• Title/Summary/Keyword: Clinical finding

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A Review of Dose Finding Methods and Theory

  • Cheung, Ying Kuen
    • Communications for Statistical Applications and Methods
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    • v.22 no.5
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    • pp.401-413
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    • 2015
  • In this article, we review the statistical methods and theory for dose finding in early phase clinical trials, where the primary objective is to identify an acceptable dose for further clinical investigation. The dose finding literature is initially motivated by applications in phase I clinical trials, in which dose finding is often formulated as a percentile estimation problem. We will present some important phase I methods and give an update on new theoretical developments since a recent review by Cheung (2010), with an aim to cover a broader class of dose finding problems and to illustrate how the general dose finding theory may be applied to evaluate and improve a method. Specifically, we will illustrate theoretical techniques with some numerical results in the context of a phase I/II study that uses trinary toxicity/efficacy outcomes as basis of dose finding.

Image interpretation errors often observed in a dental clinic (임상에서 흔히 관찰되는 영상판독 오류)

  • Park, In-Woo
    • The Journal of the Korean dental association
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    • v.54 no.9
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    • pp.712-728
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    • 2016
  • These days, the clinical course of dental imaging sector has done a lot of implant-related imaging courses, including cone beam CT. In contrast, the general image reading course is not given a lot of opportunities to learn. Therefore, it is imperative that we talk about the general image interpretation that can be read easily applied in a dental clinic. When we see a strange radiographic finding of our patient in the dental clinic, we should first check whether the radiographic finding is a normal finding or a morbidity. If the finding is diagnosed as a morbidity, you should make plans for the appropriate therapy. The most important step is classification between normal state and morbidity. Some lesions may occur without any clinical symptoms. Therefore, we should read all the parts of radiographs, even the patient does not have clinical symptoms.

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Experience of Job Satisfaction in Clinical Nurses : Application of Focus Group Methodology (임상간호사의 직무만족 경험: 초점집단 연구방법 적용)

  • Lee, Byoung-Sook;Kang, Sung-Rye;Kim, Hae-Ok
    • Journal of Korean Academy of Nursing
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    • v.37 no.1
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    • pp.114-124
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    • 2007
  • Purpose: The purpose of this study was to describe the experiences of job satisfaction in clinical nurses. Methods: Data was collected from three focus groups composed of 17 hospital nurses. Each focus group had an interview for an average of two and a half hours with the guidance of researchers. The main question was 'how do you describe your lived experience of job satisfaction as a clinical nurse?' Qualitative data from the field notes and transcribed notes were analyzed using a grounded theory methodology developed by Strauss and Corbin. Results: The core category of experience of job satisfaction in clinical nurses was identified as 'Finding success.' Supportive interpersonal relationships and environment affected this category. In the process of attaining job satisfaction through finding success, the participants were using four interactional strategies such as giving meaning, finding self-esteem, extending the horizon of life, and strengthening self-capability. The dimensions of job satisfaction in clinical nurses were the sense of achievement, stability, and pride. Conclusion: The results of this study yields very useful information for nursing mangers to design a program which enhances job satisfaction of clinical nurses based on interactional strategies.

The Prognostic Factors Related to Traumatic Brain Stem Injury

  • Kim, Hun-Joo
    • Journal of Korean Neurosurgical Society
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    • v.51 no.1
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    • pp.24-30
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    • 2012
  • Objective : This study was conducted to assess the clinical significance of traumatic brain stem injury (TBSI) reflected on Glasgow Coma Score (GCS) and Glasgow Outcome Score (GOS) by various clinical variables. Methods : A total of 136 TBSI patients were selected out of 2695 head-injured patients. All initial computerized tomography and/or magnetic resonance imaging studies were retrospectively analyzed according to demographic- and injury variables which result in GCS and GOS. Results : In univariate analysis, mode of injury showed a significant effect on combined injury (p<0.001), as were the cases with skull fracture on radiologic finding (p<0.000). The GCS showed a various correlation with radiologic finding (p<0.000), mode of injury (p<0.002), but less favorably with impact site (p<0.052), age (p<0.054) and skull fracture (p<0.057), in order of statistical significances. However, only GOS showed a definite correlation to radiologic finding (p<0.000). In multivariate analysis, the individual variables to enhance an unfavorable effect on GCS were radiologic finding [odds ratio (OR) 7.327, 95% confidence interval (CI)], mode of injury (OR; 4.499, 95% CI) and age (OR; 3.141, 95% CI). Those which influence an unfavorable effect on GOS were radiologic finding (OR; 25.420, 95% CI) and age (OR; 2.674, 95% CI). Conclusion : In evaluation of TBSI on outcome, the variables such as radiological finding, mode of injury, and age were revealed as three important ones to have an unfavorable effect on early stage outcome expressed as GCS. However, mode of injury was shown not to have an unfavorable effect on late stage outcome as GOS. Among all unfavorable variables, radiological finding was confirmed as the only powerful prognostic variable both on GCS and GOS.

A Methodology for Representation of Clinical Data in Oriental Medicine (한의학의 증상표현을 위한 방법론)

  • Park Kyung Mo;Park Jong Hyun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.5
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    • pp.845-850
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    • 2002
  • This paper suggest a methodology for representation of findings which can be called as signs and symptoms. A finding consists of unit signs and unit symptoms, and moreover findings which appear in one individual patient have so many different relationship each other. So, it is nat appropriate to list all of possible findings as medical standard or to fill findings as independent things in paper for medical record. We try to distinguish finding item from finding list, and suggest the methodology by which we can make finding list from finding items. That is, we suggest finding item[Concept], value types, relationship, logical operator, and syntax as a component of representation. And by using urinary symptom, we make the example for representation methodology. Finally, we mention the background knowledge, brief research process of related area.

Diagnosis of Morton's Neuroma Using MR Imaging scans (지간 신경종의 자기 공명 영상을 이용한 진단)

  • Hong, Ki-Do;Ha, Sung-Sik;Sim, Jae-Cheon;Kim, Jae-Young
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.1
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    • pp.131-134
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    • 2003
  • Most interdigital neuroma can be diagnosed clinically. But, diagnostic local injection method, sonography and magnetic resonance image(MRI) have been used as secondary tests for clinical confirmation or surgery. Recently, there have been active discussions on the method of interdigital neuroma diagnosis for which sonography or MRI is used. For finding out the location or the number of interdigital neuroma particularly in non-typical clinical manifestation or surgery, MRIs, which are exellent in tissue contrast, may be quite helpful. This case had an interdigital neuroma showing non-typical manifestation. MRIs were used for clinical diagnostic confirmation and finding out the location and the number of interdigital neuroma. Thus, the validity along with literary consideration is being reported.

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Determining the Optimal Cut-off Point According to the Outcome Variables Using R (R을 이용한 결과 변수에 따른 최적의 Cut-off Point 결정)

  • Juyeon Yang;Hye Sun Lee
    • Journal of Digestive Cancer Research
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    • v.10 no.2
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    • pp.99-106
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    • 2022
  • Clinical research ultimately aimed to promptly diagnose and prevent diseases through precise biomarker development. Finding the optimal cut-off point of a regularly measured biomarker can help its interpretation and ultimately help in disease investigation and diagnosis, more specifically in determining the presence of diseases. Therefore, this study aimed to use the characteristics of outcome variables in clinical research to explain how to determine the optimal cutoff point. The outcome variables can be divided into dichotomous, ordinal, and survival types. The optimal cut-off point can be determined by finding points that maximize the Youden index, extended Youden index, and log-rank statistics. This study will enable clinical researchers to accurately determine the optimal cut-off points for regularly measured biomarkers, thereby enabling prompt disease diagnosis for effective treatment.

The Clinical Characteristics and Risk Factors of Upper Digestive Lesions that are due to Ingestion of Caustic Material (부식제에 의한 상부 위장관 손상의 임상양상과 위험인자)

  • Kim, Young-Sin;Choi, Se-Min;Kim, Hyung-Min;Youn, Chun-Song;Park, Kyu-Nam
    • Journal of The Korean Society of Clinical Toxicology
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    • v.7 no.2
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    • pp.113-120
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    • 2009
  • Purpose: Though caustic injury of the upper digestive tract can lead to severe sequelae, there are few clinical studies on this subject. This study was undertaken to evaluate the clinical characteristics, the endoscopic findings and the risk factors of the upper digestive lesions in patient with caustic ingestion injury. Methods: We retrospectively reviewed the medical records of 137 patients who ingested caustic materials and who visited to our emergency room from January, 2000 to June, 2009. Results: The most common ingested agent was sodium hypochlorite (44.5%), followed by acetic acid (19.7%), hydrochloric acid (11.7%) and lye (8.0%). Ingestion for suicidal attempt (62.0%) was more frequent than accidental ingestion (30.7%). Grade IIa injury was the most frequent finding on endoscopy of the esophagus and Grade 1 injury was the most frequent finding on endoscopy of the stomach. For the late sequelae, there were 9 cases (6.6%) of esophageal stricture and 2 cases (1.5%) of gastric outlet obstruction. The initial signs and symptoms did not correlate with the development of stricture, but leukocytosis, and grade III injury were related to the risk of developing stricture. Conclusion: Caustic injury of the upper gastrointestinal tract is frequently observed on early endoscopy and it can cause significant late sequelae such as stricture. Therefore, it is necessary to evaluate these patients with regular follow up endoscopic examinations for the management of late sequelae.

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Single Oral Dose Toxicity Test and Four Weeks Repeated Oral Dose Determination Test of GST in Sprague-Dawley Rats (GST의 Sprague-Dawley Rat를 이용한 단회 경구투여 독성시험 및 4주 반복 경구투여 용량결정시험)

  • Han, Jong-Min;Hong, Jee-Hee;Lee, Hye-Yeong;Jung, In-Chul;Jin, Mi-Rim;Kim, Seong-Hyeong;Park, Yang-Chun
    • The Journal of Internal Korean Medicine
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    • v.34 no.4
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    • pp.349-361
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    • 2013
  • Objectives : This study aimed to evaluate the single oral dose toxicity and four weeks repeated dose determination of Gamisasangja-tang (GST) in male and female Sprague-Dawley rats. Methods : In the single oral toxicity study, rats were orally administered a single dose of 0 and 5,000 mg/kg GST. There were 5 rats in each group. After single administration, mortality, clinical signs, body weight changes and gross pathological finding were observed for 14 days. In the 4-weeks repeated oral dose determination study, rats were orally administered a single dose of 0, 1,250, 2,500 or 5,000 mg/kg GST. There were 5 rats in each group. Mortality, clinical signs, body weight changes, food consumption and gross pathological finding were observed for 28 days. Organ weight, clinical chemistry and hematology were tested after 28 days. Results : There was no mortality in either of the two studies. There were also no significant differences in clinical sign, body weight, organ weights, hematological or serum chemical parameters between the GST and control groups. Conclusions : The results obtained in this study suggest that the 50% lethal dose of GST is over 5,000 mg/kg, so this finding would be expected to provide scientific evidence for the safety of GST.

A Study on the Safety of Bangpungtongsung-san in Rats (랫드에서 방풍통성산의 안전성 연구)

  • Jung, Ko-Eun;Lee, Kyoung-Jin;Lee, Chul-Won;Kwak, In-Seok;Lee, Jang-Cheon;An, Won-Gun
    • Herbal Formula Science
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    • v.20 no.2
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    • pp.55-63
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    • 2012
  • Objectives : This study was conducted to investigate the safety of Bangpungtongsung-san in rats. Methods : The safety of this prescription on acute toxicity was evaluated by single dose toxicity study. Rats were orally administrated in a single dose of 0 and 2,000 mg/kg(limited dose) Bangpungtongsung-san. There were 7 rats in each groups. All animals were sacrificed after 14 days of treatment. After single administration, mortality, clinical signs, and body weight changes were observed for 14 days. Three parameters(autopsy finding, clinical chemistry, and hematology) were tested on the last day. Results : In this study with rats, Bangpungtongsung-san treatment did not show any acute toxicity. No mortality was noted for 14 days of treatment. There were no adverse effects on clinical signs, body weight changes, and autopsy finding at all treatment groups. The clinical chemistry parameters attesting to liver and kidney functions as well as the hematological parameters were within the normal ranges. Conclusions : It is considered that $LD_{50}$ of Bangpungtongsung-san is over 2,000 mg/kg in oral administration by rats. This finding of the safety of Bangpungtongsung-san is expected to strengthen the position of this prescription as nontoxic medicine.