• Title/Summary/Keyword: CCI₄

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Chemoradiotherapy versus radiotherapy alone following induction chemotherapy for elderly patients with stage III lung cancer

  • Kim, Dong-Yun;Song, Changhoon;Kim, Se Hyun;Kim, Yu Jung;Lee, Jong Seok;Kim, Jae-Sung
    • Radiation Oncology Journal
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    • v.37 no.3
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    • pp.176-184
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    • 2019
  • Purpose: It is unclear whether adding concurrent chemotherapy (CT) to definitive radiotherapy (RT) following induction CT is a tolerable and cost effective treatment for non-small-cell lung cancer (NSCLC) patients aged 70 years or older with comorbidities. This study evaluated the actual clinical outcomes between concurrent chemoradiotherapy (CCRT) and RT alone following induction CT or not in patients (≥70 years) in a single institution's clinical practice. Materials and Methods: A total of 82 patients with unresectable stage III NSCLC between 2004 and 2016 were retrospectively analyzed. Their treatment tolerance and clinical outcomes such as overall survival (OS), locoregional recurrence (LRR), treatment toxicities and distant metastasis (DM) were evaluated. Early mortality rates were also evaluated as 4-month mortality after RT. Results: Fifty-four patients received CCRT and 28 patients received RT alone. Induction CT before RT was performed for 68.5% and 50.0% in CCRT and RT alone groups. Treatment tolerance was significantly worse in CCRT (p = 0.046). The median survival was 21.1 and 18.1 months for CCRT and RT alone, which was not statistically significant. LRR and DM were also not different. Most early deaths after CCRT were attributed to non-cancer-related mortality. Acute esophagitis of grade ≥2 occurred more following CCRT (p = 0.017). In multivariate analysis, a Charlson Comorbidity Index (CCI) of ≥5 and a weight loss of ≥5% after RT were associated with poor OS. The factors adversely affecting 4-month survival were a CCI of ≥5 and CCRT. Conclusion: There were no significant differences in OS, LRR, and DM between CCRT and RT alone treatment in elderly patients. However, there was a poorer tolerance and higher incidence of acute esophagitis in the CCRT group. Specifically, when the patients had a CCI of ≥5, RT alone seems to be reasonable with a low probability of early death.

Medical Characteristics of the Elderly Pedestrian Inpatient in Traffic Accident (노인 보행자 운수사고 입원환자의 의료적 특성연구)

  • Park, Hye-Seon;Kim, Sang-Mi
    • Journal of Digital Convergence
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    • v.17 no.12
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    • pp.345-352
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    • 2019
  • This study aims to analyze the factors affecting the length of stay in elderly pediatric inpatients in traffic accidents. We used Korean National Hospital Discharge In-depth Injury data on the discharged from 2012 to 2016. Statistically significant factors affecting the length of stay are admission route, Charlson Comorbidity Index(CCI), injury parts, operation, results, hospital area, and beds for hospitals. The length of stay was shorter in the case of the admission route of the outpatient department than the emergency room, the results were not improved or death rather than improved, and the bed size was 500-999 beds or over 1000 beds rather than 100-299 beds. However, the length of stay was longer in the case of CCI score was 1-2 or over 3 rather than 0, injury parts were other parts rather than head/neck, when the operation was yes, and when the hospital area was a province, metropolitan rather than Seoul. This study intends to understand the medical characteristics of inpatient to prevent pedestrian traffic accidents in accordance with the population aging. Based on this finding, we wish to be used as the basic data for the establishment of policies to effectively manage traffic safety and medical resources in consideration of the characteristics of the elderly people.

Histopathological and Neurobehavioral Characterization in Adult Mice Exposed to Traumatic Brain Injury (C57BL/6 쥐 외상성 뇌손상 모델에서 뇌 손상 정도에 따른 조직병리학적 변화 및 신경행동학적 특징)

  • Oh, Ki Young;Choi, Dong Won;Jang, Moon Soon;Lee, Ji Han;Kim, Sang Chul;Park, Jung Soo;Lee, Suk Woo;Kim, Hoon
    • Journal of The Korean Society of Emergency Medicine
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    • v.28 no.5
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    • pp.457-466
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    • 2017
  • Purpose: Traumatic brain injury (TBI) is a significant cause of morbidity and mortality worldwide. Severity of the initial insult is one of the most significant factors affecting outcome following TBI. In order to investigate the mechanisms of cellular injury and develop novel therapeutic strategies for TBI, we designed a standardized animal TBI model and evaluated histological and functional outcomes according to the degree of impact severity. Methods: Male adult C57Bl/6 mice underwent controlled cortical impact (CCI) at varying depths of deflection (1.0-2.0 mm). We performed hematoxylin and eosin staining at 7 days after recovery from TBI. Neurobehavioral characterization after TBI was analyzed by the Barnes maze test, passive avoidance test, open field test, rotarod test, tail suspension test, and light/dark test. Results: We observed a graded injury response according to the degree of deflection depths tested (diameter, 3 mm; velocity, 3 m/s; and duration, 500 ms) compared to sham controls. In the Barnes maze test, the severe TBI (2 mm depth) group showed reduced spatial memory as compared with the sham and mild TBI (1 mm depth) groups at 7 days after TBI. There was a significant difference in the results of the open field test and light/dark test among the three groups. Conclusion: Our findings demonstrate that the graded injury responses following TBI resulted in differential histopathological and behavioral outcomes in a mouse experimental CCI model. Thus, a model of CCI with histologic/behavioral outcome analysis may offer a reliable and convenient design for preclinical TBI research involving mice.

Central Sarcopenia, Frailty and Comorbidity as Predictor of Surgical Outcome in Elderly Patients with Degenerative Spine Disease

  • Kim, Dong Uk;Park, Hyung Ki;Lee, Gyeoung Hae;Chang, Jae Chil;Park, Hye Ran;Park, Sukh Que;Cho, Sung Jin
    • Journal of Korean Neurosurgical Society
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    • v.64 no.6
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    • pp.995-1003
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    • 2021
  • Objective : People are living longer and the elderly population continues to increase. The incidence of degenerative spinal diseases (DSDs) in the elderly population is quite high. Therefore, we are facing more cases of DSD and offering more surgical solutions in geriatric patients. Understanding the significance and association of frailty and central sarcopenia as risk factors for spinal surgery in elderly patients will be helpful in improving surgical outcomes. We conducted a retrospective cohort analysis of prospectively collected data to assess the impact of preoperative central sarcopenia, frailty, and comorbidity on surgical outcome in elderly patients with DSD. Methods : We conducted a retrospective analysis of patients who underwent elective spinal surgery performed from January 1, 2019 to September 30, 2020 at our hospital. We included patients aged 65 and over who underwent surgery on the thoracic or lumbar spine and were diagnosed as DSD. Central sarcopenia was measured by the 50th percentile of psoas : L4 vertebral index (PLVI) using the cross-sectional area of the psoas muscle. We used the Korean version of the fatigue, resistance, ambulation, illnesses, and loss of weight (K-FRAIL) scale to measure frailty. Comorbidity was confirmed and scored using the Charlson Comorbidity Index (CCI). As a tool for measuring surgical outcome, we used the Clavien-Dindo (CD) classification for postoperative complications and the length of stay (LOS). Results : This study included 85 patients (35 males and 50 females). The mean age was 74.05±6.47 years. Using the K-FRAIL scale, four patients were scored as robust, 44 patients were pre-frail and 37 patients were frail. The mean PLVI was 0.61±0.19. According to the CD classification, 50 patients were classified as grade 1, 19 as grade 2, and four as grade 4. The mean LOS was 12.35±8.17 days. Multivariate stepwise regression analysis showed that postoperative complication was significantly associated with surgical invasiveness and K-FRAIL scale. LOS was significantly associated with surgical invasiveness and CCI. K-FRAIL scale showed a significant correlation with CCI and PLVI. Conclusion : The present study demonstrates that frailty, comorbidity, and surgical invasiveness are important risk factors for postoperative complications and LOS in elderly patients with DSD. Preoperative recognition of these factors may be useful for perioperative optimization, risk stratification, and patient counseling.

Increased Readmission Risk and Healthcare Cost for Delirium Patients without Immediate Hospitalization in the Emergency Department

  • Ma, I Chun;Chen, Kao Chin;Chen, Wei Tseng;Tsai, Hsin Chun;Su, Chien-Chou;Lu, Ru-Band;Chen, Po See;Chang, Wei Hung;Yang, Yen Kuang
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.398-406
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    • 2018
  • Objective: Hospitalization of patients with delirium after visiting the emergency department (ED) is often required. However, the readmission risk after discharge from the ED should also be considered. This study aimed to explore whether (i) immediate hospitalization influences the readmission risk of patients with delirium; (ii) the readmission risk is affected by various risk factors; and (iii) the healthcare cost differs between groups within 28 days of the first ED visit. Methods: Using the National Health Insurance Research Database, the data of 2,780 subjects presenting with delirium at an ED visit from 2000 to 2008 were examined. The readmission risks of the groups of patients (i.e., patients who were and were not admitted within 24 hours of an ED visit) within 28 days were compared, and the effects of the severities of different comorbidities (using Charlson's comorbidity index, CCI), age, gender, diagnosis and differences in medical healthcare cost were analyzed. Results: Patients without immediate hospitalization had a higher risk of readmission within 3, 7, 14, or 28 days of discharge from the ED, especially subjects with more severe comorbidities ($CCI{\geq}3$) or older patients (${\geq}65years$). Subjects with more severe comorbidities or older subjects who were not admitted immediately also incurred a greater healthcare cost for re-hospitalization within the 28-day follow-up period. Conclusion: Patients with delirium with a higher CCI or of a greater age should be carefully considered for immediate hospitalization from ED for further examination in order to reduce the risk of re-hospitalization and cost of healthcare.

PR Focus-꿈의 자동차 실현하는 텔레매틱스 세계

  • Korea Venture Business Association
    • Venture DIGEST
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    • s.53
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    • pp.9-9
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    • 2004
  • 현대인들에게 꼭 필요한 세 가지를 말하는데 있어‘휴대폰’, ‘컴퓨터’, ‘자동차’라고 해도 반대할 사람은 없을 것이다. 텔레매틱스는 우리에게 꼭 필요한 이 세 가지를 잘 조합해 놓은‘디지털 컨버전스’의 산물이다. 원격통신을 뜻하는 텔레커뮤니케이션과 정보과학을 뜻하는 인포매틱스의 합성어로, 자동차와 무선 통신이 결합한 차량 무선인터넷 서비스가 바로 텔레매틱스이다. 최근 동적 라우팅을 탑제한‘CCI-3400’을 출시한 카나스와 미국 수출형‘호크아이’를 출시한 파인디지털을 통해 텔레매틱스의 세계로 들어가 보자.

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Antioxidative Enzymatic Activity of Saururus Chinensis Baill & Houttuynia cordata Thunb in the liver of rats treated with CCI4

  • Park, Sun-Yi;Jung , Hae-Jin;Ha , Bae-Jin
    • Proceedings of the PSK Conference
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    • 2002.10a
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    • pp.319.3-320
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    • 2002
  • Saururus chinensis Baill (Saururaceae) is a perennial plant that has been used in the treatment of edema. jaundice and gonorrhea in Korean folk medicine. Houttuynin sodium bisulphate (HSB), alpha hydroxyl-capryl-ethyl-sodium-sulphonate. is a product formed by reacting sodium bisulphate with houttuynin. which is obtained from a medicinal herb Houttuynia cordata Thunb. (omitted)

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Effect of Sodium Taurodeoxycholate on the Disposition and Elimination of Methylene Blue in the Rats of Experimental Hepatic Failure (Sodium Taurodeoxycholate가 간장해 Rat에서 메틸렌 블루의 체내분포와 소실에 미치는 영향)

  • 권오승;심창구;이민화;김신근
    • YAKHAK HOEJI
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    • v.30 no.2
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    • pp.68-72
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    • 1986
  • Effect of sodium taurodeoxycholate (TDC) on the pharmacokinetics of methylene blue (MB) was investigated in the rats of experimental hepatic failure induced by $CCI_4$. Intravenous infusion of TDC increased the distribution volume of central compartment ($Vd_1$) and the total body clearance ($CL_t$) of MB. Increased lipophilicity through ion-pair formation with TDC seemed to be the probable cause of increased $Vd_1$ and $CL_t$.

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Constituents of Artemisia selengensis and their effect on hepatotoxicity (물쑥의 성분 및 이들 성분이 흰쥐의 간세포 독성에 미치는 영향)

  • 장우영;이강노;지옥표;유승조;김영중;김선여
    • YAKHAK HOEJI
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    • v.37 no.2
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    • pp.182-186
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    • 1993
  • $\alpha$-Linolenic acid ethylester, $C_{19}$ spiroketalenolether polyyne, herniarin and steroid were isolated from the leaves of Artemisia selengensis (Compositae). The structures of the compounds were elucidated on the basis of spectroscopic evidence. Liver protective effects of these constituents were studied using galactosamine and CCI$_{4}$-induced cytotoxicity in primary cultured rat hepatocytes.

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Performance of a Coherent QPSK System with an Adaptive Antenna Array at Base Station

  • Le Minh-Tuan;Pham Van-Su;Yoon Gi-Wan
    • Journal of information and communication convergence engineering
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    • v.4 no.1
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    • pp.10-12
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    • 2006
  • In this paper, we present a method to evaluate the BER performance of a coherent QPSK system using an adaptive array to eliminate CCI and demonstrate closed-form expressions for obtaining exact BER of the desired user for the case in which the time delays of all users are equal. The theoretical results are verified by computer simulation under the assumption that Least Mean Square beamforming algorithm is employed.