• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7085-7090
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• 2013

Objective: Published data have shown that microRNAs (miRNAs) could play a potential role as diagnostic and prognostic indicators in cancers. Data for the predictive value of microRNA-155 are inconclusive. The aim of the present analysis was therefore to evaluate the role of miR-155 in prognosis for patients with a variety of carcinomas. Methods: Relevant studies were identified by searching PubMed and EMBASE. Data were extracted from studies comparing overall survival (OS), recurrence-free survival (RFS) or cancer-specific survival (CSS) in patients with carcinoma with higher miR-155 expression and those with lower levels. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) of miR-155 for clinical outcome were calculated. Results: A total of 15 studies were included. The pooled hazard ratio (HR) for OS of higher miR-155 expression in cancerous tissue was 1.89 (95% CI: 1.20-2.99, P=0.006), which could markedly predict poorer survival in general cancer. For RFS/CSS, elevated miR-155 was also associated with poor prognosis of cancer (HR=1.50, 95% CI: 1.10-2.05, P=0.01). On subgroup analysis, the pooled HR for OS in non-small cell lung cancer (NSCLC) was 2.09 (95% CI: 0.68-6.41, P > 0.05), but for RFS/CSS was 1.28 (95% CI: 1.05-1.55, P=0.015), with statistical significance; the pooled HRs for OS and RFS/CSS in digestive system neoplasms were 3.04 (95% CI: 1.48-6.24, P=0.003) and 2.61 (95% CI: 1.98-3.42, P<0.05), respectively. Conclusions: The results indicated that the miR-155 expression level plays a prognostic role in patients with cancer, especially NSCLCs and digestive system carcinomas.

• 한국산학기술학회논문지
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• 제11권6호
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• pp.2144-2151
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• 2010

요가 및 음악 치료는 그 개념과 목적의 측면에서 볼 때 알코올 중독자의 정신적, 심리적 치료에 매우 적합한 것으로 간주되어 점차적으로 많은 클리닉이나 재활 센터에서 정식적인 프로그램의 하나로 채택되고 있다. 본 연구에서는 김해 소재 1개 알코올 전문병원의 3개동에 입원해 있는 환자 가운데 정신과 전문의에 의해 DSM-IV의 진단기준에 의거하여 알코올 의존으로 진단된 환자를 대상으로 하였다. 요가와 음악요법이 알코올 치료에 미치는 효과 분석을 위하여 2009년 11월 10일부터 12월 29일까지 요가는 1주일에 2번씩 총 10번의 프로그램을, 음악치료는 1주일에 1번 총 5번의 프로그램을 실시하였다. 이들 가운데 10회의 요가 프로그램을 모두 수행한 16명과 5회의 음악프로그램을 모두 수행한 28명을 최종 연구대상으로 선정하여 '분노시 행동', '분노시 표현', 그리고 '설문답변시의 심리상태' 세 가지의 경우에 대하여 요가와 음악요법 치료효과를 조사하였다. 그 결과 통계적으로 크게 유의하지는 않지만 세 경우 모두 음악 및 요가 요법이 효과가 있는 것으로 나타났다. 향후 실험기간의 장기화, 그리고 실험 대상자의 감정적 편이(emotional bias)를 보정하기 위한 뇌파검사 등이 병행될 경우 더욱 신뢰성 있고 의미 있는 결과를 얻을 수 있을 것으로 판단된다.

• Journal of Korean Neurosurgical Society
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• 제42권1호
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• pp.27-34
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• 2007

Objective : On the magnetic resonance image (MRI) of the infiltrating brain tumor, enhancement is usually higher in malignant tumor than in benign tumor, and tumor cells can invade into the peritumoral area without definite enhancement. In various pathological conditions, the blood brain barrier (BBB) becomes changed to pathological condition, allowing various materials extravasating into the interstitial space, and degree of enhancement is depend on the pathology. Authors performed dynamic MRI on enhancing and surrounding edematous area in order to evaluate the degrees of opening of BBB, to differentiate tumor from non-tumorous condition, and to determine its relationship with the recurrence of the tumor. Methods : Dynamic MRI was performed in 25 patients. Dynamic scans were done every 15 seconds after administration of Gd-DTPA on the enhancing and surrounding area for maximum 300 seconds, and the patterns of enhancement were ana lysed. The enhancement curve with initial steep increase followed by slow decrease was defined as "N pattern", those with initial steep increase followed by additional slow increase as "T pattern", and those with initial steep increase followed by plateau as "E pattern". Histopathological findings were compared with the dynamic scan. Results : The graphs taken from enhancing area showed "T pattern" regardless of pathology. In the surrounding area, "T pattern" was noticed in the malignant tumors, but "E pattern" or "N pattern" was noted in low-grade or benign tumors and non-tumorous condition. "T pattern" in the surrounding area was related to the malignant with tumor cell infiltration and recurrence. Conclusion : The results suggest that the malignant tumor infiltration changes the condition of BBB enough to extravasate the Gd-DTPA. Enhancement pattern in the surrounding edematous area may be a useful information to differentiate the malignant glioma with the low-grade and benign tumors or other non-tumorous conditions.

• 한국멀티미디어학회논문지
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• 제10권7호
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• pp.846-855
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• 2007

암세포 조직 영상 분석에서 유효한 특성값 추출은 암세포 등급별 분류를 위한 중요한 과정이다. 본 논문에서는 디지털 영상 세포 측정법 기반 세포핵의 3차원 정량적 분석 방법을 제안한다. 먼저 공초점 현미경을 사용하여 신세포암의 각 등급별 3차원 볼륨 데이터를 획득하고, 지도학습 방법을 기반으로 슬라이스 영상의 화소의 컬러 특성값을 이용하여 세포핵을 분할했다. 세포핵의 3차원 가시화를 위해, 윤곽선 기반 표면 렌더링과 3차원 텍스쳐 사상 방법을 이용한 볼륨 렌더링을 수행했다. 이후 세포핵의 3차원 형태학적 특성값을 정의하고 추출했다. 어떠한 3차원 특성값이 진단 정보로 유용할 것인가를 평가하기 위해, 분산 분석을 이용하여 각 등급 간 3차원 특성값의 통계적 유효성을 분석했다. 마지막으로 추출한 특성값을 2차원 특성값과 비교하고 상관관계를 분석했다. 그 결과, 세포핵 등급과 3차원 형태학적 특성값 간의 유효한 통계학적인 차이를 확인했다. 제안한 방법은 정확한 진단과 예후 추정을 위한 새로운 등급 결정 시스템 개발을 위한 기반 연구로 활용될 수 있는 가능성을 보여주었다.

• Journal of Gastric Cancer
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• 제9권4호
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• pp.256-261
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• 2009

목적: 진단 기술의 발전과 함께 위암 환자에서 동시성과 이시성암이 발견되는 빈도가 증가하고 있다. 본 연구에서는 위암에서 발견된 동시성과 이시성암의 임상병리학적 특성과 임상적 의의에 대하여 알아보고자 하였다. 대상 및 방법: 1998년 1월부터 2008년 3월까지 조선대학교병원에서 위암으로 진단된 환자들의 의무기록을 후향적으로 분석하였다. 결과: 1,048명 위암 환자 중 38명(3.6%)에서 동시성과 이시성암이 있었다. 38명 중 16명(42.1%)은 동시성암이었고 22명(57.9%)은 이시성암이었다. 위암과 이차성 원발암 간의 평균 시간간격은 $27.08{\pm}31.25$개월이었다. 가장 흔한 중복암은 폐암(8/38, 21.1%)과 대장암(8/38, 21.1%)이었다. 27명의 환자가 위암에 대하여 수술적 치료를 하였으며 이 중 5명(18.5%)은 동시성암, 22명(81.5%)은 이시성암이었다. 평균 생존 기간은 49.8개월이었으며 동시성암의 경우는 24.6개월 이시성암의 경우는 68.1개월이었고 이들의 3년 생존율은 동시성암, 이시성암 각각 33.3%, 81.1%였다. 결론: 위암에서의 이차성 원발암 진단에 대한 진단에 있어 충분한 수술 전 검사를 통한 동시성암의 발견과 지속적인 추적검사를 통한 이시성암의 발견을 위해 주의를 기울여야 한다.

• Journal of Gastric Cancer
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• 제14권3호
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• pp.196-203
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• 2014

Purpose: Vascular endothelial growth factor (VEGF) is one of the most important growth factors for metastatic tumors. To clarify the role of VEGF-A and C in patients with peptic ulcer disease (PUD) or gastric cancer (GC), we evaluated the expression levels of these two molecules. We also analyzed the effect of Helicobacter pylori infection on VEGF-A and C expression levels. Materials and Methods: Patients with dyspepsia who needed diagnostic endoscopy were selected and divided into three groups: nonulcer dyspepsia (NUD), PUD, and GC, according to their endoscopic and histopathological results. Fifty-two patients with NUD, 50 with PUD, and 38 with GC were enrolled in this study. H. pylori infection was diagnosed by the rapid urease test. After RNA extraction and synthesis of cDNA, the expression levels of VEGF-A and C were determined by quantitative reverse transcriptase polymerase chain reaction. Results: The VEGF-C expression level in the PUD and GC groups was significantly higher than that in the NUD group. Moreover, the VEGF-A expression level in the PUD and GC groups was higher than in the NUD group, although the differences were not statistically significant. Significant positive correlations were also observed between the expression levels of these two molecules in the PUD and GC groups. In addition, the expression levels of these two molecules were higher in H. pylori positive patients with PUD or GC than in H. pylori negative patients of the same groups; however, these differences did not reach statistical significance. Conclusions: Up-regulation of VEGF-C expression during gastric mucosal inflammation may play a role in the development of peptic ulcers or GC.

• 생물정신의학
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• 제18권2호
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• pp.95-100
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• 2011

Objectives To evaluate the drug interactions between aripiprazole and haloperidol, authors investigated plasma concentrations of those drugs by genotypes. Method Fifty six patients with a confirmed Diagnostic and Statistical Manual of Mental Disorders 4th edition diagnosis of schizophrenia were enrolled in this eight-week, double blind, placebo-controlled study. Twenty-eight patients received adjunctive aripiprazole treatment and twenty-eight patients received placebo while being maintained on haloperidol treatment. Aripiprazole was dosed at 15 mg/day for the first 4 weeks, and then 30 mg for the next 4 weeks. The haloperidol dose remained fixed throughout the study. Plasma concentrations of haloperidol and aripiprazole were measured by high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) at baseline, week 1, 2, 4 and 8. $^*1$, $^*5$, and $^*10$ B alleles of CYP2D6 and $^*1$ and $^*3$ alleles of CYP3A5 were determined. The Student's T-test, Pearson's Chi-square test, Wilcoxon Rank Sum test and Logistic Regression analysis were used for data analysis. All tests were two-tailed and significance was defined as an alpha < 0.05. Results In the frequency of CYP2D6 genotype, $^*1/^*10$ B type was most frequent (36.5%) and $^*1/^*1$ (30.8%), $^*10B/^*10B$ (17.3%) types followed. In the frequency of CYP3A5 genotype, $^*3/^*3$ type was found in 63.5% of subjects, and $^*1/^*3$ type and $^*1/^*1$ were 30.8% and 5.8% respectively. The plasma levels of haloperidol and its metabolites did not demonstrate significant time effects and time-group interactions after adjunctive treatment of aripiprazole. The genotypes of CYP2D6 and 3A5 did not affect the plasma concentration of haloperidol in this trial. No serious adverse event was found after adding aripiprazole to haloperidol. Conclusion No significant drug interaction was found between haloperidol and aripiprazole. Genotypes of CYP2D6 and 3A5 did not affect the concentration of haloperidol after adding aripiprazole.

• 한국자기학회지
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• 제26권3호
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• pp.105-114
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• 2016

삼각 섬유성 연골(TFCC) 손상 환자의 평가를 위하여 fat suppressed 3D fast spoiled gradient recalled T1 기법과 fat suppressed Isotropic 3D fast spin echo T1 기법을 이용하여 영상을 획득하였다. 정량적 평가를 위해 각각의 영상에서 signal to noise ratio 및 contrast to noise ratio 값을 측정하고, Mann-Whitney U 검정으로 두 기법 간의 통계적 유의성을 검증하였다. 또한 정성적 평가를 위해 영상의학의 2명이 각각의 영상을 관찰하여, TFCC의 형태, 영상 내 인공음영, 병변의 묘사 정도의 3가지 항목을 선정한 후 이를 4점 척도(0: 진단 불가, 1: 부족함, 2: 충분함, 3: 좋음)로 평가하였고, Kappa-value 검정을 이용하여 두 관찰자 간의 일치도 검증을 하였다. 영상획득에는 3.0 Tesla MR 장비와 8-channel RF coil을 사용하였다. 정량적 평가 결과, 모든 영상 단면에서 signal to noise ratio 및 contrast to noise ratio 값이 Isotropic 3D fast spin echo T1 기법이 높게 나타났으며, Mann-Whitney U 검정을 이용한 두 영상기법 간의 검증도 통계적으로도 유의하였다(p < 0.05). 정성적 평가 결과, 관찰자 1, 2 모두에서 Isotropic 3D fast spin echo T1 기법의 평가 결과가 더 높게 나타났으며, Kappa-value 검증을 이용한 두 관찰자 간 평가 결과의 일치도 검증도 통계적으로 유의하였다(p < 0.05). 결론적으로 TFCC 손상 환자의 자기공명영상 검사 시 fat suppressed Isotropic 3D fast spin echo T1 기법의 적용은 TFCC 병변의 감별에 보다 유용한 진단적 정보를 제공 할 수 있을 것이라 생각된다.

• 보건행정학회지
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• 제13권1호
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• pp.98-115
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• 2003

Concerns about growing health insurance expenditures became a national Issue in 2001 when the National Health Insurance went into a deficit. Increases in spending for ambulatory care shared the largest portion of the problem. Methods and systems to control the spending should be developed and a system to measure case mix of providers is one of core components of the control system. The objectives of this article is to examine the feasibility of applying Korean Diagnosis Related Groups (KDRGs) to classify health insurance claims for ambulatory care and to identify problem areas of the classification. A database of 11,586,270 claims for ambulatory care delivered during January 2002 was obtained for the study, and the final number of claims analyzed was 8,319,494 after KDRG numbers were assigned to the data and records with an error KDRG were excluded from the study. The unit of analysis was a claim and resource use was measured by the sum of charges incurred during a month at a department of a hospital of at a clinic. Within group variance was assessed by th coefficient of variation (CV), and the classification accuracy was evaluated by the variance reduction achieved by the KDRG classification. The analyses were performed on both all and non-outlier data, and on a subset of the database to examine the validity of study results. Data were assigned to 787 KDRGs among 1,244 KDRGs defined in the classification system. For non-outlier data, 77.4％ of KDRGs had a CV of charges from tertiary care hospitals less than 100％ and 95.43％ of KDRGs for data from clinics. The variance reduction achieved by the KDRG classification was 40.80％ for non-outlier claims from tertiary care hospitals, 51.98％ for general hospitals, 40.89% for hospitals, and 54.99% for clinics. Similar results were obtained from the analyses performed on a subset of the study database. The study results indicated that KDRGs developed for a classification of inpatient care could be used for ambulatory care, although there were areas where the classification should be refined. Its power to predict tile resource utilization showed a potential for its application to measure case mix of providers for monitoring and managing delivery of ambulatory care. The issue concerning the quality of diagnostic information contained in insurance claims remains to be improved, and significance of future studies for other classification systems based on visits or episodes is guaranteed.

• 한국방사선학회논문지
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• 제11권7호
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• pp.637-645
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• 2017

뇌혈관을 관찰할 수 있는 영상 진단장치 중 MRA, CTA, DSA 3장비 영상에 관한 SNR과 CNR을 비교, 분석하여 뇌혈관 검사 시 최적의 검사기기를 알아보고자 하였다. 2016년 11월부터 2017년 5월까지 뇌혈관 진단 검사를 받은 환자 90명을 대상으로 하였고, 측정부위는 Rt MCA, Lt MCA, ACA Image J를 이용하여 측정 하였다. 정량적 분석 결과 MRA의 평균 SNR은 254.87 CNR은 178.13, 신호강도는 326.81, CTA의 평균 SNR은 74.75, CNR은 62.2, 신호강도는 356.66, DSA의 SNR은 26.85, CNR은 25.89, 신호강도는 4400.69로 평가되었다(p<0.05). 결과적으로 SNR과 CNR 모두에서 MRA>CTA>DSA 순으로 측정 되었다. 유의성 평가 방법으로 SPSS 통계 분석 프로그램을 이용하여 ANOVA 분석을 하였고, 사후분석으로 bonferroni method를 사용하여 p<0.05 일 때 유의한 것으로 판단하였다. 결론적으로 본 실험에서 뇌혈관 질환 환자를 무작위로 선정하여 평가하였을 때 최적의 영상진단 장비로 MRA, CTA, DSA의 결과를 얻었다.