• 제목/요약/키워드: Clinical factor

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비자살적자해와 자살 간의 관계에서 습득된 자살잠재력의 역할 : 자살에 대한 대인관계적 심리이론에 기반하여 (The Role of Acquired Capability in the Relationship between Non-Suicidal Self-Injury and Suicide according to Interpersonal Psychological Theory of Suicide)

  • 김초롱;박연수;장혜인;이승환
    • 대한불안의학회지
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    • 제13권2호
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    • pp.60-65
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    • 2017
  • Non-suicidal self-injury (NSSI) has been noted as a significant risk factor for possible suicide attempts. According to the Interpersonal Psychological Theory of Suicide, individuals can attempt suicide after they have acquired the capability to commit it. The acquired capability for suicide can be defined as one's habituated level to the pain and fear associated with suicidal behaviors. This is obtained through constant exposure to painful and provocative events, NSSIs being a prime example. This article reviews prior related studies to determine the extent to which the acquired capability for suicide can be utilized as a predictive factor for fatal suicide attempts following NSSIs. Our review finds a total of 11 studies that directly or indirectly support the claim that the acquired capability for suicide should be considered as a relevant factor linking NSSIs and suicide attempts. Given that NSSIs are most frequently observed in clinical settings, our findings suggest that the acquired capability for suicide will be a useful indicator for clinicians to predict the risk of future suicide attempts by patients.

Expression and Clinical Significance of Sushi Domain-Containing Protein 3 (SUSD3) and Insulin-like Growth Factor-I Receptor (IGF-IR) in Breast Cancer

  • Zhao, Shuang;Chen, Shuang-Shuang;Gu, Yuan;Jiang, En-Ze;Yu, Zheng-Hong
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권18호
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    • pp.8633-8636
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    • 2016
  • Background: To investigate the expression of insulin-like growth factor-I receptor (IGF-IR) and sushi domain containing protein 3 (SUSD3) in breast cancer tissue, and analyze their relationship with clinical parameters and the correlation between the two proteins. Materials and Methods: The expression of IGF-IR and SUSD3 in 100 cases of breast cancer tissues and adjacent normal breast tissues after surgery was detected by immunohistochemical technique MaxVisionTM, and the relationship with clinical pathological features was further analyzed. Results: The positive rate of IGF-IR protein was 86.0% in breast cancer, higher than 3.0% in adjacent normal breast tissue (P<0.05). The positive expression rate of SUSD3 protein was 78.0% in breast cancer, higher than 2.0% in adjacent normal breast tissue (P<0.05). The expression of IGF-IR and SUSD3 was related to estrogen receptor and pathological types (P<0.05),but not with age, stage, the expression of HER-2 and Ki-67 (P>0. 05). The expression of IGF-IR and SUSD3 in breast cancer tissue was positively related (r=0.553, P<0.01). Conclusions: The expression of IGF-IR and SUSD3 may be correlated to the occurrence and development of breast cancer. The combined detection of IGF-IR, SUSD3 and ER may play an important role in judging prognosis and guiding adjuvant therapy after surgery of breast cancer.

Clinical Observation and Prognostic Analysis of Pemetrexed plus Platinum as First-line Treatment in Patients with Advanced Non-small Cell Lung Cancer

  • Wang, Ji-Ying;Cai, Yong
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6267-6271
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    • 2013
  • Objective: To determine clinical efficacy, safety and prognostic factors of pemetrexed plus platinum as first-line treatment in patients with advanced non-small cell lung cancer (NSCLC). Materials and Methods: Clinical characteristics, short-term efficacy, survival and adverse reactions of 47 advanced non-squamous NSCLC patients who had received pemetrexed plus platinum as first-line treatment in Shanghai Pulmonary Hospital from January 2009 to June 2011 were retrospectively analyzed. The Chi-squared test was applied to statistically analyze the overall response rate (ORR), disease control rate (DCR) and toxicity reactions in both groups, while survival data wereanalyzed by Kaplan-Meier and logrank methods, and the COX proportional hazards model was adopted for a series of multi-factor analyses. Results: Only two patients were lost to follow-up. The ORR, DCR, medium progression-free survival time (PFS) and medium overall survival (OS) were 31.9%, 74.5%, 5 months and 15.2 months, while 1- and 2-year survival rates were 63.8% (30/47) and 19.2% (9/47), respectively. Single-factor analysis showed that tumor pathological patterns and efficacy were in association with medium PFS (P<0.05), whereas tumor pathological patterns, smoking history and efficacy were closely connected with medium OS (P<0.05). Multi-factor analyses demonstrated that pathological patterns and efficacy were independent factors influencing OS (P<0.05). The rate of toxicity reactions in degree III/IV was low, including hematologic toxicity marked by decline in white blood cell count and decrease in the platelet count (PLT), and non-hematologic toxicity manifested by gastrointestinal reactions, such as nausea and vomiting. Conclusions: Pemetrexed plus platinum as first-line treatment has excellent efficacy and slight adverse reactions with favorable drug-tolerance in patients with advanced non-squamous NSCLC.

The efficacy of intrauterine instillation of granulocyte colony-stimulating factor in infertile women with a thin endometrium: A pilot study

  • Lee, Dayong;Jo, Jae Dong;Kim, Seul Ki;Jee, Byung Chul;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • 제43권4호
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    • pp.240-246
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    • 2016
  • Objective: The study aimed to investigate the efficacy of intrauterine instillation of granulocyte colony-stimulating factor (G-CSF) on the day of ovulation triggering or oocyte retrieval in infertile women with a thin endometrium. Methods: Fifty women whose endometrial thickness (EMT) was ${\leq}8mm$ at the time of triggering during at least one previous in vitro fertilization (IVF) cycle and an index IVF cycle were selected. On the day of triggering (n = 12) or oocyte retrieval (n = 38), $300{\mu}g$ of G-CSF was instilled into the uterine cavity. Results: In the 50 index IVF cycles, the mean EMT was $7.2{\pm}0.6mm$ on the triggering day and increased to $8.5{\pm}1.5mm$ on the embryo transfer day (p< 0.001). The overall clinical pregnancy rate was 22.0%, the implantation rate was 15.9%, and the ongoing pregnancy rate was 20%. The clinical pregnancy rate (41.7% vs. 15.8%), the implantation rate (26.7% vs. 11.7%), and the ongoing pregnancy rate (41.7% vs. 13.2%) were higher when G-CSF was instilled on the triggering day than when it was instilled on the retrieval day, although this tendency was likewise not statistically significant. Aspects of the stimulation process and mean changes in EMT were similar in women who became pregnant and women who did not. Conclusion: Intrauterine instillation of G-CSF enhanced endometrial development and resulted in an acceptable pregnancy rate. Instillation of G-CSF on the triggering day showed better outcomes. G-CSF instillation should be considered as a strategy for inducing endometrial growth and good pregnancy results in infertile women with a thin endometrium.

Interpretation of Animal Dose and Human Equivalent Dose for Drug Development

  • Shin, Jang-Woo;Seol, In-Chan;Son, Chang-Gue
    • 대한한의학회지
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    • 제31권3호
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    • pp.1-7
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    • 2010
  • Objectives: To introduce to TKM scientific dose conversion methods of human to animal or animal to human for new drug investigations. Methods: We searched guidelines of the FDA and KFDA, and compared them with references for drug-dose conversion from various databases such as PubMed and Google. Then, we analyzed the potential issues and problems related to dose conversion in safety documentation of new herbal drugs based on our experiences during Investigational New Drug (IND) applications of TKM. Results: Dose conversion from human to animal or animal to human must be appropriately translated during new drug development. From time to time, investigators have some difficulty in determining the appropriate dose, because of misunderstandings of dose conversion, especially when they estimate starting dose in clinical or animal studies to investigate efficacy, toxicology and mechanisms. Therefore, education of appropriate dose calculation is crucial for investigators. The animal dose should not be extrapolated to humans by a simple conversion method based only on body weight, because many studies suggest the normalization method is based mainly on body surface area (BSA). In general, the body surface area seems to have good correlation among species with several parameters including oxygen utilization, caloric expenditure, basal metabolism, blood volume and circulating plasma protein. Likewise, a safety factor should be taken into consideration when deciding high dose in animal toxicology study. Conclusion: Herein, we explain the significance of dose conversion based on body surface area and starting dose estimation for clinical trials with safety factor.

Combined Effect of Granulocyte-Colony-Stimulating Factor-Induced Bone Marrow-Derived Stem Cells and Red Ginseng in Patients with Decompensated Liver Cirrhosis (Combined Effect of G-CSF and Red Ginseng in Liver Cirrhosis)

  • Kim, Hyun Hee;Kim, Seung Mo;Kim, Kyung Soon;Kwak, Min A;Kim, Sang Gyung;Kim, Byung Seok;Lee, Chang Hyeong
    • 대한한의학회지
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    • 제37권4호
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    • pp.36-44
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    • 2016
  • Objectives: Granulocyte-colony-stimulating factor (G-CSF) mobilized bone marrow (BM)-derived hematopoietic stem cells could contribute to improvement of liver function. In addition, liver fibrosis can reportedly be prevented by the Rg 1 component of red ginseng. This study investigated the combined effect of G-CSF and red ginseng on decompensated liver cirrhosis. Methods: Four patients with decompensated liver cirrhosis were injected with G-CSF to proliferate BM stem cells for 4 days ($5{\mu}g/kg$ bid subcutaneously) and followed-up for 3 months. The patients also received red ginseng for 4 days (2 tablets tid per os). We analyzed Child-Pugh scores, Model for End-Stage Liver Disease (MELD) scores and cirrhotic complications. Results: All patients showed marked increases in White blood cell (WBC) and CD34+ cells in the peripheral blood, with a peak time of 4 days after G-CSF injection. Spleen size also increased after G-CSF injection, but not severely. At end of the study, 2 patients showed improvement in Child-Pugh scores, hepatic encephalopathy, and refractory ascites. During the clinical trial period, none of the 4 patients showed any other adverse events or deterioration of liver function. Conclusions: We conclude that G-CSF/red ginseng combination therapy is relatively effective in improving liver function and major complications of decompensated liver cirrhosis without adverse effects. Further clinical trials are warranted to assess the clinical effects of G-CSF for decompensated liver cirrhosis.

한국어판 프리셉터 교육행동 평가도구의 타당도와 신뢰도 검증 (Validity and Reliability of the Clinical Teaching Behavior Inventory (CTBI) for Nurse Preceptors in Korea)

  • 정면숙;김은경;김세영;김종경;유선주
    • 대한간호학회지
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    • 제49권5호
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    • pp.526-537
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    • 2019
  • Purpose: The aim of this study was to evaluate the validity and reliability of the Korean version of the Clinical Teaching Behavior Inventory (CTBI). Methods: The English CTBI-23 was translated into Korean with forward and backward translation. Survey data were collected from 280 nurses' preceptors at five acute-care hospitals in Korea. Content validity, construct validity, and criterion-related validity were evaluated. Cronbach's ${\alpha}$ was used to assess reliability. SPSS 24.0 and AMOS 22.0 software was used for data analysis. Results: The CTBI Korean version consists of 22 items in six domains, including being committed to teaching, building a learning atmosphere, using appropriate teaching strategies, guiding inter-professional communication, providing feedback and evaluation, and showing concern and support. One of the items in the CTBI was excluded with a standardized factor loading of less than .05. The confirmatory factor analysis supported good fit and reliable scores for the Korean version of the CTBI model. A six-factor structure was validated ($x^2=366.30$, p<.001, CMIN/df=2.0, RMSEA=.06, RMR=.03, SRMR=.05, GFI=.90, IFI=.94, TLI=.92, CFI=.94). The criterion validity of the core competency evaluation tool for preceptors was .77 (p<.001). The Cronbach's ${\alpha}$ for the overall scale was .93, and the six subscales ranged from .72 to .85. Conclusion: The Korean version CTBI-22 is a valid and reliable instrument for identifying the clinical teaching behaviors of preceptors in Korea. The CTBI-22 also could be used as a guide for the effective teaching behavior of preceptors, which can help new nurses adapt to the practicalities of nursing.

생물학적 폭경을 고려한 보철임상 증례 (Clinical Cases on the Restorative Procedure Preserving the Biologic Width)

  • 김정호
    • 대한심미치과학회지
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    • 제8권1호
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    • pp.28-35
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    • 1999
  • The preservation of a healthy periodontal attachment is the most significant factor in the long-term prognosis of a restored tooth. The 'Biologic Width' is composed of the connective tissue attachment and the epithelial attachment in the dentogingival junction. The violation of the biologic width may result in a progressive inflammatory process and crestal bone loss. So a careful soft tissue management is needed to preserve it for the gingival health and an esthetic restoration. The following clinical cases show the five different situations of the violation of the biologic width and their management.

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Application of Fluoride for Dental Caries Prevention in Older Adults with Dry Mouth: a Clinical Review

  • Young Joo Shim
    • Journal of Oral Medicine and Pain
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    • 제49권1호
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    • pp.12-17
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    • 2024
  • Dry mouth is common among older adults and significantly affects the oral health-related quality of life. It is a significant risk factor for dental caries, particularly root caries, in older adults due to concurrent periodontal disease and age-related comorbidities. Clinicians managing patients with dry mouth must be aware of preventive measures against dental caries. This clinical review aims to update our knowledge on the use of fluoride for caries prevention in order to establish better strategies for the management of dry mouth in older adults.