• Title/Summary/Keyword: 임상통계

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The Effect of Preoperative Clopidogrel on the Postoperative Bleeding after OPCAB (OPCAB 시행 전 Clopidogrel 사용이 술 후 출혈경향에 미치는 임상적 고찰)

  • Park, Kwon-Jae;Woo, Jong-Soo;Bang, Jung-Hee;Jeong, Sang-Seok
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.311-316
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    • 2009
  • Background: Clopidogrel is widely used just before coronary artery bypass surgery, yet its pharmacological effect can cause postoperative bleeding-related complications. The purpose of this study was to find the effect of preoperative clopidogrel exposure on the blood transfusion requirement and on the rate of reexploration for bleeding control and the rate of readmission caused by bleeding in patients who undergo off-pump coronary artery bypass surgery (OPCAB). Material and Method: This study included 103 patients who had been on clopidogrel preoperatively and they underwent OPCAB by one surgeon from January, 2005 to November, 2007. We divided the patient into two group. Group 1 consisted of 45 patients who stopped cloidogrel 5 days before surgery and group 2 consisted of 58 patients who were taking clopidogrel within 5 days before surgery. Two groups were compared in terms of the bleeding related reoperation rate and the readmission rate, the amount of postoperative bleeding and the required amount of transfusion. Result: There were no significant differences between the two groups concerning the demographic, echocardiographic and hematologic features. There were no significant differences in the postoperative bleeding amount, but the amount of required transfusion was greater in group 2 (p=0.018). While group 1 showed a 0% reoperation rate for hemostasis and 0% readmission rate as related to postoperative bleeding, group 2 showed a 6.9% reoperation and a 5.2% readmission rate, but three were no statistically significant differences between the two groups. Conclusion: Continuous use of clopidogrel did not cause postoperative major bleeding, but can increase the amount of bleeding and the amount of required transfusion postoperatively. We that discontinuation of clopidogrel for a while before elective OPCAB can help the patient's postoperative recovery.

The Effects of Isoflavone Supplementation on Serum PSA, Lipid Profile, Antioxidant and Immune System in Prostate Cancer Patients (이소플라본 섭취가 전립선암환자의 Serum PSA, 지질패턴, 항산화체계 및 면역체계에 미치는 영향)

  • Lee, Joo-Min;Hong, Sung-Joon;Lee, Min-June;Yoon, Sun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.8
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    • pp.1294-1301
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    • 2004
  • Soy foods are a unique dietary source of isoflavones, which have effects relevant to prostate cancer prevention. The present study determines the effects of a short-term isoflavone supplement on serum PSA (prostate specific antigen), lipid profile, antioxidant status, and immune system in prostate cancer patients. Ten prostate cancer patients were supplemented daily with 150 mg of isoflavone for 2 months. Blood samples were collected baseline and 2 month after for analysis of PSA, serum lipid profiles, total antioxidant status (TAS), grade of DNA damage in lymphocytes, IL-6, VEGF and TNF -$\alpha$. After 2 month isoflavone supplementation, increased significantly a total of estimated urinary isoflavone excretion and did not change PSA. Serum lipid profiles showed significant change in serum total cholesterol level (p=0.007). However, there was no significant change in HDL- and LDL-cholesterol levels. TAS was increased but not significant after isoflavone supplementation. Tail moment (TM) was decreased and especially tail length (TL) was decreased significantly (p=0.043). IL-6 level was decreased but VEGF level and TNF -$\alpha$ level were increased. The results of the present study led to the conclusion that the isoflavone dosage (150 mg) in supplement had positive effects on the serum total cholesterol level and DNA damage.

Reducing the Scan Time in Gastric Emptying Scintigraphy by Using Mathematical Models (위배출 신티그래피에서 수학적 모델을 이용한 지연영상 시간의 단축)

  • Yoon, Min-Ki;Hwang, Kyung-Hoon;Choe, Won-Sick;Lee, Byeong-Il;Lee, Jae-Sung
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.4
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    • pp.257-262
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    • 2005
  • Purpose: Gastric emptying scan (GES) is usually acquired up to 2 hours. Our study investigated whether a fraction of meal-retention in the stomach at 120 minutes (FR120) was predicted from the data measured for 90 minutes by using non-linear curve fitting. We aimed at saving the delayed imaging by utilizing mathematical models. Materials and Methods: Ninety-six patients underwent GES immediately after taking a boiled egg with 74 MBq (2 mCi) Tc-99m DTPA. The patients were divided into Group I ($T_{1/2}\;{\leq}90\;min$) and Group II ($90\;min). Group I (n=51) had 21 men and 30 women, and Group II (n=45) 15 men and 30 women. There was no significant difference in age and sex between the two groups. Simple exponential, power exponential, and modified power exponential curves were acquired from the measured fraction of meal-retention at each time (0, 15, 30, 45, 60, 75, and 90 min) by non-linear curve fitting ($MATLAB^{\circledR}$ 5.3) and another simple exponential fitting was performed on the fractions at late times (60, 75, and 90 min). A predicted FR120 was calculated from the acquired functional formulas. A correlation coefficient between the measured FR120 and the predicted FR120 was computed ($MedCalc^{\circledR}$ 6.0). Results: Correlation coefficients(r) between the measured FR120 and the predicted FR120 of each mathematical functions were as follows: simple exponential function (Group I: 0.8558, Group II: 0.5982, p<0.0001), power exponential function (Group I: 0.8755, Group II: 0.6008, p<0.0001), modified power exponential function (Group I: 0.8892, Group II: 0.5882, p<0.0001), and simple exponential function at the late times(Group I: 0.9085, Group II: 0.6832, p<0.0001). In all the fitting models, the predicted FR120 were significantly correlated with the measured FR120 in Group I but not in Group II. There was no statistically significant difference in correlation among the 4 mathematical models. Conclusion: In the cases with $T_{1/2}\;{\leq}90\;min$, the predicted FR120 is significantly correlated with the measured FR120. Therefore, FR120 can be predicted from the data measured for 90 minutes by using non-linear curve fitting, saving the delayed imaging after 90 minutes when $T_{1/2}\;{\leq}90\;min$ is ascertained.

Alexithymia in Patients with Ulcerative Colitis and Irritable Bowel Syndrome (궤양성대장염 환자와 과민성대장증후군 환자의 감정표현불능증 비교 연구)

  • Lee, Sang-Bin;Lee, Seong-Yong;Kim, Sang-Heon;Rim, Hyo-Deog
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.1
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    • pp.69-76
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    • 2003
  • Objectives: Many researches have been done to compare psychopathology of functional gastrointestinal disorder and inflammatory bowel disease which involves structural change. Recently, many studies focused on the topic of alexithymia. The results from these studies were questionable for lack of valid measures of alexithymia and valid diagnostic criteria of functional gastrointestinal disorders. Therefore, we tried to overcome these two problems and to assess alexithymia, personality characteristics, and other psychopathology. Methods: The subjects consisted of ulcerative colitis group(N=28) who were diagnosed by colonoscopy and biopsy, irritable bowel syndrome group(N=27) who were diagnosed by Rome II criteria and normal control group(N=22). All patients were diagnosed at outpatient department of Kyungpook National University Hospital. All these groups completed three psychological tests, including MMPI, Rorschach test, and well validated TAS-20K(The Korean Version of the 20-Item Toronto Alexithymia Scale). Results: Twenty-five percent of the ulcerative colitis group and 22% of the irritable bowel syndrome group scored in the alexithymia range, compared with 0% of the normal group. In Rorschach test, irritable bowel syndrome group showed high levels of weighted Sum C and EA. Most of clinical scales of MMPI were higher in two gastrointestinal groups than the normal control group. And two gastrointestinal groups showed low ego strength level, but there was no statistical significant difference between them. Conclusion: Two gastrointestinal groups showed high rate of alexithymia, other psychopathological profiles, and low ego strength but there was no significant difference between two groups.

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Comparative study in marginal fit of a pressed ceramic and feldspathic porcelain fused to metal restoration (열-가압을 이용한 금속 도재관과 전통적인 금속 도재관의 변연 적합도 비교 연구)

  • Kim, Yoon-Young;Park, Won-Hee;Yoo, Dong-Yeob;Lee, Young-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.4
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    • pp.273-279
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    • 2010
  • Purpose: The purpose of this in vitro study was to compare the marginal adaptation of a ceramic-pressed-to-metal restoration with traditional metal-ceramic restoration. Materials and methods: Duplicating the prepared resin tooth, 20 metal dies were fabricated. Twenty metal copings of 2 groups which were metal ceramic restoration and pressed to metal restoration were fabricated. The marginal opening of each coping was measured with Microscope (BX 60M-36E $41D^{(R)}$: Olympus, Japan). After porcelain build-up, the marginal opening of metal ceramic restoration and pressed to metal restoration ($PoM^{(R)}$: Ivoclar vivadent., Liechtenstein) were also evaluated in the same method. The measurements were analyzed using Wilcoxon Signed Ranks test and Mann-Whitney U test. Results: Within the limits of this study, the results were as follows. 1. Metal-ceramic restorations in coping state ($64.93{\pm}12.48\;{\mu}m$) in compared with Metal ceramic restorations after porcelain build-up ($63.43{\pm}12.86\;{\mu}m$) had no significant difference in marginal adaptation. 2. Pressed-metal-ceramic restorations in coping state ($50.00{\pm}12.28\;{\mu}m$) in compared with Pressed metal ceramic restorations after porcelain build-up ($56.72{\pm}13.80\;{\mu}m$) had no significant difference in marginal adaptation. 3. Metal-ceramic restorations in compared Pressed-metal-ceramic restorations had no significant difference in marginal adaptation. Conclusion: Pressed-metal-ceramic restorations have the advantage of being technically less change through using of the lost-wax technique and this allows for the convenience of a full-contour ceramic wax-up as opposed to the more technique-sensitive layering method. Pressed-metal-ceramic restorations may be considered in clinic on the basis of the result of this study and the advantage of this system.

A study on enamel thickness of maxillary incisors using X-ray micro computed tomography (MicroCT를 이용한 상악 전치의 법랑질 두께에 관한 연구)

  • Cho, Young-Won;Cho, Jin-Hyun;Lee, Kyu-Bok
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.4
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    • pp.301-307
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    • 2010
  • Purpose: The objectives of the current study are to assess the accuracy of X-Ray Micro Computed Tomography (microCT) in measuring enamel thickness and to evaluate enamel thickness in maxillary incisors of Koreans. Materials and methods: Five maxillary incisors were embedded in resin block. These teeth were longitudinally sectioned labiolingually through the medial axis. After polishing, the teeth were scanned using a microCT (X-EYE SYSTEM; DRGEM, Seoul, Korea). On a scanning electron microscope (S-4300; Hitachi, Tokyo, Japan) (${\times}20$) and a microCT, nearly identical planes were reconstructed. In each tooth, the thickness of labial enamel was measured 1, 3 and 5 mm above the cementoenamel junction (CEJ). Thus, the accuracy of the microCT was evaluated. In addition, using 26 maxillary central incisors and 11 maxillary lateral incisors, in the medial axis and 2 mm remote areas mesially and distally from the medial axis, the thickness of labial enamel was measured 1, 3 and 5 mm above the CEJ along the long axis of the teeth. Results: Measurements from nearly identical planes in physical and microCT sections differed by 3.81%. An independent t-test was performed and this showed that there were no significant differences in the measurements between the two methods. Mean values of labial enamel thickness in maxillary central incisors 1, 3 and 5 mm above the CEJ were $0.32{\pm}0.01$, $0.50{\pm}0.0.2$ and $0.70{\pm}0.02\;mm$, respectively. Mean values of labial enamel thickness in maxillary lateral incisors 1, 3 and 5 mm above the CEJ were $0.30{\pm}0.01$, $0.55{\pm}0.03$ and $0.80{\pm}0.02\;mm$, respectively. Conclusion: In measuring enamel thickness, microCT is one of useful way of measurement. So according to the results of this research, when restoring a porcelain laminate veneer on maxillary incisors in Koreans, careful consideration is needed in the amount of enamel reduction.

Evaluation of polymerization shrinkage stress in silorane-based composites (Silorane계 복합레진의 중합수축응력의 평가)

  • Ryu, Seung-Ji;Cheon, Ji-Hoon;Min, Jeong-Bum
    • Restorative Dentistry and Endodontics
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    • v.36 no.3
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    • pp.188-195
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    • 2011
  • Objectives: The purpose of this study was to evaluate the polymerization shrinkage stress among conventional methacrylate-based composite resins and a silorane-based composite resin. Materials and Methods: The strain gauge method was used for the determination of polymerization shrinkage strain. Specimens were divided by 3 groups according to various composite materials. Filtek Z-250 (3M ESPE) and Filtek P-60 (3M ESPE) were used as a conventional methacrylate-based composites and Filtek P-90 (3M ESPE) was used as a silorane-based composites. Measurements were recorded at each 1 second for the total of 800 seconds including the periods of light application. The results of polymerization shrinkage stress were statistically analyzed using One way ANOVA and Tukey test (p = 0.05). Results: The polymerization shrinkage stress of a silorane-based composite resin was lower than those of conventional methacrylate-based composite resins (p < 0.05). The shrinkage stress between methacrylate-based composite resin groups did not show significant difference (p > 0.05). Conclusions: Within the limitation of this study, silorane-based composites showed lower polymerization shrinkage stress than methacrylate-based composites. We need to investigate more into polymerization shrinkage stress with regard to elastic modulus of silorane-based composites for the precise result.

Efficacy of mechanical pleurodesis for the treatment of spontaneous pneumothorax with VATS - A comparison of short-term recurrence according to the intensities of pleural abrasion - (비디오 흉강경을 이용한 자연기흉 수술에서 기계적 흉막유착술의 효과 -기계적 흉막유착술의 강도에 따른 단기 재발율의 비교-)

  • 허진필;이정철;정태은;이동협;한승세
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1070-1075
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    • 1998
  • Background: With the advent of thoracoscopy, there has been increasing interest in less invasive surgical bullectomy and pleurodesis. The recurrence rate, however, has been reported higher in surgery with thoracoscopy than with open thoracotomy and it is thought to be caused by inappropriate mechanical pleurodesis during thoracoscopic surgery. Materials and methods: We compared the short-term recurrence rates according to the intensities of pleural abrasion in 62 patients who underwent VATS for treatment of spontaneous pneumothorax from April 1996 to August 1997. The patients were divided into 2 groups: group A(n=32) included patients who received relatively weak pleural abrasion using Endo-forcep instrument for grasping the gauze, and group B(n=30) received strong pleural abrasion using conventional instrument wrapped tightly with gauze. Each intensity of pleural abrasion allowed petechia on the parietal pleura in group A, and some tearing and bleeding in group B. Results: Indications for operation, sex distribution, and age were comparable in both groups. There were no differences in chest tube indwelling time(3.78±3.35 vs 3.80±2.49 days), hospital stay(4.72±1.87 vs 4.67±2.20 days), and the amount and duration of analgesics required postoperatively. Persistent air-leak more than 7 days after surgery occurred in 4/32(12.5%) and 2/30(6.7%) in group A and B, respectively. No bleeding-related complication occured. Pneumothorax recurred 12.5%(4/32) and 0%(0/30) of patients at a mean follow-up of 9.7 and 9.6 months in group A and B, respectively, and it was statistically significant(p<0.05). Conclusions: Proper intensity of pleural abrasion is very important factor to reduce recurrence after VATS for spontaneous pneumothorax. During short-term follow-upafter surgery, we could achieve excellent result in reducing recurrence rate with VATS and strong pleural abrasion which is comparable to thoracotomy.

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Analysis of Risk Factors in Coronary Artery Bypass Surgery (관동맥우회술의 위험인자 분석)

  • 정태은;한승세
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1049-1055
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    • 1998
  • Background: Coronary artery bypass surgery is an important treatment for ischemic heart disease. Recently operative mortality and morbidity has decreased, however further improvement is necessary. Materials and methods: This study was designed to evaluate the risk of operative mortality and morbidity by retrospective method. From 1992 to 1997, eighty six patients underwent coronary artery bypass surgery. There were 61 males and 25 females aged 36~74 years(mean, 58.6). Fourteen patients(16%) had previous PTCA or stent insertion, 41 patients(48%) had unstable angina, and 45 patients(52%) had three vessel disease. Patients with low LV ejection fraction(<35%) were 7 cases and urgent or emergent operation were 10 cases. There were 6 cases of combined surgery which were mitral valve replacement(2 cases), aortic valve replacement(2 cases), ASD repair(1 case), and VSD repair(1 case). Average number of distal anastomosis was 3.5 per patient and average aortic cross clamp time was 115±38.3min. Preoperative risk factors were defined as follows: female, old age(>70 years), low body surface area(<1.5M2), PTCA or stent insertion history, hypercholesterolemia, smoking, hypertension, DM, COPD, urgent or emergent operation, left main disease, low LV ejection fraction(<35%), and combined surgery. Results: Operative mortality was 7cases(8%). As a postoperative morbidity, perioperative myocardial infarction was 6 cases, cerebrovascular accident 6 cases, reoperation for bleeding 5 cases, acute renal failure 4 cases, gastrointestinal complication 3 cases, and mediastinitis 3 cases. In the evaluation of operative risk factors, low body surface area, DM and low LV ejection fraction were found to be predictive risk factors of postoperative morbidity(p<0.05), and low ejection fraction was especially a risk factor of hospital mortality(p<0.05). Conclusions: In this study, low body surface area, DM and low LV ejection fraction were risk factors of postoperative morbidity and low ejection fraction was a risk factor of hospital mortality.

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Increased Incidence of Endometrial Polyps in Women with Endometriosis; the Association with Severity (자궁내막증 여성에서 증가된 자궁내막용종의 빈도; 질환의 중증도와의 관련성)

  • Chang, Hye Jin;Hwang, Kyung Joo;Kim, Mi Ran;Ahn, Sang Tae;Byun, Jae Guang;Lee, Eun Hee;Park, Jin Young
    • Clinical and Experimental Reproductive Medicine
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    • v.33 no.3
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    • pp.199-205
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    • 2006
  • Objective: The aim of this study was to evaluate the correlation between severity of endometriosis and the incidence of endometrial polyp. Methods: The study population consisted of six hundred thirty-one women who had undergone laparoscopic operation due to infertility, severe dysmenorrhea or ovarian tumors. We divided two groups: 434 women with endometriosis (study group) and 197 women without the disease (control group). The presence of endometriosis was documented by diagnostic or therapeutic laparoscopic operation and the disease severity was scored according to revised The American Fertility Society classification. We confirmed the endometrial polyps by pathologic examination after hysteroscopic polypectomy, and compared endometrial polyp incidence according to severity of endometriosis. Results: There was no significant difference between groups with regard to age, mean duration of infertility. Endometrial polyps were found in 274 women (63.0%) with endometriosis and in 58 controls (29.8%, p=0.0000). The incidence of endometrial polyps differed significantly according to stage of endometriosis. The incidence of endometrial polyps were 77/142 (54.2%), 58/90 (64.4%), 73/108 (67.6%, p<0.05), 66/94 (70.2%, p<0.05) in endometriosis stage I, II, III, and IV. There was a linear correlation between stage of endometriosis and endometrial polyps incidence (p=0.008). Conclusion: Endometriosis is accompanied by endometrial polyps. This results showed positive correlation between severity of the endometriosis and incidence of endometrial polyps. It is the possible mechanism for low pregnancy rate in the severe endometriosis.