Objective: Microarray data were analyzed to explore key genes and their functions in progression of colorectal cancer (CRC). Methods: Two microarray data sets were downloaded from Gene Expression Omnibus (GEO) database and differentially expressed genes (DEGs) were identified using corresponding packages of R. Functional enrichment analysis was performed with DAVID tools to uncover their biological functions. Results: 631 and 590 DEGs were obtained from the two data sets, respectively. A total of 32 common DEGs were then screened out with the rank product method. The significantly enriched GO terms included inflammatory response, response to wounding and response to drugs. Two interleukin-related domains were revealed in the domain analysis. KEGG pathway enrichment analysis showed that the PPAR signaling pathway and the renin-angiotensin system were enriched in the DEGs. Conclusions: Our study to systemically characterize gene expression changes in CRC with microarray technology revealed changes in a range of key genes, pathways and function modules. Their utility in diagnosis and treatment now require exploration.
Background : Economic evaluation of clinical pharmacokinetic consultation services for theophylline, which is being widely used recently, is considered in patients for both proper care and cost efficiency. Mathods : This is a cost-benefit analysis of clinical pharmacokinetic consultation service for theophylline. Trial groups were chosen from 2 general hospitals which was performing clinical pharmacokinetic consultation- services in 1998. Control group was chosen from another one general hospital. The analysis includes 25 patients (sample patients) for trial group and 17 patients for control group. Results : On the basis of incremental analysis, it is estimated that the total (direct and indirect) annual costs of the clinical, pharmacokinetic services of theophylline for the patients in the trial group was about \65 million, whereas total annual benefits from those services was estimated to be about \551 million. The net benefits incurred to the sample patients, thus calculated, was about \485 million per year. In the analysis, we assumed that indirect benefits accruing to those services were non-existent. If that amount was included, the estimated net benefits would be much greater than the calculated one. Conclusion : We found that clinical pharmacokinetic consultation services for theophylline could produce more marginal benefits than marginal costs by those services from the social point of view. More controlled prospective trial in the future would be helpful for affirmation of the results of this study.
Oh, Jaeseong;Yi, Sojeong;Gu, Namyi;Shin, Dongseong;Yu, Kyung-Sang;Yoon, Seo Hyun;Cho, Joo-Youn;Jang, In-Jin
Genomics & Informatics
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v.16
no.3
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pp.52-58
/
2018
In this report, we present a case study of how pharmacogenomics and pharmacometabolomics can be useful to characterize safety and pharmacokinetic profiles in early phase new drug development clinical trials. During conducting a first-in-human trial for a new molecular entity, we were able to determine the mechanism of dichotomized variability in plasma drug concentrations, which appeared closely related to adverse drug reactions (ADRs) through integrated omics analysis. The pharmacogenomics screening was performed from whole blood samples using the Affymetrix DMET (Drug-Metabolizing Enzymes and Transporters) Plus microarray, and confirmation of genetic variants was performed using real-time polymerase chain reaction. Metabolomics profiling was performed from plasma samples using liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. A GSTM1 null polymorphism was identified in pharmacogenomics test and the drug concentrations was higher in GSTM1 null subjects than GSTM1 functional subjects. The apparent drug clearance was 13-fold lower in GSTM1 null subjects than GSTM1 functional subjects (p < 0.001). By metabolomics analysis, we identified that the study drug was metabolized by cysteinylglycine conjugation in GSTM functional subjects but those not in GSTM1 null subjects. The incidence rate and the severity of ADRs were higher in the GSTM1 null subjects than the GSTM1 functional subjects. Through the integrated omics analysis, we could understand the mechanism of inter-individual variability in drug exposure and in adverse response. In conclusion, integrated multi-omics analysis can be useful for elucidating the various characteristics of new drug candidates in early phase clinical trials.
Statistical analyses used in clinical articles published on the Journal of Korean Neurosurgical Society were identified and appropriateness of statistical aspects in reporting results was assessed. Forty seven clinical articles were selected in this study, which were published from February, 2005 to February, 2006 on the journal. The frequency of statistical analysis was as follows : descriptive statistics only 24 [51.1%]. one type of statistical method 10 [21.3%], two or more methods 13 [27.6%]. An assessment of statistical aspects was performed in 24 clinical articles reporting inferential statistics. Ten articles [41.7%] did not adequately describe or reference all statistical methods used. There were six articles [25.0%] not reporting the confidence level used as the critical criteria of the statistical significance. In thirteen articles [54.2%] it seems more appropriate to implement multivariate analyses in addition to univariate analyses. We recommend that the journal readers should concentrate on improving their knowledge of basic statistics and statistical review for manuscripts submitted should be sought from professionals in the fields of biostatistics and epidemiology.
The objective of this study is to analyze the research articles on clinical social work practice effectiveness to build a scientific and scholaristic image of clinical social work practice. The data for analysis were the articles published in 13 professional journals including Korean J. of Social Welfare in the period of 1979 to 1999. The appearance rate of effectiveness studies was 1.28% with only 18 articles. Experimental studies consisted only 4 out of 18, and there were only 10 Quasi-experimental studies. Statistical errors were observed in most studies, so it is too early to call that the clinical social work practice is either effective or not effective. In order to see the comprehensive trends of the clinical social work practice, other clinical papers were also examined. The appearance rate was also as low as 8.75% (effectiveness studies included). While 18 articles were about the therapy model, other clinical papers were about generic practice models. However, those newly developed generic practice models had not yet been widely used nor tested for effectiveness. Thus, the followings were suggested: active research activities with solid methodology, team work with the field, theory and method development, education and re-education, and collaborative team work with other related fields. It was also pointed that the cross analysis of research papers by the publishing period, authors major and other background variables would be useful.
Lim L. L-Y.;Valenti L.A.;Knapp J.C.;Dobson A.J.;Plotnikoff R.;Higginbotham N.;Heller R.F.
대한예방의학회:학술대회논문집
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1994.02b
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pp.180-187
/
1994
A slightly modified version of the Quality-of-Life after Myocardial Infarction (QLMI) questionnaire developed by Oldridge and colleagues was applied in a self-administered mode to patients with suspected acute myocardial infarction (AMI) in a randomized controlled trial of secondary prevention. Acceptability of the questionnaire was good, with 93% of responders answering all items. Factor analysis suggested three quality-of-life (QL) dimensions which we called 'emotional', 'physical' and 'social'. These differed somewhat from the dimensions proposed by Oldtidge and colleagues. However, a sensitivity analysis showed relative invariance of results to weighting schemes. Scores on our three dimensions were responsive to differences between the treatment groups, and demonstrated construct validity based on associations between the measured QL and variables expected to affect QL. We conclude that the QLMI questionnaire has good potential as an instrument for assessing QL in post-AMI patients and that it can be successfully self-administered.
Do, Eun Young;Gwon, Mi-Ri;Kim, Bo Kyung;Ohk, Boram;Lee, Hae Won;Kang, Woo Youl;Seong, Sook Jin;Kim, Hyun-Ju;Yoon, Young-Ran
Translational and Clinical Pharmacology
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v.25
no.2
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pp.67-73
/
2017
Glimepiride, a third generation sulfonylurea, is an antihyperglycemic agent widely used to treat type 2 diabetes mellitus. In this study, an untargeted urinary metabolomic analysis was performed to identify endogenous metabolites affected by glimepiride administration. Urine samples of twelve healthy male volunteers were collected before and after administration of 2 mg glimepiride. These samples were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and then subjected to multivariate data analysis including principal component analysis and orthogonal partial least squares discriminant analysis. Through this metabolomic profiling, we identified several endogenous metabolites such as adenosine 3', 5'-cyclic monophosphate (cAMP), quercetin, tyramine, and urocanic acid, which exhibit significant metabolomic changes between pre- and posturine samples. Among these, cAMP, which is known to be related to insulin secretion, was the most significantly altered metabolite following glimepiride administration. In addition, the pathway analysis showed that purine, tyrosine, and histidine metabolism was affected by pharmacological responses to glimepiride. Together, the results suggest that the pharmacometabolomic approach, based on LC-MS/MS, is useful in understanding the alterations in biochemical pathways associated with glimepiride action.
The purpose of this study was to analyze the importance-performance of clinical nutrition management in convalescent hospitals. The research was carried out based on questionnaires administered from March to April, 2015 to 73 dietitians at 40 convalescent hospitals in the Gyeongnam area. There was a statistically significant difference between the mean scores for importance (4.01/5.00) and performance (2.95/5.00) of clinical nutrition management. The importance and performance grid analysis showed that participation in a nutritional management committee, administration of patients using a cooperation program among hospital departments, cooperation with a medical team on patient's nutrition status, nutrition initial assessment, nutrition care process for patients showing malnutrition, nutrition care process for tube feeding patients, management of a therapeutic diet, meal management using dietary slip instructions including a therapeutic diet, and explication of a therapeutic diet for patients scored high regarding importance and performance (doing great area). Medical records on patient's nutrition management, and nutrition counseling for requested patient scored low regarding the importance and high regarding performance (overdone area). Participation in medical rounds, personal nutrition education for patients, group nutrition education for patients, nutrition education for medical teams, development of a menu for therapeutic diet and standardized recipes, and provision of information on diet therapy for patients after discharge scored low regarding importance and performance (low priority area). Accreditation of convalescent hospitals and interest of medical professionals in clinical nutrition management were effective variables for the importance-performance gap of clinical nutrition management. In conclusion, the accreditation process and positive awareness of medical professionals with regard to clinical nutrition management had positive effects on reduction of the importance-performance gap in clinical nutrition management at convalescent hospitals. The strength of clinical nutrition management in the accreditation and development of an education program for increasing medical team or administrator interest in clinical nutrition management could lead to improvement of clinical nutrition management for elderly patients in convalescent hospitals.
Objectives: The purpose of this study is to analyze csatisfaction with clinica1 training in the department of Korean Medicine Obstetrics and Gynecology and the related factors. Methods: All the students on the graduating class of school of Korean Medicine, Dong-Shin University must be trained for 1 year in the department of Korean Medicine Obstetrics and Gynecology according to clinical training guideline including Objective Structured Clinical Examination (OSCE). After completing clinical training, we distributed questionaries to them about a reflex of the object of study, usefulness, difficulty, satisfaction and preference. And then, we analyzed the related factors including descriptive statistics, frequency analysis and correlation analysis by SPSS 12.0. Results: In general, a reflex of the aim of study (7.31±1.59), satisfaction with contents (7.44±1.58), and difficulty (6.13±1.34) were evaluated restectively. There is no statistically significant difference with sex. There is a statistically significant positive correlation between a reflex of the aim of study and satisfaction with contents. The primary preferences of clinical practice were Clinic Training, Ward Training, PBL (Problem Based Learning), OSCE. In OSCE, a reflex of the aim of study (7.04±1.83) and usefulness (7.02±1.97) were highly evaluated. There is no statistically significant difference with sex. The primary preferences for clinical OSCE practice were breast examination, genital examination, ultrasound scan, and pap smear. Facilities and equipment (6.84±2.01), contents of clinical training (7.29±1.83), the handout (7.20±1.98) and time scheduling (7.29±1.90) were evaluated respectively in general composition of clinical training. Conclusions: Clinical training program in the department of Korean Medicine Obstetrics and Gynecology can be highly estimated from the viewpoint of satisfaction with clinical training and the related factors.
Purpose: The purpose of this study was to investigate the influence of nursing students' self-reflection and insight, and academic selfefficacy on their clinical reasoning competence. Methods: Data were collected from 147 third- and fourth-year nursing students who had more than 6 months of clinical training experience. Clinical reasoning competence, self-reflection and insight, and academic self-efficacy were measured using self-reported questionnaires. Data analysis was conducted with IBM SPSS 25.0 using one-way ANOVA, independent t-test, Pearson correlation coefficient, and multiple regression analysis. Results: Clinical reasoning competence was positively correlated with self-reflection and insight (r=.24, p=.003) and academic self-efficacy (r=.30, p<.001). Academic self-efficacy (β=.23, p=.011), dissatisfaction with major (β=-.17, p=.034), and 5~8 case studies (β=-.39, p=.027) were identified as factors influencing clinical reasoning competence (adjusted R2=.15). Conclusion: To improve the clinical reasoning competence of nursing students, it is necessary to develop the academic self-efficacy of complex cases and provide critical inquiries, debriefing tailored to clinical reasoning, and sufficient reflection during clinical and simulation practice.
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