• 대한후두음성언어의학회지
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• 제29권1호
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• pp.30-36
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• 2018

Background and Objectives : The effect of palliative injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients on voice and swallowing function is uncertain and there are few previous studies of its suitability, benefits as a palliative treatment option. The purpose of this study is to confirm the objective results of voice and swallowing function after palliative office-based hyaluronic acid injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients. Materials and Method : 36 patients who had unilateral vocal cord paralysis from non-thyroidal, extralaryngeal neoplasms were included in this study. To evaluate the clinical outcome, we analyzed perceptual GRBAS grading, acoustic analysis, aerodynamic study, Electroglottography (EGG), Voice Handicap Index (VHI-30) about voice function and disability rating scale (DRS), gastric tube dependency, aspiration pneumonia about swallowing function and 36-Item Short Form Survey version 2 (SF-36v2) about quality of life. Results : In GRBAS scale, G (p<0.001), R (p=0.004), B (p=0.001), A (p=0.011), and S (p=0.007) showed significant improvement. Jitter, shimmer, speaking fundamental frequency, maximal phonation time, VHI-30, DRS score, gastric tube dependency, aspiration pneumonia, and SF-36v2 were significantly improved after injection (p=0.016, p=0.011, p=0.045, p=0.005, p<0.001, p<0.001 p=0.003, p<0.001, and p<0.001 respectively). Conclusion : From this study we concluded office-based hyaluronic acid injection can be used as a useful palliative treatment option in cancer-related ill patients with unilateral vocal cord paralysis. Palliative hyaluronic acid injection laryngoplasty avoids the need for tube feeding, thus reducing the risk of aspiration pneumonia. These outcomes are accompanied by significant improvement in voice quality.

• Korean Journal of Radiology
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• 제22권2호
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• pp.281-290
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• 2021

Objective: To assess the performance of content-based image retrieval (CBIR) of chest CT for diffuse interstitial lung disease (DILD). Materials and Methods: The database was comprised by 246 pairs of chest CTs (initial and follow-up CTs within two years) from 246 patients with usual interstitial pneumonia (UIP, n = 100), nonspecific interstitial pneumonia (NSIP, n = 101), and cryptogenic organic pneumonia (COP, n = 45). Sixty cases (30-UIP, 20-NSIP, and 10-COP) were selected as the queries. The CBIR retrieved five similar CTs as a query from the database by comparing six image patterns (honeycombing, reticular opacity, emphysema, ground-glass opacity, consolidation and normal lung) of DILD, which were automatically quantified and classified by a convolutional neural network. We assessed the rates of retrieving the same pairs of query CTs, and the number of CTs with the same disease class as query CTs in top 1-5 retrievals. Chest radiologists evaluated the similarity between retrieved CTs and queries using a 5-scale grading system (5-almost identical; 4-same disease; 3-likelihood of same disease is half; 2-likely different; and 1-different disease). Results: The rate of retrieving the same pairs of query CTs in top 1 retrieval was 61.7% (37/60) and in top 1-5 retrievals was 81.7% (49/60). The CBIR retrieved the same pairs of query CTs more in UIP compared to NSIP and COP (p = 0.008 and 0.002). On average, it retrieved 4.17 of five similar CTs from the same disease class. Radiologists rated 71.3% to 73.0% of the retrieved CTs with a similarity score of 4 or 5. Conclusion: The proposed CBIR system showed good performance for retrieving chest CTs showing similar patterns for DILD.

• 한국동물위생학회지
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• 제34권4호
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• pp.389-395
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• 2011

The aims of this study were to assess the lung lesions and to compare gross observations with histopathological findings in the lungs of slaughter pigs. During August of 2010 through July of 2011, the 1,200 lung samples were randomly collected from slaughtered pigs in Korea. We examined prevalence of lung lesions and classified the lung lesion according to the severity of lung lesions. For the comparison of gross lesions with histopathological findings, BALT hyperplasia was also examined. Among the tested samples, 1,100 (91.7%) had pneumonic lung lesions. In the seasonal prevalence of pneumonic lung lesions, spring was the highest followed by winter, summer and autumn, respectively. The mean pneumonic score ($mean{\pm}SD$) was $21.37{\pm}17.87$ and the highest gross lesion according to stages was 11~20% (27.2%, 326/1,200). The prevalence of pleuritis was 7.0% and the highest prevalence was determined in summer. In severity, the lungs collected in this study were frequently in chronic stage (36.4%, 437/1,200), and it was shown that BALT hyperplasia was more extensive in chronic lesion. In this study, the prevalence of pneumonic lung lesions showed a high side and appeared particularly high in the spring. Severity of lung lesion was the most prevalent chronic lesions which were consistent with histopathologic findings.

• 임상이비인후과
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• 제29권2호
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• pp.223-228
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• 2018

Background and Objectives : Necortizing fasciitis in the cervical region is a very rare disease with high mortality and morbidity rates. The purpose of this study was to analyze the clinical characteristics, treatment results, complication and prognosis of necrotizing fasciitis patients. Materials and Methods : We retrospectively reviewed the inpatient charts treated for cervical necrotizing fasciitis at our Otorhinolaryngology clinic. We diagnosed necrotizing fasciitis by the clinical findings such as swelling, redness and pain of infected area and necrosis of subcutaneous fat layer and fascia observed during surgery. Twenty such patients were identified and treated from January 2011 to December 2016. Results : 20 adults consisting of 14 male and 6 females with cervical necrotizing fasciitis were diagnosed and treated. The most commonly known associated preceding illness were dental abscess and tonsillitis. The most pathogen was Streptococcus species (12/20), followed by Klebsiella pneumonia (6/20), Staphylococcus species (2/20). The mean duration of hospitalization was 32.2 days (range,14-86). The mean Modified Laboroatory Risk Indicator for Necrotizing Fasciitis (M-LRINEC) score is 7.4 and more than 4 points was eighteen. All patients received parenteral antibiotics and surgical drainage after admission. Conclusions : The reason for the high survival rate in the study was the early diagnosis, as well as the early surgical procedure and antibiotics. After the operation, frequent betadine irrigation could improve the patient's condition and recover without severe complication.

• 한국방사선학회논문지
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• 제17권6호
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• pp.873-879
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• 2023

본 연구는 인공지능(AI)을 사용하여 흉부 엑스레이 이미지에서 이물질을 탐지하는 방법을 탐구하였다. 의료영상학, 특히 흉부 엑스레이는 폐렴이나 폐암과 같은 질병을 진단하는 데 매우 중요한 역할을 한다. 영상의학 검사가 증가함에 따라 AI는 효율적이고 빠른 진단을 위한 중요한 도구가 되었다. 하지만 이미지에는 단추나 브래지어 와이어와 같은 일상적인 장신구를 포함한 이물질이 포함될 수 있어 정확한 판독을 방해할 수 있다. 본 연구에서는 이러한 이물질을 정확하게 식별하는 AI 알고리즘을 개발하였고, 미국 국립보건원 흉부 엑스레이 데이터셋을 가공하여 YOLOv8 모델을 기반으로 처리하였다. 그 결과 정확도, 정밀도, 리콜, F1-score가 모두 0.91에 가까울 정도로 높은 탐지 성능을 보였다. 이번 연구는 AI의 뛰어난 성능에도 불구하고 이미지 내 이물질로 인해 판독 결과가 왜곡될 수 있는 문제점을 해결함으로써 영상의학 분야에서 AI의 혁신적인 역할과 함께, 임상 구현에 필수적인 정확성에 기반하여 신뢰성을 강조하였다.

• Interdisciplinary Bio Central
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• 제4권4호
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• pp.11.1-11.8
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• 2012

Genes that are indispensable for survival are referred to as essential gene. Due to the momentous significance of these genes for cellular activity they can be selected potentially as drug targets. Here in this study, an essential gene for Streptococcus suis was predicted using coherent statistical analysis and powerful genome comparison computational method. At first the whole genome protein scatter plot was generated and subsequently, on the basis of statistical significance, a reference genome was chosen. The parameters set forth for selecting the reference genome was that the genome of the query (Streptococcus suis) and subject must fall in the same genus and yet they must vary to a good degree. Streptococcus pneumoniae was found to be suitable as the reference genome. A whole genome comparison was performed for the reference (Streptococcus pneumoniae) and the query genome (Streptococcus suis) and 14 conserved proteins from them were subjected to a screen for potential essential gene property. Among those 14 only one essential gene was found to be with impressive similarity score between reference and query. The essential gene encodes for a type of 'Clp protease'. Clp proteases play major roles in degrading misfolded proteins. Results found here should help formulating a drug against Strptococcus suis which is responsible for mild to severe clinical conditions in human. However, like many other computational studies, the study has to be validated furthermore through in vitro assays for concrete proof.

• 한국간호교육학회지
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• 제23권3호
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• pp.330-340
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• 2017

Purpose: This study was conducted to explore the relationship between simulation-based clinical judgment and performance ability for tracheal suction in nursing students. Methods: With a convenience sampling, 207 nursing students participated in this descriptive study. Lasater clinical judgment rubric was used for self-reported clinical judgment in addition to observe the skill of tracheal suction using a checklist. Data were analyzed by descriptive statistics, t-test and Pearson's correlation coefficients using the SPSS/WIN 22. Results: A scenario with pneumonia patient was developed to observe the skill of tracheal suction during simulation-based practices. Then self-reported clinical judgment was scored. The mean score of total sum of clinical judgment, total mean of clinical judgment, and performance skill were $36.44{\pm}4.82$, $13.44{\pm}1.71$, and $42.32{\pm}5.05$, respectively. Statistically, students having good skills in suction showed significant differences in clinical judgment of interpreting (p=.031) compared to students having fair skills. Conclusion: The results of this study show that a structured debriefing method utilizing Lasater clinical judgment rubric is helpful. Also, simulation-based practice related to adult nursing in the respiratory system was useful for increasing the core basic skills among nursing students.

• Journal of Gastric Cancer
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• 제11권4호
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• pp.206-211
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• 2011

Purpose: Laparoscopic total gastrectomy (LTG) for gastric cancer is still uncommon because of technical difficulties, especially in esophagojejunostomy (EJ). There are many reports for various laparoscopic procedures of EJ using linear or circular staplers. On the other hands, there has been no report for hand-sewn anastomosis. We report successfully performed intracorporeally hand-sewn EJ after LTG. Materials and Methods: The clinicopathologic data and short-term surgical outcomes of 6 patients who underwent totally laparoscopic total gastrectomy for upper gastric cancer from December 2010 and July 2011 were retrospectively reviewed. Results: The mean age was 66.5 years and mean body mass index (kg/$m^2$) was 24.6. All patients had medical comorbidities. The mean patient ASA score was 2.17. Among the 6 patients, previous abdominal operation was performed for 2 patients and combined operation was performed for 3 patients. The mean blood loss, operation time, and EJ anastomosis time was 130 ml, 379.7 minutes, and 81.5 minutes, respectively. The mean time to first flatus, first oral intake, and postoperative hospital stay was 3.0, 3.0, and 12.5 days, respectively. There was no 30-day mortality case. Postoperative aspiration pneumonia and multiple periventricular lacunar infarctions developed in 1 patient. There were no anastomosis-related complications and other major surgical complications. Conclusions: When the intracorporeal anastomotic technique becomes popular in LTG the intracorporeally hand-sewn EJ may be accepted as one method among the various laparoscopic procedures of EJ.

• Pediatric Infection and Vaccine
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• 제12권1호
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• pp.67-74
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• 2005

목 적 : 최근 신생아학의 발달과 신생아 집중 치료의 발달로 기관내 삽관 후 인공 환기요법 치료가 빈번하게 이루어져 호흡곤란증이 있는 신생아의 사망률은 감소된 반면 이에 따른 여러 합병증이 병발할 가능성이 높아지게 되었다. 이에 저자들은 인공 환기요법을 사용한 신생아에서 VAP의 발생빈도와 위험요인 및 주된 균주에 대해 알아보았다. 방 법 : 2000년 1월 1일부터 2003년 6월 30일까지 한림대학교 강남성심병원 신생아 집중치료실에 입원하여 인공 환기요법을 사용한 신생아 50명을 대상으로 하여 입원 기록지를 후향적으로 분석하였다. VAP의 진단은 기관내 삽관 당시에는 폐렴이 보이지 않으나 기관내 삽관 후 최소 48시간 경과 후 흉부 방사선상 새롭게 침윤이 발생한 경우로 정의하였다. 상기 조건에 만족하는 환아 13명을 VAP군으로, 만족하지 않는 환아 37명을 대조군으로 분류하였다. 결 과 : 인공 환기요법을 사용했던 환아 50명 중 VAP의 발생빈도는 26.0%(13명)였다. 동맥관 개존증과 뇌실내 출혈이 VAP 발생과 연관이 있었고 재태연령, 출생체중, 1분 및 5분 Apgar 점수 및 호흡곤란 증후군, 기관지폐 이형성증, 미숙아 망막증, 패혈증, 급성 신부전, 폐출혈, 공기 누출 증후군 등과는 연관이 없었다. 본 연구에서는 총 12균주가 동정되었는데 MR-CNS 4례(33.3%), E. cloacae 3례(25.0%), P. aeruginosa 2례(16.7%), MRSA 1례(8.3%), Acinetobacter baumanii 1례(8.3%), K. pneumoniae 1례(8.3%)로 MR-CNS가 가장 많았다. 결 론 : 본원 신생아 집중치료실에서 인공 환기요법 치료 후 발생한 폐렴의 빈도는 26.0%이며 MR-CNS가 가장 많이 배양되였다. 기관삽관 말단의 배양은 VAP의 정확한 진단을 위해서는 적절치 않을 수 있으나 신생아에게 필요한 침습적이지 않고 정확한 방법에 대한 연구가 필요하다고 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제50권4호
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• pp.409-414
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• 2001

연구배경 : 국내의 지역사회획득 폐렴 원인균에 대한 연구가 부족하며, 특히 레지오넬라 폐렴균은 중증환자에서 중요한 원인균임을 고려할 때 이에 대한 연구가 시급하다. $NOW^{TM}$ Legionella Urinary Antigen Test는 Legionella 폐렴균의 90%를 차지하는 Legionella penumophila serogroup 1에 대해 90% 이상의 민감도를 갖는 검사법으로 이를 이용하였다. 방 법 : 1999년 7월부터 일년간 강원지역 일개 대학병원에 입원한 지역사회획득 폐렴환자를 대상으로 요즘 레지오넬라 항원 검사를 시행하였다. 결 과 : 총 54예중 요중 레지오넬라 항원이 양성으로 나온 예는 없었다. 환자의 59.3%는 중환자실에 입원한 중증의 지역사회획득 폐렴 환자였다. 결 론 : 국내에서 Legionella pneumophila에 의한 지역사회 획득 폐렴은 매우 드물 것으로 생각되어, 향후 치료지침을 만드는데 고려해야 할 요소로 생각된다.