• Title/Summary/Keyword: Clinical adjustment

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Lack of Association between Hsa-Mir-499 rs3746444 Polymorphism and Cancer Risk: Meta-analysis Findings

  • Jiang, Sheng-Gao;Chen, Lin;Tang, Jin-Hai;Zhao, Jian-Hua;Zhong, Shan-Liang
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.339-344
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    • 2015
  • Epidemiologic findings concerning the association between the hsa-mir-499 rs3746444 A>G polymorphism and cancer risk have yielded mixed results. We aimed to investigate the association by performing a meta-analysis of all available studies. We searched PubMed and EMBASE for studies published up to November 2014, using odds ratios (ORs) with 95% confidence intervals (CIs) to assess the strength of any association. The Benjamini-Hochberg (BH) method was used to correct the p values for multiple comparisons. We included 39 studies, including 14,136 cases and 16,937 controls. The results of overall meta-analysis suggested a borderline association between hsa-mir-499 rs3746444 polymorphism and cancer susceptibility (AG+GG vs. AA: OR=1.15, 95% CI=1.04-1.26, corrected p value=0.04). After removing studies not conforming to Hardy-Weinberg equilibrium (HWE), however, this association disappeared (AG+GG vs AA: OR=1.18, 95% CI=1.03-1.34, corrected p value=0.21). When stratified analysis by ethnicity, cancer type or HWE in controls, although some associations between hsa-mir-499 rs3746444 polymorphism and cancer susceptibility were detected, these associations no longer existed after adjustment using BH method. In conclusion, our meta-analysis suggests that hsa-mir-499 rs3746444 A>G polymorphism is not associated with risk of cancer based on current evidence.

Risk Factors for Delayed Hinge Fracture after Plate-Augmented Cervical Open-Door Laminoplasty

  • Hur, Junseok W.;Park, Youn-Kwan;Kim, Bum-Joon;Moon, Hong-Joo;Kim, Joo-Han
    • Journal of Korean Neurosurgical Society
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    • v.59 no.4
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    • pp.368-373
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    • 2016
  • Objective : Delayed hinge fracture (HF) that develops after cervical open door laminoplasty can be a source of postoperative complications such as axial pain. However, risk factors related to this complication remain unclear. We performed a retrospective clinical series to determine risk factors for delayed HF following plate-only open-door cervical laminoplasty. Methods : Patients who underwent plate-only open-door laminoplasty and had available postoperative computed tomography (CT) scans (80 patients with 270 laminae) were enrolled. Hinge status, hinge gutter location, open location, hinge width, number of screws used, operation level, and open angle were observed in the CT to determine radiographic outcome. Demographic data were collected as well. Radiographic and clinical parameters were analyzed using univariate and multivariate logistic regression analysis to determine the risk factors for HF. Results : Univariate logistic regression analysis results indicated poor initial hinge status, medially placed hinge gutter, double screw fixation on the elevated lamina, upper surgical level, and wide open angle as predictors for HF (p<0.05). Initial hinge status seemed to be the most powerful risk factor for HF (p=0.000) and thus was collinear with other variables. Therefore, multivariate logistic regression analysis was performed excluding initial hinge status, and the results indicated that medially placed hinge gutter, double screw fixation on the elevated lamina, and upper surgical level were risk factors for HF after adjustment for other confounding factors. Conclusion : To prevent HF and to draw a successful postoperative outcome after cervical laminoplasty, surgical and clinical precautions should be considered.

The Clinical Effect of High Voltage AC Reid Therapy(HEALTHTRON) on Peripheral Circulatory Disturbance and Functional Outcome of Rehabilitation in CVA Patients (교류고압전계요법이 뇌졸중환자의 말초혈류 및 재활기능에 미치는 효과에 대한 임상연구)

  • Sung Kang Keyng;Hwang Choong Yeon;Lee Sang Kwan;Lee So Young;Cheong Sang Su;Kang Se Young;Lee Jong Deck
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.3
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    • pp.609-615
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    • 2002
  • A medical treatment of alternating current high-voltage electric field therapy is a method in which we get a healing effect, applying electric field to an organism through an artificial device. In order to estimate the clinical effects of alternating current high-voltage electric field load(HEALTHTRON) on the rehabilitation of stroke patients, improvement of a peripheral blood circulation, and psychogenic symptom, we used BEUNZEUNGHEYNG Instrument, NIHSS(the National Institutes of Health Stroke Scale), FIM(Functional Independence Measure)lnstrument to research BEUNZEUNGHEYNG and recovery of rehabilitative funation. and also we used Thermography, Pulse Meter to measure body temperature and pulse, blood elements, and neuro modulators. We have reached the following conclusions after researching the clinical effects of alternating current high-voltage electric field therapy on the recovery of rehabilitative function and peripheral blood circulation. 1. HEALTHTRON efficiently has increased the volume of peripheral blood circulation in stroke patients. 2. HEALTHTRON rapidly has treated the symptoms of sleeplessness, alertness, and dizziness of stroke patients. 3. HEALTHTRON rapidly has improved rehabilitative function of stroke patients and the adjustment to their activities.

Effectiveness and Complication Rate of Percutaneous Endoscopic Gastrostomy Placement in Pediatric Oncology Patients

  • Kidder, Molly;Phen, Claudia;Brown, Jerry;Kimsey, Kathryn;Oshrine, Benjamin;Ghazarian, Sharon;Mateus, Jazmine;Amankwah, Ernest;Wilsey, Michael
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.6
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    • pp.546-554
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    • 2021
  • Purpose: Malnutrition is a significant issue for pediatric patients with cancer. We sought to evaluate the effectiveness and complication rate of percutaneous endoscopic gastrostomy (PEG) placement in pediatric oncology patients. Methods: A retrospective chart review was performed on 49 pediatric oncology patients undergoing PEG placement at Johns Hopkins All Children's Hospital between 2000 and 2016. Demographic and clinical characteristics, complications, absolute neutrophil count at time of PEG placement and at time of complications, length of stay, and mortality were identified. Weight-for-age Z-scores were evaluated at time of- and six months post-PEG placement. Results: The overall mean weight-for-age Z-score improved by 0.73 (p<0.0001) from pre- (-1.11) to post- (-0.38) PEG placement. Improvement in Z-score was seen in patients who were malnourished at time of PEG placement (1.14, p<0.0001), but not in those who were not malnourished (0.32, p=0.197). Site infections were seen in 12 (24%), buried bumper syndrome in five (10%), and tube dislodgement in one (2%) patient. One patient (2%) with fever was treated for possible peritonitis. There were no cases of other major complications, including gastric perforation, gastrocolic fistula, clinically significant bleeding, or PEG-related death documented. Conclusion: Consistent with previous studies, our data suggests a relationship between site complications (superficial wound infection, buried bumper syndrome) and neutropenia. Additionally, PEG placement appears to be an effective modality for improving nutritional status in malnourished pediatric oncology patients. However, larger prospective studies with appropriate controls and adjustment for potential confounders are warranted to confirm these findings.

Clinical Survival: Male Nurses Adaptation Process for Female Nurses (임상에서의 생존: 여성간호사에 대한 남성간호사의 적응 과정)

  • Kim, HyunSu;Yun, HeeJang
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.2
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    • pp.139-146
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    • 2019
  • The purpose of this study is to find meaning of male nurses's adaptation to female nurses by grsping deeply what the adaption process of male nurses is from male nurses's point of views. What is the adaptation of male nurses to female nurses? With this research subject, we explored the adaptation process of male nurses to female nurses through phenomenological method. The study participants were 12 male nurses with more than 25 months of experience working in hospitals who agreed to the intention and method of the study. The results of this study were derived from 39 meanings of composition, 13 theme bundles, and 4 categories. As for the category, it was revealed that, in the case of maladjustment situation, there was a tendency to assimilate into force, interpersonal relationship, to improve the job ability, and to become a dedicated nurse. The results of this study can be used as basic data to develop effective nursing workforce management measures in the clinical field by understanding the adaptation process to female nurses of male nurses.

Nursing students' experiences of adapting to clinical practice in the COVID-19 pandemic (COVID-19 감염병 시대, 간호대학생의 임상실습 적응 경험)

  • Kwon, Suhye;Kim, Youngkyoung;Bang, Miseon;Ryu, Min
    • The Journal of Korean Academic Society of Nursing Education
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    • v.28 no.1
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    • pp.57-69
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    • 2022
  • Purpose: This study was performed to explore and describe the overall clinical practice adaptation experiences among nursing students during the COVID-19 pandemic. Methods: This qualitative study applied the grounded theory method by Corbin and Strauss. Data were collected from May to August 2021 through individual in-depth interviews with 14 nursing students from three universities in B metropolitan city. Results: From open coding, 20 sub-categories and 10 categories were identified. Analysis revealed that the core category was the process of "keeping the place of learning while adhering to the restrictions of the era of pandemic" and that it consisted of four phases: confusion, withdrawal, adjustment, and growth. Through this process, participants utilized various action/interactional strategies such as "shifting to positive thinking," "building a shield to protect oneself," and "focusing on learning." The consequences of these strategies were "adapting to the reality of the infectious disease situation" and "strengthening a foothold to grow as a future nurse." Conclusion: An in-depth understanding of nursing students' experiences of adapting to clinical practice during the COVID-19 pandemic will guide nursing educators to promote effective teaching strategies to better support nursing students in a time of infectious disease crisis.

Recent outcome of extremely low birth weight infants - The use of CRIB(clinical risk index for babies) II score for analyzing the survival rate - (초극소 저출생 체중아의 최근 치료 성적 - CRIB(clinical risk index for babies) II 점수를 이용한 생존율 분석 -)

  • Kim, Do-Hyeon;Shim, So-Yeon;Kim, Jae-Ri;Shin, Seung-Han;Kim, Eun Sun;Joung, Kyoung-Eun;Kim, Sang Duk;Lee, Jin A;Choi, Chang Won;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong Il;Choi, Jung-Hwan
    • Clinical and Experimental Pediatrics
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    • v.49 no.9
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    • pp.952-958
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    • 2006
  • Purpose : The survival rate of infants weighing less than 1,000 g at birth(extremely low birth weight infants, ELBWI) has increased due to recent advances in perinatal and neonatal intensive care. The purpose of this study was to evaluate the survival rates of ELBWI born at Seoul National University Hospital during the last six years. Methods : A total of 99 infants were divided into three groups(period I: 2000 to 2001, period II: 2002 to 2003, period III : 2004 to 2005) based on date of birth. We compared the survival rate of ELBWI over the three periods, using CRIB II score for adjustment for clinical severity. Results : Overall survival rate of ELBWI was 74.7 percent. The survival rate of ELBWI increased over the three periods(period I: 60.7 percent, period II : 73.3 percent, period III : 85.3 percent). The threshold of viability(defined as survival of at least 50 percent of infants) was 25 weeks of gestation and 600 g at birth. The birth weight-specific survival rates increased considerably over the three periods for infants <750 g at birth(period I: 10 percent, period II: 46.2 percent, period III : 70.6 percent). The survival rates of ELBWI over the three periods increased much remarkably after adjustment for clinical severity by CRIB II score. Conclusion : In our institution, survival rates of ELBWI during the last six years continued to improve, particularly for infants weighing <750 g at birth. This increase in survival rates was not associated with the clinical severity of ELBWI.

THE AMOUT OF LOSS AND THE DEGREE OF SURFACE SMOOTHNESS OF GOLD ALLOY BY GOLD ALLOY POLISHING RUBBER POINT MATERIALS (금합금 연마재 종류에 따른 금합금 소실량과 연마 정도)

  • Kim, Myoung-Hwa;Yim, Soon-Ho;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.35 no.2
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    • pp.277-295
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    • 1997
  • After clinical adjustment of dental casting restoration, re-polishing procedure is recommanded because the smooth gold sureface is lost. But there is the possibility to get more loose contact than that intended by loss of gold alloy according to the kinds of polishing materials and polishing time. Therefore in this study I polished type II gold alloy with 390gm force, 20,000rpm speed, and 8 kinds of gold alloy polishing materials, fabricated by 4 companies and then measured the amount of loss of gold alloy with Surfcorder SEF-30D and observed alloy surfaces polished by 3 brown rubber points with SEM. The amount of loss of gold alloys polished with 8 kinds of polishing materials and the degree of smoothness of gold alloys according to polishing time and polishing materials were compared. The following results were obtained : 1. When the amount of loss of gold alloys polished with 3 kinds of brown rubber point was compared, Alphalex brown point had the most amount of alloy loss, followed in decreasing order by Shofu brown point and Eveflex brown point. There was statistically significant difference in the amount of alloy loss according to polishing materials. 2. When the amount of loss of gold alloys polished with 5 kinds of green rubber point was compared, Shofu green point had the most amount of alloy loss, followed in decreasing order by Alphaflex green point, Dedeco green clasp polisher, and Eveflex green point. There was statistically significant difference in the amount of alloy loss according to polishing materials except Alphaflex green point and Dedeco green clasp polisher. 3. When the amount of loss of gold alloys polished with all kinds of rubber point was compared, there was no significant difference in Eveflex brown point, Alphaflex green point, and Dedeco green clasp polisher. 4. When average amount of alloy loss per 1 revolution by polishing materials was compared, Alphalex brown point had the greatest value as $0.329{\mu}m$ and Shofu supergreen point had the lowest value as $0.022{\mu}m$. 5. When the degree of sureface smoothness of gold alloy polished with 3 kinds of brown rubber point was compared, In Alphalex brown point surface roughness was completely lost after 20 seconds polishing time, in Shofu brown point 30 seconds, in Eveflex brown point 40 seconds. But in every gold alloys fine scratch formed by rubber points was observed. Based on the results of this study, as rubber polishing materials used in polishing of dental casting restoration after clinical adjustment influenced on the tightness of occlusal or proximal contact, we should make dental casting restoration with minimum error through careful laboratory procedure and form very smooth surface of restoration with tripoli and rouge after use of silicone polishing materials.

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Cerebrospinal Fluid Lumbar Tapping Utilization for Suspected Ventriculoperitoneal Shunt Under-Drainage Malfunctions

  • Lee, Jong-Beom;Ahn, Ho-Young;Lee, Hong-Jae;Yang, Ji-Ho;Yi, Jin-Seok;Lee, Il-Woo
    • Journal of Korean Neurosurgical Society
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    • v.60 no.1
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    • pp.1-7
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    • 2017
  • Objective : The diagnosis of shunt malfunction can be challenging since neuroimaging results are not always correlated with clinical outcomes. The purpose of this study was to evaluate the efficacy of a simple, minimally invasive cerebrospinal fluid (CSF) lumbar tapping test that predicts shunt under-drainage in hydrocephalus patients. Methods : We retrospectively reviewed the clinical and radiological features of 48 patients who underwent routine CSF lumbar tapping after ventriculoperitoneal shunt (VPS) operation using a programmable shunting device. We compared shunt valve opening pressure and CSF lumbar tapping pressure to check under-drainage. Results : The mean pressure difference between valve opening pressure and CSF lumbar tapping pressure of all patients were $2.21{\pm}24.57mmH_2O$. The frequency of CSF lumbar tapping was $2.06{\pm}1.26times$. Eighty five times lumbar tapping of 41 patients showed that their VPS function was normal which was consistent with clinical improvement and decreased ventricle size on computed tomography scan. The mean pressure difference in these patients was $-3.69{\pm}19.20mmH_2O$. The mean frequency of CSF lumbar tapping was $2.07{\pm}1.25times$. Fourteen cases of 10 patients revealed suspected VPS malfunction which were consistent with radiological results and clinical symptoms, defined as changes in ventricle size and no clinical improvement. The mean pressure difference was $38.07{\pm}23.58mmH_2O$. The mean frequency of CSF lumbar tapping was $1.44{\pm}1.01times$. Pressure difference greater than $35mmH_2O$ was shown in 2.35% of the normal VPS function group (2 of 85) whereas it was shown in 64.29% of the suspected VPS malfunction group (9 of 14). The difference was statistically significant (p=0.000001). Among 10 patients with under-drainage, 5 patients underwent shunt revision. The causes of the shunt malfunction included 3 cases of proximal occlusion and 2 cases of distal obstruction and valve malfunction. Conclusion : Under-drainage of CSF should be suspected if CSF lumbar tapping pressure is $35mmH_2O$ higher than the valve opening pressure and shunt malfunction evaluation or adjustment of the valve opening pressure should be made.

A comparative study of impression methods using stock tray and intraoral scanner in a completely edentulous patient with an atypical arch shape: a case report (비정형적인 악궁을 가진 완전 무치악 환자에서 기성 트레이와 구강 스캐너를 이용한 인상 채득 방법의 비교 연구: 증례 보고)

  • Jae-Hoon Park;Ji-Hyun Kim;Jae-Min Seo;Jung-Jin Lee;Yeon-Hee Park
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.4
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    • pp.344-355
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    • 2023
  • In complete denture fabrication, accurate preliminary impressions are crucial for obtaining an accurate final impression. However, it can be challenging in cases of atypical arch shapes. This case report compares diagnostic casts made with a stock tray and an intraoral scanner (IOS) in a patient with an atypical arch shape. A 58-year-old edentulous male patient with long, narrow, atypical arches was referred to the Oral and Maxillofacial Surgery department for complete denture fabrication. Compared to the diagnostic cast obtained using IOS with adequately captured anatomical parameters, the primary model obtained using a stock tray showed prominent overextended flanges on the labial and buccal sides of the maxillary arch and less prominent overextended flanges in the mandibular arch with pressure spots in the posterior palatal seal area. The custom tray fabricated from such a model required additional adjustment resulting in increased chair time during the final impression procedure.