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Hepatic Re-resection Versus Transarterial Chemoembolization for the Treatment of Recurrent Hepatocellular Carcinoma after Initial Resection: a Systematic Review and Meta-analysis

  • Wang, Di-Ya;Liu, Lei;Qi, Xing-Shun;Su, Chun-Ping;Chen, Xue;Liu, Xu;Chen, Jiang;Li, Hong-Yu;Guo, Xiao-Zhong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5573-5578
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    • 2015
  • Background: A systematic review and meta-analysis were performed to compare the post-recurrence survival with hepatic re-resection versus transarterial chemoembolization (TACE) for recurrent hepatocellular carcinoma (HCC) after initial resection. Materials and Methods: All relevant papers were searched via PubMed, EMBASE, and Cochrane Library databases. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Subgroup analysis was performed according to country. Sensitivity analysis was performed in studies which clearly reported the recurrent regions, in moderate/high-quality studies, in studies published in full-text form, and in studies published after 2005. Results: In total, twelve papers were included in our study. Five and seven of them were of moderate- and poor-quality, respectively. The overall meta-analysis demonstrated a statistically significantly higher post-recurrence survival in the hepatic re-resection group than in those undergoing TACE (HR=0.64, 95%CI=0.52-0.79, P<0.0001). Heterogeneity was statistically significant and statistical significance remained in the subgroup analysis. Sensitivity analyses were also consistent with the overall analysis. Conclusions: Hepatic re-resection might provide a better post-recurrence survival than TACE for recurrent HCC after initial resection. However, considering the low quality of published studies and the potential bias of treatment selection, further randomized trials should be warranted to confirm these findings.

A Study on the Clinical Application of the Exterior-Interior Relationship Between the Heart and Small Intestine -Focusing on Prescriptions for Urine Disorders- (심소장(心小腸) 표리(表裏) 관계의 임상 적용에 대한 고찰 -소변이상 관련 처방을 중심으로-)

  • Ahn, Jinhee
    • Journal of Korean Medical classics
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    • v.33 no.3
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    • pp.1-19
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    • 2020
  • Objectives : The aim of this paper is to examine texts that deal with the clinical application of the exterior-interior relationship between the Heart and Small Intestine. Methods : Texts that apply the Heart and Small Intestine relationship to treating urine disorders were selected and analyzed. Results : The relevance of the Heart-SI relationship to urine disorders was first discussed in the 『Zhubingyuanhoulun(諸病源候論)』, and the theory was finally applied to clinical treatment of urine disorders in the 『Waitaimiyao(外臺秘要)』. Text analysis revealed that Daochisan of the 『Yujiweiyi(玉機微義)』, Daochisan of the 『Yizongjinjian(醫宗金鑑)』, HupoDaochitang of the 『Yichunshengyi(醫醇賸義)』, and Daochiyinjiaweifang of the 『Xuezhenglun(血證論)』 were of Daochisan affiliation, while those that were not of this affiliation were Gandihuangwan of the 『Waitaimiyao(外臺秘要)』, Xijiaotang of the 『Shengjizonglu(聖濟總錄)』 and 『Pujifang(普濟方)』, Rushensan and Xijiaodihuangtang of the 『Qixiaoliangfang(奇效良方)』, and Liangxinlishuitang of the 『Bianzhenglu(辨證錄)』, indicating that the formulas used for treatment were mostly affiliated with Daochisan. When clinically applying the exterior-interior relationship of the Heart and SI to urine disorders, the phenomenon can be most closely matched to the biomedical concept of Overactive Bladder. Discussion : Based on the finding that the formula following the exterior-interior relationship of the Heart and SI was first mentioned in 『Waitaimiyao(外臺秘要)』 published in 752, and was continuously mentioned in the 『Xuezhenglun(血證論)』 which was published in 1884, it is highly probable that the exterior-interior relationship theory of the Heart and SI and its clinical application closely influenced each other.

Effects of lamotrigine on attention-deficit hyperactivity disorder in pediatric epilepsy patients

  • Han, Seung-A;Yang, Eu Jeen;Song, Mi-Kyoung;Kim, Sun Jun
    • Clinical and Experimental Pediatrics
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    • v.60 no.6
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    • pp.189-195
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    • 2017
  • Purpose: The purpose of this study was to investigate the effects of lamotrigine for the treatment of attention-deficit hyperactivity disorder (ADHD) symptoms in children with epilepsy. Methods: Pediatric patients newly diagnosed with epilepsy (n=90 [61 boys and 29 girls]; mean age, $9.1{\pm}3.4years$) were enrolled. All patients were evaluated with the Korean ADHD rating scale (K-ARS)-IV before treatment with lamotrigine and after doses had been administered. The mean interval of ADHD testing was approximately 12.3 months. The initial dosage of lamotrigine was 1 mg/kg/day (maximum 25 mg/day for the first 2 weeks), and increased by 1 mg/kg every 2 weeks until titrated up to 7 mg/kg/day (or maximum 200 mg/day). Results: The mean ADHD test score of the 90 subjects was $17.0{\pm}1.8$ at baseline. It was slightly reduced to $15.6{\pm}1.7$ after lamotrigine monotherapy (P>0.01). Prior to treatment, a total of 31 patients (34.4%) met the diagnostic criteria for ADHD according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, Of these 31 patients, 27 (87.1%) had significantly improved ADHD scores with lamotrigine monotherapy ($28.0{\pm}1.6$ reduced to $18.1{\pm}2.6$, P<0.001). Among these 27 patients, 25 (92.6%) showed normalized electroencephalogram (EEG) and 26 (96.3%) achieved total freedom from seizures within 12 months of the initiation of lamotrigine monotherapy. Conclusion: The results from our study show that lamotrigine had a positive effect in pediatric epilepsy patients by reducing ADHD symptoms, preventing seizures, and normalizing EEG. However, further research is required to determine whether lamotrigine is efficacious against ADHD symptoms independent of its effects on epileptic seizures.

Development of Monte Carlo Simulation Code for the Dose Calculation of the Stereotactic Radiosurgery (뇌 정위 방사선수술의 선량 계산을 위한 몬테카를로 시뮬레이션 코드 개발)

  • Kang, Jeongku;Lee, Dong Joon
    • Progress in Medical Physics
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    • v.23 no.4
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    • pp.303-308
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    • 2012
  • The Geant4 based Monte Carlo code for the application of stereotactic radiosurgery was developed. The probability density function and cumulative density function to determine the incident photon energy were calculated from pre-calculated energy spectrum for the linac by multiplying the weighting factors corresponding to the energy bins. The messenger class to transfer the various MLC fields generated by the planning system was used. The rotation matrix of rotateX and rotateY were used for simulating gantry and table rotation respectively. We construct accelerator world and phantom world in the main world coordinate to rotate accelerator and phantom world independently. We used dicomHandler class object to convert from the dicom binary file to the text file which contains the matrix number, pixel size, pixel's HU, bit size, padding value and high bits order. We reconstruct this class object to work fine. We also reconstruct the PrimaryGeneratorAction class to speed up the calculation time. because of the huge calculation time we discard search process of the ThitsMap and used direct access method from the first to the last element to produce the result files.

History of nursing and medicine as phenomena of knowledge/power (지식/권력의 현상으로 본 간호와 의학사)

  • Kim, Nam-Sun;Hong, Yoon-Mi;Lee, Kyu-Eun
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.3
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    • pp.373-380
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    • 2002
  • Purpose : The purpose of this study is to analyze the history of nursing and medicine as phenomena of knowledge/power from the viewpoint of Foucault. Method : The present study adopts the genealogical method by Foucault, which tries to unite languages and knowledge. Foucault who attempted to show that the basic ideas which people normally take to be permanent truths about human nature and society change in the course of history. Results : It has been emphasized that the development of modern health care has been due to the progressive efforts of medicine and to medical discoveries. Foucault examines the institutionalization of knowledge and the power exerted thereby, with special reference to the devices of social regulation and their function over the madness, the disease, the crime, and the sexuality. The concept of power is that it is exerted spontaneously in verbal behaviors of individuals through knowledge of everyday life such as definition of body or mind. Therefore as to the problem of knowledge/power, this study tries to understand the meaning of history of nursing and medicine through an analysis of the formation of text of history. In order to have authority in a power relation, the medical professional asserts that medical discourse is the most scientific knowledge. Conclusion : According to the above findings, it can be concluded that the body is also directly invested in a political field: power relations have an immediate hold upon it; they invest it, mark it, train it, torture it, force it to carry out tasks, to perform ceremonies, to emit signs. Therefore the devaluation of nursing care is reinforced by the medicine which has the legitimate authority through use of the political skills about the body.

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Disaster Health Literacy of Middle-aged Women

  • Seifi, Bahar;Ghanizadeh, Ghader;Seyedin, Hesam
    • Journal of Menopausal Medicine
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    • v.24 no.3
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    • pp.150-154
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    • 2018
  • As disasters have been increasing in recent years, disaster health literacy is gaining more important for a population such as middle-age women. This is because they face developmental crises (menopause) and situational crisis (disaster). Due to the growing elderly population, it is imperative to seriously consider the issue of aging women's healthcare, and their educational needs relative to emergencies and disasters. The purpose of study was to clarify the importance of disaster health literacy for middle-age women. This study is a review of the literature using PubMed, ScienceDirect, Web of Science, Google Scholar, SCOPUS, OVID, ProQuest, Springer, and Wiley. Data was collected with keywords related to the research topic ("Women's health" OR "Geriatric health") AND ("Health literacy" OR "Disaster health literacy" OR "Disaster prevention literacy" OR "Risk knowledge" OR "Knowledge management") AND ("Disasters" OR "Risk" OR "Crises") in combination with the Boolean-operators OR and AND. We reviewed full text English-language articles published November 2011 November 2017. Additional references were identified from reference lists in targeted publications, review articles and books. This review demonstrated that disaster health literacy is critical for elderly women, because they may suffer from physical and psychological problems triggered by developmental crises such as menopause and situational crises such as disasters. Disaster literacy could enable them to improve resiliency and reduce disaster risk. Education has vital role in health promotion of middle-age women. Policymakers and health managers should be aware of the challenges of elderly women as a vulnerable group in disasters and develop plans to incorporate disaster health literacy for preparedness and prevention in educating this group.

Research on the type of technology convergence in the medical device industry based on topic modeling and citation analysis (토픽모델링과 인용 분석에 기반한 의료기기 산업의 기술융합 유형 연구)

  • Lee, Seonjae;Lee, Sungjoo;Seol, Hyeonju
    • Journal of the Korea Convergence Society
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    • v.12 no.7
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    • pp.207-220
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    • 2021
  • Industrial convergence is manifested in various forms by various drivers, and understanding and categorizing the direction of convergence according to the factors in which the convergence occurs is an essential requirement for the establishment of a company's customized convergence strategy and the government's corporate support policy. In this study, the type of convergence is analyzed from the perspective of knowledge flow between heterogeneous technologies, and for this purpose, the result of topic modeling of the text information of the patent and the citation information of the corresponding patent allocated for each topic are used. The methodology presented through case studies in the medical device field is verified. Through the proposed methodology, companies can predict the flow of convergence and use it as decision-making data to create new business opportunities. It is expected that the government and research institutions will be usefully used as basic data for policy preparation.

Topic Modeling and Keyword Network Analysis of News Articles Related to Nurses before and after "the Thanks to You Challenge" during the COVID-19 Pandemic (COVID-19 '덕분에 챌린지' 전후 간호사 관련 뉴스 기사의 토픽 모델링 및 키워드 네트워크 분석)

  • Yun, Eun Kyoung;Kim, Jung Ok;Byun, Hye Min;Lee, Guk Geun
    • Journal of Korean Academy of Nursing
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    • v.51 no.4
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    • pp.442-453
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    • 2021
  • Purpose: This study was conducted to assess public awareness and policy challenges faced by practicing nurses. Methods: After collecting nurse-related news articles published before and after 'the Thanks to You Challenge' campaign (between December 31, 2019, and July 15, 2020), keywords were extracted via preprocessing. A three-step method keyword analysis, latent Dirichlet allocation topic modeling, and keyword network analysis was used to examine the text and the structure of the selected news articles. Results: Top 30 keywords with similar occurrences were collected before and after the campaign. The five dominant topics before the campaign were: pandemic, infection of medical staff, local transmission, medical resources, and return of overseas Koreans. After the campaign, the topics 'infection of medical staff' and 'return of overseas Koreans' disappeared, but 'the Thanks to You Challenge' emerged as a dominant topic. A keyword network analysis revealed that the word of nurse was linked with keywords like thanks and campaign, through the word of sacrifice. These words formed interrelated domains of 'the Thanks to You Challenge' topic. Conclusion: The findings of this study can provide useful information for understanding various issues and social perspectives on COVID-19 nursing. The major themes of news reports lagged behind the real problems faced by nurses in COVID-19 crisis. While the press tends to focus on heroism and whole society, issues and policies mutually beneficial to public and nursing need to be further explored and enhanced by nurses.

Keyword Network Analysis and Topic Modeling of News Articles Related to Artificial Intelligence and Nursing (인공지능과 간호에 관한 언론보도 기사의 키워드 네트워크 분석 및 토픽 모델링)

  • Ha, Ju-Young;Park, Hyo-Jin
    • Journal of Korean Academy of Nursing
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    • v.53 no.1
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    • pp.55-68
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    • 2023
  • Purpose: The purpose of this study was to identify the main keywords, network properties, and main topics of news articles related to artificial intelligence technology in the field of nursing. Methods: After collecting artificial intelligence-and nursing-related news articles published between January 1, 1991, and July 24, 2022, keywords were extracted via preprocessing. A total of 3,267 articles were searched, and 2,996 were used for the final analysis. Text network analysis and topic modeling were performed using NetMiner 4.4. Results: As a result of analyzing the frequency of appearance, the keywords used most frequently were education, medical robot, telecom, dementia, and the older adults living alone. Keyword network analysis revealed the following results: a density of 0.002, an average degree of 8.79, and an average distance of 2.43; the central keywords identified were 'education,' 'medical robot,' and 'fourth industry.' Five topics were derived from news articles related to artificial intelligence and nursing: 'Artificial intelligence nursing research and development in the health and medical field,' 'Education using artificial intelligence for children and youth care,' 'Nursing robot for older adults care,' 'Community care policy and artificial intelligence,' and 'Smart care technology in an aging society.' Conclusion: The use of artificial intelligence may be helpful among the local community, older adult, children, and adolescents. In particular, health management using artificial intelligence is indispensable now that we are facing a super-aging society. In the future, studies on nursing intervention and development of nursing programs using artificial intelligence should be conducted.

Trends in Research on Patients With COVID-19 in Korean Medical Journals

  • Heejeong Choi;Seunggwan Song;Heesang Ahn;Hyobean Yang;Hyeonseong Lim;Yohan Park;Juhyun Kim;Hongju Yong;Minseok Yoon;Mi Ah Han
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.1
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    • pp.47-54
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    • 2024
  • Objectives: This study was conducted to systematically summarize trends in research concerning patients with coronavirus disease 2019 (COVID-19) as reported in Korean medical journals. Methods: We performed a literature search of KoreaMed from January 2020 to September 2022. We included only primary studies of patients with COVID-19. Two reviewers screened titles and abstracts, then performed full-text screening, both independently and in duplicate. We first identified the 5 journals with the greatest numbers of eligible publications, then extracted data pertaining to the general characteristics, study population attributes, and research features of papers published in these journals. Results: Our analysis encompassed 142 primary studies. Of these, approximately 41.0% reported a funding source, while 3.5% disclosed a conflict of interest. In 2020, 42.9% of studies included fewer than 10 participants; however, by 2022, the proportion of studies with over 200 participants had increased to 40.6%. The most common design was the cohort study (48.6%), followed by case reports/series (35.2%). Only 3 randomized controlled trials were identified. Studies most frequently focused on prognosis (58.5%), followed by therapy/intervention (20.4%). Regarding the type of intervention/exposure, therapeutic clinical interventions comprised 26.1%, while studies of morbidity accounted for 13.4%. As for the outcomes measured, 50.7% of studies assessed symptoms/clinical status/improvement, and 14.1% evaluated mortality. Conclusions: Employing a systematic approach, we examined the characteristics of research involving patients with COVID-19 that was published in Korean medical journals from 2020 onward. Subsequent research should assess not only publication trends over a longer timeframe but also the quality of evidence provided.