임상문서 정보교류 시스템의 의미론적 상호운용성 확립을 위한 메타데이터 국제표준 적용방안

박유랑,김혜현,안은양,김형회,김주한,박래웅,박동균,정은영,김주한 대한의사협회 2012 대한의사협회지 Vol.55 No.8

Around the world electronic health records data are being shared and exchanged between two different systems for direct patient care, as well as for research, reimbursement, quality assurance,epidemiology, public health, and policy development. It is important to communicate the semantic meaning of the clinical data when exchanging electronic health records data. In order to achieve semantic interoperability of clinical data, it is important not only to specify clinical entries and documents and the structure of data in electronic health records, but also to use clinical terminology to describe clinical data. There are three types of clinical terminology: interface terminology to support a user-friendly structured data entry; reference terminology to store, retrieve, and analyze clinical data; and classification to aggregate clinical data for secondary use. In order to use electronic health records data in an efficient way, healthcare providers first need to record clinical content using a systematic and controlled interface terminology, then clinical content needs to be stored with reference terminology in a clinical data repository or data warehouse, and finally, the clinical content can be converted into a classification for reimbursement and statistical reporting. For electronic health records data collected at the point of care to be used for secondary purposes, it is necessary to map reference terminology with interface terminology and classification. It is necessary to adopt clinical terminology in electronic health records systems to ensure a high level of semantic interoperability.

GAB2 Amplification in Squamous Cell Lung Cancer of Non-Smokers

박유랑,배소현,지원준,서을주,이재철,김형렬,장세진,최창민 대한의학회 2017 Journal of Korean medical science Vol.32 No.11

Lung squamous cell cancer (SCC) is typically found in smokers and has a very low incidence in non-smokers, indicating differences in the tumor biology of lung SCC in smokers and non-smokers. However, the specific mutations that drive tumor growth in non-smokers have not been identified. To identify mutations in lung SCC of non-smokers, we performed a genetic analysis using arrays comparative genomic hybridization (ArrayCGH). We analyzed 19 patients with lung SCC who underwent surgical treatment between April 2005 and April 2015. Clinical characteristics were reviewed, and DNA was extracted from fresh frozen lung cancer specimens. All of copy number alterations from ArrayCGH were validated using The Cancer Genome Atlas (TCGA) copy number variation (CNV) data of lung SCC. We examined the frequency of copy number changes according to the smoking status (non-smoker [n = 8] or smoker [n = 11]). We identified 16 significantly altered regions from ArrayCGH data, three gain and four loss regions overlapped with the TCGA lung squamous cell carcinoma (LUSC) patients. Within these overlapped significant regions, we detected 15 genes that have been reported in the Cancer Gene census. We also found that the proto-oncogene GAB2 (11q14.1) was significantly amplified in non-smokers patients and vice versa in both ArrayCGH and TCGA data. Immunohistochemical analyses showed that GAB2 protein was relatively upregulated in non-smoker than smoker tissues (37.5% vs. 9.0%, P = 0.007). GAB2 amplification may have an important role in the development of lung SCC in non-smokers. GAB2 may represent a potential biomarker for lung SCC in non-smokers.

CCR+: Metadata Based Extended Personal Health Record Data Model Interoperable with the ASTM CCR Standard

박유랑,윤영조,장태훈,서화정,김주한 대한의료정보학회 2014 Healthcare Informatics Research Vol.20 No.1

Objectives: Extension of the standard model while retaining compliance with it is a challenging issue because there is currently no method for semantically or syntactically verifying an extended data model. A metadata-based extended model, named CCR+, was designed and implemented to achieve interoperability between standard and extended models. Methods: Furthermore, a multilayered validation method was devised to validate the standard and extended models. The American Society for Testing and Materials (ASTM) Community Care Record (CCR) standard was selected to evaluate the CCR+ model; two CCR and one CCR+ XML files were evaluated. Results: In total, 188 metadata were extracted from the ASTM CCR standard; these metadata are semantically interconnected and registered in the metadata registry. An extended-data-model-specific validation file was generated from these metadata. This file can be used in a smartphone application (Health Avatar CCR+) as a part of a multilayered validation. The new CCR+ model was successfully evaluated via a patient-centric exchange scenario involving multiple hospitals, with the results supporting both syntactic and semantic interoperability between the standard CCR and extended, CCR+, model. Conclusions: A feasible method for delivering an extended model that complies with the standard model is presented herein. There is a great need to extend static standard models such as the ASTM CCR in various domains: the methods presented here represent an important reference for achieving interoperability between standard and extended models.

Prediction of Microbial Infection of Cultured Cells Using DNA Microarray Gene-Expression Profiles of Host Responses

박유랑,Tae Su Chung,Young Joo Lee,송영욱,이은영,Yeo Won Sohn,Sukgil SONG,박웅양,김주한 대한의학회 2012 Journal of Korean medical science Vol.27 No.10

Infection by microorganisms may cause fatally erroneous interpretations in the biologic researches based on cell culture. The contamination by microorganism in the cell culture is quite frequent (5% to 35%). However, current approaches to identify the presence of contamination have many limitations such as high cost of time and labor, and difficulty in interpreting the result. In this paper, we propose a model to predict cell infection, using a microarray technique which gives an overview of the whole genome profile. By analysis of 62 microarray expression profiles under various experimental conditions altering cell type,source of infection and collection time, we discovered 5 marker genes, NM_005298,NM_016408, NM_014588, S76389, and NM_001853. In addition, we discovered two of these genes, S76389, and NM_001853, are involved in a Mycolplasma-specific infection process. We also suggest models to predict the source of infection, cell type or time after infection. We implemented a web based prediction tool in microarray data, named Prediction of Microbial Infection (http://www.snubi.org/software/PMI).

렌틸 유묘기 광 처리 파장에 따른 항산화 활성 변화

박유랑(You Rang Park),신유진(You Jin Shin),엄석현(Seok Hyun Eom) 한국원예학회 2022 한국원예학회 학술발표요지 Vol.2022 No.11

광 파장에 따른 유묘기 렌틸의 세 재배종 별 플라보노이드 집적 양상

박유랑(You Rang Park),임유진(You Jin Lim),엄석현(Seok Hyun Eom) 한국원예학회 2023 한국원예학회 학술발표요지 Vol.2023 No.10

렌틸 유묘기 광 처리 파장에 따른 항산화 활성 변화

박유랑(You Rang Park),신유진(You Jin Shin),엄석현(Seok Hyun Eom) 한국원예학회 2022 한국원예학회 학술발표요지 Vol.2022 No.11

F-48 보건의료 빅데이터 분석을 통한 미세먼지 노출과 폐렴 발생의 상관 관계에 대한 연구

지원준,박유랑,김혜령,최창민 대한결핵 및 호흡기학회 2017 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.124 No.0

목적: 미세먼지에 대한 노출이 급성 호흡기 질환 발생의 위험을 증가시킨다는 것은 기존의 연구에서 보고된 바 있으나, 폐렴 발생에 미치는 영향에 대해서는 연구는 미흡한 상태이다. 본 연구를 통해 미세먼지(PM10)와 초미세먼지(PM2.5)의 노출 기간에 따른 폐렴 발생의 위험에 대하여 조사해보고자 하였다. 방법: 본 연구는 후향적 코호트 연구로 국민건강보험공단에서 제공하고 있는 표본코호트 데이터베이스와 국립환경과학원의 미세먼지 농도측정확정자료를 이용하여 수행되었다. 폐렴 발생은 한국표준질병분류에서 폐렴에 해당하는 J100, J110, J2-18, J851 진단 코드가 2015년도에 새롭게 부여된 경우로 정의하였다. 전국 16개 시도에서 최대 4주까지 지역별 미세먼지 측정 수치와 폐렴 발생과의 상관관계를 분석하기 위해 포아송 회귀분석이 사용되었고, 메타분석을 이용하여 전국 단위의 상관관계를 확인하였다. 성적: 2015년 국민건강보험공단 표본코호트 데이터베이스에서 확인된 폐렴 환자는 54,727명이였으며, 여성이 52.6%이였다. 폐렴 발생은 연령별로는 18세 이하에서 50.2%으로 가장 많았고, 지역별로는 경기도(21.1%)와 서울(16.7%)의 순으로 많이 발생하였다. 미세먼지의 노출에 따른 폐렴발생 위험을 분석한 결과, 폐렴 발생 당일의 초미세먼지(PM2.5) 농도가 폐렴 발생에 가장 영향이 컸으며(OR 1.05, 95% CI 1.02-1.07), 이러한 영향은 최대 2주 누적 노출까지 지속(OR 1.03, 95% CI 1.00-1.05)되었다. 반면, 미세먼지(PM10)는 폐렴 발생 당일에는 영향을 주었으나(OR 1.01, 95% CI 1.00-1.02) 이후의 노출은 폐렴 발생과 일관된 상관관계를 보여주지 못하였다. 결론: 미세먼지(PM10)보다는 초미세먼지(PM2.5)가 폐렴 발생 위험에 미치는 영향이 크며, 초미세먼지(PM2.5)로 인한 폐렴 위험도의 증가는 최대 2주까지의 누적 노출과 관련이 있는 것으로 확인하였다.

Demonstration of patient transport monitoring system within hospital using mobile IoT technology : a feasibility study

이장호,박유랑,권솔비,김슬기,지원준,최창민 대한결핵 및 호흡기학회 2018 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.126 No.-

Objective: During intrahospital transport (IHT), adverse events are inevitable. Real time monitoring can be helpful for preventing these events during IHT. We attempted to determine the viability of risk signal detection using wearable devices and mobile applications during IHT. Methods: We used two wearable devices to monitor oxygen saturation and heart rate for 23 patients during IHT. To determine the agreement between the devices, records collected every 4 seconds were matched and imputation was performed if no records were collected at the same time by both devices. We used intra-class correlation coefficients (ICC) to evaluate the relationships between the two devices. Results: Data for 21 patients were delivered to the cloud over LTE, and data for 2 patients were delivered over Wi-Fi. The ICC for the heart rate between the two devices was 0.940 (95% confidence interval: 0.939-0.942) and that of oxygen saturation was 0.719 (95% confidence interval: 0.711-0.727). Systemic error analyzed with Bland-Altman analysis was 0.428 for heart rate and -1.404 for oxygen saturation. During the study, 14 patients had 20 risk signals: 9 signals for 8 patients with less than 90% oxygen saturation, 4 for 4 patients with a heart rate of 60 or less, and 7 for 5 patients due to network error. Conclusion: We developed a system that notifies the clinicians of the risk of a patient during IHT using a wearable device and a mobile application. Although there were some problems such as network errors, this paper is meaningful in that the risk detection system was validated with actual patients.

유전체 발현정보 표현 표준객체모델인 MAGE-OM (Microarray Gene Expression-Object Model)을 구현한 데이터베이스 구축

박지연,박유랑,박석,김주한 대한의료정보학회 2003 Healthcare Informatics Research Vol.9 No.3

: 유전자칩 표준 모델을 구현한 데이터베이스 설계--------------------------------------------------------------------------------------------------------------------------------------------This study was supported by a grant from Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea (03-PJ1-PG3-21000-0009).