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1코로나19 대유행 이후 폐렴 환자의 응급실 체류시간과 예후 변화

저자 : 하지성 ( Ji Sung Ha ) , 서상원 ( Sang Won Seo ) , 이장영 ( Jang Young Lee ) , 이원석 ( Won Suk Lee ) , 성원영 ( Won Young Sung ) , 이근택 ( Keun Taek Lee )

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 1호 발행 연도 : 2022 페이지 : pp. 84-93 (10 pages)

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Objective: This study aimed to investigate the impact of the coronavirus disease 2019 (COVID-19) outbreak on the emergency department length of stay (ED-LOS) and outcomes of patients admitted with pneumonia. Methods: This was a retrospective observational study that included adult pneumonia patients admitted to the emergency department during the period from February to July 2019 and the corresponding period in 2020. After the COVID- 19 outbreak, many changes occurred in medical systems, causing prolonged ED-LOS. We divided ED-LOS into pre-, mid-, and post-ED-LOS and compared ED-LOS, hospital LOS and in-hospital mortality rates of pneumonia patients during the above-mentioned periods. In addition, a multivariable logistic regression analysis was performed to identify the risk factors leading to in-hospital mortality in 2020. Results: A total of 365 patients were included in the study. Pre-ED-LOS, mid-ED-LOS, post-ED-LOS, and in-hospital mortality in the 2020 group were significantly higher than those of the 2019 group (P<0.05). Mid-ED-LOS (odds ratio [OR], 1.474; P=0.001) and post-ED-LOS (OR, 1.098; P=0.024) were identified as being independently associated with an increased risk of in-hospital mortality in 2020. Conclusion: Our study shows that ED-LOS and in-hospital mortality increased after the COVID-19 pandemic. Mid-EDLOS and post-ED-LOS were independently associated with an increased risk of in-hospital mortality in patients with pneumonia in 2020.

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2제주지역 돼지에서 증식성 괴사성 폐렴의 원인체 검출

저자 : 김재훈 ( Jae-hoon Kim ) , 정지열 ( Ji-youl Jung ) , 양형석 ( Hyoung-seok Yang ) , 김재훈 ( Jae-hoon Kim )

발행기관 : 한국동물위생학회 간행물 : 한국가축위생학회지 (KOJVS) 45권 1호 발행 연도 : 2022 페이지 : pp. 63-69 (7 pages)

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Proliferative and necrotizing pneumonia (PNP) is a form of interstitial pneumonia that occurs in post-weaning pigs. In this study, we investigated the presence of swine influenza virus (SIV), porcine reproductive and respiratory syndrome virus (PRRSV), porcine circovirus type 2 (PCV2) and Aujeszky’s disease virus (ADV) in PNP lesions in Jeju pigs. Based on the histopathologic criteria for PNP, a total of 50 cases were selected in Jeju pigs between 2008 and 2010. Coupled with histopathological examinations, the presence of ADV and SIV by polymerase chain reaction (PCR) and reverse transcription PCR (RT-PCR) and PRRSV and PCV2 by immunohistochemical (IHC) methods were investigated. Based on the PCR and RT-PCR methods, ADV and SIV nucleic acids were not detected in all cases. According to IHC, PRRSV was detected in 38 of the 50 cases examined (76%) and PCV2 in 25 cases (50%). PRRSV or PCV2 were detected in 19 (38%) or 6 (12%) cases, respectively. Both PRRSV and PCV2 were identified in other 19 cases (38%). Antigens of PRRSV and PCV2 were commonly observed in the cytoplasm of macrophages and clusters of necrotic cells in alveolar cavities. The results of the present study demonstrate that PRRSV is predominantly associated with PNP in Jeju pigs. Co-infection with PRRSV and PCV2 may enhance the severity of PNP lesions in affected pigs.

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3선행한 하기도감염 없이 발생한 폐쇄세기관지염의 임상 양상

저자 : 현종효 ( Jong Hyo Hyun ) , 정지은 ( Ji Eun Jeong ) , 김영환 ( Young Hwan Kim ) , 장윤영 ( Yoon Young Jang ) , 정혜리 ( Hai Lee Chung )

발행기관 : 대한천식알레르기학회 간행물 : Allergy asthma & respiratory disease 10권 2호 발행 연도 : 2022 페이지 : pp. 89-96 (8 pages)

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Purpose: We investigated young children who developed bronchiolitis obliterans (BO) without preceding severe lower respiratory tract infection (LRTI). Methods: Twenty patients referred for chronic respiratory symptoms and diagnosed with BO were enrolled and divided into 2 age groups: group 1 (<2 years, n=12) and group 2 (≥2, <6 years, n=8). A diagnosis of BO was made based on clinical and radiologic findings: (1) persistent cough or abnormal breath sounds which were not responsive to any treatment for more than 6 weeks; and (2) mosaic perfusion on high-resolution computed tomography. None of the subjects had experienced LRTI since birth, and those who had any underlying problems were excluded. The clinical characteristics and disease course were examined retrospectively. Results: Mean age of the patients was 6.8 months and 3.4 years in group 1 and 2, respectively. All patients presented with chronic cough and the most common type of cough was mixed (wet and dry), 67% in group 1 and 50% in group 2. Persistent stridor was the major respiratory sign in group 1 (67%), but 63% of group 2 patients showed no abnormal breath sounds. Chest x-ray finding was nonspecific in 75% each of both groups. The respiratory symptoms and signs resolved rapidly in most patients treated with pulse corticosteroid therapy. Bronchial hyperresponsiveness and decreased forced expiratory volume in 1 second were observed in 3 of group 2 children at age 6, during the follow-up. Conclusion: Our study shows that BO could develop without preceding severe LRTI. It also suggests that BO should be considered in the infants with persistent stridor accompanied by chronic cough. (Allergy Asthma Respir Dis 2022;10:89-96)

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4조산아 기관지폐이형성증의 발생에서 호산구 활성화 표지자

저자 : 최선희 ( Sun-hee Choi ) , 정성훈 ( Sung-hoon Chung ) , 이경석 ( Kyung-suk Lee ) , 배종우 ( Chong-woo Bae ) , 나영호 ( Yeong-ho Rha )

발행기관 : 대한천식알레르기학회 간행물 : Allergy asthma & respiratory disease 10권 1호 발행 연도 : 2022 페이지 : pp. 40-44 (5 pages)

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Purpose: Eosinophil-derived neurotoxin (EDN) is not the only a marker for eosinophil activation, but also acts as an alarm protein. Very few studies have examined the potential role of eosinophils in the development of bronchopulmonary dysplasia (BPD). This study aims to address the roles of eosinophil and EDN in the early phase of BPD development. Methods: Patients were preterm neonates with respiratory distress syndrome (RDS) born at 36 weeks of gestation or less. Blood and urine samples were collected to measure total eosinophil count in the blood, serum eosinophil cationic protein (ECP), serum EDN, and urinary EDN during the first week of life. Results: Fifty-two preterms were recruited, of whom 43 infants were analyzed. Comparisons were made between the RDS (n=16) and non-RDS groups (n=27) and between the BPD (n=6) and non-BPD groups (n=26). There were no differences between RDS and non-RDS group in total eosinophil count, serum ECP, serum EDN, or urinary EDN, except when compared by gestational age, birth weight and prenatal dexamethasone use. Urinary EDN was increased significantly in the BPD group compared to the non-BPD group. Conclusion: We demonstrated the roles of eosinophil and EDN in the development of BPD and suggest that urinary EDN may be utilized as a noninvasive factor predicting the development of BPD. (Allergy Asthma Respir Dis 2022;10:40-44)

5기침소리별 이상신호들

저자 : 한국지방재정공제회

발행기관 : 한국지방재정공제회 간행물 : 지방재정 2021권 1호 발행 연도 : 2021 페이지 : pp. 160-161 (2 pages)

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6만성기침: 무엇을 평가하고 어떻게 치료할 것인가?

저자 : 송우정

발행기관 : 대한내과학회 간행물 : 대한내과학회 추계학술발표논문집 2021권 2호 발행 연도 : 2021 페이지 : pp. 65-69 (5 pages)

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7만성기침의 치료

저자 : 김진우

발행기관 : 대한내과학회 간행물 : 대한내과학회 추계학술발표논문집 2021권 2호 발행 연도 : 2021 페이지 : pp. 80-88 (9 pages)

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8검사는 정상인데 오래된 기침, 진단과 치료는?

저자 : 정이영

발행기관 : 대한내과학회 간행물 : 대한내과학회 춘계학술발표논문집 2021권 0호 발행 연도 : 2021 페이지 : pp. 198-206 (9 pages)

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9Inception V3를 이용한 흉부촬영 X선 영상의 폐렴 진단 분류

저자 : 김지율 ( Ji-yul Kim ) , 예수영 ( Soo-young Ye )

발행기관 : 한국방사선학회 간행물 : 한국방사선학회논문지 14권 6호 발행 연도 : 2020 페이지 : pp. 773-780 (8 pages)

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4차 산업의 발전으로 의학 · 보건 · 바이오 등 여러 과학기술 분야에서는 질병을 예방하고 질병에 대한 피해를 줄이기 위한 연구가 이루어지고 있으며, 최근에는 ICT 기술의 발전과 더불어 인공지능 기술이 급부상하고 그 효용성이 입증되면서 영상의학 검사의 영상 분석에 인공지능 기술이 도입되어 연구되고 있다. 본 논문에서는 흉부 X선 영상을 이용하여 폐렴의 분류와 검출에 대한 딥러닝 모델을 직접 적용해보고 실제로 Inception 계열의 딥러닝 모델이 폐렴 검출에 있어 유용한 모델인지 평가하고자 한다. 실험재료는 캐글(Kaggle)에서 무료로 제공 및 공유하는 흉부 X선 영상 데이터 세트를 사용하였으며 전체 3,470개의 흉부X선 영상 데이터 중 학습 데이터 세트 1,870개, 검증 데이터 세트 1,100개, 테스트 데이터 세트 500개로 분류하였다. 실험결과 Inception V3 딥러닝 모델의 Metric 평가에 대한 결과값은 정확도는 94.80%, 정밀도는 97.24%, 재현율은 94.00%, F1 스코어는 95.59의 결과값을 나타내었다. 그리고 흉부 X선 영상의 페렴 검출 및 분류에 대하여 Inception V3 딥러닝 모델링에 대한 최종 에포크의 정확도는 학습 모델링의 경우 94.91%, 검증 모델링은 89.68%의 정확도를 나타내었다. 손실함수 값의 평가는 학습 모델링은 1.127%, 검증 모델링은 4.603%의 손실함수 값을 나타내었다. 이러한 결과로 Inception V3 딥러닝 모델은 흉부영상 데이터의 특징 추출 및 분류에 있어 매우 우수한 딥러닝 모델이며 학습상태 또한 매우 우수하다고 평가하였다. 테스트모델링에 대한 매트릭스 정확도 평가 결과 정상 흉부 X선 영상 데이터의 경우 96%, 폐렴 흉부 X선 영상데이터의 경우 97%의 정확도가 입증되었다. Inception 계열의 딥러닝 모델의 경우 흉부 질환의 분류에 있어 유용한 딥러닝 모델이 될 것이라고 판단되며 인력의 보조적인 역할 또한 수행할 수 있을 것이라고 기대되어 부족한 의료인력 문제에도 해결점이 될 것이라고 사료된다. 향후 딥러닝을 이용한 폐렴의 진단에 대한 유사 연구 시 본 연구는 유사 연구의 기초자료로 제시될 것이라고 기대된다.


With the development of the 4th industrial, research is being conducted to prevent diseases and reduce damage in various fields of science and technology such as medicine, health, and bio. As a result, artificial intelligence technology has been introduced and researched for image analysis of radiological examinations. In this paper, we will directly apply a deep learning model for classification and detection of pneumonia using chest X-ray images, and evaluate whether the deep learning model of the Inception series is a useful model for detecting pneumonia. As the experimental material, a chest X-ray image data set provided and shared free of charge by Kaggle was used, and out of the total 3,470 chest X-ray image data, it was classified into 1,870 training data sets, 1,100 validation data sets, and 500 test data sets. I did. As a result of the experiment, the result of metric evaluation of the Inception V3 deep learning model was 94.80% for accuracy, 97.24% for precision, 94.00% for recall, and 95.59 for F1 score. In addition, the accuracy of the final epoch for Inception V3 deep learning modeling was 94.91% for learning modeling and 89.68% for verification modeling for pneumonia detection and classification of chest X-ray images. For the evaluation of the loss function value, the learning modeling was 1.127% and the validation modeling was 4.603%. As a result, it was evaluated that the Inception V3 deep learning model is a very excellent deep learning model in extracting and classifying features of chest image data, and its learning state is also very good. As a result of matrix accuracy evaluation for test modeling, the accuracy of 96% for normal chest X-ray image data and 97% for pneumonia chest X-ray image data was proven. The deep learning model of the Inception series is considered to be a useful deep learning model for classification of chest diseases, and it is expected that it can also play an auxiliary role of human resources, so it is considered that it will be a solution to the problem of insufficient medical personnel. In the future, this study is expected to be presented as basic data for similar studies in the case of similar studies on the diagnosis of pneumonia using deep learning.

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10소아 알레르기비염의 위험 인자와 보호 인자

저자 : 전윤홍 ( Yoon Hong Chun ) , 김민지 ( Minji Kim ) , 김효빈 ( Hyo-bin Kim ) , 나영호 ( Yeong-ho Rha ) , 박양 ( Yang Park ) , 박용민 ( Yong Mean Park ) , 성명순 ( Myongsoon Sung ) , 신윤호 ( Youn Ho Shin ) , 염혜영 ( Hye Yung Yum ) , 이경석 ( Kyung Suk Lee ) , 이용주 ( Yong Ju Lee ) , 지혜미 ( Hye Mi Jee ) , 최봉석 ( Bong Seok Choi ) , 최선희 ( Sun Hee Choi ) , 김현희 ( Hyun Hee Kim )

발행기관 : 대한천식알레르기학회 간행물 : Allergy asthma & respiratory disease 10권 2호 발행 연도 : 2022 페이지 : pp. 73-79 (7 pages)

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Among allergic diseases of the Korean pediatric population, allergic rhinitis shows the most rapidly increasing prevalence. Its economic burden is substantial in many Asian countries including South Korea. This investigation of its risk factors aims to reduce the socioeconomic burden by blocking exposure of susceptible individuals to identified causes. However, the risk factors of allergic rhinitis varied considerably depending on the seasons, geographical locations, and populations involved. This review article primarily deals with studies on the risk factors for allergic rhinitis in Korean children that were published during the last 10 years and additionally investigates associated large scale international studies. Our investigation identified several single-nucleotide polymorphisms, inhalant allergens, pollution, tobacco smoke, chemicals, and family affluence as risk factors for allergic rhinitis. In contrast, breastfeeding, older sibling, and microbial diversity were protective factors against allergic rhinitis. This suggests that various genetic and environmental factors might affect the manifestation and presentation of allergic rhinitis complexly. These findings are beneficial as they can provide insights into modifiable risk factors that may hinder the development of allergic rhinitis. (Allergy Asthma Respir Dis 2022;10:73-79)

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