• Title/Summary/Keyword: Clinical Terminology

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Correlation of Bevacizumab-induced Proteinuria with Therapeutic Effects in Patients with Colorectal Cancer (직결장암 환자에서 Bevacizumab에 의한 단백뇨 발현과 치료효과와의 상관관계 분석)

  • Sa, Yea-Ji;Kim, Kyung-Duck;Ahn, Hye-Lim
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.4
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    • pp.234-242
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    • 2020
  • Background: Bevacizumab-induced proteinuria is known to occur when vascular endothelial cell receptors are blocked, which leads to decreased protein filtration. Although several studies have analyzed the correlation between therapeutic effect of bevacizumab and proteinuria, no conclusion has been established. Methods: In this retrospective study, colorectal cancer patients who received bevacizumab and urinary protein check from January 2015 to December 2016, were included. The incidence of proteinuria and the grade according to Common Terminology Criteria for Adverse Events (CTCAE) 4.0 were evaluated after bevacizumab administration. The primary objective was to correlate proteinuria with overall response rate (ORR) and time to progression (TTP). Primary lesion, metastasized organs, surgery or radiation therapy, chemotherapy were investigated for analysis of risk factors for proteinuria development. Results: A total of 149 patients included in the analysis. Proteinuria occurred 19.5% (n=29) in the study patients; 20 in grade 1, 7 in grade 2, and 2 in grade 3. ORR was 55.2% in the proteinuria group and 51.7% in the non-proteinuria group. There was no difference between two groups (p=0.89). The TTP through the survival curve was similar in both groups (10 months, p=0.97). The risk of proteinuria was high in patients who had liver metastasis (p=0.02) and no surgery (p=0.01). Conclusions: These result indicates that bevacizumab-induced proteinuria expression was not correlated with the therapeutic effect on patients with colorectal cancer. Further analysis is required to find out the correlation between proteinuria and therapeutic effects. The risk of proteinuria was increased from patients who had liver metastasis, and no surgery.

Trends and Future Direction of the Clinical Decision Support System in Traditional Korean Medicine

  • Sung, Hyung-Kyung;Jung, Boyung;Kim, Kyeong Han;Sung, Soo-Hyun;Sung, Angela-Dong-Min;Park, Jang-Kyung
    • Journal of Pharmacopuncture
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    • v.22 no.4
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    • pp.260-268
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    • 2019
  • Objectives: The Clinical Decision Support System (CDSS), which analyzes and uses electronic health records (EHR) for medical care, pursues patient-centered medical care. It is necessary to establish the CDSS in Korean medical services for objectification and standardization. For this purpose, analyses were performed on the points to be followed for CDSS implementation with a focus on herbal medicine prescription. Methods: To establish the CDSS in the prescription of Traditional Korean Medicine, the current prescription practices of Traditional Korean Medicine doctors were analyzed. We also analyzed whether the prescription support function of the electronic chart was implemented. A questionnaire survey was conducted querying Traditional Korean Medicine doctors working at Traditional Korean Medicine clinics and hospitals, to investigate their desired CDSS functions, and their perceived effects on herbal medicine prescription. The implementation of the CDSS among the audit software developers used by the Korean medical doctors was examined. Results: On average, 41.2% of Traditional Korean Medicine doctors working in Traditional Korean Medicine clinics manipulated 1 to 4 herbs, and 31.2% adjusted 4 to 7 herbs. On average, 52.5% of Traditional Korean Medicine doctors working in Traditional Korean Medicine hospitals adjusted 1 to 4 herbs, and 35.5% adjusted 4 to 7 herbs. Questioning the desired prescription support function in the electronic medical record system, the Traditional Korean Medicine doctors working at Korean medicine clinics desired information on 'medicine name, meridian entry, flavor of medicinals, nature of medicinals, efficacy,' 'herb combination information' and 'search engine by efficacy of prescription.' The doctors also desired compounding contraindications (eighteen antagonisms, nineteen incompatibilities) and other contraindicatory prescriptions, 'medicine information' and 'prescription analysis information through basic constitution analyses.' The implementation of prescription support function varied by clinics and hospitals. Conclusion: In order to implement and utilize the CDSS in a medical service, clinical information must be generated and managed in a standardized form. For this purpose, standardization of terminology, coding of prescriptions using a combination of herbal medicines, and unification such as the preparation method and the weights and measures should be integrated.

A Study of Parallel Test Among Three ADVIA 2120 System (3대의 ADVIA 2120 System 평행시험에 대한 연구)

  • Chang, Sang-Wu;Cho, Eun-Hae;Kim, Nam-Yong;Chu, Kyung-Bok;Lee, Suk-Jong;Hong, Sung-No;Oh, Jong-Do
    • Korean Journal of Clinical Laboratory Science
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    • v.38 no.1
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    • pp.16-21
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    • 2006
  • Parallel testing means ordering a number of tests at the same time so abnormalities in any of the tests can be found quickly and used in making the diagnosis. This is a good medical strategy to eliminate diseases and it is relatively inexpensive if all the tests are potential sources of information and performed on the same analyzer. In regression, the equation for the straight line is recast as y = bx + a. This change in terminology leads to confusion. Here a is the y-intercept or constant and b is the coefficient or slope of the line. A few more words of caution about regression - as in all of statistics there are certain assumptions: the x value is a true measure, both X and Y distributions are normal, and homoscedasticity, i.e., the variance of y is the same for each value of x. In this study the linearity classification made by different scientists were always in agreement. Typical examples of curves that were considered linear are presented in Fig. 1-5. Because these automated procedures values were usually within five percent of each other the curvature could be easily detected. The plot of the WBC, RBC, hemoglobin, hematocrit and platelet concentrations from approximately 74.4 to $0{\times}10^3/{\mu}L$ and $80.4-0{\times}10^3/{\mu}L$, $5.6-0{\times}10^6/{\mu}L$ and $6.1-0{\times}1106/{\mu}L$, 18.3-0 g/dL and 19.0-0 g/dL, 54.1-0% and 56.8-0% and 642.0 to $0.03{\times}10^3{\mu}L$ and $754.0-0{\times}10^3/{\mu}L$ on the ADVIA 2120 C Versus and A and B typical of an acceptable linear study as shown in Fig. 1-5. The grand mean of R2, intercept and slope is 0.99898, 0.99459 and 1.54626.

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An improvement plan of Curriculum in Departments of Dental Technology (치기공과 교육과정의 개선방안)

  • Bae, Bong-Jin;Lee, Hwa-Sik;Park, Myung-Ho
    • Journal of Technologic Dentistry
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    • v.31 no.4
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    • pp.55-66
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    • 2009
  • This research collected the curriculum for Dental Technology from a total of 20 schools --3-year colleges and 4-year colleges-- all in Korea. And we analyzed the average credits of subjects from students. As a result of this analysis, we get the conclusion below: 1. In the arithmetic mean of the major basis subjects which graduates and undergraduates answered about each subjects; Seminar, Dental morphology I II, Dental morphology practice I II, and Dental devices & instruments don't have many credits. And averages of the major application subjects credits which are Implants(especially low), Occlusal anatomy practice I II, Dental ceramics practice I II, and Dental ceramics practice are low, mostly have a converged tendency in high points. 2. In an analysis of the correlation which is based on the major basis subjects: Dental esthetic, oral anatomy I II, Dental materal practice III, Dental casting pracedure, Oral hygiene, Health & medical law, Management administration, and Medical terminology have a meaningful difference. (${\rho}$ < 0.05) 3. In an analysis of the correlation which is based on the major application subjects; Crown and bridge prosthodontics practice IV, Complete denture prosthodontics I II III, Complete denture prosthodontics practice I II III, Dental ceramics I II, Dental ceramics practice I II, Dental ceramics practice IIII, Occlusal anatomy I II, Occlusal anatomy practice I, Operative dentistry laboratory technology I, Operative dentistry laboratory technology practice II, Dental attachment laboratory technology practice, Implants, and Dental laboratory clinical practice have meaningful difference. (${\rho}$ < 0.05) 4. In an analysis of the correlation which is based on the ratio of a theory to an actual training; 40:60(38.57%) is the highest, followed by 30:70(30.04%), 50:50(23.32%), 60:40(5.83%), and 70:30(2.24%). These have meaningful difference. (${\rho}$ < 0.05) 5. In an analysis of the correlation which is based on the distinction of sex: Partial denture prosthodontics practice I II III, Complete denture prosthodontics I II III, Complete denture prosthodontics practice I II III, Occlusal anatomy practice I II, Implants, Medical terminology have meaningful difference. (${\rho}$ < 0.05) For the purpose of training entrepreneurs of middle standing who is required by a future society, Department of Dental Technology's Curriculum need to be managed with planning a curriculum which reflects opinions of graduates, undergraduates and a society, and also are considered not focusing on a supplier but focusing on a user.

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A Retrospective Study on the Clinical Safety of Bee Venom Pharmacopuncture at Craniofacial Acupuncture Points for the Treatment of Facial Disorders

  • Lee, Chang Hee;Yoon, Jin-Young;Shim, Sung-Eun;Kim, Jeong Hyun;Kim, Jun-Yeon;Kim, Ha-Na;Hwang, Ji-Min;Kim, Jung-Hyun;Goo, Bon Hyuk;Park, Yeon-Cheol;Seo, Byung-Kwan;Baek, Yong-Hyeon;Nam, Sang-Soo
    • Journal of Acupuncture Research
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    • v.36 no.4
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    • pp.245-250
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    • 2019
  • Background: This study was designed to evaluate the clinical safety of Bee Venom (BV) pharmacopuncture at craniofacial acupuncture points. Methods: This was a retrospective study of 108 patients diagnosed with peripheral facial paralysis, trigeminal neuralgia, or facial spasm who were admitted to Kyung Hee University Korean Medicine Hospital at Gangdong, from April 1st, 2017 to August 30th, 2017. Patients were allocated into either, Group 1 (the non-allergy group of patients who did not have an allergic reaction to BV) or Group 2, the group who had allergic reactions to BV. To evaluate the clinical safety of BV pharmacopuncture after each treatment, several criteria were used to measure any side effects: outcome, Common Terminology Criteria for Adverse Events scale, Mueller HL scale, treatment decision after adverse reaction, causality, measures performed for patients with adverse reactions, and efficacy assessment. Results: BV pharmacopuncture delivered in 0.1-0.2 mL at a concentration of 1:30,000 at the craniofacial acupuncture points, showed no statistically significant differences in baseline characteristics between non-allergy Group 1 and allergy Group 2. Amongst the 108 patients, 11 reported side effects after BV pharmacopuncture treatment. These adverse events included rash (n = 7), pruritus (n = 5), swelling (n = 1), vesicles (n = 1), erythema (n = 1), and hives (n = 1). All side effects resolved without sequelae. Conclusion: In this study, BV pharmacopuncture delivered at low doses at the craniofacial acupuncture points, resulted in 10% of patients experiencing non serious side effects suggesting that BV pharmacopuncture was clinically well tolerated.

Development of case-based learning and co-teaching clinical practice education model for pre-service nurses (예비간호사를 위한 사례기반학습 및 코티칭 임상실습 교육모형 개발)

  • Hyunjeong Kim;Heekyoung Hyoung;Hyunwoo Kim;Seryeong Kim
    • Journal of Christian Education in Korea
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    • v.72
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    • pp.245-271
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    • 2022
  • The purpose of this study is to develop a nursing clinical practice education model that applies case-based learning and co-teaching to nursing students, and to secure the validity of the developed model. To verify the validity of the nursing clinical practice education model, it was applied to the subject of 'Health Response and Nursing VI (Perception/ Cognition) Practice' in the 2nd semester of 2021 at J University in Jeonju, and the instructor's response to the model was evaluated. Surveys and focus group interviews were conducted on confidence in clinical practice and teaching and learning models. After deriving the case-based learning stage and co-teaching elements through a review of precedent literature and case studies, an initial model was devised after expert review, and the devised model was reviewed for internal validity by nursing education experts, and then modified and supplemented. As a result of the learner response evaluation conducted after applying the model to the clinical practice subject for external validation verification, the confidence in clinical performance was 4.22 points and the satisfaction with the teaching-learning model was 4.68 points. Summarizing the results of the focus group interview, the importance of prior learning and the learning of selected cases based on actual cases, learning terminology and professional knowledge, eliminated fear of the practice field, felt familiar, and learned various cases. He said that he was able to think critically through the time to organize the knowledge learned in the practice field. In addition, through co-teaching, it was found that field leaders and advisors taught the theoretical and practical aspects at the same time through examples, thereby experiencing practical education closer to practice. It is expected that the nursing clinical practice education model developed through this study, applying case-based learning and co-teaching, will be an effective teaching and learning model that can reduce the gap between theory and practice and improve the clinical performance of nursing students.

Clinical Observations of Gastrointestinal Cow Milk Allergy in Children According to a New Classification (새로운 분류법에 따른 소아 위장관 우유 알레르기 질환에 관한 임상적 고찰)

  • Hwang, Jin Bok;Choi, Seon Yun;Kwon, Tae Chan;Oh, Hoon Kyu;Kam, Sin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.40-47
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    • 2004
  • Purpose: A new classification of gastrointestinal food allergy was published, but the changes of terminology between previously reported terms and the new ones were in a state of disorder. This has resulted in confusion between medical communication and diagnostic and therapeutic approaches. The clinical observations of infants presenting with gastrointestinal cow milk allergy (GI-CMA) were performed, and the changes in the terminology reviewed through the published Korean literature. Methods: Between March 2003 and July 2003, data from 37 consecutive infants with GI-CMA, aged 2 weeks to 15 months, were reviewed. The challenge and elimination test of cow milk, and the endoscopic and histologic findings, were used for the seven subdivisions of GI-CMA according to a new classification on the basis of patients' ages, clinical manifestations and location of gastrointestinal lesions. Results: The 37 patients had a mean age of $5.4{\pm}4.8$ months, with those observed in 26 (70.3%) of patients being below 6 months of age. The seven final diagnoses were; cow milk protein-induced enterocolitis (CMPIE) in 12 (32.4%), cow milk protein proctitis (PROC) in 12 (32.4%), IgE-mediated (IGE) in 6 (16.2%), gastroesophageal reflux-associated cow milk allergy (GERA) in 5 (13.5%) and eosinophilic gastroenterocolitis in 2 (5.4%). CMPIE was revealed as the typical type in 7 (18.9%) and the atypical type in 5 (13.5%), and all of typical CMPIE revealed cow milk protein-induced enteropathy. The mean age at symptom onset was $4.3{\pm}0.8$ months, and for those with typical and atypical CMPIE, and PROC and GERA were $3.8{\pm}4.6$, $10.4{\pm}3.8$, $3.4{\pm}3.9$ and $7.8{\pm}5.7$ months, respectively (p<0.05). The period from onset of symptom to diagnosis was $2.4{\pm}3.3$ (0.5~12) months, with those observed in atypical CMPIE and GERA being over 3months. Although the birth weights in all patients were within the 10~90 percentile range, the body weights on diagnoses were below the 3 percentile in 48.6%; IGE 16.7%, EOS 0%, typical CMPIE 85.7%, atypical CMPIE 60.0%, PROC 25.0% and GERA 100% (p<0.05). Through the review of the Korean literature, 8 case reports and 14 original articles for GI-CMA were found. Conclusion: GI-CMA is not a rare clinical disorder and is subdivided into seven categories on the basis of the patient's age, clinical manifestations and location of the gastrointestinal lesions. The terms for GI-CMA are changing with new classifications, and careful approaches are necessary for medical communications.

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A Method for the Reduction of Skin Marker Artifacts During Walking : Application to the Knee

  • Mun, Joung-Hwan
    • Journal of Mechanical Science and Technology
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    • v.17 no.6
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    • pp.825-835
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    • 2003
  • Previous studies have demonstrated the importance of joint angle errors mainly due to skin artifact and measurement errors during gait analysis. Joint angle errors lead to unreliable kinematics and kinetic analyses in the investigation of human motion. The purpose of this paper is to present the Joint Averaging Coordinate System (JACS) method for human gait analysis. The JACS method is based on the concept of statistical data reduction of anatomically referenced marker data. Since markers are not attached to rigid bodies, different marker combinations lead to slightly different predictions of joint angles. These different combinations can be averaged in order to provide a "best" estimate of joint angle. Results of a gait analysis are presented using clinically meaningful terminology to provide better communication with clinical personal. In order to verify the developed JACS method, a simple three-dimensional knee joint contact model was developed, employing an absolute coordinate system without using any kinematics constraint in which thigh and shank segments can be derived independently. In the experimental data recovery, the separation and penetration distance of the knee joint is supposed to be zero during one gait cycle if there are no errors in the experimental data. Using the JACS method, the separation and penetration error was reduced compared to well-developed existing methods such as ACRS and Spoor & Veldpaus method. The separation and penetration distance ranged up to 15 mm and 12 mm using the Spoor & Veldpaus and ACRS method, respectively, compared to 9 mm using JACS method. Statistical methods like the JACS can be applied in conjunction with existing techniques that reduce systematic errors in marker location, leading to an improved assessment of human gait.

A Case Report of Hormone Receptor Positive and HER-2 Receptor Positive Metastatic Breast Cancer Stage IV Patient Treated with a Combination of Traditional Korean Medicine and Chemotherapy for 6 Years (호르몬 수용체 및 HER-2 수용체 양성 유방암 4기 다발성 전이 환자의 6년간의 한양방 병용치료 치험 1례)

  • Park, Kyeong Ju;Lee, A-ram;Kim, Sung su;Seong, Sin
    • Journal of Korean Traditional Oncology
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    • v.24 no.2
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    • pp.13-21
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    • 2019
  • Objective : The purpose of this study is to report and observe effects of Traditional Korean Medicine (TKM) on stage IV metastatic breast cancer patient. Method : A right breast cancer patient diagnosed with metastatic lesions on liver, lung, spleen, multiple bones and skin on right breast April 2013. The patient received Herceptin + Docetaxel + Zometa from May 2013 and started to receive TKM since July 2013 to decrease side effects of chemotherapy. From December 2013 to November 2014, she had received Herceptin 18 times more. The clinical outcomes were measured by computed tomography, laboratory findings including tumor markers (CEA, CA15-3), liver function test (AST, ALT), and numeric rating scales (NRS). Results : After 6 years of TKM treatment combined with standard chemotherapy, tumor size was partially decreased in lung, liver, right pleura and spleen. Levels of tumor markers also showed decrease. There were no severe adverse events induced by TKM based on National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE) version 4.0. Conclusion : This case suggests that TKM combined with standard chemotherapy could be a promising method for treating metastatic stage IV breast cancer.

Acupuncture for Chemotherapy-induced Peripheral Neuropathy : a Pilot Study (항암화학요법 유발 말초신경병증에 대한 침치료의 효과 : 파일럿 연구)

  • Han, Chang Woo;Hwang, Eui Hyoung;Kim, Hyo Jeong;Shin, Ho-Jin
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.4
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    • pp.460-463
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    • 2014
  • Chemotherapy-induced peripheral neuropathy (CIPN) which is one of the common chemotherapy related toxicity poses a significant clinical challenge. Here we conducted a prospective pilot study to evaluate the efficacy of acupuncture on CIPN. Patients with CIPN were administered acupuncture procedure with continuation of previous conventional medication. Acupuncture procedures were conducted three times per week for 3 weeks. We assessed patients with Common Terminology Criteria for Adverse Events (CTCAE) v4.0, Visual Analog Scale (VAS), Functional Assessment of Cancer Therapy/Gynecologic Oncology Group Neurotoxicity (FACT/GOG-Ntx) at the time of baseline and every week after the acupuncture procedures. Total 5 patients were included and treated with acupuncture. CTCAE grades were the same of 2 in all patients. VAS mean value changed from 5.2 to 3.2, and FACT/GOG-Ntx total score that suggests the higher relates to better quality of life changed from 93.3 to 110 as mean value at the end of the 3rd week, though this index difference did not show any statistically significant difference. This pilot study suggests that acupuncture procedure may have a role for CIPN treatment. Launching a more larger and properly controlled study will be required to ascertain the efficacy of acupuncture.