• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.259-263
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• 2015

Background: In the field of cancer, the ICD-10 coding convention is based on the site of a neoplasm in the body and usually ignores the morphology, thus the same code may be assigned to tumors of different morphologic types in an organ. Nowadays, all general (provincial) and center hospitals in Thailand are equipped with the hospital information system (HIS) database. Objective: This study aimed to find the characteristics and magnitude of agreement represented by the positive predictive value (PPV) of provisional cancer diagnoses in the HIS database in Pattani Hospital in Thailand in comparison with the final cancer diagnosis of the ICD-10 codes generated from a well established cancer registry in Songklanagarind Hospital, the medical school hospital of Prince of Songkla University. Materials and Methods: Data on cancer patients residing in Pattani province who visited Pattani Hospital from January 2007 to May 2011 were obtained from the HIS database. The ICD-10 codes of the HIS computer database of Pattani Hospital were compared against the ICD-10 codes of the same person recorded in the hospital-based cancer registry of Songklanagarind Hospital. The degree of agreement or positive predictive value (PPV) was calculated for each sex and for both sexes combined. Results: A total of 313 cases (15.9%) could be matched in the two databases. Some 222 cases, 109 males and 113 females, fulfilled the criteria of referral from Pattani to Songklanagarind Hospitals. Of 109 male cancer cases, 76 had the same ICD-10 codes in both hospitals, thus, the PPV was 69.7% (95%CI: 60.2-78.2%). Agreement in 76 out of 113 females gave a PPV of 67.3% (95%CI: 57.8-75.8%). The two percentages were found non-significant with Fisher's exact p-value of 0.773. The PPV for combined cases of both sexes was 68.5% (95%CI: 61.9-74.5%). Conclusions: Changes in final diagnosis in the referral system are common, thus the summary statistics of a hospital without full investigation facilities must be used with care, as the statistics are biased towards simple diseases able to be investigated by available facilities. A systematic feedback of patient information from a tertiary to a referring hospital should be considered to increase the accuracy of statistics and to improve the comprehensive care of cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• 제15권7호
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• pp.3233-3238
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• 2014

Background: The aim of this study was to analyze the demographic and clinical characteristics of male breast cancer patients in Serbia, and furthermore to determine overall survival and predictive factors for prognosis. Materials and Methods: In the period of 1996-2006 histopathological diagnosis of breast cancer was made in 84 males at the Institute for Oncology and Radiology of Serbia. For statistical analyses the Kaplan-Meier method, long-rank test and Cox proportional hazards regression model were used. Results: The mean age at diagnosis with breast cancer was $64.3{\pm}10.5$ years with a range from 35-84 years. Nearly 80% of the tumors showed ductal histology. About 44% had early tumor stages (I and II) whereas 46.4% and 9.5% of the male exhibitied stages III and IV, respectively. Only 7.1% of male patients were grade one. One-fifth of all patients had tumors measuring ${\leq}2cm$, and 14.3% larger than 5 cm. Lymph node metastasis was recorded in 40.4% patients and 47% relapse. Estrogen and progesterone receptor expression was positive in 66.7% and 58.3%, respectively. Among 14.3% of individuals tumor was HER2 positive. About two-thirds of all male patients had radical mastectomy (66.7%). Adjuvant hormonal (tamoxifene), systematic chemotherapy (CMF or FAC) and adjuvant radiotherapy were given to 59.5%, 35.7% and 29.8% patients respectively. Overall survival rates at five and ten years for male breast cancer were 55.0% and 43.9%, respectively. According to the multivariate Cox regression predictive model, a lower initial disease stage, a lower tumor grade, application of adjuvant hormone therapy and no relapse occurrence were significant independent predictors for good overall survival. Conclusions: Results of the treatment would be better if disease is discovered earlier and therefore health education and screening are an imperative in solving this problem.

• 보건교육건강증진학회지
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• 제18권1호
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• pp.35-47
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• 2001

As the complexity of the our environment is further complicated by advancements in industry and increase in vehicle traffic flow, the incidents of injury causing accidents are on the rise. Consequently, there is increasing emphasis on the importance of systematic and continual safety education for injury preventive behaviors. This study investigates safety related problems of elementary school students based on the PRECEDE model, proposed by Green et al.(1980 Green), to comprehensively identify the requirements of school safety education. The identified requirements were used to diagnose the current state of elementary school safety education through the analysis of multidimensional factors. A questionnaire survey was conducted on 594 sixth grade students from randomly selected 4 schools in Seoul to examine their injury preventive behaviors and to determine the educational diagnosis variables that affect it. The duration of the survey was 3 weeks starting from April 12, 1999 to May 8, 1999. A summary of the survey results are presented below; 1. Situations in which accidents have occurred were, in their order of frequency, ‘during play or sports activities within the school grounds’ was most frequent at 59.6％, ‘during play on local streets’ at 49.5％, and ‘traffic accidents’ at 41.6％. 2. Categorization of the injury preventive behavior showed that ‘not playing at high traffic flow locations such as streets and construction sites’ had the higher level of observance, while ‘wearing of helmets and joint protection devices during playing’ was least observed. 3. Considering injury preventive behaviors in relation to educational diagnosis variables indicated, for predisposing factors, lower ‘perception to injury accidents’ (p〈0.001) combined with higher ‘concerns for injury accidents’(p〈0.001), ‘practice of preventive behavior’(p〈0.001), and ‘the level of safety knowledge’(p〈0.001) resulted in significantly higher observance of injury preventive behaviors. For enabling factors, higher ‘perceived level of the school safety education’ (p〈0.001) and ‘availability of safety education resources’(p〈0.01) indicated significantly higher observance of injury preventive behaviors. For the reinforcing factor, frequent exposure to ‘safety education brochure’ (p〈0.01) and ‘audio-visual material for safety education’(p〈0.01) combined with more ‘regional safety education’ (p〈0.01), ‘home safety education’ (p〈0.01), ‘school safety education’(p〈0.001), and, ‘parents’ observance of preventive behaviors' (p〈0.001) showed significantly higher observance of injury preventive behaviors. 4. An analysis of the factors that affect injury preventive behaviors showed that the enabling factor ‘awareness of school safety education’ had the highest correlation with injury preventive behaviors followed by factors, in their order of significance, ‘practice of preventive behavior’, ‘perception to injury accidents’, ‘level of safety knowledge’, ‘parents’ observances of preventive behaviors', and ‘concerns for injury accidents.’

• 영재교육연구
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• 제10권2호
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• pp.1-23
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• 2000

영재 교육 체제는 영재 각자의 능력과 다양한 흥미와 변화하는 요구를 수용할 수 있을 만큼의 충분한 융통성과 개방성을 지녀야 하며, 우리의 교육 실정에 적합한 교육 발달의 틀이 필요하다. 본 연구의 목적은 아직 이론적이고 내용적 수준에 머물러 있는 영재 교육의 개념적 모형을 실제 교수${\cdot}$학습 장면에서 쉽게 적용할 수 있는 절차적이며 처방적인 체제적 모형으로 전호나함으로써 보다 효과적인 영재 교육 체제를 개발하고자 함니다. 이를 위해 영재 교육의 가장 대표적인 모형인 Renzulli의 전교 심화학습 모형(Schoolwide Enrichment Model: SEM)을 바탕으로 교수체제설계(ISD)를 적용한 결과, 기획${\cdot}$진단${\cdot}$처방${\cdot}$실행${\cdot}$평가의 5단계로 SEM의 체제적 모형을 재구성하였다. 또한 체제적으로 수정된 SEM 모형이 갖는 영제 교수${\cdot}$학습 상황에서의 특징을 6가지로 요약하여 정리하였다. 그러나, 각 학교에 최적한 모형을 개발하기 위해서는 본 연구에서 제시된 체제적 모형에 바탕해 계속적인 수정과 검토가 있어야 할 것이다.

• Korean Journal of Radiology
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• 제19권6호
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• pp.1110-1118
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• 2018

Objective: To perform a meta-analysis to quantitatively assess functional magnetic resonance imaging (MRI) in the diagnosis of locally recurrent prostate cancer. Materials and Methods: A comprehensive search of the PubMed, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews was conducted from January 1, 1995 to December 31, 2016. Diagnostic accuracy was quantitatively pooled for all studies by using hierarchical logistic regression modeling, including bivariate modeling and hierarchical summary receiver operating characteristic (HSROC) curves (AUCs). The Z test was used to determine whether adding functional MRI to T2-weighted imaging (T2WI) results in significantly increased diagnostic sensitivity and specificity. Results: Meta-analysis of 13 studies involving 826 patients who underwent radical prostatectomy showed a pooled sensitivity and specificity of 91%, and the AUC was 0.96. Meta-analysis of 7 studies involving 329 patients who underwent radiotherapy showed a pooled sensitivity of 80% and specificity of 81%, and the AUC was 0.88. Meta-analysis of 11 studies reporting 1669 sextant biopsies from patients who underwent radiotherapy showed a pooled sensitivity of 54% and specificity of 91%, and the AUC was 0.85. Sensitivity after radiotherapy was significantly higher when diffusion-weighted MRI data were combined with T2WI than when only T2WI results were used. This was true when meta-analysis was performed on a per-patient basis (p = 0.027) or per sextant biopsy (p = 0.046). A similar result was found when $^1H$-magnetic resonance spectroscopy ($^1H$-MRS) data were combined with T2WI and sextant biopsy was the unit of analysis (p = 0.036). Conclusion: Functional MRI data may not strengthen the ability of T2WI to detect locally recurrent prostate cancer in patients who have undergone radical prostatectomy. By contrast, diffusion-weight MRI and $^1H$-MRS data may improve the sensitivity of T2WI for patients who have undergone radiotherapy.

• 대한치과보철학회지
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• 제57권1호
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• pp.66-74
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• 2019

과도한 마모는 치료받지 않을 시 여러 문제점들을 야기시킬 수 있기 때문에, 정확한 분석 및 진단을 바탕으로 예지성 있는 치료계획을 수립하도록 노력해야 하고, 수직고경에 대한 평가 및 그에 따른 단계적인 치료를 통해 안정된 악간 관계를 회복시켜 주어야 한다. 또한 임플란트 치료의 장기적인 성공을 위해서는 이상적인 위치와 각도로 임플란트를 식립하는 것이 중요하며, 다수의 임플란트 치료에서는 그 중요성이 더욱 증가한다. 따라서 철저한 계획 및 진단에 따른 정확한 수술과 보철 과정이 중요하다. 본 증례에서는 다수의 치아 상실 및 전반적인 치아 마모로 인해 수직고경이 상실되어 있는 68세의 남자 환자에게 치료 전 단계에서부터 다양하고 체계적인 분석을 통해 수직고경을 회복하는 치료 계획을 세웠다. 콘빔컴퓨터단층촬영 데이터를 활용하여 새로 설정한 수직고경에 맞춰 가이드 수술을 시행하였고, 임플란트를 포함한 전악 고정성 보철 수복을 통해 기능 및 심미적으로 환자와 술자 모두 만족할 만한 결과를 얻었기에 이를 보고하고자 한다.

• 대한임상검사과학회지
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• 제54권4호
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• pp.256-264
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• 2022

허혈성 뇌졸중은 뇌동맥의 혈전이나 색전에 의해 폐색되어 산소가 포함된 혈액이 뇌에 도달하는 것을 방지하고, 신경 세포의 괴사를 유발하는 것이다. 본 연구의 목적은 지금까지 연구된 허혈성 뇌졸중의 조기 진단을 가능하게 하는 심혈관 질환 및 심방세동 질환과 관련된 혈청 후보 마커를 정리하고, 각 마커의 OR을 비교 분석하는 것이다. 본 연구에서는 메타분석 기법을 이용하여 혈청 후보 마커의 효과 크기를 분석하고자 하였다. '심혈관질환', '심방세동', '허혈성 뇌졸중', '혈청 표지자'를 키워드로 포함하는 논문에 대한 학술 Database 검색에서 추출된 데이터는 모두 허혈성 뇌졸중 환자에 대한 결과로 제한하였다. 이 연구에서 가장 많이 검색된 마커는 NT-proBNP, D-dimer, CRP 및 GFAP 등으로 나타났다. 결론적으로, NT-proBNP는 허혈성 뇌졸중의 조기 진단에 매우 유용한 것으로 보이며, 특히 심방세동(AF)의 표지자로 알려져 있으며, 앞으로 더 많은 심방세동 표지자가 발굴되어 연구되어야 할 것이다.

• Imaging Science in Dentistry
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• 제53권3호
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• pp.193-198
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• 2023

Purpose: Artificial intelligence (AI) is poised to play a major role in medical diagnostics. Periodontal disease is one of the most common oral diseases. The early diagnosis of periodontal disease is essential for effective treatment and a favorable prognosis. This study aimed to assess the effectiveness of AI in diagnosing periodontal bone loss through radiographic analysis. Materials and Methods: A literature search involving 5 databases (PubMed, ScienceDirect, Scopus, Health and Medical Collection, Dentistry and Oral Sciences) was carried out. A specific combination of keywords was used to obtain the articles. The PRISMA guidelines were used to filter eligible articles. The study design, sample size, type of AI software, and the results of each eligible study were analyzed. The CASP diagnostic study checklist was used to evaluate the evidence strength score. Results: Seven articles were eligible for review according to the PRISMA guidelines. Out of the 7 eligible studies, 4 had strong CASP evidence strength scores (7-8/9). The remaining studies had intermediate CASP evidence strength scores (3.5-6.5/9). The highest area under the curve among the reported studies was 94%, the highest F1 score was 91%, and the highest specificity and sensitivity were 98.1% and 94%, respectively. Conclusion: AI-based detection of periodontal bone loss using radiographs is an efficient method. However, more clinical studies need to be conducted before this method is introduced into routine dental practice.

• Journal of Acupuncture Research
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• 제27권4호
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• pp.67-84
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• 2010

Objectives : To review RCTs on acupuncture treatment for shoulder pain in order to establish a standard acupuncture treatment model in treating shoulder pain. Methods : RCT articles on traditional acupuncture treatment for shoulder pain were searched through online database. Quality of studies were assessed using the FEAS and the modified Jadad score. Results : Eighteen trials of acupuncture for shoulder pain were analyzed. Based on the results of these reviews the following factors might contribute to optimal results from acupuncture treatment. 1) Usage of LI, SI, TE meridians, usage of $LI_{15}$, $TE_{14}$, $GB_{21}$, $LI_{11}$, $LI_4$, $SI_{14}$, $LI_{14}$, $TE_{15}$ acupuncture points. 2) More than four acupuncture points should be used. 3) More than 15 minutes of needle retention time. 4) Needle length-40mm and diameter-0.30mm. 5) More than 9 times treatment 6) More than 5 weeks treatment duration. Conclusions : There was no relation between quality of article and effectiveness of acupuncture. To improve the remedial value, it is necessary to mention De-qi, stimulation of acupuncture and correct variation in diagnosis with the above-mentioned. It is better that clinical trials of acupuncture treatment is designed that type of RCT and double blind. Also when it is set that sham nonpenetrating acupuncture, no treatment group as a control group, and participants don't distinguish wheather acupuncture treatment or not, it will be more meaningful.

• 한국융합학회논문지
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• 제8권12호
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• pp.77-84
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• 2017

초고령화 사회로의 진입으로 인해 웰니스에 대한 관심이 높아지면서, 인공지능 의사를 통한 개인 맞춤형 의료서비스가 확대되고 있는 추세이다. 개인 맞춤형 의료서비스를 위해서는 기존의 병원시스템 구성요소인 PM/PA, OCS, EMR, PACS, LIS 만으로는 정확한 의료분석 서비스를 제공하기 어려운 문제점이 발생된다. 따라서 개인 맞춤형 의료서비스에 적합한 병원시스템 모델 및 구축방안에 대한 제시가 필요한 실정이다. 현재 국내에서도 의료 클라우드 서비스, 왓슨을 도입한 인공지능 진료서비스 등이 일부 시행되고 있지만, 아직 체계적인 병원시스템 구축을 통한 사례는 많지 않다. 따라서 이 논문에서는 개인 맞춤형 의료서비스에 적합한 병원시스템 모델을 제안한다. 이를 위해 기존의 병원시스템 구성요소에 의료 빅데이터 구축 및 AI 의료 분석시스템을 하나로 통합한 모델을 설계하고 모듈별 구축방안을 제시한다. 제안 모델은 향후 새로운 병원시스템 도입 및 구축을 위한 포괄적인 가이드 라인을 제공하는 기반연구로서 의미를 가진다.