• 제목/요약/키워드: Evidence-Based Medicine

검색결과 1,232건 처리시간 0.034초

High Expression of MICA in Human Kidney Cancer Tissue and Renal Cell Carcinoma Lines

  • Jia, Hong-Ying;Liu, Jun-Li;Zhou, Cheng-Jun;Kong, Feng;Yuan, Ming-Zhen;Sun, Wen-Dong;Wang, Jue;Liu, Ling;Zhao, Jing-Jie;Luan, Yun
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권4호
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    • pp.1715-1717
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    • 2014
  • The overall incidence and mortality of renal cell carcinoma (RCC), the most common kidney cancer, are steadily increasing for reasons that are not fully explained. Our aim was to explore the expression of membrane MHC class I chain-related gene A (mMICA) in human RCC cell lines and tissue specimens, and to determine expression of soluble MICA (sMICA) in serum of patients with renal cell carcinoma, we used flow cytometry (FCM) and immunohistochemistry as well as an enzyme linked immunosorbent assay (ELISA). The results showed that percentage of mMICA expression was significantly increased in human kidney cancer tissues and RCC cell lines (786-O and Ketr-3) than that in healthy adults and human embryonic kidney 293 (HEK293) cell line individuality (P<0.05). sMICA content in healthy adults was negative, but in renal cancer patients was significantly elevated (P<0.05). Our research showed that high expression of MICA in human kidney cancer, this results show that MICA might serve as potential tumor-associated antigen (TAA) in RCC.

RAND 방법으로 합의한 임상진료지침의 정의와 질 평가 기준 (Consensus on definition and quality standard of clinical practice guideline using RAND method)

  • 지선미;김수영;신승수;허대석;김남순
    • 보건행정학회지
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    • 제20권2호
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    • pp.1-16
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    • 2010
  • Background : Clinical practice guidelines are an increasingly familiar part of clinical practice. Moreover, rigorously developed evidence based guidelines has been widely used. However, in Korea, some of published documents as clinical practice guidelines have shown considerable disparity in structure, contents and quality. This is mainly because there is no consensus on the definition and quality standard of clinical practice guidelines. The purpose of this study was to draw consensus on the definition and the quality standard about clinical practice guidelines. Method : We developed a questionnaire about the definition of clinical practice guidelines with inclusion criteria(23 items) and the quality standard(30 items). We selected 9 experts who had prior experience in developing and implementing guidelines. Rating methods for appropriateness of items were adopted from the RAND method. Consensus was drawn in three rounds. Results : Of the 47 items agreed, 40 items were determined to be appropriate. Clinical practice guidelines were defined as "scientifically and systematically developed statements to assist practitioners and patients on making decisions about appropriate health care for specific clinical circumstances." Narrative reviews, systematic reviews or health technology assessment without recommendations, translation of foreign guidelines, guidelines for patients only and training manuals were not considered as clinical practice guidelines. For the quality standard of clinical practice guidelines, 27 items were deemed necessary. Conclusions : The consensus on the definition with inclusion criteria and the quality standard of clinical practice guidelines carries an important meaning as the first attempt to draw a general agreement in our society. The unique achievement of the consensus reflects the current status of clinical practice guidelines that there has been a high tendency to adapt foreign guidelines. We hope efforts of this kind will continue to bring improvement in clinical practice guidelines.

쇄골 골절 치료의 최근 경향 (Recent Treatment Options for the Clavicle Fracture)

  • 오주한;최혜연
    • Clinics in Shoulder and Elbow
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    • 제15권1호
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    • pp.43-51
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    • 2012
  • 목적: 쇄골 골절의 치료에 관한 광범위한 자료 검토를 통해 현 시점에서의 적절한 쇄골 골절 치료방법을 찾고자 한다. 대상 및 방법: 성인에서 발생한 쇄골 골절과 관련된 전반적인 내용, 즉 쇄골 골절의 역학, 분류, 수술 적응증, 최근 도입된 치료 방법의 현황 및 결과를 문헌 고찰을 통해 정리하였다. 또한, 쇄골 중간 부위 골절의 수술 적응증의 확대와, 새로운 치료법의 하나로 주목받고 있는 anatomically precontoured plate의 도입을 비롯한 최신 지견에 대해 살펴보았다. 결과 및 결론: 지금까지 쇄골 골절은 비수술적 방법으로 대부분 치료되어 왔다. 하지만 최근 들어 기존에 추산되었던 것 보다 많은 수의 불유합, 부정유합 발생이 보고되면서 수술적 치료의 적응증이 점점 확대되는 추세이다. 하지만 아직까지는 쇄골 골절에 대한 이상적인 치료 방침이 확립되지 않았음을 고려할 때, 환자 개개인의 임상 정보와 선호도를 세심히 고려한 맞춤형 치료가 이루어져야 하겠다.

High Frequency of Enteric Protozoan, Viral, and Bacterial Potential Pathogens in Community-Acquired Acute Diarrheal Episodes: Evidence Based on Results of Luminex Gastrointestinal Pathogen Panel Assay

  • Hawash, Yousry A.;Ismail, Khadiga A.;Almehmadi, Mazen
    • Parasites, Hosts and Diseases
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    • 제55권5호
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    • pp.513-521
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    • 2017
  • Infectious diarrhea is endemic in most developing countries. We aimed to investigate the protozoan, viral, and bacterial causes of acute diarrhea in Taif, Saudi Arabia. A cross-sectional prospective 1-year study was conducted on 163 diarrheal patients of various ages. Stool samples were collected, 1 per patient, and tested for 3 protozoa, 3 viruses, and 9 bacteria with the Luminex Gastrointestinal Pathogen Panel. Overall, 53.4% (87/163) of samples were positives (20.8% protozoa, 19.6% viruses, 2.8% bacteria, and 9.8% mixed). Rotavirus (19.6%), Giardia duodenalis (16.5%), and Cryptosporidium spp. (8.5%) were the mostly detected pathogens. Adenovirus 40/41 (4.2%), Salmonella (3%), Shiga toxin-producing Escherichia coli (3%), and Entamoeba histolytica (2.4%) were also detected. Norovirus GI/II, Vibrio cholerae, Yersinia enterocolitica, and Clostridium difficile toxin A/B were not detected in any patients. All pathogens were involved in coinfections except E. histolytica. Giardia (5.5%) and rotavirus (3%) were the most commonly detected in co-infections. Enterotoxigenic E. coli (2.4%), Campylobacter spp. (2.4%), E. coli 0157 (1.8%), and Shigella spp. (1.2%) were detected in patients only as co-infections. Infections were more in children 0-4 years, less in adults <40 years, and least >40 years, with statistically significant differences in risk across age groups observed with rotavirus (P<0.001), Giardia (P=0.006), and Cryptosporidium (P=0.036) infections. Lastly, infections were not significantly more in the spring. This report demonstrates the high burden of various enteropathogens in the setting. Further studies are needed to define the impact of these findings on the clinical course of the disease.

Core Stabilization With the Lumbar Extension Exercise in Low Back Pain

  • Noh, Dong-koog;Cha, Young-joo;Kim, Dae-hun;You, Joshua (Sung) H.
    • 한국전문물리치료학회지
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    • 제25권4호
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    • pp.27-36
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    • 2018
  • Background: We developed a novel integrative lumbar stabilization technique that combines lumbar extension (LE) exercise with abdominal drawing-in maneuver (ADIM) to ameliorate low back pain (LBP) associated with neuromuscular imbalance and instability, based on the collective evidence of contemporary spinal rehabilitation. Objects: The specific aim of the present study was to investigate the effects of LE exercise with and without ADIM on core muscle strength, lumbar spinal instability, and pain, as well as functional characteristics in individuals with LBP using advanced radiographic imaging techniques. Methods: patients with mechanical LBP (N = 40, 6 males; $35.1{\pm}7.6years$) were recruited and randomly assigned either to the combined LE and ADIM (experimental group) or the LE alone (control group). Outcome measures included the visual analog scale, the modified Oswestry Disability Index, muscle strength imbalance (MSI), and radiographic imaging. The lumbar intervertebral displacement (LID), intervertebral (IV) and total lumbar extension (TLE) angles were calculated to evaluate the lumbar segmental instability. Results: The experimental group showed significant differences in the L3-L4, L5-S1 LIDs, L4-L5 and L5-S1 IV angles, and TLE angle as compared to the controls (p<.05). Immediate pain reduction and muscle strength imbalance ratio were significantly different between the groups (p<.05). Conclusion: These results suggest that the addition of ADIM significantly increased lumbar spinal stabilization in individuals with LBP, thereby reducing pain associated with functional lumbar flexion during daily activities.

한국과 일본의 건강증진정책 비교 (Comparative Study on the Health Promotion Policy in Korea and Japan)

  • 남은우;조은주;남정자
    • 보건교육건강증진학회지
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    • 제21권3호
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    • pp.19-33
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    • 2004
  • The focus of this paper is to critically evaluate the contemporary health promotion policy of g Korea and Japan. The primary purpose of this comparative research project is to stimulate policy debate and to strengthen the design and implementation of evidence-based policies that improve population health and reduce health related disparities. For the purpose of the research object we adopted analysis of health promotion(HP) sources. The HP Source which is still under development in Europe, is a potentially valuable tool for global use. This European Commission funded project lead by the London School of Hygiene and Tropical Medicine has brought together organisations from all of the European Union Member States, plus Norway, Iceland, Latvia, Switzerland and the Czech Republic to contribute their data. The findings of this research will be conclude by making recommendations for further comparative studies and in particular how EUHPID and the HP Source tool and database can be expanded for use at global level through the IUHPE. The result as follows: 1. The Health Promotion Act enacted 1995 in Korea and 2000 in Japan. The government has a national document on HP titled Health Plan 2010 and Healthy Korea 2010 in Korea and Healthy Japan 21 in Japan. 2. The Health Plan 2010 of Korea contains 14 goals, i.e. life expectancy, smoking, nutrition, mental health, dental health, reproductive health, hypertension, cerebrovascular diseases, arthritis, diabetes mellitus, cardiovascular diseases, and cancer. It should be emphasized that the Korean HP national document adds 3 goals of health expectancy, reproductive health, and arthritis to its Japanese counterpart. Health Plan 2010 of Korea specifies 37 objectives in 14 goals, and Healthy Japan 21 proposes 48 objectives and 80 targets in 9 goals. 3. Health Plan 2010 and Healthy Japan 21 have not been evaluated yet, and no regular systematic monitoring reporting of HP policies is available in Korea and Japan yet. 4. National Health Promotion Fund is a financial source of HP programs at the national level in Korea. Its annual amount is 736 billion Won(equivalent to approximately 640 million US$), otherwise no specific Health Promotion Fund in Japan.

Serum Adiponectin Level Association with Breast Cancer Risk: Evidence from a Case-Control Study

  • Ahmed, Syed Danish Haseen;Khanam, Aziza;Sultan, Naheed;Idrees, Farah;Akhter, Naheed
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권12호
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    • pp.4945-4948
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    • 2015
  • Background: Adiponectin is a protein, synthesized by adipose tissue, which has a questionable role in breast cancer pathogenesis. This study focused on serum levels of adiponectin among cases and controls, and its possible association with breast cancer risk. Materials and Methods: This case-control study covered 175 diagnosed breast cancer patients with positive histopathology from Breast Clinic, surgical unit-1, Civil Hospital, Karachi and 175 healthy controls from various screening programs. Blood samples were obtained after an overnight fast and later analyzed. Results: Fasting blood glucose was significantly raised, while serum adiponectin was significantly decreased in breast cancer cases when compared to control subjects. To find the precise influence of serum adiponectin on the risk of breast cancer, subjects were divided in to quartiles based on serum levels of adiponectin. It is observed that risk of breast cancer decreased with rising quartile. Q2 (25th-50th) had the highest OR=1.76 (CI: 0.93- 3.34), Q3 (50th-75th) has OR= 0.89 (CI: 0.48-1.64), while subjects in the highest quartile Q4 (>75th) had significantly (p< 0.05) decreased risk of breast cancer having OR=0.06 (CI: 0.02-0.15), when compared to the lowest quartile. Conclusions: We demonstrated a statistically significant association of elevated serum adiponectin with decreased risk of breast cancer. This signifies a protective role of adiponectin via an intricate mechanism of masking mitogenic growth factors in breast carcinogenesis.

Dietary Resistant Starch Contained Foods and Breast Cancer Risk: a Case-Control Study in Northwest of Iran

  • Tajaddini, Aynaz;Pourzand, Ali;Sanaat, Zohreh;Pirouzpanah, Saeed
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권10호
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    • pp.4185-4192
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    • 2015
  • Background: A protective effect of resistant starch (RS) containing foods on carcinogenesis has been shown from several lines of experimental evidence for gastrointestinal cancers. Therefore, we aimed to investigate the association between RS contained foods and breast cancer (BC) risk in a hospital-based, age- and origin-matched, case-control study. Materials and Methods: A validated, semi-quantitative, food frequency questionnaire (FFQ) was completed by 306 women newly diagnosed with BC aged 25 to 65 years, and 309 healthy women as matched controls. Odds ratios (ORs) and 95% confidence intervals (95%CI) were estimated using conditional logistic regression models. Results: Reduced BC risk was associated with the highest tertile of whole-wheat bread and boiled potato consumption with adjusted ORs at 0.34 (95%CI: 0.19-0.59) and 0.61 (95%CI: 0.37-0.99), respectively. Among consumers of whole-wheat bread, the protective role of cereals remained relatively apparent at higher intakes level of fiber rich breads at adjusted models (OR=0.53, 95%CI: 0.28-1.01). Moreover, high intake of legumes was found out to be a significant protective dietary factor against risk of BC development with an OR of 0.01 (95%CI: 0.03-0.13). However, consumption of white bread and biscuits was positively related to BC risk. Conclusions: Our results show that certain RS containing foods, in particular whole wheat bread, legumes and boiled potato may reduce BC risk, whereas higher intake of white bread and biscuits may be related to increased BC risk.

Significance of Rumex Vesicarius as Anticancer Remedy Against Hepatocellular Carcinoma: a Proposal-Based on Experimental Animal Studies

  • Shahat, Abdelaaty A;Alsaid, Mansour S;Kotob, Soheir E;Ahmed, Hanaa H
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권10호
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    • pp.4303-4310
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    • 2015
  • Rumex vesicarius is an edible herb distributed in Egypt and Saudi Arabia. The whole plant has significant value in folk medicine and it has been used to alleviate several diseases. Hepatocellular carcinoma (HCC), the major primary malignant tumor of the liver, is one of the most life-threatening human cancers. The goal of the current study was to explore the potent role of Rumex vesicarius extract against HCC induced in rats. Thirty adult male albino rats were divided into 3 groups: (I): Healthy animals received orally 0.9 % normal saline and served as negative control group, (II): HCC group in which rats were orally administered N-nitrosodiethylamine NDEA, (III): HCC group treated orally with R. vesicarius extract in a dose of 400 mg/kg b.wt daily for two months. ALT and AST, ALP and ${\gamma}$-GT activities were estimated. CEA, AFP, AFU, GPC-3, Gp-73 and VEGF levels were quantified. Histopathological examination of liver tissue sections was also carried out. The results of the current study showed that the treatment of the HCC group with R. vesicarius extract reversed the significant increase in liver enzymes activity, CEA, AFP, AFU, glypican 3, golgi 73 and VEGF levels in serum as compared to HCC-untreated counterparts. In addition, the favorable impact of R. vesicarius treatment was evidenced by the marked improvement in the histopathological features of the liver of the treated group. In conclusion, the present experimental setting provided evidence for the significance of R. vesicarius as anticancer candidate with a promising anticancer potential against HCC. The powerful hepatoprotective properties, the potent antiangiogenic activity and the effective antiproliferative capacity are responsible for the anticancer effect of this plant.

큐렛형 팁을 장착한 압전방식 초음파 치석제거기가 치근대체물 삭제에 미치는 영향 (The Effect of a Piezoelectric Ultrasonic Scaler with Curette Tip on Root Substitute Removal in Vitro)

  • 이영규
    • Journal of Periodontal and Implant Science
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    • 제30권2호
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    • pp.429-442
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    • 2000
  • Based on current evidence in the literature, it is known that endotoxin is a weakly adherent surface phenomenon and that power-driven instruments can be used to accomplish definitive root detoxification and maximal wound healing without overinstrumentation of root and without extensive cementum removal. And one of the newly developed curette tips used with low power of piezoelectric ultrasonic scaler, is effective to remove calculus and not to remove the excessive cementum. The purpose of this study is therefore, to assess the influence of ultrasonic power and various working parameters on root substitute removal when instrumentation is performed with the curette tip on piezoelectric ultrasonic scaler. This study assessed defect depth, width and area resulting from instrumentation using a piezoelectric ultrasonic scaler with a curette type tip in vitro to acrylic resin block as a root substitute. The working parameters was standardized by the sledge device which controls lateral force(0.5 N, 1 N, 2 N) and instrumentation time(5 sec, 10 sec, 20 sec) and power setting was adjusted 0,2,4,8 in P mode. Power setting had the greatest influence on defect depth compared to lateral force and instrumentation time(standardized regression parameter estimates${\pm}$standard error, $0.37{\pm}0.02$, $0.19{\pm}0.02$, $0.07{\pm}0.02$). The effects on defect area also greatest for power setting($0.57{\pm}0.03$) compared to lateral force and instrumentation time($0.33{\pm}0.03$, $0.12{\pm}0.03$). The effect of the power setting on the defect width($0.15{\pm}0.01$) is not so great as defect depth or defect area compared to lateral force($0.12{\pm}0.01$) and effect of instrumentation time is minimal($0.02{\pm}0.01$). It could be concluded that the power setting has the greatest influence on the defect depth and area in curette type tip with low power of piezoelectric ultrasonic device. Many parameters can be adjusted in various situation in clinical use of piezoelectric ultrasonic scaler but the power setting is the first parameter to be adjusted.

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