• Title/Summary/Keyword: Clinical factor

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Outcomes of Critical Pathway in Laparoscopic and Open Surgical Treatments for Gastric Cancer Patients: Patients Selection for Fast-Track Program through Retrospective Analysis

  • Choi, Ji Woo;Xuan, Yi;Hur, Hoon;Byun, Cheul Su;Han, Sang-Uk;Cho, Yong Kwan
    • Journal of Gastric Cancer
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    • v.13 no.2
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    • pp.98-105
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    • 2013
  • Purpose: The aim of this study is to investigate the clinical factors affecting on the cure rate by invasive and open surgery for gastric cancer and to establish a subgroup of patients who can be applied by the early recovery after surgery program through this retrospective analysis. Materials and Methods: In this retrospective study, we analyzed 425 patients who underwent gastric cancer surgery between January 2011 and December 2011 and were managed with conventional clinical therapies. This clinical algorithm was made when the patient was in minimally invasive surgery group and discharged from hospital one day faster than them in open surgery group. Results: The completion rate of the clinical pathway was 62.4%. Despite the different applications of clinical pathway, completion rate in minimally invasive surgery group was significantly higher than that of open group (P<0.001). In multivariate analysis, the surgical procedure of minimally invasive surgery (odds ratio=4.281) was the most predictable factor to complete clinical pathway. Additionally, younger patients (odds ratio=1.933) who underwent distal gastrectomy (odds ratio=1.999) without combined resection (odds ratio=3.069) were predicted to accomplish the clinical pathway without any modifications. Conclusions: We concluded that high efficacy of the clinical pathway for gastric cancer surgery was expected to selected patients through retrospective analysis (expected completion rate=85.4%). In addition, these patients would become enrolled criteria for early recovery program in gastric cancer surgery.

MiR-421 Regulates Apoptosis of BGC-823 Gastric Cancer Cells by Targeting Caspase-3

  • Wu, Jian-Hong;Yao, Yong-Liang;Gu, Tao;Wang, Ze-You;Pu, Xiong-Yong;Sun, Wang-Wei;Zhang, Xian;Jiang, Yi-Biao;Wang, Jian-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5463-5468
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    • 2014
  • MicroRNAs might act as oncogenes or tumor suppressors in cancer. Recent studies have shown that miR-421 is up-regulated in human gastric cancer. Here, we found that miR-421 was over-expressed in gastric cancer tissues and cell lines. Bioinformatics analysis predicted that the caspase-3 gene was a target of miR-421. Caspase-3 was negatively regulated by miR-421 at the post-transcriptional level. Bax and Bcl-2 were also regulated by miR-421. Moreover, tumor necrosis factor receptor-I and -II, death receptors in the apoptosis pathway, were up-regulated by miR-421. The over-expression of miR-421 promoted gastric cancer cell growth and inhibited apoptosis of the BGC-823 gastric cancer cell line. These observations indicate that miR-421 acts as a tumor promoter by targeting the caspase-3 gene and preventing apoptosis of gastric cancer cells through inhibition of caspase-3 expression. These findings contribute to our understanding of the functions of miR-421 in gastric cancer.

Analysis on Clinical Characteristics and Influencing Factors of Patients with Locoregionally Advanced Nasopharyngeal Carcinoma

  • Zheng, Wei;Xu, Yuan-Ji;Qiu, Su-Fang;Zong, Jing-Feng;Huang, Ling-Ling;Huang, Chao-Bin;Lin, Shao-Jun;Pan, Jian-Ji
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4393-4399
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    • 2015
  • Background: To explore the independent prognostic factors for the recurrence/metastasis of patients with locoregionally advanced nasopharyngeal carcinoma (LANPC). Materials and Methods: A total of 604 patients initially diagnosed as LANPC by pathohistology in Fujian Provincial Cancer Hospital were selected to analyze the relationship between the clinical pathological patterns, therapeutic protocols and clinical stages with the recurrence/metastasis of LANPC. Results: The 1-, 3- and 5-year locoregionally recurrent rates of LANPC patients were 2.0%, 9.5% and 12.9% respectively, with average recurrent period being 78 months. Univariate analysis results indicated that clinical stages had certain influence on the recurrent period of LANPC patients. However, COX regression models showed that ages, genders and clinical stages were not the independent prognostic factors influencing the recurrence. The 1-, 3- and 5-year metastatic rates of LANPC patients were 6.6%, 17.5% and 18.8% respectively, with average metastatic period of 73 months. Univariate analysis results demonstrated that ages, N stages, clinical stages, locations of lymph node, retropharyngeal lymph node and extracapsular invasion of lymph node had certain influence on the metastatic period of LANPC patients. Additionally, further COX regression analysis results suggested that T stages, reduction protocols and extracapsular invasion of lymph node were the independent prognostic factors influencing the metastasis of patients with LANPC, in which T stages and extracapsular invasion of lymph node were the pestilent factors while reduction protocols the protective factor. Conclusions: Induction chemotherapy is beneficial to LANPC patients with initial treatment, and the metastatic rate decreases greatly after the application of reduction chemotherapy.

Clinical Factors Related with Antipsychotics Treatment in Bipolar Inpatients - Comparison of Risperidone and Classical Antipsychotics - (양극성장애 입원환자에서 항정신병약물치료와 관련된 임상요인 - 리스페리돈과 전형적 항정신병약물과의 비교를 중심으로 -)

  • Lim, Se-Won;Lee, Min Soo;Kwak, Dong-Il;Jung, In-Kwa
    • Korean Journal of Biological Psychiatry
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    • v.7 no.1
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    • pp.99-106
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    • 2000
  • Background : In spite of relative high risk of extrapyramidal side effect and tardive dyskinesia, it is common clinical practice to use antipyschotics in treatment of bipolar I disorder. But in Korea, there has been few study about clinical factors related with antipsychotics treatment in bipolar disorder patients. So the author studied about the clinical factors related with antipsychotics treatment in bipolar inpatients focusing on the comparison of risperidone and classical antipsychotics. Method : By reviewing medical record retrospectively, datas about patient-related, illness-related, and treatment-related clinical factors on antipsychotics use were collected. Association between antipsychotics dose and duration and clinical factors were analysed by statistical method. Results : Aggressive behavior was only statistically significant factor associated with antipsychotics use. And in the case of aggression, maintenance dose of risperidone was not changed(p=0.84), but dose of classical antipsychotics was increased significantly(p=0.005). Total hospital days and antipsychotics treatment duration showed no difference between risperidone and classical antipsychotics treatment groups. Conclusion : Clinical factors associated with antipsychotics use was aggressive behavior. In the case of aggression, risperidone required lesser dose increment compared with classical antipsychotics.

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A CLINICAL STUDY ON THE PROGNOSIS AND SUCCESS IN CONVENTIONAL ENDODONTIC TREATMENT (재래식 근관치료의 예후와 성공에 관한 임상적 연구)

  • Baek, Seung-Ho;Lim, Sung-Sam
    • Restorative Dentistry and Endodontics
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    • v.10 no.1
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    • pp.115-126
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    • 1984
  • The purpose of this study was to determine the incidence and the degree of interappointment pain and post obturation pain associated with the pretreated clinical factors or conditions, and to examine the correlation between the success or failure and the pretreated clinical factors or conditions and postoperative pain. The author experienced the conventional root canal therapy in one hundred fifty-one teeth after recording the following clinical factors or conditions - sex, age, pulp vitality status, presence or absence of periapical rarefaction, single or multirooted teeth, pretreatment pain, and investigated the pain during and after treatment for seven days. After six months all the cases were re-evaluated through the clinical sign, symptom, and the recalled radiograph. The following results were obtained; 1. Of the 151 teeth (73.5%) had no interappointment pain, 31 teeth (20.5%) slight pain; and 9 teeth (6.0%) moderate to severe pain. 2. The presence of the pretreatment pain significantly increased the incidence and degree of interappointment, and there were no significant relationship between interappointment pain and other clinical factors or conditions. 3. Of the 151 teeth, 142 teeth (4.0%) experienced no post obturation pain, 3 teeth (2.0%) slight pain, 6 teeth (4.0%) moderate to severe pain. 4. There were no statistical correlation between postobturation pain and any of the clinical factor or conditions. 5. 141 teeth (3.4%) of 151 teeth were evaluated as success in this study, and success rate was decreased significantly in the cases of periapical rarefaction before treatment and postobturation pain. But there were no significant relationship between success or failure and other clinical factors or conditions.

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Effects of empathy and self-regulation capacities of paramedic students on clinical practice stress (응급구조학 전공학생의 공감능력, 자기조절능력이 임상실습스트레스에 미치는 영향)

  • Minchae, Kim;Junghee, Park;Hyowon, Choi;Jinyoung, Kim
    • The Korean Journal of Emergency Medical Services
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    • v.26 no.3
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    • pp.149-159
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    • 2022
  • Purpose: This study aimed to determine a method to reduce stress in clinical practice by identifying how the empathy and self-regulation capacities of paramedic students influence their stress levels. Methods: Selected articles were statistically analyzed using SPSS 21.0. Data on 172 3rd-year and 4th-year paramedic students in Daejeon were used. The subject's general characteristics (sex, university education, the number of the medical training center, work type, satisfaction with college life, and satisfaction with their major) were analyzed according to empathy and self-regulation ability by t-test and ANOVA. Pearson's correlation coefficient was used for the correlation of empathy, self-regulation ability, and clinical practice stress. Hierarchical regression was used for factors influencing clinical practice. Results: Clinical practice stress levels were significantly different between general characteristics of sex (t=3.002, p=0.003), university education (t=2.815, p=0.006), the number of the medical training center (t=-2.998, p=0.003), work type (t=-2.998, p=0.003), satisfaction with college life (t=5.280, p=0.000), and satisfaction with major (t=5.132, p=0.000). Empathy (r=-.520, p<.001) and self-regulation ability (r=-.330, p<.001) significantly negatively correlated with major variables, and the major factor influencing clinical practice stress levels was empathy. Conclusion: Extension of education and various experiences for improving empathy and developing management programs should be performed to decrease clinical practice stress on paramedic students.

Changes in Clinical Practice Satisfaction of Healthcare Students Before and After COVID-19 (COVID-19 전·후의 보건계열 학생들의 임상 실습 만족도의 변화)

  • Namkoong, Seung;Ro, Hyo-Lyun
    • Journal of the Korean Society of Physical Medicine
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    • v.17 no.3
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    • pp.41-50
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    • 2022
  • PURPOSE: This study sought to investigate the change in the satisfaction levels of healthcare students regarding clinical practice before and after the coronavirus disease 19 (COVID-19) outbreak. METHODS: This was a longitudinal survey using a structured questionnaire. The first survey was conducted before the COVID-19 outbreak in April 2018, and the second survey was conducted after the outbreak from May to June 2022. The questionnaire used before and after COVID-19 had the same content and was categorized into the following six factors to determine clinical practice satisfaction: practice guidance, practice environment, practice time, practice evaluation, interpersonal relationships, and effectiveness of practice. Before the COVID-19 pandemic, a total of 153 healthcare students (average age: 22.43 ± 1.47 years old), participated from 4 departments: nursing, physical therapy, occupational therapy, and dental hygiene. After COVID-19, 84 students (average age: 22.75 ± 2.87 years old), from the physical therapy, occupational therapy, nursing, and dental hygiene departments participated in the survey. RESULTS: Clinical practice satisfaction was evaluated considering the factors of practical guidance, practice environment, practice time, interpersonal relationships, and practical effects. It was observed that the satisfaction with clinical practice increased in nursing, physical therapy, occupational therapy, and dental hygiene students after COVID-19 compared to the situation before the outbreak. There was no difference seen in the practice time and practice evaluation factors in the occupational therapy department and in the practice time factor in the dental hygiene department before and after COVID. CONCLUSION: In clinical practice under the extremely constrained circumstances imposed by the COVID-19 pandemic, it seems that the emotional internal response is greater, and the satisfaction with clinical practice appears to be relatively higher than before the outbreak.

Development of Core Competency Scale for clinical nursing student educators (간호학 임상실습 현장지도자 핵심역량 측정도구 개발)

  • Park, Hyun Sook;Choi, Eun Hee;Kim, Gyung Duck;Kim, Young Hee;Jeon, Mi Yang;Hwang, Hyenam
    • The Journal of Korean Academic Society of Nursing Education
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    • v.28 no.4
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    • pp.345-356
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    • 2022
  • Purpose: This study aimed to develop a Core Competency Scale for clinical nursing student educators. Methods: In this study, we constructed a conceptual framework, selected initial items, verified the content validity, conducted two rounds of Delphi expert consultation, selected secondary and tertiary items, and extracted the final items. The study included 242 clinical educators for nursing students. Item analysis, factor analysis, criterion validity, and internal consistency were used for the data analyses. Results: For the final scale, 35 items were selected and 5 factors were categorized, which together explain 61.7% of the total variance. The factors were education and evaluation, research and cooperation, ethical/legal principles, presenting leadership, and clinical practice. The scores for the scale significantly correlated with the teaching efficacy scale for clinical nursing instructors. The Cronbach's alpha coefficient for the 35 items was .96. Conclusion: The findings of this study demonstrated that the core competency scale has good validity and reliability. This scale can be used to assess the competency of clinical educators for nursing students; hence, it will help in evaluating the relationship between the skills of clinical educators for nursing students and the self-efficacy of those students.