms. In this article, we propose two different models explaining the relationships between diseases and acupoints based on the branch treatment [Zhibiaofa] and the root treatment [Zhibenfa]. Methods : We explained the relationships between diseases/symptoms and acupoints from the example data from our previous study on traditional acupuncture point selection patterns for pain control. Diseases include low back pain, migraine, irritable bowel syndrome, osteoarthritis, ankle sprain, carpal tunnel syndrome, and dysmenorrhea, and acupoints included LI4, BL23, BL25, SP6, BL60, TE5, and CV4. Results : The relationships between diseases/symptoms and acupoints can be explained directly based on the branch treatment, and also can be explained indirectly through pattern identification based on the root treatment. Pattern identifications included both meridian-based pattern identification based on the spatial information of diseases and visceral organ-based pattern identification based on the characteristics of diseases. Conclusions : In the East Asian traditional medicine, Korean medicine doctors choose the most appropriate acupoints based either on the diseases/symptoms (i.e., branch treatment) or on the results of pattern identifications (i.e., root treatment). It is necessary to understand the two different approaches to choose specific acupoints for the targeted diseases.

Proposal of Form-Color-Pulse-Symptom Diagnostic System for Enhancement of Diagnostic Rate of 8 Principle Pattern Identification - Focusing on Cold Heat Pattern Identification - (팔강변증의 진단율 향상을 위한 형색맥증진단(形色脈證診斷)시스템 설계 - 한열변증을 중심으로 -)

  • Chi, Gyoo Yong;Lee, In Seon;Jeon, Soo Hyung;Kim, Jong Won
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.33 no.3
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    • pp.163-168
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    • 2019
  • In order to enhance the 8 principle pattern diagnosis rate comparing with diagnostic method by self-report questionnaire on cold/heat pattern in the clinical practice, a new diagnostic method using form-color-pulse-symptom (FCPS) system is proposed. FCPS system is composed of outputs of cold/heat pattern through the calculation process of contribution degree to the cold, heat pattern and qi, blood, yin, yang deficiency patterns, based on analysis of 16 mechanisms of disease calculated by diagnostic system of oriental medicine (DSOM) first. And second component is an output of differentiated 8 principle patterns in detail through binding and calculating process with digital informations of pulse, color, form, constitution obtained by computerized measurement system. Putting together above two processes consecutively, cold-heat complex or true/false cold/heat patterns and personalized characters of cold/heat patterns of each patient can be subdivided through a computation method of determining each pattern. In conclusion, 8 principle pattern identification can be performed more accurately using FCPS system than existent self report questionnaire method. These hypothetic proposal is needed to be proven by clinical trial for the future and then the accurate numbers used in each calculational function should be revised properly.

Study on the Data Analysis of CaPSPI for clinical application, a Diagnostic System for Climacteric and Postmenopausal Syndrome Pattern Identification (갱년기 변증 진단 도구 CaPSPI(Diagnostic System for Climacteric and Postmenopausal Syndrome Pattern Identification) 임상적용 결과 분석 연구)

  • Park, Young-Hee;Lee, In-Seon
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.4
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    • pp.78-96
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    • 2021
  • Objectives: It is a statistical study to examine the data of CaPSPI (Diagnostic System for Climacteric and Postmenopausal Syndrome Pattern Identification), developed for diagnosis of menopause disorders and to record the status of treatment of it. Methods: From November 1, 2020 to June 19, 2021, 36 cases of data of 33 respondents of the CaPSPI were analyzed. For the use of the basic data of the clinical menopausal disorder, we investigated frequency of menopausal symptoms and the difference between them depending on the period of menopause, and the presentation of usage prescriptions. And the diagnostic results for three kinds' diagnosis [for examination (D1), for treatment (D2), by doctors (D3)] were compared. The diagnostic consistency of D1 and D3 and the statistical significance between DT and disease elements (證素) was investigated. Results: 1. Hot flush was the highest in the symptom survey of the menopause that the subjects complained of, followed by insomnia. There was no significant difference in symptom expression according to menopausal period. 2. The diagnostic consistency of D1 and D2 showed significant diagnostic consistency only in liver depression, and the diagnostic consistency of D1 and D3 showed significant consistency in liver depression and Dual Deficiency of Heart and Spleen. 3. D3' diagnosis and disease elements had statistical significance for cases of P<0.1 was found to be related to the theory of oriental medicine. Conclusions: It is needed to continue to accumulate diagnosis and treatment results through CaPSPI in the future to strengthen the basis for patten identification and treatment of menopause disorders.

Anatomic Description of the Infraorbital Soft Tissues by Three-dimensional Scanning System

  • Peralta, Alonso Andres Hormazabal;Choi, You-Jin;Hu, Hyewon;Hu, Kyung-Seok;Kim, Hee-Jin
    • Journal of Korean Dental Science
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    • v.14 no.2
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    • pp.101-109
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    • 2021
  • Purpose: For minimally invasive procedures, three-dimensional (3D) anatomical knowledge of the structures of the face is essential. This study aimed to describe the thickness of the skin and subcutaneous tissue and depths of the facial muscles located in the infraorbital region using a 3D scanner to provide critical clinical anatomical guidelines for improving minimally invasive cosmetic procedures. Materials and Methods: The 3D scanning images of 38 Korean cadavers (22 males and 16 females; age range: 51~94 years at the time of death) were analyzed. Eight facial landmarks (P1~P8) were marked on the cadaveric faces. The images were scanned in three steps-undissected face, hemiface after skinning, and revealing the facial muscles. Student's t-test was used to identify significant differences. Result: The skin and subcutaneous tissue tended to become thicker from the upper to lower and medial to lateral aspects, and the muscles followed the same pattern as that of the most superficial located muscle and the deepest located muscles. No significant sex-related differences were found in the skin at any landmark. However, the muscles tended to be deeper in the female participants. Conclusion: The study data can serve as a basis for creating or enhancing clinical anatomy-based guidelines or improving procedures in the infraorbital region.