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Comparison of Two Rapid Antigen Detection Tests for Diagnosis of Group A Streptococcal Pharyngotonsillitis (A군 연쇄구균성 인두편도염 진단을 위한 두 종류 신속항원검사법의 비교)

  • Song, Seung Kyu;Hong, Mi Ae;Oh, Kyung Chang;Ahn, Seung In;Tae, Mi Hyon;Shin, Hye Jung;Chang, Jin Keun;Cha, Sung Ho
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.973-979
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    • 2002
  • Purpose : Recently, a number of rapid antigen detection tests have been available to diagnose group A streptococcal pharyngotonsillitis. The purpose of this study was to determine the sensitivity, specificity and consistency of the two rapid antigen detection tests. Methods : Among the patients who visited our clinic from November 2001 to February 2002, 61 patients who had clinical findings of pharyngeal erythema or edema, pharyngeal exudates and soft palatine petechiae were enrolled in our study. A total of 61 patients were tested with rapid antigen detection tests and throat culture. BD $LINK2^{TM}$ Strep A(Becton, Dickinson & Company, U.S.A.) and $QuickVue^{(R)}$ $In-Line^{TM}$(Quidel Corporation, U.S.A.) were selected for rapid antigen detection tests. Results : Of the 61 patients tested, 22 patients were confirmed as group A streptococcal pharyngotonsillitis by throat culture. The BD $LINK2^{TM}$ Strep A had a sensitivity of 81.8% and a specificity 89.7%. The positive and negative predictive values were 81.8% and 89.7%, respectively. The $QuickVue^{(R)}$ $In-Line^{TM}$ had a sensitivity of 77.3% and a specificity of 100%. The positive and negative predictive values were 100% and 88.6%, respectively. The kappa values of BD $LINK2^{TM}$ Strep A and $QuickVue^{(R)}$ $In-Line^{TM}$ were 0.72 and 0.81, respectively. Conclusion : In addition to high sensitivity, specificity and consistency, both kits are easy to use and simple to interpret, and therefore have the potential to be used with backup throat culture for diagnosis of acute pharyngotonsillitis.

Cardiovascular and Perceived Exertion Response to Treadmill Running and Cycle Ergometer Exercise in Responder and Nonresponder Acute Coronary Syndrome Patients (심장재활에 참여한 급성 관상동맥증후군 환자에서 약물 반응과 운동 형태의 변화에 따른 심혈관과 운동자각도의 반응)

  • Kim, Young-Joo;Kim, Chul-Hyun
    • Journal of Life Science
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    • v.18 no.9
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    • pp.1263-1270
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    • 2008
  • The purpose of this study is to investigate the effect of exercise mode and anti-hypertensive drug responding status on the cardiovascular response and perceived exertion in acute coronary syndrome (ACS) patients. Seventy-five patients who participated in six-week exercise rehabilitation therapy performed a treadmill running and a cycle ergometer exercise at intensities of 60%HRR and 85%HRR respectively. Systolic and diastolic blood pressure, mean arterial blood pressure (MAP), rate pressure production (RPP), and ratings of perceived exertion (RPE) were measured. The results of cardiovascular response by the different exercise modes with moderate and intensive intensity of anti-hypertensive drug responder and nonresponder ACS patients were following: First cycle ergometer exercise induced significantly higher SBP, DBP, MAP, RPP and MAP than treadmill running exercise at the intensities of 60%HRR and 85%HRR in both anti-hypertensive responder and nonresponder ACS patients (p<0.05). Secondly anti-hypertensive nonresponder ACS patients had significantly higher DBP and MAP that anti-hypertensive responder ACS patients at all the exercise modes (p<0.05). Finally there was no difference of RPP between anti-hypertensive responder and nomresponder ACS patients, although anti-hypertensive nonresponder ACS patients showed higher blood pressure and RPP than anti-hypertensive responder ACS patients. In conclusion, cycle ergometer induced increased cardiovascular response at same intensities of treadmill running exercise and anti-hypertensive nonresponder ACS patients had even more increased cardiovascular response than anti-hypertensive responder ACS patients with no difference in perceived exertion during exercise. These results suggested that cycle ergometer exercise should be greatly careful with the risk of higher blood pressure, especially for those who are patients with hypertensive blood pressure.

A Gelatinase A Isoform, GA110, of Human Follicular Fluid Is Degraded by the Bovine Oviductal Fluid Component (소의 수란관액에 의한 사람 난포액의 Gelatinase A 동위효소인 GA110의 분해)

  • Kim, Min-Jung;Kim, Ji-Young;Leec, Seung-Jae;Yoon, Yong-Dal;Cho, Dong-Jae;Kim, Hae-Kwon
    • Development and Reproduction
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    • v.5 no.1
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    • pp.23-33
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    • 2001
  • When mammalian oocytes ovulate into the oviduct, associating follicular fluid components are exposed to the oviductal environment, possibly resulting in the mutual interaction between fillicu1ar and oviductal fluids. In the Present study, we have demonstrated for the first time that components of fallicular fluid could be modified by the oviductal fluid. Gelatin zymographic analyses of human follicular fluid (hFF) obtained from IVF patients showed consistently the presence of 110 kDa gelatinase (GA110) in addition to many bands among which 62 kDa gelatinase was predominant. Addition of EDTA or phenanfhroline to the gelatinase substrate buffer during gel incubation abolished GA110 band whereas phenylmethylsulffnyl fluoride (PMSF) did not. In contrast, bovine oviductal fluid(bOF) exhibited only 62 kDa gelatinase. Surprisingly, when bOF was added to hFF in 1:1 ratio and then the mixture was incubated for 3 h at 37$^{\circ}$C, GA110 of hFF disappeared. Disappearance of GA110 by bOF was observed even within 30 min after mixing with hFF. Addition of aminophenylmercuric acetate (APMA) to hFF also abolished enzymatic activity of GA110 but increased the activityof 62 kDa gelatinase. However, APMA abolished many other gelatinases as well unlike bOF. Interestingly, treatment of hFF with EDTA for 3 h remarkably increased the enzymatic activity of GA110 but not that of other gelatinases. Addition of phenanthroline, PMSF or soybean trypsin inhibitor (SBTI) did not affect overall gelatinase activities. Again, addition of bOF to the hFF pretreated with any of the above proteinase inhibitors abolished the appearance of GA110. Human serum also showed GAI 10 of which activity was greatlyenhanced by EDTA treatment. Similar to hFF, serum GA110 also disappeared by the addition of bOF. Human granulosa cell homogenate did not reveal any appreciable gelatinase activity except 92 kDa gelatinase. Anti-human gelatinase A antibody reacted with 62 kDa gelatinase of hFF. Based upon these results, it is concluded that bOF could selectively degrade an isoform of gelatinase A present in hFF and human serum.

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Correlation between Clinicopathology and Expression of HSP70, BAG1 and Raf-1 in Human Diffuse Type Gastric Carcinoma (미만형 위암에서 임상병리학적 인자와 Hsp70, BAG1과 Raf-1 발현간의 상관성)

  • Jung, Sang Bong;Lee, Hyoun Wook;Chung, Kyung Tae
    • Journal of Life Science
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    • v.26 no.1
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    • pp.101-108
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    • 2016
  • The aim of this study was to evaluate the relationships between the expression of Heat shock protein70 (HSP70), Raf-1 and Bcl-2-associated athanogene-1 (BAG1) protein in diffuse type gastric carcinoma and examine association of HSP70, Raf-1 and BAG1 expression with various clinic-pathological factors and survival. Heat shock protein70 is induced in the cells in response to various stress conditions, including carcinogens. Overexpression of heat shock protein 70 has been observed in many types of cancer. The proto-oncoprotein Raf is pivotal for mitogen-activated protein kinase (MAPK) signaling, and its aberrant activation has been implicated in multiple human cancers. Overexpression of BAG1 protein has been documented in some type of human cancer. BAG1 has been reported to interact with protein involved with a variety of signal pathway, and regulation of cell differentiation, survival and apoptosis. These interaction partners include HSP70 and Raf-1. The percentage of tumors exhibiting HSP70 positivity was significantly in cases of positive lymph node metastasis (64.9%) compared to cases without lymph node metastasis (35.1%, p=0.007). HS70 expression was correlated with pathological N-stage (p=0.006). Expression of BAG1 was detected in the majority of diffuse type gastric carcinoma tissues (71.7%), especially in younger patients (80% vs 52.6%, p=0.035). Furthermore BAG1 expression was correlated with tumor size (p=0.020). Raf-1 expression was found to be significantly associated with tumor size (p=0.005). The result indicate that HSP70 was significantly correlated the progression of diffuse type gastric cancer. Expression of BAG1 and Raf-1 may be used as diagnostic markers for gastric carcinoma.

Targeted Therapies and Radiation for the Treatment of Head and Neck Cancer (두경부 암의 표적 지향적 방사선 치료)

  • Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.77-90
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    • 2004
  • Purpose: The purpose of this review Is to provide an update on novel radiation treatments for head and neck cancer Recent Findings: Despite the remarkable advances In chemotherapy and radiotherapy techniques, the management of advanced head and neck cancer remains challenging. Epidermal growth factor receptor (EGFR) Is an appealing target for novel therapies In head and neck cancer because not only EGFR activation stimulates many important signaling pathways associated with cancer development and progression, and importantly, resistance to radiation. Furthermore, EGFR overexpression Is known to be portended for a worse outcome in patients with advanced head and neck cancer. Two categories of compounds designed to abrogate EGFR signaling, such as monoclonal antibodies (Cetuxlmab) and tyrosine kinase inhibitors (ZD1839 and 051-774) have been assessed and have been most extensively studied In preclinical models and clinical trials. Additional TKIs In clinical trials include a reversible agent, Cl-1033, which blocks activation of all erbB receptors. Encouraging preclinical data for head and neck cancers resulted In rapid translation Into the clinic. Results from Initial clinical trials show rather surprisingly that only minority of patients benefited from EGFR inhibition as monotherapy or In combination with chemotherapy. In this review, we begin with a brief summary of erbB- mediated signal transduction. Subsequently, we present data on prognostic-predictive value of erbB receptor expression in HNC followed by preclinlcal and clinical data on the role of EGFR antagonists alone or in combination with radiation In the treatment of HNC. Finally, we discuss the emerging thoughts on resistance to EGFR biockade and efforts In the development of multiple-targeted therapy for combination with chemotherapy or radiation. Current challenges for investigators are to determine (1 ) who will benefit from targeted agents and which agents are most appropriate to combine with radiation and/or chemotherapy, (2) how to sequence these agents with radiation and/or cytotoxlc compounds, (3) reliable markers for patient selection and verification of effective blockade of signaling in vivo, and (4) mechanisms behind intrinsic or acquired resistance to targeted agents to facilitate rational development of multi-targeted therapy, Other molecuiar-targeted approaches In head and neck cancer were briefly described, Including angloenesis Inhibitors, farnesyl transferase inhibitors, cell cycle regulators, and gene therapy Summary: Novel targeted theraples are highly appealing in advanced head and neck cancer, and the most premising strategy to use them Is a matter of intense Investigation.

Understanding of the Workers in the North Area of Ulsan on the Oral Health and Hygienic Status (울산시 일부 생산직 근로자의 구강보건 인식에 대한 조사연구)

  • Lee, Ga-Ryeong
    • Journal of dental hygiene science
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    • v.4 no.3
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    • pp.117-126
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    • 2004
  • For a month of September, 2004, a questionnaire regarding dental hygiene was distributed to 165 workers of Ulsan area. A total of 125 questionnaire were analyzed: 102 collected of the distributed 165 pieces, and 23 questionnaires reported by patients of a dental clinic in Dong-gu, Woolsan. The result is as follows; (1) Labor workers of Ulsan have thought that they are in good dental health, 44.1% of respondents, following by those who they believe they are in moderate health and those who they think are in poor condition. 89.0% of total workers have experienced dental treatment. (2) Regarding the location of dental treatment, 85.0% of respondents have pointed out dental hospitals and clinics, while 3.9% have indicated that they had treatment from unlicensed dentists. Specifically, workers in their 40s over have ever experienced dental treatment by unlicensed dentists. Those who think they are in poor dental condition have tended to have more dental treatment by unlicensed dentists. (3) Regarding the reason that they put off the treatment, 59.1% of respondents have indicated that they have no time to have the treatment, following by economic burden and the lack of confidence in dentists. When they have tooth aches or the gum ache, 60% of respondents have suggested that they endure the ache or take a medicine to alleviate the pain, showing a lower understanding of early dental treatment. (4) Regarding the reason why they are unwilling to go to dentists, respondents have revealed the anxiety against pain, 50.4%, following by the difficulty of scheduling and unsatisfied services. (5) 47.2% of respondents have brushed their teeth 3 times everyday, following by those who have done it 2 times a day and those one a day. Regarding how to brush the teeth, most of respondents have brushed their teeth in the upper, lower, and the both side, 61.4%. The younger respondents and those who think they are in good dental health have tended to brush their teeth up and down. (6) Regarding the cause of the gum disease, 67.7% of respondents have thought that it is caused by poor dental hygiene, following by natural occurrence due to age, hereditary nature, and physical predisposition. (7) 67.7% of respondents have experienced dental scaling, while 32.3% of them have had no experience in it. 53.5% of workers have thought that scaling may not be recommended since they have the teeth scaled periodically once they had dental scaling, a higher rate than 46.5% who think scaling is good for the gum health.

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A Case of Late-onset Episodic Myopathic Form with Intermittent Rhabdomyolysis of Very-long-chain acyl-coenzyme A Dehydrogenase (VLCAD) Deficiency Diagnosed by Multigene Panel Sequencing (유전자패널 시퀀싱으로 진단된 성인형 very-long-chain acyl-coenzyme A dehydrogenase (VLCAD) 결핍증 증례)

  • Sohn, Young Bae;Ahn, Sunhyun;Jang, Ja-Hyun;Lee, Sae-Mi
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.19 no.1
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    • pp.20-25
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    • 2019
  • Very-long-chain acyl-CoA dehydrogenase (VLCAD) deficiency (OMIM#201475) is an autosomal recessively inherited metabolic disorder of mitochondrial long-chain fatty acid oxidation. The clinical features of VLCAD deficiency is classified by three clinical forms according to the severity. Here, we report a case of later-onset episodic myopathic form of VLCAD deficiency whose diagnosis was confirmed by plasma acylcarnitine analysis and" multigene panel multigene panel sequencing. A 34-year old female patient visited genetics clinic for genetic evaluation for history of recurrent myopathy with intermittent rhabdomyolysis. She suffered first episode of rhabdomyolysis with acute renal failure requiring hemodialysis at twelve years old. After then, she suffered several times of recurrent rhabdomyolysis provoked by prolonged exercise or fasting. Physical and neurologic exam was normal. Serum AST/ALT and creatinine kinase (CK) levels were mildly elevated. However, according to her previous medical records, her AST/ALT, CK were highly elevated when she had rhabdomyolysis. In suspicion of fatty acid oxidation disorder, multigene panel sequencing and plasma acylcarnitine analysis were performed in non-fasting, asymptomatic condition for the differential diagnosis. Plasma acylcarnitine analysis revealed elevated levels of C14:1 ($1.453{\mu}mol/L$; reference, 0.044-0.285), and C14:2 ($0.323{\mu}mol/L$; 0.032-0.301) and upper normal level of C14 ($0.841{\mu}mol/L$; 0.065 -0.920). Two heterozygous mutation in ACADVL were detected by multigene panel sequencing and confirmed by Sanger sequencing: c.[1202G>A(;) 1349G>A] (p.[(Ser 401Asn)(;)(Arg450His)]). Diagnosis of VLCAD deficiency was confirmed and frequent meal with low-fat diet was educated for preventing acute metabolic derangement. Fatty acid oxidation disorders have diagnostic challenges due to their intermittent clinical and laboratorial presentations, especially in milder late-onset forms. We suggest that multigene panel sequencing could be a useful diagnostic tool for the genetically and clinically heterogeneous fatty acid oxidation disorders.

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Development of smartphone-based voice therapy program (스마트폰기반 음성치료 프로그램 개발연구)

  • Lee, Ha-Na;Park, Jun-Hee;Yoo, Jae-Yeon
    • Phonetics and Speech Sciences
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    • v.11 no.1
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    • pp.51-61
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    • 2019
  • The purpose of this study was to develop a smartphone based voice therapy program for patients with voice disorders. Contents of voice therapy were collected through analysis of mobile contents related to voice therapy in Korea, experts and users' demand survey, and the program was developed using Android Studio. Content needed for voice therapy was collected through analysis of mobile contents related to voice therapy. The user satisfaction evaluation for application was conducted for five patient with functional voice disorders. The results showed that the mobile contents related to voice therapy in Korea were mostly related to breathing, followed by voice and singing, but only 13 applications were practically practiced for voice therapy. Expert and user demand surveys showed that the patients and therapists both had a high need for content that could provide voice training in places other than the treatment room. Based on this analysis, 'Home Voice Trainer', an smartphone based voice therapy program, was developed. Home Voice Trainer is an application for voice therapy and management based on Android smartphones. It is designed to train voice therapy activities at home that have been trained offline. In addition, the records of voice training of patients were managed online so that patients can maintain voice improvement through continuous voice consulting even after the end of voice therapy. User evaluations show that patients are satisfied with the difficulty and content of voice therapy programs provided by home voice trainers, but lack of a portion of user interface, such as the portion of home button and interface between screens. Further study suggests the clinical application of home voice trainer to the patients with voice disorders. It is expected that the development study and the clinical application of smart contents related to voice therapy will be actively conducted.

Analytical Psychology in Psychiatric Clinics (진료현장에서의 분석심리학 : 정신건강의학과 진료실에서 접하는 문제들의 분석심리학적 접근 경험)

  • Sang-Hag Park
    • Sim-seong Yeon-gu
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    • v.35 no.2
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    • pp.85-112
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    • 2020
  • How does analytical psychology help understand patients at general psychiatric clinics? It's necessary to think about how knowledge of analytical psychology can help young psychiatrists who are in training. Patients who come to us bring symptoms(problems). Symptoms can be compared to tickets to a movie theater. Symptoms accompanied by complaints of pain are not only pathological phenomena to be eliminated, but an important pathway to access the patients' inner problems. In terms of seeing the whole, the point of view in analytical psychology is to see the unconscious as well as the consciousness, even the elements the patients do not speak or know of. When determining indications and contra-indications during the initial process of treating a patient, it is more important to acknowledge the therapist's capabilities and limitations than the patient's condition or limitations The approach to complaints of the same symptoms may differ depending on whether the patient is in the first half or the second half of one's life. Analytical psychology is empirical psychology that experiences and it adheres to a phenomenological position that recognizes the phenomenon as true in itself, not logically right or wrong. The analytical psychological view of understanding mental phenomena asks the causal perspective of why the symptoms occurred. At the same time, the therapist, along with the patient, must seek answers to the question of why now and for what purpose. A therapist is a person who experiences the patient's personal development process together. In analytical psychotherapy, the therapist's attitude is more emphasized than the treatment method or technique; it is regarded as of the utmost importance. In this regard, analytical psychology is a practical and useful therapeutic tool, and is a field of study that can be widely used in actual psychiatric clinics. In addition to understanding the patient, it is also the most important discipline for the therapists, especially for the education and growth of those who want to become a treatment tool themselves.

Utilization Pattern of Complementary Therapy in Hypertension, Diabetes and Chronic Arthritis Patients Visited to Local Health Center (일개 보건소를 방문하는 고혈압, 당뇨 및 관절염환자의 보완요법 이용실태)

  • Park, Ae-Ju;Park, Jae-Yong;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.107-122
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    • 2003
  • Objectives: The objective of this study is to investigate the use rate and some aspect of complementary therapies used by patients with chronic illness(hypertension, diabetic mellitus and chronic arthritis). Methods: 600 patients visiting the health center for one month(Jan. 2001) were interviewed on their complementary therapies used by the subjects for the previous year. Results: About fourteen-eight percent of the respondents used therapies; 35% of patients with hypertension, 44.6% of patients with diabetic mellitus and 62.9% of patients with chronic arthritis, which shows the highest rate among patients with three chronic disease. The use rate of complementary therapies indicates few meaningful differences according to the general characteristics of the interviewees. Hypertension patients used herb medication(31.0%) acupuncture(29.6%) and most of all the other therapies. Diabetic patients used dietary therapy(57.5%) and herb medication(35.1%). Chronic arthritis patients used acupuncture(85%) and herb medication(34.7%). 36.8% of all the patients who used complementary therapies tried more than two therapies. 18.3% of hypertension patients, 24.1% of diabetic patients and 55.9% of chronic arthritis patients used more than two therapies. Acupuncture(47%) was used most frequently, followed by herb medications(26.3%), health assistance utensils(21.8%). oriental therapy(21.8%), physical therapy(9.5%), health assistance food(8.4%), herb(7.7%), Korea hand acupuncture(3.2%), abdomen respiration(1.1%), and pore therapy(0.7%) Oriental clinic was visited most frequently(42.8%), which was used to cure diseases(61.8%), and to relieve symptoms(26.0%). (p<0.001) The cost spent on complementary therapies last year was 90,000 won(40.3%) and there are some cases of more than 500,000 won(31.2%). Most of the patients(56.1%) were satisfied with the complementary therapies, with 6% of them having side effects. 74% of the patients used complementary therapies answered that they would continue them and 56.1% of them also answered that they would continue them and 56.1% of them also answered that they would advise other patients to do them. Advantages(compared with those of orthodox medical treatment) are psychological comfort(28.1%), body protection(26.0%), effectiveness(20.0%). 34% of the patients using complementary therapies wanted to have informational orientation on complementary therapies. These findings reveal that a considerable number of patients with chronic illness(47.5%) tried a variety of complementary therapies. Though 6% of the patients using therapies had side effects, most of the subjects seemed satisfied with them and they are supposed to continue them. Conclusions: In conclusion, health center personnels and medical doctors should pay more attention to the complementary therapies used by patients with chronic illness. They also have to try their best to advise more scientific and informative complementary programs with less side effects and more help to improve their conditions.

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