• 제목/요약/키워드: clinical informatics

검색결과 272건 처리시간 0.021초

Sex Steroids Regulate Expression of Genes Containing Long Interspersed Elements-1s in Breast Cancer Cells

  • Chaiwongwatanakul, Saichon;Yanatatsaneejit, Pattamawadee;Tongsima, Sissades;Mutirangura, Apiwat;Boonyaratanakornkit, Viroj
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권8호
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    • pp.4003-4007
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    • 2016
  • Long interspersed elements-1s (LINE-1s) are dispersed all over the human genome. There is evidence that hypomethylation of LINE-1s and levels of sex steroids regulate gene expression leading to cancer development. Here, we compared mRNA levels of genes containing an intragenic LINE-1 in breast cancer cells treated with various sex steroids from Gene Expression Omnibus (GEO), with the gene expression database using chi-square analysis (http://www.ncbi.nlm.nih.gov/geo). We evaluated whether sex steroids influence expression of genes containing an intragenic LINE-1. Three sex steroids at various concentrations, 1 and 10 nM estradiol (E2), 10 nM progesterone (PG) and 10 nM androgen (AN), were assessed. In breast cancer cells treated with 1 or 10 nM E2, a significant percentage of genes containing an intragenic LINE-1 were down-regulated. A highly significant percentage of E2-regulated genes containing an intragenic LINE-1 was down-regulated in cells treated with 1 nM E2 for 3 hours (p<3.70E-25; OR=1.91; 95% CI=2.16-1.69). Similarly, high percentages of PG or AN-regulated genes containing an intragenic LINE-1 wwere also down-regulated in cells treated with 10 nM PG or 10 nM AN for 16 hr (p=9.53E-06; OR=1.65; 95% CI=2.06-1.32 and p=3.81E-14; OR=2.01; 95% CI=2.42-1.67). Interestingly, a significant percentage of AN-regulated genes containing an intragenic LINE-1 was up-regulated in cells treated with 10 nM AN for 16 hr (p=4.03E-02; OR=1.40; 95% CI=1.95-1.01). These findings suggest that intragenic LINE-1s may play roles in sex steroid mediated gene expression in breast cancer cells, which could have significant implications for the development and progression of sex steroid-dependent cancers.

Color comparison between non-vital and vital teeth

  • Greta, Delia Cristina;Colosi, Horatiu Alexandru;Gasparik, Cristina;Dudea, Diana
    • The Journal of Advanced Prosthodontics
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    • 제10권3호
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    • pp.218-226
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    • 2018
  • PURPOSE. The aim of this study was to define a color space of non-vital teeth and to compare it with the color space of matched vital teeth, recorded in the same patients. MATERIALS AND METHODS. In a group of 218 patients, with the age range from 17 to 70, the middle third of the buccal surface of 359 devitalized teeth was measured using a clinical spectrophotometer (Vita Easyshade Advance). Lightness ($L^*$), chromatic parameters ($a^*$, $b^*$), chroma ($C^*$), hue angle (h) and the closest Vita shade in Classical and 3D Master codifications were recorded. For each patient, the same data were recorded in a vital reference tooth. The measurements were performed by the same operator with the same spectrophotometer, using a standardized protocol for color evaluation. RESULTS. The color coordinates of non-vital teeth varied as follows: lightness $L^*$: 52.83-92.93, $C^*$: 8.23-58.90, h: 51.20-101.53, $a^*$: -2.53-24.80, $b^*$: 8.10-53.43. For the reference vital teeth, the ranges of color parameters were: $L^*$: 60.90-97.16, $C^*$: 8.43-39.23, h: 75.30-101.13, $a^*$: -2.36-9.60, $b^*$: 8.36-39.23. The color differences between vital and non-vital teeth depended on tooth group, but not on patient age. CONCLUSION. Non-vital teeth had a wider color space than vital ones. Non-vital teeth were darker (decreased lightness), more saturated (increased chroma), and with an increased range of the hue interval. An increased tendency towards positive values on the $a^*$ and $b^*$ axes suggested redder and yellower non-vital teeth compared to vital ones.

측두하악장애의 유병률과 관련요인에 관한 연구 -일부 일반사무직, 서비스직, 교직원을 대상으로- (Temporomandibular disorders and risk factors in office workers, service workers, and teachers)

  • 서의경;김순덕;이준영;임재석
    • 한국치위생학회지
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    • 제12권3호
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    • pp.563-576
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    • 2012
  • 목적 : 본 연구는 업무형태에 따른 측두하악장애의 유병률과 업무 시 노출되는 직무스트레스 및 구강 내 악습관이 측두하악장애와 어떠한 연관성이 있는지 알아보아 보건학적 기초자료를 제공하고자 실시되었다. 방법 : 본 연구의 자료 수집을 위하여 서울과 경기 일부지역에 근무하고 있는 일반사무직, 서비스직, 교직원으로부터 편의 추출된 452명을 대상으로 2010년 1월부터 2010년 4월까지 설문조사를 실시하였고, 수거된 353명을 연구대상으로 하였다. 설문지는 측두하악장애의 증상, 하악사용에 관한 구강 내 악습관, 직무스트레스, 인구사회학적 특성으로 구성되었다. 측두하악장애의 증상의 정도를 구분하기 위해 설문지의 양성응답 수의 빈도에 따라 무증상인 1단계에서 양성응답 수가 가장 많은 4단계 까지 총 4그룹으로 나누었다. 측두하악장애의 유병률을 알아보기 위하여 빈도분석을 시행하였고, 측두하악장애의 증상의 정도에 따른 여러 요인들 간의 연관성 및 관련요인을 알아보기 위하여 교차분석 및 경향성 분석과 다항로지스틱회기 분석을 시행하였다. 결과 : 측두하악장애의 유병률은 75.4%였고, 측두하악장애에 대한 주관적 증상으로는 관절잡음이 56.4%로 가장 주된 증상 중 하나였으나 남녀 간의 차이는 통계적으로 유의하지 않았다. 다음으로는 두통이나 목의 통증이 36.5%이었고, 귀, 관자놀이, 볼 주위의 통증이 22.1%로 높았다. 측두하악장애의 주관적인 증상 수에 따른 인구사회학적 특성은 증상이 없는 경우 여성에서 19.1%, 남성에서 36.6%로 여성에서 더 높은 유병률을 보였다. 연령별로는 40세 이상의 그룹보다 20 - 30대그룹에서 측두하악장애 증상수가 높아지는 경향을 보였다. 하악 사용과 관련된 악습관 및 직무스트레스는 측두하악장애 증상수와 유의한 관련성이 있는 것으로 나타났는데, 하악 사용과 관련된 습관의 개수가 많아질수록 측두하악장애의 증상의 개수도 많아졌고, 습관이 한 가지씩 늘어날수록 측두하악장애 증상이 없는 1단계보다 3단계가 될 위험이 1.45배, 4단계가 될 위험이 1.57배 높아졌다. 스트레스 수준도 가장 하위단계에서 한 단계 높아지면 측두하악장애 1단계에서 4단계가 될 위험이 2.49배, 두 단계 높아지면 3.43배 높아졌다. 결론 : 본 연구의 결과 측두하악장애와 업무특성에 따른 연관성은 설명하지 못하였지만, 직무스트레스가 높은 경우 측두하악장애 증상의 개수 또한 높아짐을 확인할 수 있었다. 이는 측두하악장애의 주관적인 증상을 발생시키는데 있어서 업무형태 보다는 심인적인 부분이 더 중요한 인자임을 의미한다. 그러므로 측두하악장애 평가 시 신체적인 문제뿐 아니라 행동적, 심리 사회적 문제로 예측인자를 폭넓게 인식함으로써 다각적인 접근을 하는 것이 필요하며, 측두하악장애 증상이 발생된 경우 임상적 치료뿐 아니라 행동요법 및 심리 치료와 자가 관리 등이 함께 수반되어 기여요인 조절을 조절하는 것이 중요하다 하겠다.

Evaluation of Digital PCR as a Technique for Monitoring Acute Rejection in Kidney Transplantation

  • Lee, Hyeseon;Park, Young-Mi;We, Yu-Mee;Han, Duck Jong;Seo, Jung-Woo;Moon, Haena;Lee, Yu-Ho;Kim, Yang-Gyun;Moon, Ju-Young;Lee, Sang-Ho;Lee, Jong-Keuk
    • Genomics & Informatics
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    • 제15권1호
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    • pp.2-10
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    • 2017
  • Early detection and proper management of kidney rejection are crucial for the long-term health of a transplant recipient. Recipients are normally monitored by serum creatinine measurement and sometimes with graft biopsies. Donor-derived cell-free deoxyribonucleic acid (cfDNA) in the recipient's plasma and/or urine may be a better indicator of acute rejection. We evaluated digital PCR (dPCR) as a system for monitoring graft status using single nucleotide polymorphism (SNP)-based detection of donor DNA in plasma or urine. We compared the detection abilities of the QX200, RainDrop, and QuantStudio 3D dPCR systems. The QX200 was the most accurate and sensitive. Plasma and/or urine samples were isolated from 34 kidney recipients at multiple time points after transplantation, and analyzed by dPCR using the QX200. We found that donor DNA was almost undetectable in plasma DNA samples, whereas a high percentage of donor DNA was measured in urine DNA samples, indicating that urine is a good source of cfDNA for patient monitoring. We found that at least 24% of the highly polymorphic SNPs used to identify individuals could also identify donor cfDNA in transplant patient samples. Our results further showed that autosomal, sex-specific, and mitochondrial SNPs were suitable markers for identifying donor cfDNA. Finally, we found that donor-derived cfDNA measurement by dPCR was not sufficient to predict a patient's clinical condition. Our results indicate that donor-derived cfDNA is not an accurate predictor of kidney status in kidney transplant patients.

Comparison of Two Different Immobilization Devices for Pelvic Region Radiotherapy in Tomotherapy

  • Kim, Dae Gun;Jung, James J;Cho, Kwang Hwan;Ryu, Mi Ryeong;Moon, Seong Kwon;Bae, Sun Hyun;Ahn, Jae Ouk;Jung, Jae Hong
    • 한국의학물리학회지:의학물리
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    • 제27권4호
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    • pp.250-257
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    • 2016
  • The purpose of this study was to compare the patient setup errors of two different immobilization devices (Feet Fix: FF and Leg Fix: LF) for pelvic region radiotherapy in Tomotherapy. Thirty six-patients previously treated with IMRT technique were selected, and divided into two groups based on applied immobilization devices (FF versus LF). We performed a retrospective clinical analysis including the mean, systematic, random variation, 3D-error, and calculated the planning target volume (PTV) margin. In addition, a rotational error (angles, $^{\circ}$) for each patient was analyzed using the automatic image registration. The 3D-errors for the FF and the LF groups were 3.70 mm and 4.26 mm, respectively; the LF group value was 15.1% higher than in the FF group. The treatment margin in the ML, SI, and AP directions were 5.23 mm (6.08 mm), 4.64 mm (6.29 mm), 5.83 mm (8.69 mm) in the FF group (and the LF group), respectively, that the FF group was lower than in the LF group. The percentage in treatment fractions for the FF group (ant the LF group) in greater than 5 mm at ML, SI, and AP direction was 1.7% (3.6%), 3.3% (10.7%), and 5.0% (16.1%), respectively. Two different immobilization devices were affected the patient setup errors due to different fixed location in low extremity. The radiotherapy for the pelvic region by Tomotherapy should be considering variation for the rotational angles including Yaw and Pitch direction that incorrect setup error during the treatment. In addition the choice of an appropriate immobilization device is important because an unalterable rotation angle affects the setup error.

관성측정장치를 이용한 요추 가동범위 측정방법의 반복성 및 검사자 내 검사-재검사 신뢰도 연구 (Test-retest Reliability and Intratest Repeatability of Measuring Lumbar Range of Motion Using Inertial Measurement Unit)

  • 안지훈;김현호;윤우석;이순호;신유빈;김상민;박영재;박영배
    • Journal of Acupuncture Research
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    • 제31권1호
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    • pp.61-73
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    • 2014
  • Objectives : The purpose of this study is to estimate the test-retest reliability and the intratest repeatability in measuring the lumbar range of motion of healthy volunteers with wireless microelectromechanical system inertial measurement unit(MEMS-IMU) system and to discuss the feasibility of this system in the clinical setting to evaluate the lumbar spine movement. Methods : 19 healthy male volunteers were participated, who got under 21 points at oswestry disability index(ODI) were adopted. Their lumbar motion were measured with IMU twice in consecutive an hour for the test-retest reliability study. Intratest repeatability was calculated in the two tests separately. The calculated intraclass correlation coefficients(ICC) were discussed and compared with the those of the previous studies. Results : Lumbar range of motion of flexion $41.45^{\circ}$, extension $16.34^{\circ}$, right lateral bending $16.41^{\circ}$ left lateral bending $13.63^{\circ}$ right rotation $-2.47^{\circ}$, left rotation $-0.61^{\circ}$. ICCs were 0.96~1.00(intratest repeatability) and 0.61~0.92(test-retest reliability). Conclusion : This study shows that MEMS-IMU system demonstrates a high test-retest reliability and intratest repeatability by calculated intraclass correlation coefficients. The results of this study represents that wireless inertial sensor measurement system has portable and economical efficiency. By MEMS-IMU system, we can measures lumbar range of motion and analyze lumbar motion effectively.

건강보험 상대가치 개정 연구의 성과와 한계 (The Refinement Project of Health Insurance Relative Value Scales: Results and Limits)

  • 강길원;이충섭
    • 보건행정학회지
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    • 제17권3호
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    • pp.1-25
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    • 2007
  • Relative value scales introduced in 2001 remarkably improved health insurance fee schedule, but current relative value scales have many problems. In the beginning the government intended to introduce 'resource based relative value scales(RBRVSs)' like USA, but political adjustment of RBRVS studied in 19.17 weakened the relationship between relative value scale and resource consumption. So unbalance of health insurance fees are existing till now. Also relative value was not divided to physician work and practice expense, and malpractice fee was not divided separately. To correct the unbalance of current relative value scales, the refinement project of health insurance relative value scales started in 2003. The project team divided relative value scales into three components, which are physician work, practice expense, malpractice fee. Physician work was studied by professional organizations like Korean medical association. To develop the practice expense relative value, project team organized clinical practice expert panels(CPEPs) composed of physicians, nurses, and medical technicians. CPEPs constructed direct expense data like labor costs, material costs, equipment costs about each medical procedures. The practice expense relative values of medical procedures were developed by the allocation of the institution level direct & indirect costs according to CPEPs direct costs. Institution level direct & indirect costs were collected in 21 hospitals, 98 medical clinics, 53 dental clinics, 78 oriental clinics, and 46 pharmacies. The malpractice fee relative values were developed through the survey of malpractice related costs of hospitals, clinics, pharmacies. Putting together three components of relative values in one scale, the final relative values were made. The final relative values were calculated under budget neutrality by medical departments, that is, total relative value score of a department was same before and after the revision. but malpractice fee relative value scores were added to total scores of relative values. So total score of a department was increased by the malpractice fee relative value score of that department This project failed in making 'resource based' relative value scales in the true sense of the word, because the total relative value scores of medical departments were fixed. However the project team constructed the objective basis of relative value scale like physician's work, direct practice expense, malpractice fee. So step by step making process of the basis, the fixation of total scores by the departments will be resolved and the resource based relative value scale will be introduced in true sense.

Improving Tuberculosis Medication Adherence: The Potential of Integrating Digital Technology and Health Belief Model

  • Mohd Fazeli Sazali;Syed Sharizman Syed Abdul Rahim;Ahmad Hazim Mohammad;Fairrul Kadir;Alvin Oliver Payus;Richard Avoi;Mohammad Saffree Jeffree;Azizan Omar;Mohd Yusof Ibrahim;Azman Atil;Nooralisa Mohd Tuah;Rahmat Dapari;Meryl Grace Lansing;Ahmad Asyraf Abdul Rahim;Zahir Izuan Azhar
    • Tuberculosis and Respiratory Diseases
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    • 제86권2호
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    • pp.82-93
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    • 2023
  • Tuberculosis (TB) is a significant public health concern. Globally, TB is among the top 10 and the leading cause of death due to a single infectious agent. Providing standard anti-TB therapy for at least 6 months is recommended as one of the crucial strategies to control the TB epidemic. However, the long duration of TB treatment raised the issue of non-adherence. Non-adherence to TB therapy could negatively affect clinical and public health outcomes. Thus, directly observed therapy (DOT) has been introduced as a standard strategy to improve anti-TB medication adherence. Nonetheless, the DOT approach has been criticized due to inconvenience, stigma, reduced economic productivity, and reduced quality of life, which ultimately could complicate adherence issues. Apart from that, its effectiveness in improving anti-TB adherence is debatable. Therefore, digital technology could be an essential tool to enhance the implementation of DOT. Incorporating the health belief model (HBM) into digital technology can further increase its effectiveness in changing behavior and improving medication adherence. This article aimed to review the latest evidence regarding TB medication non-adherence, its associated factors, DOT's efficacy and its alternatives, and the use of digital technology and HBM in improving medication adherence. This paper used the narrative review methodology to analyze related articles to address the study objectives. Conventional DOT has several disadvantages in TB management. Integrating HBM in digital technology development is potentially effective in improving medication adherence. Digital technology provides an opportunity to improve medication adherence to overcome various issues related to DOT implementation.

Prevalence of Inflammatory Bowel Disease Unclassified, as Estimated Using the Revised Porto Criteria, among Korean Pediatric Patients with Inflammatory Bowel Disease

  • Sung Hee Lee;Minsoo Shin;Seo Hee Kim;Seong Pyo Kim;Hyung-Jin Yoon;Yangsoon Park;Jaemoon Koh;Seak Hee Oh;Jae Sung Ko;Jin Soo Moon;Kyung Mo Kim
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제27권4호
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    • pp.206-214
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    • 2024
  • Purpose: Few studies have reported the prevalence of inflammatory bowel disease unclassified (IBDU) among Korean pediatric IBD (PIBD) population. To address this gap, we used two tertiary centers and nationwide population-based healthcare administrative data to estimate the prevalence of Korean pediatric IBDU at the time of diagnosis. Methods: We identified 136 patients aged 2-17 years with newly diagnosed IBD (94 Crohn's disease [CD] and 42 ulcerative colitis [UC]) from two tertiary centers in Korea between 2005 and 2017. We reclassified these 136 patients using the revised Porto criteria. To estimate the population-based prevalence, we analyzed Korean administrative healthcare data between 2005 and 2016, which revealed 3,650 IBD patients, including 2,538 CD and 1,112 UC. By extrapolating the reclassified results to a population-based dataset, we estimated the prevalence of PIBD subtypes. Results: Among the 94 CD, the original diagnosis remained unchanged in 93 (98.9%), while the diagnosis of one (1.1%) patient was changed to IBDU. Among the 42 UC, the original diagnosis remained unchanged in 13 (31.0%), while the diagnoses in 11 (26.2%), 17 (40.5%), and one (2.4%) patient changed to atypical UC, IBDU, and CD, respectively. The estimated prevalences of CD, UC, atypical UC, and IBDU in the Korean population were 69.5%, 9.4%, 8.0%, and 13.1%, respectively. Conclusion: This study is the first in Korea to estimate the prevalence of pediatric IBDU. This prevalence (13.1%) aligns with findings from Western studies. Large-scale prospective multicenter studies on PIBDU are required to examine the clinical features and outcomes of this condition.

Usefulness of Impulse Oscillometry in Predicting the Severity of Bronchiectasis

  • Ji Soo Choi;Se Hyun Kwak;Min Chul Kim;Chang Hwan Seol;Seok-Jae Heo;Sung Ryeol Kim;Eun Hye Lee
    • Tuberculosis and Respiratory Diseases
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    • 제87권3호
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    • pp.368-377
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    • 2024
  • Background: Bronchiectasis is a chronic respiratory disease that leads to airway inflammation, destruction, and airflow limitation, which reflects its severity. Impulse oscillometry (IOS) is a non-invasive method that uses sound waves to estimate lung function and airway resistance. The aim of this study was to assess the usefulness of IOS in predicting the severity of bronchiectasis. Methods: We retrospectively reviewed the IOS parameters and clinical characteristics in 145 patients diagnosed with bronchiectasis between March 2020 and May 2021. Disease severity was evaluated using the FACED score, and patients were divided into mild and moderate/severe groups. Results: Forty-four patients (30.3%) were in the moderate/severe group, and 101 (69.7%) were in the mild group. Patients with moderate/severe bronchiectasis had a higher airway resistance at 5 Hz (R5), a higher difference between the resistance at 5 and 20 Hz (R5-R20), a higher resonant frequency (Fres), and a higher area of reactance (AX) than patients with mild bronchiectasis. R5 ≥0.43, resistance at 20 Hz (R20) ≥0.234, R5-R20 ≥28.3, AX ≥1.02, reactance at 5 Hz (X5) ≤-0.238, and Fres ≥20.88 revealed significant univariable relationships with bronchiectasis severity (p<0.05). Among these, only X5 ≤-0.238 exhibited a significant multivariable relationship with bronchiectasis severity (p=0.039). The receiver operating characteristic curve for predicting moderate-to-severe bronchiectasis of FACED score based on IOS parameters exhibited an area under the curve of 0.809. Conclusion: The IOS assessed by the disease severity of FACED score can effectively reflect airway resistance and elasticity in bronchiectasis patients and serve as valuable tools for predicting bronchiectasis severity.