• Title/Summary/Keyword: Clinical implication

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Clinical Significance of Soluble Major Histocompatibility Complex Class I Chain-related A in Renal Cell Carcinoma Patients

  • Qiu, Yu;Zhao, Ya-Kun;Yuan, Gang-Jun;Zhu, Qing-Guo
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.5651-5655
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    • 2013
  • Objective: Major histocompatibility complex class I chain-related A (MICA) is a stress-inducible glycoprotein that can be shed as a soluble protein. This study was conducted to determine the expression of MICA in renal cell carcinoma (RCC) and examine the clinical relevance of soluble MICA (sMICA) in this disease. Methods: Immunohistochemistry and real-time PCR analyses were performed to assess the expression of MICA in 48 pairs of RCC and adjacent normal renal tissues. Serum levels of sMICA were measured in 48 RCC patients, 12 patients with benign renal tumors, and 20 healthy individuals. The correlations between sMICA levels and clinicopathological parameters were analyzed and the diagnostic performance of sMICA in RCC was evaluated. Results: RCCs exhibited elevated expression of MICA compared to adjacent normal tissues. Serum concentrations of sMICA were significantly greater in RCC patients ($348.5{\pm}32.5pg/ml$) than those with benign disease ($289.3{\pm}30.4pg/ml$) and healthy controls ($168.4{\pm}43.2pg/ml$) and significantly correlated with advanced tumor stage, lymph node metastasis, distant metastasis, vascular invasion, and higher histological grade. Using a cut-off point of 250 pg/ml, sMICA demonstrated a specificity and sensitivity of 63.2% and 75.6%, respectively, in distinguishing between RCC and benign renal tumors. Conclusion: MICA expression is upregulated in RCC and increased serum sMICA levels predict aggressive tumor behavior. However, the applicability of sMICA alone is limited in distinguishing RCC from benign renal tumors.

Use of Music Technology in Music Therapy (음악치료에서의 음악테크놀로지 활용)

  • Park, Ye Seul
    • Journal of Music and Human Behavior
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    • v.12 no.2
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    • pp.61-77
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    • 2015
  • The purpose of this study was to investigate music therapists'use and perception of computer-based music technology. Questionnaires were distributed either electronically or in-person to 367 music therapists with credentials. Of the 367 initially distributed questionnaires, 101 were returned and 61 were analyzed after excluding 40 incomplete responses. The survey was comprised of two sections: the use of music technology and perceived importance of music technology in music therapy practice. The results showed that 65.6% of the respondents had used music technology in their clinical practice. The most frequently used type of music technology was Finale, followed by Garage band, and Cubase. With regard to the areas where music technology was used, it was implemented primarily for adolescents for musical or emotional goals, and was applied most frequently as a musical resource. In addition, most respondents showed a positive attitude toward music technology and added that they would need to be trained to use music technology for their clinical practice. These results provide practical information on how music therapists use and perceive computer-based music technology, and its implication for music therapy clinical practice.

Development of Nurse's Handover Standards between Hospital Units using SBAR (SBAR를 이용한 간호단위간 인수인계 표준항목 개발에 관한 연구)

  • Kim, Eun Man;Yu, Mi;Ko, Ji Woon
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.1
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    • pp.127-142
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    • 2015
  • Purpose: The purpose of this study was to develop the adapted standard items of situation, background, assessment, recommendations (SBAR) processing for handover between nursing units in Korean hospitals and evaluate the validity and relevance of the standard items. Methods: A delphi method with 33 experts was used to evaluate content validity of the standard items. Then, 1,175 nurses working in general hospitals of more than 500 beds were recruited to evaluate the validity and relevance of the standard items for clinical implication. Results: Content validity was higher than 0.8. The highest scores for relevance among items in handover standards were state of consciousness in the assessment domain for a ward to a ward transfer ($3.82{\pm}0.40$), for a ward to an ICU ($3.85{\pm}0.38$), an ICU to a ward ($3.81{\pm}0.39$) and an ER to a ward ($3.85{\pm}0.37$). Congenital malformation was the highest relevance score for handover from a delivery room to a neonatal unit ($3.91{\pm}0.30$). Conclusion: This study evaluated validity and relevance of the essential contents for handover standards between units to improve communication quality among nurses. The findings of this study should also be applied in clinical nursing areas and the quality of information and effectiveness of usage of the standard should be evaluated.

Implication of microRNA as a potential biomarker of myocarditis

  • Oh, Jin-Hee;Kim, Gi Beom;Seok, Heeyoung
    • Clinical and Experimental Pediatrics
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    • v.65 no.5
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    • pp.230-238
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    • 2022
  • Myocarditis was previously attributed to an epidemic viral infection. Additional harmful reagents, in addition to viruses, play a role in its etiology. Coronavirus disease 2019 (COVID-19) vaccine-induced myocarditis has recently been described, drawing attention to vaccine-induced myocarditis in children and adolescents. Its pathology is based on a series of complex immune responses, including initial innate immune responses in response to viral entry, adaptive immune responses leading to the development of antigen-specific antibodies, and autoimmune responses to cellular injury caused by cardiomyocyte rupture that releases antigens. Chronic inflammation and fibrosis in the myocardium eventually result in cardiac failure. Recent advancements in molecular biology have remarkably increased our understanding of myocarditis. In particular, microRNAs (miRNAs) are a hot topic in terms of the role of new biomarkers and the pathophysiology of myocarditis. Myocarditis has been linked with microRNA-221/222 (miR-221/222), miR-155, miR-10a*, and miR-590. Despite the lack of clinical trials of miRNA intervention in myocarditis yet, multiple clinical trials of miRNAs in other cardiac diseases have been aggressively conducted to help pave the way for future research, which is bolstered by the success of recently U.S. Food and Drug Administration-approved small-RNA medications. This review presents basic information and recent research that focuses on myocarditis and related miRNAs as a potential novel biomarker and the therapeutics.

Clinical implication of Dendritic Cell Infiltration in Cervical Tuberculous Lymphadenitis (결핵성 경부 림프절염에서 수지상돌기세포의 침윤과 임상양상의 연관성)

  • Jung, Jae Woo;Lee, Young Woo;Choi, Jae Cheol;Yoo, Seung Min;Lee, Hwa Yeon;Lim, Seoung Young;Shin, Jong Wook;Kim, Jae Yoel;Park, In Whn;Kim, Mi Kyung;Choi, Byoung Whui
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.5
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    • pp.523-531
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    • 2006
  • Background : Cervical tuberculous lymphadenopathy is a very common disease with a similar incidence to pulmonary tuberculosis. Dendritic cells play a role of initial antigen presentation of this illness. Nevertheless, the precise role of these antigen-presenting cells according to the clinical features in unclear. The aim of this study was to determine the clinical implication of dendritic cell infiltration in the cervical lymph nodes. Methods : A review of the clinical characteristics was carried out retrospectively based on the clinical records and radiography. Immunohistochemical staining was performed on the available histology specimens of 72 cases using the S-100b polyclonal antibody for dendritic cells. The number of dendritic cells with tuberculous granuloma were determined. A $X^2$ test, unpaired T test and multiple logistic regression analysis were performed. Results : Thirty percent of subjects had previous or concurrent pulmonary TB. Twenty one percent of cases showed a positive reaction on the AFB stain. Within a granuloma, the number of infiltrated dendritic cells was $113.0{\pm}7.0$. The incidence of fever and cough decreased with increasing infiltration of dendritic cells Multivariate regression analysis showed that the infiltration of dendritic cells could significantly contribute to fever. Conclusion : Overall, dendritic cells can control a Mycobacterium tuberculosis infection and modulate the immune response, as well as resolve the clinical manifestations of TB lymphadenopathy.

Clinical Implication of Acetylcholinesterase in Acute Organophosphate Poisoning (유기인계 농약 중독 환자에서 초기 적혈구 아세틸콜린에스테라제 활성도의 임상적 의의)

  • Kim, Hoon;Han, Seung-Baik;Kim, Jun-Sig;Lee, Mi-Jin;Park, Joon-Seok;Kwon, Woon-Yong;Eo, Eun-Kyung;Oh, Bum-Jin;Lee, Sung-Woo;Suh, Joo-Hyun;Roh, Hyung-Keun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.6 no.1
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    • pp.25-31
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    • 2008
  • Purpose: Acute organophosphate (OP) poisoning may be monitored by measuring the acetylcholinesterase (AChE). It is important to assess severity and establish prognostic tests in the early stage of OP poisoning. The aim of this study was to look at the relationship between various clinical aspects of the OP poisoning, prognostic indicators of OP poisoning including Simplified Acute Physiology Score (SAPS) 3, and the associated changes in AChE levels. Methods: Clinical data and initial AChE levels from thirty-seven patients with OP poisoning were prospectively reviewed from 12 teaching hospitals in South Korea from August 2005 to July 2006. Clinical manifestations at the time of arrival such as miosis, respiratory abnormality, salivation, urinary incontinence, GCS score, AVPU scale, need for intubation, and mechanical ventilation requirements were recorded. SAPS 3 was calculated using clinical data and laboratory results. Results: The median level of AChE was 9.8 (1.3-53.6) U/gHb. There was no significant difference in AChE levels between the groups with and without cholinergic symptoms. The median level of AChE of the patients who required intubation and those who did not were 3.5 U/gHb and it 19.7 U/gHb respectively (Mann-Whitney test; p<0.001). The AChE levels were also significantly different (p=0.007) in patients who needed mechanical ventilation compared to those who did not with AChE levels found to be 3.1 U/gHb and it was 14.8 U/gHb, respectively. Level of consciousness assessed using the AVPU scale was correlated with AChE levels (Kruskal-Wallis test; p=0.013). GCS score were correlated with AChE levels (p=0.007, Spearman's rho = 0.454). In addition, the lower the level of initial AChE, the longer the ICU stay (p=0.029, Spearman's rho=-0.380). SAPS 3 was inversely correlated with the initial AChE (p<0.001, Spearman's rho=-0.633). Conclusion: In the acute OP poisoning, low AChE levels appear to help indicate the severity of poisoning. The initial AChE level may be a useful prognostic parameter for acute OP poisoning.

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Detection of Viral Antigens in Stool Using EIA in Hospitalized Children and Clinical Implication (간접 효소 면역측정법을 이용한 입원 환아의 대변에서 바이러스 항원의 검출과 임상적 의의)

  • Min, Jung Hye;Seo, Jeong Wan;Park, Hye Kyung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.143-152
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    • 2004
  • Purpose: The purpose of this study is to detect viral coproantigens in children who were hospitalized with acute diarrhea and to compare its association with clinical symptoms. Methods: Seventy-four stool samples were collected from children admitted to Ewha Mokdong Hospital from March 1996 to December 1999. The samples were frozen and analyzed for rotavirus, adenovirus, enterovirus, astrovirus, and calicivirus by enzyme immunoassay (EIA) with monoclonal antibody. 53 stool samples were collected from patients with diarrhea (diarrheal group) and 21 stool samples from patients hospitalized for reasons other than diarrhea (control group). Clinical features and laboratory findings were reviewed in both groups. Results: Among 74 stool samples, virus antigens were detected in 60 samples. Of the 60 virus-positive stool samples, 47 enterovirus, 26 rotavirus, 16 adenovirus, 11 astrovirus, and 11 calicivirus antigens were detected by EIA. Of the 60 virus-positive stool samples, 28 samples have one viral antigen, 30 samples have 2 or more viral antigens, and 2 samples showed a simultaneous infection of Salmonella group B and enterovirus. There was no relationship between the detected virus and clinical features. Conclusion: In this study, viral coproantigen and clinical symptoms were not associated. In the future, further larger scale studies are necessary.

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The Clinical Implication of MAGE Gene Detection in Bronchial Washing Fluid in Routine Practice (기관지 세척액 검사를 이용한 MAGE 유전자 검사의 임상적 의의)

  • Lee, Seung-June;Yun, Myung-Jae;Lee, Seong-Tae;Oh, Hye-Jin;Song, Sook-Hee;Sohn, In;Kim, Yeon-Jung;Han, Kyung-Hoon;Kim, Sun-Hee;Kim, Su-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.6
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    • pp.442-449
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    • 2010
  • Background: Melanoma antigen genes (MAGE) are expressed in many human malignant cells and are silent in normal tissues other than in testis and in placenta. But MAGE expression in benign lung diseases, such as pulmonary tuberculosis or cases with severe inflammation, needs further evaluation to overcome false-positive findings. We evaluated detection rates of the melanoma antigen genes (MAGE) RT-nested PCR in bronchoscopic washing samples from patients with benign lung disease, as well as in patients with malignancies. Methods: Bronchial washing fluid from 122 patients was used for cytological examination and MAGE gene detection using RT-nested-PCR of common A1-6 mRNA. We compared the results from the RT-nested PCR and the pathologic or bacteriologic diagnosis. We also analyzed the expression rate and false positive rate of MAGE gene. Results: Among 122 subjects, lung cancer was diagnosed in 23 patients and benign lung disease was diagnosed in 99 patients. In patients with lung cancer, the positive rate of MAGE expression was 47.8% (11/23) and in benign lung disease group, the expression rate was 14.1% (14/99). Among benign lung disease group, the expression rate of MAGE gene (25.0%) in patients with pulmonary tuberculosis (11/44) was especially high. Conclusion: MAGE A1-6 RT-nested PCR of bronchial washing fluid can be used as a complementary method in lung cancer, but that test results in a high false positive rate in tuberculosis patients.

TIC DISORDER AND OBSESSIVE COMPULSIVE DISORDER IN CHILDHOOD (틱 장애 및 소아기 발병 강박 장애)

  • Hong, Hyun-Ju;Song, Dong-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.183-191
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    • 2005
  • Tic disorder including Tourette's disorder is a neurodevelopmental disorder that appears in childhood and characterized by the presence of motor and vocal tics. Childhood-onset obsessive-compulsive disorder (OCD) is suggested to be a phenomenologically and etiologically distinct subtype of OCD, bearing a close genetic relationship to tic-disorders. Tourette's disorder and OCD are comorbid in $40-75\%$ of patients initially diagnosed with either disorder. Basal ganglia and cortico-striato-thalamic circuits are implicated in the pathophysiology of both disorders and these disorders have similar clinical features. Over the past decades, the progress in research on Tourette's disorder and OCD has been extraordinary. This review describes some of important insights from these work, involving these areas : 1) clinical implication 2) genetics and epidemiology 3) brain imaging study 4) neuroche-mistry 5) pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS).

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A Study on the Policy Implication on the Management of Narcotics Distribution for Medical Use (의료용 마약류 유통 관리에 대한 고찰과 정책적 함의: 유통자료 및 청구자료 분석을 중심으로)

  • Yu, Su-Yeon;Cho, Hyunmin;Kang, Hyeun Ah;Kim, Sukyeong
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.4
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    • pp.280-285
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    • 2015
  • Objectives: To suggest direction for improving policies by understanding current management of narcotics or psychotropic drugs and analyzing their distributions and usage. Method: We conducted a comparison analysis between health insurance claims and the amount supplied to health care institutions for narcotics or psychotropic drugs through health insurance claims data and drug distribution supply data from 2010 to 2012 collected from Korea Pharmaceutical Information Service Center (KPIS). Furthermore, we carried out literature investigation and online search to comprehend the current management of narcotics drugs in Korea. Results: The amount supplied to medical institutions for all drugs in 2012 was 19.4 trillion won, which increased from 19.5 trillion in 2011 by 0.54%. For narcotic drugs, the amount supplied was 318.4 billion won in 2011 and increased to 335.1 billion won by 5.3% in 2012, which exceeded the rate of increase for the amount supplied for all drugs. The proportion of amount claimed in the total amount supplied to medical institutions for all drugs was 60.5% in 2012, whereas the proportion of amount claimed for narcotic drugs was 55.6%, which showed that narcotic drugs were used relatively less within health insurance. Furthermore, management of the current domestic distribution supply data focuses on manufacturing and medical institution supply stages. Conclusion: Hereafter, the management of narcotics or psychotropic drugs needs to be improved by reinforcing active monitoring in optimal prescription and usage in patients by collecting and analyzing information on drug usage of patients.