Objective: This study evaluated and compared the adherence to the CONSORT for quality of reports on the randomized controlled trials (RCT) abstracts by four major Korean Science Citation Index (SCI) journals and The New England Journal of Medicine (NEJM). Methods: A descriptive analysis of published RCT abstracts in Korean SCI journals and NEJM from 2007/01 to 2011/06 was conducted by two reviewers, independently extracting data from a PubMed search. A modification of CONSORT for abstract was used including 16 checklist items. Reporting of checklist items for individual group was conducted to compare adherence patterns between two groups. Results: We identified the potential 57 RCT abstracts from Korean SCI and 50 from NEJM meeting our inclusion criteria; among them, three abstracts from Korean SCI and one from NEJM were excluded. Among total 16 checklist items based on CONSORT statement, Korean SCI journals and NEJM were statistically equivalent in 4 items; Korean journals were better in three items and NEJM were in nine. The methodological quality domains were inadequately reported in both journals: allocation concealment about 1.9% and 4.0%, and blinding 44.4% and 40.8%. In general, The CONSORT adherence of NEJM was better than that of Korean SCI in the method and result domain (p < 0.0001). Conclusions: The quality of NEJM reporting of RCT abstracts was better than that of Korean SCI, in general. This study on adherence of RCT reports from Korean SCI journals and NEJM abstracts to the CONSORT statement reveals that there is a need for improvement, especially Korean SCI. Further investigation on the quality of RCT reports and ways to improve reporting quality is required.
This study was conducted to provide the data for the improvement of home health nursing services through the investigation of burden and satisfaction felt by family caregivers under home health nursing care. The study subjects consisted of 200 family caregivers who were enrolled m six university hospital home care services. Data were collected by using constructed questionnaires through mail from March to April of 1999. and analyzed by using t-test. ANOVA, Duncan-test. and Pearson Correlation Coefficients. The results were as follows: 1. The mean score of burden was 2.24. Among the SIX burden dimensions. the highest score was marked in time-dependence dimension. Caregivers were found to have greater burden in the low income families living in flats. In relation to the characteristics of patients. higher scores were shown in the male patients with cerebrospinal diseases. who also revealed higher score of dependency in the Activities of Daily Living. As a whole. there was no significant difference between home nursing care and clinical nursing care in terms of family caregivers' burden. The burden of time-dependence dimension in home nursing care was significantly higher than that of clinical nursing care while the burdens of physical. social. and financial dimensions were significantly lower than those of the clinical nursing care. 2. The mean score of satisfaction was 3.14. Among the six items. the highest score was marked in the nursing care and treatment skill. while the lowest score was marked in the cost containment. Family caregivers with higher academic background and higher income showed higher satisfaction score. The mean score of home care nursmg was significantly higher than that of clinical nursing care.
Purpose: 'White-eye blowout' fracture is often occur in young patients and defined as blow out fracture with little or no clinical sign of soft tissue trauma such as edema, ecchymosis, but with marked motility restrictions in vertical gaze. In this conditions, immediate operation is essential. We reported the clinical investigation study of these cases about clinical symptoms and radiologic findings and introduce our experiences about immediate operations in 'white-eye blowout' fractures. Methods: From January 2008 to December 2009, nine pediatric patients who were diagnosed as pure white-eye blowout fractures were involved this study. Patients with other facial bone fractures or with poor general medical condition were excluded. In all cases, we performed immediate operation within 48 hours. Results: All patients had diplopia, vertical gaze restriction or systemic symptoms. Six patients had nausea, vomiting and syncope caused by oculocardiac reflex. In all patients, preoperative symptoms were improved after immediate operation. There were no postoperative complications such as infection, hematoma or wound dehiscence. Conclusion: When we meet the young patients with history of periocular trauma, with little or no soft tissue trauma signs, but with marked vertical gaze restriction or general symptoms caused by oculocardiac reflex, we should immediately examine by facial bone computed tomography and refer the patient to ophthalmologist for ophthalmic evaluations. If patient is diagnosed as orbital floor fracture with entrapped muscle or soft tissue, the earlier surgical reduction get better clinical outcomes.
Purpose: We analyzed and compared the clinical and radiologic results between minimally invasive plate osteosynthesis and internal fixation using intramedullary (IM) nail in the treatment of distal tibia fractures. Materials and Methods: From March 2005 to June 2013, 65 cases of distal tibia fractures treated with either plate fixation or IM nail fixation were analyzed retrospectively by clinical and radiologic evaluations. The clinical results were compared using the American Orthopaedic Foot and Ankle Society (AOFAS) score, Olerud-Molander ankle score (OMAS), and visual analogue scale (VAS) score at the last follow-up. The radiologic results were compared by time to bone union, complications such as nonunion, delayed union, and malunion. Results: The clinical results (according to OMAS, AOFAS score, and VAS score) were 77.47, 84.76, and 1.75, respectively, in the plating group, and 90.21, 91.00, and 1.25, respectively, in the nailing group, and there was no statistically significant difference. Plating group showed earlier union than the nailing group and the nailing group showed higher frequency of non-union and delayed union than plating group. Conclusion: In treatment of distal tibia fractures, two methods showed appropriate results. Therefore, thorough investigation of the types of fracture, state of soft tissues, and advantages and disadvantages of the two methods should be conducted in the treatment of distal tibia fractures.
Purpose: Zinc deficiency can induce serious clinical problems in the gastrointestinal (GI) system and immune system and can affect growth and development. It is more severe in younger patients. Chronic zinc deficiency is reflected more precisely in hair than in serum. We studied hair zinc levels and other hair and serum micronutrients in chronic malnourished children to identify which micronutrients are affected or correlated with the other ones. Methods: Hair mineral analyses were performed in 56 children (age, 1-15 years) presenting with malnutrition, poor growth, poor appetite, anorexia, with/without other GI symptoms (diarrhea, abdominal pain, constipation) from August 2012 to March 2015. Biochemical studies for macronutrients and major micronutrients were also conducted. Results: Hair zinc deficiency was diagnosed in 88%, and serum zinc deficiency was diagnosed in 55% of the children. There was no statistical correlation between serum and tissue zinc level. Hair zinc levels were highly correlated with serum vitamin D (r=-0.479, p=0.001), which also showed correlation with hair levels of magnesium and calcium. (r=0.564, 0.339, p=0.001, 0.011). Hair calcium level was correlated with serum pre-albumin (r=0.423, p=0.001). These correlations may explain the phenomenon that the major clinical manifestation of zinc deficiency is poor body growth. Clinical symptoms were resolved in most children after zinc supplementation. Conclusion: Hair zinc and mineral analyses are useful as a therapeutic guide in the clinical investigation of children with malnutrition and poor growth.
Objective: Our aim was to investigation the roles of MHC class I chain-related gene A(MICA) and natural killer cell group 2D(NKG2D) in human renal cancer cells. Materials and Methods: The expression of membrane MICA (mMICA) on renal cells and NKG2D on NK cells were detected by flow cytometry (FCM); the content of sMICA were detected by enzyme linked immunosorbent assay (ELISA) and the distribution of mMICA on renal tumor tissues by immunohistochemistry; the interaction between MICA and NKG2D was observed by antibody closed method. Results: Our results showed that the expression of mMICA in renal cancer tissues was significantly higher than in controls, where the soluble MICA was not expressed. Cytotoxic activity of NK cells was significantly reduced after exposure to NKG2D and MICA antibodies (P<0.05), and serum containing sMICA can obviously lower the function of NKG2D (P<0.05). Conclusions: The interaction of mMICA and NKG2D play important roles in mediation of cytotoxicity of NK cells in RCC. On the other hand, sMICA may mediate tumor immune escape through down- regulated NKG2D expression.
Purpose: To identify user requirements for electronic nursing record (ENR) systems so as to ensure system usability. Methods: A mixed methods approach were applied in three steps : (i) task and workflow analysis with literature review of nursing documentation, (ii) literature reviews of system usability, and (iii) Use Case idenfication and consensus-based validation. We analyzed the nursing activity logs collected from a time-motion investigation of six hospitals. The Use Cases were validated by eight clinical experts from different hospitals and two experts from academia in a sequential Delphi survey. Consensus was achieved for the significance score and agreement among the panel. Results: Eight task groups and patterns of task flow were observed, which were translated into nine Use Cases. The specification of Use Cases was derived from principles, guidelines, and recommendations on nursing documentation and electronic health record systems, which was organized into three requirements of each Use Case: functionality, information, and design characteristics. Each Use Case achieved an agreement of 50~70%, and significance scores of 4 or 5 on a 5-point Likert scale. Conclusion: The nine Use Case identified were considered to be important and adequate in terms of both clinical and informatics contexts.
Ko, Taek Yong;Kim, Jong In;Park, Eok Sung;Mun, Jeong Min;Park, Sung Dal
Journal of Chest Surgery
/
제51권3호
/
pp.187-194
/
2018
Background: Death domain-associated protein (DAXX), originally identified as a pro-apoptotic protein, is now understood to be either a pro-apoptotic or an anti-apoptotic factor with a chromatin remodeler, depending on the cell type and context. This study evaluated DAXX expression and its clinical implications in squamous cell carcinoma of the esophagus. Methods: Paraffin-embedded tissues from 60 cases of esophageal squamous carcinoma were analyzed immunohistochemically. An immune reaction with more than 10% of tumor cells was interpreted as positive. Positive reactions were sorted into 2 groups: reactions in 11%-50% of tumor cells and reactions in more than 51% of tumor cells, and the correlations between expression and survival and clinical prognosticators were analyzed. Results: Forty-three of the 60 cases (71.7%) showed strong nuclear DAXX expression, among which 19 cases showed a positive reaction (31.7%) in 11%-50% of tumor cells, and 24 cases (40.0%) showed a positive reaction in more than 51% of tumor cells. A negative reaction was found in 17 cases (28.3%). These patterns of immunostaining were significantly associated with the N stage (p=0.005) and American Joint Committee on Cancer stage (p=0.001), but overall survival showed no significant difference. There were no correlations of DAXX expression with age, gender, or T stage. However, in stage IIB (p=0.046) and stage IV (p=0.014) disease, DAXX expression was significantly correlated with survival. Conclusion: This investigation found upregulation of DAXX in esophageal cancer, with a 71.7% expression rate. DAXX immunostaining could be used in clinical practice to predict aggressive tumors with lymph node metastasis in advanced-stage disease, especially in stages IIB and IV.
Background: DNA methyltransferase-3a (DNMT3a) plays significant roles in embryogenesis and the generation of aberrant methylation in carcinogenesis. This study aimed to investigate associations between single nucleotide polymorphisms (SNPs) of the DNMT3a gene and risk of Helicobacter pylori infection, gastric atrophy and gastric cancer. Methods: The subjects comprised 447 patients with gastric cancer; 111 individuals with gastric atrophy and 961 healthy controls. Two SNPs (rs1550117 and rs13420827) of the DNMT3a gene were genotyped by Taqman assay. DNMT3a expression was analyzed in cancer tissues from 89 patients by tissue microarray technique. Odds ratio (ORs) and 95% confidence intervals were calculated by multivariate logistic regression. Results: Among healthy controls, risk of H.pylori infection was significantly higher in subjects with the rs1550117 AA genotype, compared to those with GG/AG genotypes of DNMT3a [OR=2.08, (95%CI: 1.02-4.32)]. However, no significant correlation was found between the two SNPs and risk of developing gastric atrophy or gastric cancer. In addition, no increase in DNMT3a expression was observed in the gastric cancer with H.pylori infection. Conclusions: This study revealed that DNMT3a rs1550117 polymorphism is significantly associated with an increased risk of H. pylori infection, but did not support any evidence for contributions of DNMT3a rs1550117 and rs13420827 to either gastric atrophy or gastric cancer. The biological roles of DNMT3a polymorphisms require further investigation.
Peroxidase-like activity of Vitreoscilla hemoglobin (VHb) has been recently disclosed. To maximize such activity, two catalytically conserved residues (histidine and arginine) found in the distal pocket of peroxidases have successfully been introduced into that of the VHb. A 15-fold increase in catalytic constant ($k_{cat}$) was obtained in P54R variant,which was presumably attributable to the lower rigidity and higher hydrophilicity of the distal cavity arising from substitution of proline to arginine. None of the modifications altered the affinity towards either $H_2O_2$ or ABTS substrate. Spectroscopic studies revealed that VHb variants harboring the T29H mutation apparently demonstrated a spectral shift in both ferric and ferrous forms (406-408 to 411 nm, and 432 to 424-425 nm, respectively). All VHb proteins in the ferrous state had a $\lambda_{soret}$ peak at ~419 nm following the carbon monoxide (CO) binding. Expression of the P54R mutant mediated the downregulation of iron superoxide dismutase (FeSOD) as identified by two-dimensional gel electrophoresis (2-DE) and peptide mass fingerprinting (PMF). According to the high peroxidase activity of P54R, it could effectively eliminate autoxidation-derived $H_2O_2$, which is a cause of heme degradation and iron release. This decreased the iron availability and consequently reduced the formation of the $Fe^{2+}$-ferric uptake regulator protein ($Fe^{2+}$-Fur), an inducer of FeSOD expression.
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