• Title/Summary/Keyword: Evidence-Based Treatment

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Case Control Study of Recognition level for Dermatomycosis of Dermatomycosis Patient to be Treated in Ulleung Hospital of Ulleung island (울릉도의 일개 병원을 내원한 피부 진균증 환자들의 피부 진균증에 대한 인식도에 관한 사례 연구)

  • Bae, Jung-Min;Jung, Man-Jin;Ha, Dong-Yeup;Jung, Ho-Keun;Jung, Ki-Hun;Jung, Byung-Wook;Oh, Min-Koo;Bae, Sung-Han;An, Woo-Sup
    • Journal of agricultural medicine and community health
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    • v.30 no.2
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    • pp.205-211
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    • 2005
  • Objectives: In Ulleung island, many people was suffered from dermatomycosis. But many patients was not recognized to dermatomycosis due to little symptom. So, public health education was needed. We will plan education direction based on evidence. So, in one way, the recognition level was needed to determine education direction. Methods: From June to July in 2005, 45 patients was made a question. The questionnaire was composed of chief complaint, site, duration, similar disease in family, 5 questiones and so on. If patients was recognized to 1 question, 1 score was added. Remain 4 question was done in same manner. Results: The low score group were that total socre was beyond 2. And The high score group were that total score was above 3. The low score group was 24 persons, average age was 59. The high score group was 21 persons and average age was 42. Male and female ratio was 7 : 17 in low score group and 10 : 11 in high score group. Coinfection was 17 patients in low score group and 2 patients in high score group. There was only 17 patients that wete recognized that dermatomycosis and "Moozom" were same disease. And, many patients was not recognized to possibility of reinfection after treatment of dermatomycosis. Conclusions: In Ulleung island, coinfection rate was higher than other area bacause of low recognition level. And infection rate in family was higher too. So, there was essential to educate of dermatomycosis prevention. Dermatomycosis patient became older and was more female than other area, so there was need to centralize people to be needed of public health education. Finally, many statistical study for dermatomycosis should be needed for many patients and general populations in Ulleung island.

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Roles of Cancer Registries in Enhancing Oncology Drug Access in the Asia-Pacific Region

  • Soon, Swee-Sung;Lim, Hwee-Yong;Lopes, Gilberto;Ahn, Jeonghoon;Hu, Min;Ibrahim, Hishamshah Mohd;Jha, Anand;Ko, Bor-Sheng;Lee, Pak Wai;MacDonell, Diana;Sirachainan, Ekaphop;Wee, Hwee-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2159-2165
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    • 2013
  • Cancer registries help to establish and maintain cancer incidence reporting system, serve as a resource for investigation of cancer and its causes, and provide information for planning and evaluation of preventive and control programs. However, their wider role in directly enhancing oncology drug access has not been fully explored. We examined the value of cancer registries in oncology drug access in the Asia-Pacific region on three levels: (1) specific registry variable types; (2) macroscopic strategies on the national level; and (3) a regional cancer registry network. Using literature search and proceedings from an expert forum, this paper covers recent cancer registry developments in eight economies in the Asia-Pacific region - Australia, China, Hong Kong, Malaysia, Singapore, South Korea, Taiwan, and Thailand - and the ways they can contribute to oncology drug access. Specific registry variables relating to demographics, tumor characteristics, initial treatment plans, prognostic markers, risk factors, and mortality help to anticipate drug needs, identify high-priority research area and design access programs. On a national level, linking registry data with clinical, drug safety, financial, or drug utilization databases allows analyses of associations between utilization and outcomes. Concurrent efforts should also be channeled into developing and implementing data integrity and stewardship policies, and providing clear avenues to make data available. Less mature registry systems can employ modeling techniques and ad-hoc surveys while increasing coverage. Beyond local settings, a cancer registry network for the Asia-Pacific region would offer cross-learning and research opportunities that can exert leverage through the experiences and capabilities of a highly diverse region.

Comparison of healing pattern with or without bone graft after odontogenic cyst enucleation (악골에서 발생한 치성 낭종제거 후 골이식 여부에 따른 치유속도와 양상 비교)

  • Baek, Chae-Hwan;Park, Joon-Hyung;Kim, Gun-Jong;Hong, Jong-Rak;Kim, Chang-Soo;Paeng, Jun-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.6
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    • pp.515-519
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    • 2010
  • Introduction: Bone defects in the jaw are frequently observed after odontogenic cyst enucleation. The success of bone healing appears to be related to the size of the bone defect, the anatomical location, the patient's age and other parameters. The use of bone grafting material is dependent on the operator's preference. No evidence-based definite treatment protocol has been established. This study evaluated the effect of a bone graft into the defect after odontogenic cyst enucleation. Materials and Methods: A total of 55 patients, who had been treated for an odontogenic cyst with cyst enucleation from 2000 to 2009 at the department of Oral and Maxillofacial Surgery, Samsung Medical Center, were included in this study. Patients who were followed-up for more than 1 year were included. Two groups were defined according to the bone graft (with or without a bone graft) after cyst enucleation. The differences in the healing periods and patterns of bone healing were compared clinically and radiologically. The postoperative 1 year radiographs were analyzed for bone healing and density. Statistical analysis was performed using a Pearson chi square test and Wilcoxon rank-sum test. Results: More infection signs were observed in the bone graft group than in the other group, but there was no statistically significant difference. Radiographically, there was also no significant difference in the size of the radiolucent lesions between the two groups. Conclusion: There was no significant difference in healing between the groups with a bone graft and without bone graft after cyst enucleation.

PERIPHERAL ODONTOMA IN A CHILD: CASE REPORT (소아에서 발생한 변연성 치아종의 증례보고)

  • Lee, Young-Ho;Park, Ho-Won;Lee, Ju-Hyun;Seo, Hyun-Woo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.3
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    • pp.301-305
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    • 2012
  • The odontoma is a hamartoma of odontogenic origin and consists of enamel, dentin, cementum and pulp tissue. Two types of odonotma are histologically recognized: complex and compound. Odontoma may be the cause of noneruptoin or impaction of teeth, formation of cyst and resorption of adjacent bone. The recommended treatment for an odontoma is conservative surgical excision. No propensity for recurrence has been noted. Peripheral odontoma is relatively rare lesion and shows the histological characteristics of an intraosseous odontoma. This report described a 3-year-old Korean girl with a firm gingival mass in the posterior mandibular area, which had been gradually enlarging over 18months. Radiographic examination showed a radiopaque mass but no evidence of underlying intraosseous lesion. Excisional biopsy was performed for the mass removal and histopathological examination. The result of histopathological study was identified as hamartous supernumerary tooth germ. Based on the clinical presentation, radiographic and histopathologic findings, we concluded that the final diagnosis was peripheral odontoma. For three years after surgery, there is no clinical sign of recurrence.

Clinical Practice Guideline of Acute Respiratory Distress Syndrome

  • Cho, Young-Jae;Moon, Jae Young;Shin, Ein-Soon;Kim, Je Hyeong;Jung, Hoon;Park, So Young;Kim, Ho Cheol;Sim, Yun Su;Rhee, Chin Kook;Lim, Jaemin;Lee, Seok Jeong;Lee, Won-Yeon;Lee, Hyun Jeong;Kwak, Sang Hyun;Kang, Eun Kyeong;Chung, Kyung Soo;Choi, Won-Il
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.4
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    • pp.214-233
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    • 2016
  • There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment. We also suggest high positive end-expiratory pressure (2B), extracorporeal membrane oxygenation as a rescue therapy (2C), and neuromuscular blockage for 48 hours after starting mechanical ventilation (2B). The application of recruitment maneuver may reduce mortality (2B), however, the use of systemic steroids cannot reduce mortality (2B). In mechanically ventilated patients, we recommend light sedation (1B) and low tidal volume even without ARDS (1B) and suggest lung protective ventilation strategy during the operation to lower the incidence of lung complications including ARDS (2B). Early tracheostomy in mechanically ventilated patients can be performed only in limited patients (2A). In conclusion, of 12 recommendations, nine were in the management of ARDS, and three for mechanically ventilated patients.

Heat shock protein X purified from Mycobacterium tuberculosis enhances the efficacy of dendritic cells-based immunotherapy for the treatment of allergic asthma

  • Kim, Hye-Young;Kang, Hyun Kyu;Cho, Joon;Jung, In Duk;Yoon, Gun Young;Lee, Min-Goo;Shin, Sung Jae;Park, Won Sun;Park, Jong-Hwan;Ryu, Seung-Wook;Park, Yeong-Min;You, Ji Chang
    • BMB Reports
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    • v.48 no.3
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    • pp.178-183
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    • 2015
  • Dendritic cells play an important role in determining whether na${\ddot{i}}$ve T cells mature into either Th1 or Th2 cells. We determined whether heat-shock protein X (HspX) purified from Mycobacterium tuberculosis regulates the Th1/Th2 immune response in an ovalbumin (OVA)-induced murine model of asthma. HspX increased interferon-gamma, IL-17A, -12 and transforming growth factor (TGF)-${\beta}$ production and T-bet gene expression but reduced IL-13 production and GATA-3 gene expression. HspX also inhibited asthmatic reactions as demonstrated by an increase in the number of eosinophils in bronchoalveolar lavage fluid, inflammatory cell infiltration in lung tissues, airway luminal narrowing, and airway hyper-responsiveness. Furthermore, HspX enhanced OVA-induced decrease of regulatory T cells in the mediastinal lymph nodes. This study provides evidence that HspX plays critical roles in the amelioration of asthmatic inflammation in mice. These findings provide new insights into the immunotherapeutic role of HspX with respect to its effects on a murine model of asthma.

Review of root canal irrigant delivery techniques and devices (최신 근관 세척 방법과 기구에 대한 고찰)

  • Yoo, Yeon-Jee;Shin, Su-Jeong;Baek, Seung-Ho
    • Restorative Dentistry and Endodontics
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    • v.36 no.3
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    • pp.180-187
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    • 2011
  • Introduction: Eliminating the residual debris and bacteria in the root canal system is one of the main purposes of the endodontic treatment. However, the complexity on the anatomy of the root canal system makes it difficult to eliminate the bacterial biofilm existing along the root canal surface and necrotic pulp tissue by mechanical instrumentation and chemical irrigation. Recently, more effective irrigant delivery systems for root canal irrigation have been developed. The purpose of this review was to present an overview of root canal irrigant delivery techniques and devices available in endodontics. Review: The contents of this paper include as follows; - syringe-needle irrigation, manual dynamic irrigation, brushes - sonic and ultrasonic irrigation, passive ultrasonic irrigation, rotary brush, RinsEndo, EndoVac, Laser Conclusion: Though technological advances during the last decade have brought to fruition new agitation devices that rely on various mechanisms, there are few evidence based study to correlate the clinical efficacy of these devices with improved outcomes except syringe irrigation with needle and ultrasonic irrigation. The clinicians should try their best efforts to deliver antimicrobial and tissue solvent solutions in predictable volumes safely to working length.

Developing Evaluation Index and Item for Water Environment Improvement of Gyeongin ARA Waterway (경인 아라뱃길의 물환경 개선을 위한 오염원인 평가항목 및 지표 개발)

  • Lee, Kyung-Su;Kim, Tae-Hyeong
    • The Journal of the Korea Contents Association
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    • v.18 no.8
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    • pp.469-482
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    • 2018
  • This research has developed the criteria and index for systematically and objectively assessing the quality of river water by fixing the various factors that affect Gyeongin ARA waterway's water quality through analysis with the Delphi Technique and analytic hierarchy program (AHP) Method. Based on the results, the highest criteria are, in order of importance, physical and environmental factors 28%, administrative factors 26%, natural fixed factors 26% and finally, cultural and social factors 20%. The three dimensions of the criteria show that for the internal physical and environmental factors, the most important are the loss of self-purification capacity, and the external factors are Gulpocheon and the sludge deposit due to Gyulhweon-weir the bridge. The facility factor in management was affected by the coagulation and waste water disposal facilities. The problem for the policy and institutional factors was seen in the regulatory area. The aquatic ecology/ point pollution source for the natural fixed factors show that it is due to the polluted water of Gulpo-cheon and the living environment/ non-point pollution source is shown through the inflow water from other rivers. Cultural and social factors show that the economical causes were due to the cargo and passenger flight operations and the external factors of having a lack of sewage treatment equipment have an importance effect. In order to estimate the order of priority through logical evidence and objectivity, future research must be continued on the evaluation indexes to measure the specific methodology and technique needed to improve the Gyeongin ARA Waterway.

Analysis of Performance on Activities in Critical Pathway of Total Hip Replacement Surgery (고관절 전치환술 환자의 임상관리도 수행 정도)

  • Lim, You Jin;Jeong, Kyung In;Jeong, Ha Yun;Sun, JeongJu;Kim, Yun Kyung;Choi, Ji Kyung;Lee, Kum Lae;Kim, Jeong Suk;Yang, Jin Ju;Kim, Hye Ja;Jang, Keum Seong;Choi, Ja Yun
    • Korean Journal of Adult Nursing
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    • v.18 no.5
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    • pp.819-827
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    • 2006
  • Purposes: The purpose of this study was to evaluate the extent of performance on activities in critical pathway (CP) according to eight domains and six admission days on nursing records of patients who received total hip replacement surgery. Methods: We reviewed 90 nursing records of patients who received total hip replacement surgery from June, 2004 to July, 2005 at C University Hospital. Data were collected using Hong's CP (2002) and were analyzed using ANOVA. Results: The domain of diet was valued the highest in CP performance scoring, followed by the domains of assessment, activities, and test. There were differences in the performance scores according to the period of admission in all of the domains. Among 132 activities in the CP, 18 activities were completely performed, of which most included activities belonging to the domain of assessment on the admission day. Twelve activities were never performed, of which most included activities belonging to the domain of treatment on the day of operation and the first day after operation. Conclusions: Therefore, further studies on the development of a new system to increase CP utilization and on updating the contents of CP from the best practice based on evidence is recommended.

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Predictive Value of Xrcc1 Gene Polymorphisms for Side Effects in Patients undergoing Whole Breast Radiotherapy: a Meta-analysis

  • Xie, Xiao-Xue;Ouyang, Shu-Yu;Jin, He-Kun;Wang, Hui;Zhou, Ju-Mei;Hu, Bing-Qiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6121-6128
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    • 2012
  • Radiation-induced side effects on normal tissue are determined largely by the capacity of cells to repair radiation-induced DNA damage. X-ray repair cross-complementing group 1 (XRCC1) plays an important role in the repair of DNA single-strand breaks. Studies have shown conflicting results regarding the association between XRCC1 gene polymorphisms (Arg399Gln, Arg194Trp, -77T>C and Arg280His) and radiation-induced side effects in patients undergoing whole breast radiotherapy. Therefore, we conducted a meta-analysis to determine the predictive value of XRCC1 gene polymorphisms in this regard. Analysis of the 11 eligible studies comprising 2,199 cases showed that carriers of the XRCC1 399 Gln allele had a higher risk of radiation-induced toxicity than those with the 399 ArgArg genotype in studies based on high-quality genotyping methods [Gln vs. ArgArg: OR, 1.85; 95% CI, 1.20-2.86] or in studies with mixed treatment regimens of radiotherapy alone and in combination with chemotherapy [Gln vs. ArgArg: OR, 1.60; 95% CI, 1.09-2.23]. The XRCC1 Arg399Gln variant allele was associated with mixed acute and late adverse reactions when studies on late toxicity only were excluded [Gln allele vs. Arg allele: OR, 1.22; 95% CI, 1.00-1.49]. In contrast, the XRCC1 Arg280His variant allele was protective against radiation-induced toxicity in studies including patients treated by radiotherapy alone [His allele vs. Arg allele: OR, 0.58; 95% CI, 0.35-0.96]. Our results suggest that XRCC1 399Gln and XRCC1 280Arg may be independent predictors of radiation-induced toxicity in post-surgical breast cancer patients, and the selection of genotyping method is an important factor in determining risk factors. No evidence for any predictive value of XRCC1 Arg194Trp and XRCC1 -77T>C was found. So, larger and well-designed studies might be required to further evaluate the predictive value of XRCC1 gene variation on radiation-induced side effects in patients undergoing whole breast radiotherapy.