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위식도 역류진단을 위한 24시간 식도산도검사 양성지표들과 Bernstein 검사의 의의
김윤년,강영우,김기식,정우진,박승국,윤영호,황재석,김권배,허규찬 대한소화기학회 1998 대한소화기학회지 Vol.31 No.2
Background/Aims: We carried out this study to adapt various positive parameters of 24 hour pHmetry for diagnosis of gastroesophageal reflux disease and to determine a correlation between Bernstein test and 24 hour pHmetry. Methods: Sixty-six patients who complained of non-cardiac chest pain underwent Bernstein test and 24 hour pHrnetry. We defined the positive parameters of 24 hour pHmetry as the time percentage of esophageal pH below 4, above 5.78% or 11%, DeMeester score ahove 14,7, symptom index, above 25% or 50%, symptom sensitivity index above 5%. We compared the results of Bernstein test with those of 24 hour pHmetry. Results: On esophageal 24 hour pHmetry, the number of the patients who showed the time percentage of esophageal pH below 4 above 5.78% was 9 (13.6%), above 11% was 4 (6.1%). DeMeester score above 14.7 was seen in 10 (15.2%). Symptom index above 25% was seen in 9 (13.6%), above 50% in 4 (6.1%). Symptom sensitivity index above 5% was observed in 5 (7.6%). Total positive rate was 24.2%-27.2%. On Bemstein test, positive rate was 50%. Ten to twelve patients (30.3%-36.4%) out of 33 patients who were positive for Bernstein test showed positive esophageal 24 hour pHmetry. Six patients out of 33 patients who were negative for Bernstein test showed positive esophageal 24 hour pHmetry. There was no conelation between 24 hour pHmetry and Bernstein test using a kappa index. Conclusions: The positive rate of 24 hour pHmetry for Korean people was lower than that of western people and there was no correlation between Bernstein test and 24 hour pHmetry, We think further investigation should be conducted to confirm the positive parameters of 24 hour pHmetry.
A New Method of ECG Feature Detection Based on Combined Wavelet Transform for u-health Service
김윤년,김민수,서석태,조영창,손창식 대한의용생체공학회 2011 Biomedical Engineering Letters (BMEL) Vol.1 No.2
Purpose The analysis of the ECG is required of accuracy for diagnosing many cardiac diseases. In this work, we propose an algorithm using wavelet transform to analyze and classify ECG (electrocardiogram) signal obtained from the developed patch type electrode. This paper presents a new combined wavelet transform artificial neural network (CWTANN) based system for classification and detection of QRS complex, P and T waves. CWTANN provided useful information for detection of cardiac disease or abnormality. Methods In this paper, we proposed a method to detect characteristic waves, such as P, QRS and T wave from abnormal ECG signal. Daubechies, Coiflets and Symlets order 5 wavelet transform were applied to the ECG. The methods have been proven out for detection of normal signal,ventricular tachycardia (VT) and PVC (premature ventricular contraction) in the ECG through subband decomposition and combined wavelet transform. Results From the results, the detection rate achieved was 96.2% for off-line classification, which is indeed a good rate of accuracy for data recognition. Using the simple proposed wavelet scheme, the developed methodology achieves higher detection rates. Conclusions The proposed ECG detection method can be used P, QRS, T wave detection by sum of combined scale using DWT. Thus the clinical use of the methodology is to be beneficial in the analysis of various heart diseases. The new CWTANN method is expected used in monitoring of ECG for mobile home healthcare applications.
김윤년,강영우,전영준,송홍석,조진환,조준찬,박이태 대한내과학회 1986 대한내과학회지 Vol.30 No.2
Primary mediastinal seminoma is a rare germ cell tumor histologically identical to testicular seminoma. We experienced one case of Primary mediastinal seminoma recently. He was 51-year old, and complained of progressively severe anterior chest pain and dyspnea for 3 weeks before the time of diagnosis. Echo-cardiogram showed massive pericardial effusion in anterior portion of the right ventricle and posterior portion of the left ventricle with thickened pericardium, During admission, cardiac tamponade was developed, and pericardiectomy was performed. But we couldn`t excised totally because of severe adhesion of anterior mediastinal structures. Pathological findings were pure seminoma developed in thymus with fibrosis and organized hemorrhage in pericardium and pericardial peel. In our case seminoma is associated with possibly tuberculous constrictive effusive pericarditis. We treated with combination chemotherapy followed by irradiation with favorable results.
김윤년,송홍석,곽동협 대한내과학회 1986 대한내과학회지 Vol.30 No.2
A clinical review was done retrospectively on 105 patients with histiocytic lymphoma who visited to the Dong San Medical Center between Jan. 1974 and Aug, 1984, The results of the this study were as follows: JVIale to female ratio was 1.56:1 with male predorminance and the age distribution was between 4 and 82 with mean age of 44,7 years. Palpable neck mass was the most frequent complaint(52cases: 49.5%). Abdominal pain, fever were observed in 14 cases (13.3%) respectively and abdominal mass in 11 cases(10.5%), weight loss in 9 cases(8.6%), throat pain in 9 cases(8.6%) and abdominal swelling in 8 cases(7.6%). Physical findings revealed lymph node enlargement in 74cases (70.5%) with cervical, inguinal, axillary, mesenteric and supraclavicular in order of frequency. Hepatomegaly was observed in 17.1% splenomegaly in 2.5% and abdominal mass in 20cases(19.0%). Extranodal involvement was observed in 71 cases(67.6%) and organs of involvement were as follows: GIT in 18 cases(17.1%), waldeyer`s ring in 17 cases(16.2%), skin in 16 cases(15.2%) liver in 7 cases(6.7%), bone in 6 cases(5.7%), bone marrow in 5 cases(4.8%), retroperitoneum in 5 cases(4.8%), anterior nasal cavity in 4 cases(3.8%), lung and pleura in 2 cases(l.9%) respectively. Laboratory findings revealed anemia in 47.1%, leukocytosis in 27.5%, leukopenia in 14.7% lymphopenia in 43.4%, hypoalbuminemia in 31.5%, azotemia in 10.4%, increased alkaline phosphatase in 13.9% and hypercalcemia in 8.2%. By Ann Arbor staging, stage I was in 23cases (21.9%), stage g in 34cases(32.4%), stage III in 16cases(15.2%), stage g in 32 cases(30.5) and stage B in 20 cases(27.6%). Treatment was performed as follows: Radiotherapy in 20 cases, combination chemotherapy in 18 cases and combined modality therapy in 8 cases. After treatment, 5 year survival rate was 72.2% in adequately treated patients. 2 year survival rate was 83.4% in complete remission group and 58.6% in partial remission group and there was no long-term survival in patients with partial remission.
김윤년,서석태,이인희,손창식,박희준,Hyoung-Seob Park,Hyuck-Jun Yoon 대한의료정보학회 2010 Healthcare Informatics Research Vol.16 No.4
Objectives: Congenital muscular torticollis, a common disorder that refers to the shortening of the sternocleidomastoid in infants, is sensitive to correction through physical therapy when treated early. If physical therapy is unsuccessful, surgery is required. In this study, we developed a support vector regression model for congenital muscular torticollis to investigate the prognosis of the physical therapy treatent in infants. Methods: Fifty-nine infants with congenital muscular torticollis received physical therapy until the degree of neck tilt was less than 5o. After treatment, the mass diameter was reevaluated. Based on the data, a support vector regression model was applied to predict the prognoses. Results: 10-, 20-, and 50-fold cross-tabulation analyses for the proposed model were conducted based on support vector regression and conventional multi-regression method based on least squares. The proposed methodbased on support vector regression was robust and enabled the effective analysis of even a small amount of data containing outliers. Conclusions: The developed support vector regression model is an effective prognostic tool for infants with congenital muscular torticollis who receive physical therapy.