• Title/Summary/Keyword: Control Variables

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Roadmapping technique in the hybrid operating room for the microsurgical treatment of complex intracranial aneurysms

  • Juan Luis Gomez-Amador;Cristopher G Valencia-Ramos;Marcos Vinicius Sangrador-Deitos;Aldo Eguiluz-Melendez;Gerardo Y Guinto-Nishimura;Alan Hernandez-Hernandez;Samuel Romano-Feinholz;Luis Alberto Ortega-Porcayo;Sebastian Velasco-Torres;Jose J Martinez-Manrique;Juan Jose Ramirez-Andrade;Marco Zenteno-Castellanos
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.1
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    • pp.50-61
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    • 2023
  • Objective: To describe the roadmapping technique and our three-year experience in the management of intracranial aneurysms in the hybrid operating room. Methods: We analyzed all patients who underwent surgical clipping for cerebral aneurysms with the roadmapping technique from January 2017 to September 2019. We report demographic, clinical, and morphological variables, as well as clinical and radiological outcomes. We further describe three illustrative cases of the technique. Results: A total of 13 patients were included, 9 of which (69.2%) presented with subarachnoid hemorrhage, with a total of 23 treated aneurysms. All patients were female, with a mean age of 47.7 years (range 31-63). All cases were anterior circulation aneurysms, the most frequent location being the ophthalmic segment of the internal carotid artery (ICA) in 11 cases (48%), followed by posterior communicating in 8 (36%), and ICA bifurcation in 2 (8%). Intraoperative clip repositioning was required in 9 aneurysms (36%) as a result of the roadmapping technique in the hybrid operating room. There were no residual aneurysms in our series, nor reported mortality. Conclusions: The roadmapping technique in the hybrid operating room offers a complementary tool for the adequate occlusion of complex intracranial aneurysms, as it provides a real time fluoroscopic-guided clipping technique, and clip repositioning is possible in a single surgical stage, whenever a residual portion of the aneurysm is identified. This technique also provides some advantages, such as immediate vasospasm identification and treatment with intra-arterial vasodilators, balloon proximal control for certain paraclinoid aneurysms, and simultaneous endovascular treatment in selected cases during a single stage.

The Relationship between Oriental Medical Diagnosis and Arteriosclerosis by Carotid-Ankle Vascular Index(CAVI) in Acute Cerebral Infarction Patients (CAVI를 이용한 급성기 중풍환자의 Arteriosclerosis와 한방변증의 관련성 연구)

  • Choi, Won-Woo;Kim, Mi-Young;Kim, Young-Jee;Lee, Seung-Yeop;Leem, Jung-Tae;Kim, Chang-Hyun;Min, In-Kyu;Park, Sung-Wook;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-No;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of Internal Korean Medicine
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    • v.29 no.4
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    • pp.970-978
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    • 2008
  • Objectives : This study aimed to clarify the relationship between the Oriental medical diagnosis and arteriosclerosis by measuring carotid-ankle vascular index(CAVI) in acute cerebral infarction patients. Method : One hundred thirty-one subjects were recruited from the patients admitted to the Internal Medical Department at Kyunghee University Oriental Medical Center from April 2007 to August 2008. We sorted cerebral infarction patients and assessed one hundred fourteen patients' CAVI data. We diagnosed dampness-phlegm by Oriental medical diagnosis and evaluated stroke type by single or multiple infarctions. then, we analyzed their characteristics with type of stroke, risk factor, lifestyle, metabolic syndrome and dampness-phlegm diagnosis. Result : 1. On the demographic variables of the patients, age, hypertension, hyperlipidemia, multiple infarction group and metabolic syndrome and dampness-phlegm group were significantly higher in the high CAVI score group than in the control. 2. According to the significant difference in the dampness-phlegm group, we analyzed dampness-phlegm related index for pattern identifications by CAVI score. As a result, dark circles, insomnia, headache, white coating tongue. slippery pulse, and rough pulse were significantly higher in the high CAVI score group then in the control. 3. In multivariate analysis, age, hypertension, multiple infarction and dampness-phlegm groups showed a close relationship with the high CAVI score group. Conclusions : According to the analysis, significance between dampness-phlegm diagnosed patients group and high CAVI score were clarified. Moreover, multiple location infarctions also have a relationship with high CAVI score in cerebral infarction patients. These results can be utilized in the future as a basis material.

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What Factors Affect Mortality over the Age of 40? (40세 이후의 사망에 영향을 주는 요인에 관한 코호트내 환자-대조군 연구)

  • Park, Jong-Ku;Koh, Sang-Baek;Kim, Chun-Bae;Park, Kee-Ho;Wang, Seung-Jun;Chang, Sei-Jin;Sin, Soon-Ae;Kang, Myung-Guen
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.3
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    • pp.383-394
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    • 1999
  • Objectives: This study was conducted to identify the factors influencing the mortality of Koreans over the age of 40 by a nested case-control study. Methods: The cohort consisted of the beneficiaries of Korea Medical Insurance Corporation for Government Employees & Private School Teachers and Staff(KMIC) who received health examinations of KMIC in 1992 and 1993 retrospectively. At that time, they were more than 40 years old. The cases were 19,258 cohort members who had died until December 31, 1997. The controls were 19,258 cohort members who were alive until December 31, 1997. Controls were matched with age and sex distribution of the cases. The data used in this study were the funeral expenses requesting files, and the files of health examinations and health questionnaires gathered in 1992 and 1993. To assess the putative risk factors of death, student t-test, chi-square test, multiple logistic regression analysis were used. Results : In multiple logistic regression analysis, independent risk factors of death were as follows; systolic blood pressure, diastolic blood pressure, blood glucose, AST, urine glucose, urine protein, alcohol drinking(frequency), cigarette smoking and perceived health status, intake of restoratives and blood transfusion showed positive associations with death; coffee consumption showed negative associations with death; and body mass index and serum total cholesterol showed J-shaped association with death. Conclusions: Regarding the direction of association, the result of analysis on the data restricted to '96-'97 was same as that of '93-'97. But in some variables such as obesity, serum cholesterol, the odds ratios of death in the data of '96-'97 were higer than those of '93-'94, which suggested that the data of '93-'94 was bearing effect-cause relationship. We concluded that it suggested further researches using long-term follow-up data to be needed in this area.

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Hearing Loss in the Workers Exposed to Organic Solvents and Noise (유기용제와 소음에 폭로된 근로자들의 청력 손실)

  • 김영기;이용환
    • Journal of Life Science
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    • v.9 no.2
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    • pp.136-145
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    • 1999
  • The purpose of this study was to evaluate the effect of organic slovents and noise on hearing loss. We selected organic solvents exposed group of 32 cases, noise exposed group of 31 cases, both noise and solvent exposed group of 31 cases, and control group of 53 cases and studied the relation between exposure level of noise and organic solvents and degree of hearing loss. The results were as follows. The subjects under investigation were exposed to noise and organic solvents under threshold limit values and the amount of urinary hippuric acid excretion were also under biological exposure indices. In case of noise, both noise and organic solvents exposed group and noise exposed group were more exposed than organic solvents exposed group(p<0.05). When urinary hippuric acid excretion were concerned, both noise iud organic solvents exposed group and organic solvents exposed group showed higher values than noise exposed group(p<0.05). In comparison of mean auditory threshold values by frequency, on the air conduction test, both noise and organic solvents exposed group showed significantly higher hearing loss than noise exposed group in 500Hz of right ear, 500 and 2000Hz of left ear(p<0.05). Forty-three cases among 147 subjects were regarded as hearing loss group and average age(42.6years) of hearing loss group was higher than normal groups average age of 38.0 years. Urinary hippuric acid excretions of hearing loss group were significantly higher than normal group(p<0.05). Thirty-eight percent(12cases) of noise exposed group, 40.6 $\%$(13cases) of organic solvents exposed group, 51.6 $\%$(16cases) of both noise and organic solvents exposed group, and 3.8 $\%$(2cases) of unexposed group were regarded as hearing losers. Exposed groups showed higher incidence of hearing loss than unexposed group but there were no significant differences among the exposed groups. The variables showing significant correlation with hearing loss were age and the amount of hippuric acid in urinary excretion. When age were adjusted for the purpose of seeing the effects of hearing losses due to organic solvent, urinary excretion of hippuric acids was the only variable with significant correlation with hearing loss (p<0.05). When odds ratio to hearing loss between control and exposed groups was considered, noise exposed group showed 6.1 times (95 $\%$ CI: 3.3-8.7), organic solvents exposed group showed 7.4 times (95 $\%$ CI: 3.5-14.6) and both noise and organic solvents exposed group showed 17.2 times(95% CI: 5.6-31.8) higher values than unexposed group(p<0.01). Above results suggest that health screening test of hearing loss is also needed in organic solvents exposed workers.

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A Neurobehavioral Performance Assessment in Lacunar Infarction Case-control Study (열공성 뇌경색 환자-대조군에서 신경행동검사의 수행 평가)

  • Kim, Ham-Gyum;Park, Sue-Kyung;Lee, Kun-Sei;Kim, Hyeoug-Su;Kim, Wha-Sun;Chang, Soung-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.3
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    • pp.255-262
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    • 2003
  • Objectives : We carried out tests for neurobehavior by using WHO-NCTB (neurobehavioral core test battery) and Perdue pegboard score test to identify differences between lacunar infarction cases and controls. Methods : Among the subjects who underwent MRI between February 2001 and March 2002 in a university hospital located in Seoul and who were diagnosed only as lacunar infarction without any intracranial disease, 46 patients were selected as cases (male: 21, female: 25). Controls were selected who had no cerebrovascular disease on MRI by matching age (5 years), gender, and education (2 years) in a ratio of 1:1 , Among WHO-NCTB, the following 5 tests and Perdue pegboard score test were used to categorize the study subjects: digit and symbol matching, simple reaction time, Benton visual retention, digit span, and Pursuit aiming test, Results : Among the above 6 tests of neurobehavior, lacunar infarction cases showed lower score than controls except for the simple reaction time test. As the controlling variables of multivariate analysis in the stepwise regression analysis, the followings were selected due to their significant association: age, education, BMI, gender, drinking, exercise, add systolic blood pressure. From multivariate regression analysis, there was significant difference (p<0.05) between lacunar infarction cases and controls in digit and symbol matching, Benton visual retention, digit span, pursuit aiming, and Perdue pegboard score test, but not in the score of simple reaction time test. Conclusions : We suggest that the above 5 tests for neurobehavior, with the exception of the simple reaction time test, might be used as the basis for recommendation of further treatment and other neurological tests by the earlier defection for neurological abnormality in lacunar infarction.

Factors Influencing Workers' Perception and Attitude Toward Special Periodic Health Screening Test (특수건강진단에 대한 근로자의 인식과 태도에 영향을 미치는 요인)

  • Nam, Si-Hyun;Kam, Sin;Park, Jae-Yong
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.2 s.50
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    • pp.334-346
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    • 1995
  • To investigate the factors influencing workers' perception and attitude toward special periodic health screening test for workers, a survey with self-administered questionnaires was performed on 779 workers who had special periodic health screening test from September 1 to October 15, 1994. A study model was developed by modifying the health belief model. The end and intermediate response variables of the model were the voluntary participation and necessity perception on the special screening for workers. The result of analysis was consistent with the study model. Rates for the necessity perception and voluntary participation on the special screening for workers were 77.2%, 79.2%, respectively. Factors influencing on the voluntary participation were necessity perception, benefit of special screening for workers, and cue to action. And on the necessity perception were susceptibility and severity to occupational disease, knowledge to special screening for workers, and support of company. General and occupational characteristics influencing on the susceptibility and severity to occupational disease were sex, age, educational level, work duration, and health education. On the knowledge to special screening for workers were age, educational level, work duration, and locus-of-control. On the benefit of special screening for workers were age, locus-of-control, pride on health, and health education. Therefore, to increase the voluntary participation and necessity perception on the special periodic health screening for workers, 1) if a worker is judged as occupational disease, the judgment should be widely known in his workplace, 2) the screening result forms should be directly sent to the workers themselves, 3) for the positivity of employers, the campaign and education program subjected to them should be planned, 4) health education should give the first consideration to the younger, lower educational level, and newly employed women, and its frequency should be increased and it should be more frequently dealt with occupation-related subjects, and 5) the employers should have a careful concern in not being disadvantageous to workers due to result of screening.

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P53 Overexpression and Outcome of Radiation Therapy in Head & Neck Cancers (두경부종양 환자에서 p53의 과발현과 방사선치료결과)

  • Kim In Ah;Choi Ihl Bhong;Kang Ki Mun;Jang Ji Young;Kim Kyung Mi;Park Kyung Shin;Young Shin Kim;Kang Chang Suk;Cho Seung Ho;Kim Hyung Tae
    • Radiation Oncology Journal
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    • v.17 no.1
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    • pp.1-8
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    • 1999
  • Purpose : Experimental studies have implicated the wild type p53 In cellular response to radiation. Whether altered p53 function can lead to changes in clinical radiocurability remains an area of ongoing study. This study was performed to investigate whether any correlation between change of p53 and outcome of curative radiation therapy in patients with head and neck cancels. Methods : Immunohistochemical analysis with a mouse monoclonal antibody (DO-7) specific for human p53 was used to detect to overexpression of protein in formalin fixed, paraffin-embedded tumor sample from 55 head and neck cancer patients treated with curative radiation therapy (median dose of 7020 cGy) from February 1988 to March 1996 at 51. Mary's Hospital. Overexpression of p53 was correlated with locoregional control and survival using Kaplan-Meier method. A Cox regression multi-variate analysis was peformed that included all clinical variables and status of p53 expression. Results : Thirty-seven (67.2$\%$) patients showed overexpression of p53 by immunohistochemical staining in their tumor. One hundred percent of oral cavity, 70$\%$ of laryngeal, 66.7$\%$ of oropharyngeal, 66.7$\%$ of hypopharyngeal cancer showed p53 overexpression (P=0.05). The status of p53 had significant relationship with stage of disease (P=0.03) and history of smoking (P=0.001). The overexpression of p53 was not predictive of response rate to radiation therapy. The locoregional control was not significantly affected by p53 status. Overexpression of p53 didn't have any prognostic implication for disease free survival and overall survival. Primary site and stage of disease were significant prognostic factors for survival. Conclusions : The p53 overexpression as detected by immunohistochemical staining had significant correlation with stage, primary site of disease and smoking habit of patients. The p53 overexpression didn't have any predictive value for outcome of curative radiation therapy in a group of head and neck cancers.

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The Effects of Science Question Enhancement Instruction on the Science Question Level and Achievement of Middle School Students (질문 강화 수업이 중학생들의 질문 수준과 학업 성취도에 미치는 영향)

  • Chung, Young-Lan;Bae, Jae-Hee
    • Journal of The Korean Association For Science Education
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    • v.22 no.4
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    • pp.872-881
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    • 2002
  • Student questioning is included in the priority of science literacy, to enable students to solve problems by exploring questions, communicating and constructing knowledge(AAAS, 1989). Also, the essence of student questioning in science lies in its function as a link between thinking and learning. But educators did not pay much attention to students' questioning in Korea. The purpose of this study was to investigate the effects of science question enhancement instruction on students' science questioning level and achievement. Also, this study showed the effects of other variables(logical thinking, science achievement, interest, and gender) on students' science questioning level. The pretest-posttest control group design group design was used. The sample was consisted of 80 second grade middle school students in experimental group(Science question enhancement instruction) and 74 students in control group(Traditional learning). Students in both groups were received identical content instruction on the unit 'Structures and functions of plant'. These groups were treated for 15 hours during 6 weeks. Students' questions were rated using the four levels described by the Middle School Students' Science Question Rating Scale(r= .96,)(Cuccio-Schirripa & Steinner, 2000). Science achievement data were collected using a 17 item multiple choice test(Cronbach ${\alpha}$= .84). To investigate students' logical thinking ability, a abridged GALT(Cronbach ${\alpha}$= .69) was used. Five-way ANOVA, ANCOVA, and multiple regression analysis were used to analyze the results. The results indicated that students who received instruction on researchable questioning outperformed those students who were not instructed on high-order questioning(p< .01). Results of correlations indicated that instruction(r= .640), science achievement(r= .311) and logical thinking ability(r= .212) was significantly and positively related with students' questioning level. But, interest and gender did not show any significant correlation with students' questioning level. Science question enhancement instruction was more effective on science achievement than the traditional instruction(p< .01).

Development of A Three-Variable Canopy Photosynthetic Rate Model of Romaine Lettuce (Lactuca sativa L.) Grown in Plant Factory Modules Using Light Intensity, Temperature, and Growth Stage (광도, 온도, 생육 시기에 따른 식물공장 모듈 재배 로메인 상추의 3 변수 군락 광합성 모델 개발)

  • Jung, Dae Ho;Yoon, Hyo In;Son, Jung Eek
    • Journal of Bio-Environment Control
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    • v.26 no.4
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    • pp.268-275
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    • 2017
  • The photosynthetic rates of crops depend on growth environment factors, such as light intensity and temperature, and their photosynthetic efficiencies vary with growth stage. The objective of this study was to compare two different models expressing canopy photosynthetic rates of romaine lettuce (Lactuca sativa L., cv. Asia Heuk romaine) using three variables of light intensity, temperature, and growth stage. The canopy photosynthetic rates of the plants were measured 4, 7, 14, 21, and 28 days after transplanting at closed acrylic chambers ($1.0{\times}0.8{\times}0.5m$) using light-emitting diodes, in which indoor temperature and light intensity were designed to change from 19 to $28^{\circ}C$ and 50 to $500{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$, respectively. At an initial $CO_2$ concentration of $2,000{\mu}mol{\cdot}mol^{-1}$, the canopy photosynthetic rate began to be calculated with $CO_2$ decrement over time. A simple multiplication model expressed by simply multiplying three single-variable models and a modified rectangular hyperbola model were compared. The modified rectangular hyperbola model additionally included photochemical efficiency, carboxylation conductance, and dark respiration which vary with temperature and growth stage. In validation, $R^2$ value was 0.849 in the simple multiplication model, while it increased to 0.861 in the modified rectangular hyperbola model. It was found that the modified rectangular hyperbola model was more suitable than the simple multiplication model in expressing the canopy photosynthetic rates affected by environmental factors (light Intensity and temperature) and growth factor (growth stage) in plant factory modules.

The Factors Influencing Survival of Out-of-hospital Cardiac Arrest with Cardiac Etiology (병원 밖에서 발생한 심인성 심장정지환자의 생존 관련 요인 7년간 국가심장정지조사사업 자료 활용)

  • Jeong, Su-Yeon;Kim, Chul-Woung;Hong, Sung-Ok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.560-569
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    • 2016
  • Purpose The purpose of this study was not only to explore the factors associated with the survival of OHCA(Out-of-hospital Cardiac Arrest), but to provide ideas for improving the operation of emergency medical system in Korea. Method 90,734 OHCAs(Out-of-hospital Cardiac Arrest) with a cardiac etiology, who had been transported by 119 EMS ambulances for seven years from 2006 to 2012 in Korea, were analyzed. The data had a multilevel structure in that patient's survival in the same region is interrelated, so two-level (patient-region) logistic regression analysis was applied to adjust this correlation. Results The adjusted OR in group who were given CPR(Cardiopulmonary Resuscitation) by a bystander were 1.40 for survival to discharge. In addition, the adjusted OR in the group with an implementation of AED (automated external defibrillator) before arriving in hospital was 2.98 for survival to discharge. we categorized some continuous variables (number of emergency physician, OHCAs volume fo hospital, area deprivation level) into five quintiles. The adjusted OR in the number of emergency physician compared with Q1(lowest) was 1.29(Q2), 2.89(Q3), 3.39(Q4), 4.07(Q5), respectively. the adjusted OR in OHCAs volume of each hospital compared with Q1(lowest) was 2.06(Q2), 3.06(Q3), 3.46(Q4), 4.36(Q5), respectively. Lastly, the adjusted OR in deprivation level compared with Q1(least deprived area) was 0.72(Q4), 0.64(Q5) so that the adjusted OR of survival to discharge tended to decrease in more deprived districts. Conclusion The survival to discharge was better significantly in group given CPR by a bystander and with the implementation of AED before arriving in hospital. The survival to discharge tended to be significantly better in hospitals with a larger number of emergency physicians and higher volume of OHCAs in less deprived districts.