• Title/Summary/Keyword: clinical diagnostics

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Agreement between Parent and Teacher Reports in Clinical Setting : Comparing SDQ-Kr with K-CBCL (임상에서 부모-교사 보고의 일치 : SDQ-Kr과 K-CBCL의 비교)

  • Kim, Heung-Kyu;Ahn, Joung-Sook;Kim, Min-Hyock
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.23 no.3
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    • pp.127-133
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    • 2012
  • Objectives : The aims of this study were to examine agreement between parent and teacher ratings of the Korean version Strengths and Difficulties Questionnaire (SDQ-Kr) for the children's psychopathology and to determine whether it is effective in diagnostics as the Korean version of Childhood Behavior Checklist (K-CBCL). Methods : SDQ-Kr and K-CBCL were completed by parents and teachers of 165 children aged 6-12 years. The clinical diagnosis was made by a child and adolescent psychiatrist who did not have knowledge of the outcome. Spearman's correlations were computed for associations between parents' and teachers' ratings on a subscale level. The Mann-Whitney U test was performed for the influence of child's age and sex on the results. Finally, AUC values were calculated for the diagnostic capacity and the difference between informants was tested using the z test. Results : High correlations were observed between parents' and teachers' SDQ-Kr on every scale. Parents were more sensitive to emotional symptoms of girls, while teachers appeared to be more responsive to externalized symptoms of boys, inattention-hyperactivity of young children, and emotional symptoms of seniors. Parents' SDQ-Kr demonstrated the highest prediction of attention-deficit hyperactivity disorder. Conclusion : Teachers' SDQ-Kr can be used in identification of child psychopathology when parents are absent or when their reliability is considered low.

Full mouth rehabilitation with Implant-Guided Surgery and Fixed prosthesis (Implant-Guided Surgery를 이용한 고정성 임플란트 보철물의 전악 수복 증례)

  • Kim, Seong-Mo;Park, Jin-Hong;Ryu, Jae-Jun;Shin, Sang Wan;Lee, Jeong-Yol
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.2
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    • pp.126-133
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    • 2018
  • The development of cone beam computerized tomography (CBCT) allows three-dimensional analysis of the patient's anatomy. The surgical guide is a combination of CBCT, computer-aided design/computer-aided manufacturing (CAD/CAM) and implant diagnostics software, which allows well planned prostheses design and ideal implant placement. Guided surgery minimizes possible anatomical damage and allows for more reproducible treatment planning. In this case, the operation time was shortened by using a surgical guide for multiple implants placement in a fully edentulous patient. Immediate loading were performed more easily using preliminary preparation of provisional prosthesis. The patient was satisfied with improved esthetics and chewing function.

Etiology and clinical characteristics of fever of unknown origin in children: a 15-year experience in a single center

  • Kim, Yi-Seul;Kim, Kyung-Ran;Kang, Ji-Man;Kim, Jong-Min;Kim, Yae-Jean
    • Clinical and Experimental Pediatrics
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    • v.60 no.3
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    • pp.77-85
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    • 2017
  • Purpose: Fever is one of the most common symptoms in children. In previous studies, infectious disease was the most common cause of pediatric fever of unknown origin (FUO). The aim of this study is to investigate the etiology, clinical characteristics and prognosis of pediatric FUO in 21 century with more diagnostics available and to analyze the factors for certain disease categories. Methods: Among the children under 18 years old who were hospitalized at Samsung Medical Center from January 2000 to December 2014, the patients who met the criteria including fever of ${\geq}38.0^{\circ}C$ for longer than ${\geq}14days$ and failure to reach a diagnosis after one week of investigations were included. Results: Total 100 patients were identified. Confirmed diagnosis was achieved in 57 patients (57%). Among them, infectious diseases (n=19, 19%) were most common, followed by connective tissue diseases (n=15, 15%), necrotizing lymphadenitis (n=8, 8%), and malignancies (n=7, 7%). Children with fever duration over 28 days had a trend for higher frequency of connective tissue diseases (28.3%) except undiagnosed etiology. The symptoms such as arthritis, lymph node enlargement and only fever without other symptoms were significantly related with connective tissue diseases, necrotizing lymphadenitis and undiagnosed respectively (P<0.001). Ninety-two patients have become afebrile at discharge and 1 patient died (1%). Conclusion: Almost half of our patients were left without diagnosis. Although it has been known that infectious disease was most common cause of pediatric FUO in the past, undiagnosed portion of FUO have now increased due to development of diagnostic techniques for infectious diseases.

Clinical significance linked to functional defects in bone morphogenetic protein type 2 receptor, BMPR2

  • Kim, Myung-Jin;Park, Seon Young;Chang, Hae Ryung;Jung, Eun Young;Munkhjargal, Anudari;Lim, Jong-Seok;Lee, Myeong-Sok;Kim, Yonghwan
    • BMB Reports
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    • v.50 no.6
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    • pp.308-317
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    • 2017
  • Bone morphogenetic protein type 2 receptor (BMPR2) is one of the transforming growth $factor-{\beta}$ ($TGF-{\beta}$) superfamily receptors, performing diverse roles during embryonic development, vasculogenesis, and osteogenesis. Human BMPR2 consists of 1,038 amino acids, and contains functionally conserved extracellular, transmembrane, kinase, and C-terminal cytoplasmic domains. Bone morphogenetic proteins (BMPs) engage the tetrameric complex, composed of BMPR2 and its corresponding type 1 receptors, which initiates SMAD proteins-mediated signal transduction leading to the expression of target genes implicated in the development or differentiation of the embryo, organs and bones. In particular, genetic alterations of BMPR2 gene are associated with several clinical disorders, including representative pulmonary arterial hypertension, cancers, and metabolic diseases, thus demonstrating the physiological importance of BMPR2. In this mini review, we summarize recent findings regarding the molecular basis of BMPR2 functions in BMP signaling, and the versatile roles of BMPR2. In addition, various aspects of experimentally validated pathogenic mutations of BMPR2 and the linked human diseases will also be discussed, which are important in clinical settings for diagnostics and treatment.

7 Clinical Cases Report for Psoriasi (건선(乾癬)의 임상 치험례 보고)

  • Rho, Young-Ho;Eom, Hyun-Sup;Kim, Gyeong-Cheol;Shin, Soon-Shik
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.2
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    • pp.553-556
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    • 2005
  • The purpose of this study was to contribute to the development of clinical treatment for psoriasis through analyzing and investigating the result of the process of the treatment used for the treatment for psoriasis with prescription of Gamisoyosan, prescription for psoriasis No.1, and No.2. This clinical treatment approached by using 3 steps. In Step 1 7 patients with psoriasis were classified based on the severity of the disease and the types of psoriasis. Step 2, Proper treatment was applied to patients in accordance with typical types of symptoms and types of diagnosis in Oriental Medicine. In step 3, all the process of the treatment was recorded with pictures and the patients' signs of self-consciousness from initial treatment to final treatment determined the result. As a result of the treatment, it showed that prescription of Gamisoyosan applied to pustular psoriasis on the palms, pustular psoriasis on the sole of feet and geographic psoriasis on the whole bodies worked effectively and prescription for psoriasis No.1 applied to nummular psoriasis and prescription for psoriasis No.2. applied to nummular psoriasis made progress for the patients. Side effects and any other abnormal symptoms were not found. In conclusion, therefore, it is anticipated that selected treatment and prescription should be given according to types of diagnosis in Oriental Medicine referring the types of psoriasis. It is considered that more attention, deep and thorough study in mechanism of pathogenesis mechanism of treatment according to the types of psoriasis may make it possible for doctors to treat and prescribe patients.

In Vivo Enhanced Indocyanine Green-Photothermal Therapy for a Subconjunctival Tumor

  • Kim, Chang Zoo;Lee, Sang Joon;Hwang, Sang Seok;Chae, Yu-Gyeong;Kwon, Daa Young;Ko, Taek Yong;Kim, Jun Hyeong;Jung, Min Jung;Masanganise, Rangarirai;Oak, Chulho;Ahn, Yeh-Chan
    • Current Optics and Photonics
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    • v.5 no.3
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    • pp.311-321
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    • 2021
  • Indocyanine green (ICG) is a dye approved for use in clinical diagnostics. ICG remains in the intravascular space following intravenous administration, due to its ability to rapidly bind to the plasma proteins, and its therapeutic potential has been studied in well-vascularized cutaneous tumors. Here we have evaluated the clinical response of a subconjunctival tumor to photothermal therapy (PTT) using an ICG-enhanced near-infrared diode laser and its adverse effects, in a rabbit. 22 male New Zealand white rabbits with subconjunctival tumors were enrolled (control group 6, laser-only group 8, laser-with-ICG group 8). Rabbits in the laser-with-ICG group received ICG (twice, 2 mg/kg each time, intravenously) directly followed by irradiation with a diode laser (λ = 810 nm). Rabbits in the laser-only group were irradiated with the diode laser. ICG angiography, ultrasonography, and pathologic examination were performed to evaluate PTT response at specific time points (0, 2, and 4 weeks after PTT). Two weeks after initial treatment, the eight rabbits treated by laser with ICG showed a 100% response rate. There was no clinical response in both laser-only and control groups. ICG-PTT is a potential and effective palliative therapeutic modality for subconjunctival tumors.

Personalized Diabetes Risk Assessment Through Multifaceted Analysis (PD- RAMA): A Novel Machine Learning Approach to Early Detection and Management of Type 2 Diabetes

  • Gharbi Alshammari
    • International Journal of Computer Science & Network Security
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    • v.23 no.8
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    • pp.17-25
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    • 2023
  • The alarming global prevalence of Type 2 Diabetes Mellitus (T2DM) has catalyzed an urgent need for robust, early diagnostic methodologies. This study unveils a pioneering approach to predicting T2DM, employing the Extreme Gradient Boosting (XGBoost) algorithm, renowned for its predictive accuracy and computational efficiency. The investigation harnesses a meticulously curated dataset of 4303 samples, extracted from a comprehensive Chinese research study, scrupulously aligned with the World Health Organization's indicators and standards. The dataset encapsulates a multifaceted spectrum of clinical, demographic, and lifestyle attributes. Through an intricate process of hyperparameter optimization, the XGBoost model exhibited an unparalleled best score, elucidating a distinctive combination of parameters such as a learning rate of 0.1, max depth of 3, 150 estimators, and specific colsample strategies. The model's validation accuracy of 0.957, coupled with a sensitivity of 0.9898 and specificity of 0.8897, underlines its robustness in classifying T2DM. A detailed analysis of the confusion matrix further substantiated the model's diagnostic prowess, with an F1-score of 0.9308, illustrating its balanced performance in true positive and negative classifications. The precision and recall metrics provided nuanced insights into the model's ability to minimize false predictions, thereby enhancing its clinical applicability. The research findings not only underline the remarkable efficacy of XGBoost in T2DM prediction but also contribute to the burgeoning field of machine learning applications in personalized healthcare. By elucidating a novel paradigm that accentuates the synergistic integration of multifaceted clinical parameters, this study fosters a promising avenue for precise early detection, risk stratification, and patient-centric intervention in diabetes care. The research serves as a beacon, inspiring further exploration and innovation in leveraging advanced analytical techniques for transformative impacts on predictive diagnostics and chronic disease management.

A National Survey on Utilization of Pattern Identification among Korean Medicine Doctors (전국 한방의료기관 한의사 대상 한의 변증활용 현황 조사)

  • Yeo, Minkyung;Park, Kihyun;Jang, Eunsu;Lee, Youngseop
    • Journal of Society of Preventive Korean Medicine
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    • v.19 no.3
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    • pp.45-55
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    • 2015
  • Objective : The aim of this study was to survey the present utilization of pattern identification(PI) in the clinical field among Korean Medicine Doctors. Method : This survey was conducted from Oct. 1 to Oct. 31, 2014 by face-to-face interview using structured questionnaire. The subjects were 400 korean medicine doctors who worked in hospitals or clinics. The questionnaire consisted of two sections - a demographics section(i.e., sex, age, clinical experience, place of work, residence and so on) and the main research section(i.e., the PI utilization rate, the utilization of PI systems, the utilization of PI in the clinical domain and in the treatment domain, the correlation between utilization PI and so on). Results : This study revealed that subjects used the PI to 66.7% of their patients on average. The utilization rate of PI in patients was significantly higher for female physicians than for male physicians, for physicians worked in clinics than for physicians who worked in hospitals and for physicians with more than 10 years clinical experience than for physicians with less than 10 years clinical experience. In the utilization of PI systems, Visceral PI was most as 92.0%. There were significant difference on the PI utilization rate according to utilization of Meridian and Collateral PI, Triple Energizer PI, Defense, Qi, Nutrient and Blood PI, Six-Meridian PI and Six Excesses PI. As a result of analysing the PI utilization rate by clinical domain and in the treatment domain, the Treatment and the Drug Treatment showed the highest values. Among utilized PI systems, the correlation coefficients between Defense, Qi, Nutrient and Blood PI and Triple Energizer PI showed the highest value, but the correlation coefficients between Sasang Constitutional Medicine with the each PI showed substantially lower value. Conclusion : The results of this study demonstrate that usage of PI was higher than usage of U code(in KCD) usage in clinical field. we suggested that additional studies on using PI and developing more appropriate standardized tool should be conducted to widen scope of PI's utilization.

Human Papillomavirus Distribution among Women in Western Shandong Province, East China using Reverse Blot Hybridization Assay

  • Lee, Dongsup;Kim, Geehyuk;Kim, Sunghyun;Park, Sunyoung;Wang, Hye-young;Park, Sangjung;Han, Lin;Yubo, Ren;Li, Yingxue;Park, Kwang Hwa;Lee, Hyeyoung
    • Biomedical Science Letters
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    • v.21 no.2
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    • pp.69-76
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    • 2015
  • Cervical cancer is the third most common cancer in women worldwide and there is a significant association between human papillomavirus (HPV) infection and cervical cancer. Certain HPV groups, labeled high-risk (HR) HPV groups, are strongly associated with malignancies of the human cervix. HPV prevalence and genotype distribution were analyzed using the REBA $HPV-ID^{(R)}$ (YD Diagnostics, Yongin, Korea) assay based on the reverse blot hybridization assay (REBA) with a total of 324 liquid-based cytology samples from women in Western Shandong Province, East China and results were compared with cytological diagnosis. Most of the HPV genotypes that were detected in high-grade cervical lesions were HR-HPV genotypes such as HPV 16, 18, 33, 53, and 58. The prevalence of these HR-HPV genotypes increased in high-grade cervical lesions. However, from low- to high-grade cervical lesions, the ability to detect LR-HPV genotypes decreased. Additionally, in general, the single HPV genotype infection rate increases in proportion to the severity of the lesion. The study findings suggest that a currently available preventive vaccine against HPV 16 and 18 may have limited effectiveness for prevention of all HPV infection in this province. Finally, based on these findings, these data could guide national or regional vaccination programs in the Western Shandong Province of East China to substantially reduce the burden of cervical lesions.

Clinical Laboratory Aspect of Carbapenem-Resistant Enterobacteriaceae (카바페넴내성장내세균속균종의 임상검사 측면)

  • Park, Chang-Eun
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.1
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    • pp.18-27
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    • 2020
  • The correct distinction of carbapenem-resistant Enterobacteriaceae (CRE) and ccarbapenemase producing Enterobacteriaceae (CPE) and the rapid detection of CPE are important for instituting the correct treatment and management of clinical infections. Screening protocols are mainly based on cultures of rectal swab specimens on selective media followed by phenotypic tests to confirm a carbapenem-hydrolyzing activity, the rapid carbapenem inactivation method, lateral flow immunoassay, the matrix-assisted laser desorption ionization-time-of-flight test and molecular methods. The CPE is accurate for detection, and is essential for the clinical treatment and prevention of infections. A variety of phenotypic methods and gene-based methods are available for the rapid detection of carbapenemases, and these are expected to be routinely used in clinical microbiology laboratories. Therefore, to control the spread of carbapenemase, many laboratories around the world will need to use reliable, fast, high efficiency, simple and low cost methods. Optimal effects in patient applications would require rapid testing of CRE to provide reproducible support for antimicrobial management interventions or the treatment by various types of clinicians. For the optimal test method, it is necessary to combine complementary test methods to discriminate between various resistant bacterial species and to discover the genetic diversity of various types of carbapenemase for arriving at the best infection control strategy.