• Title/Summary/Keyword: Multicenter study

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Clinical manifestations patterns of allergic disease in Korean children under the age of 6 : multi-center study (다 기관 설문 조사를 통한 알레르기 질환의 연령별 임상 양상)

  • Kim, Dong Il;Yang, Hyeon Jong;Park, Young Mean;Rha, Yeong Ho;Choung, Ji Tai;Pyun, Bok Yang
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.640-645
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    • 2008
  • Purpose : It is widely known that allergic diseases progress through an allergic march. However, there have not been any recent reports in Korea on how the diseases progress. Methods : Parents who visited one of the Pediatric Allergy Clinics of four university hospitals in Seoul with a child under the age of 6 years during the period from May 1-30, 2006 were asked to complete a questionnaire. Results : A total of 229 parents answered the questionnaire about their children, of which 122 were male and 107 were female. The most common allergic disease before 2 years of age was atopic dermatitis (79%). Meanwhile, in 2- to 4-year age group, allergic rhinitis (38%) and asthma (37%) were predominant. The most common allergic disease in the 4- to 6-year age group was asthma (72%), followed by allergic rhinitis (64%). Seventy-three percent of the children had a family history of allergic disease, most often in the fathers (39%). Among patients with allergic rhinitis, 50% had experienced asthma in their earlier days and 30% had experienced atopic dermatitis. In addition, 57% of the children with asthma had suffered from atopic dermatitis. Parents believed that asthma was the most serious allergic disease. Conclusion : In the present study, allergic disease showed a tendency to march from atopic dermatitis to asthma and then to allergic rhinitis. Early diagnosis and treatment of atopic dermatitis is, therefore, considered important for prevention of the allergic march.

The Clinical Interchange between Western Medicine and Oriental Medicine: with the Stroke Patient Outcomes Research (일부 한.양방병원 뇌혈관질환 환자의 진료결과 및 만족도의 비교연구 -한양방협진 진료프로토콜의 적용을 중심으로-)

  • Park, Jong-Ku;Kang, Myung-Guen;Lee, Seong-Soo;Kim, Dal-Rae;Choi, Seo-Young;Han, Chang-Ho;Yoo, Jun-Sang;Kim, Min-Gi;Kim, Chun-Bae
    • The Journal of Internal Korean Medicine
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    • v.22 no.4
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    • pp.691-702
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    • 2001
  • Objectives : This study was done to assess the effects of the clinical interchange between the Western Medicine and the Oriental Medicine for ischemic stroke patients. The patient outcomes include changes in neurologic function by modified NIH stoke scale, stroke pattern identification scale, and patient satisfaction, Methods : For the assessment of effects, this study was performed with 178 inpatients who had undergone the stroke care at three hospitals (W Hospital adopted western therapy, S Oriental Hospital adopted Sasang constitution medicine therapy, and H Oriental Hospital adopted mixed therapy according to a joint protocol on Western Oriental medical care) from November 1997 to December 1998. Patients were interviewed or written with self-entered questionnaire forms, and clinical data were obtained, Physicians or oriental doctors wrote clinical questionnaire forms according to the care process. Results : The patient outcomes within three hospitals at 2 stages (at admission and discharge in the modified NIH stroke scale. at admission and second weeks during admission in the stroke pattern identification scale) were found to be decreased, Especially in the results of hierarchical multiple regression analysis, the degree of improvement of modified NIH stroke scale of the stroke patients at W Hospital was significant large than it at S Oriental Hospital. Also, the degree of improvement of stroke pattern identification scale at W Hospital was significantly large than it at other two hospitals. However, the patient's satisfaction score at three hospitals wasn't significantly different. Conclusions : The result of this study suggested that the joint clinical research of Western & Oriental medical practitioners was possible even if there was a conflict between Western Medicine and Oriental Medicine. Therefore Western & Oriental medical practitioners share a mutual responsibility to apply evidence-based practice, to seek scientific empirical proof through randomized clinical trials between the multicenter.

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Multicenter Epidemiologic Study on Hepatocellular Carcinoma in Turkey

  • Can, Alper;Dogan, Erkan;Bayoglu, Ibrahim Vedat;Tatli, Ali Murat;Besiroglu, Mehmet;Kocer, Murat;Dulger, Ahmet Cumhur;Uyeturk, Ummugul;Kivrak, Derya;Orakci, Zuat;Bal, Oznur;Kacan, Turgut;Olmez, Sehmus;Turan, Nedim;Ozbay, Mehmet Fatih;Alacacioglu, Ahmet
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2923-2927
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    • 2014
  • Background: Hepatocellular cancer (HCC) is one of the important health problems in Turkey, being very common and highly lethal. The aim of this study was to determine clinical, demographic features and risk factors. Materials and Methods: Nine hundred and sixth-three patients with HCC from 13 cities in Turkey were included in this study. Results: Only 205 (21%) of the 963 patients were women, with a male:female predominance of 4.8:1 and a median age of 61 years. The etiologic risk factors for HCC were hepatitis B in 555 patients (57.6%), 453 (81%) in men, and 102 (19%) in women, again with male predominance, hepatitis C in 159 (16.5%), (14.9% and 22.4%, with a higher incidence in women), and chronic alcohol abuse (more than ten years) in 137 (14.2%) (16.8% and 4.9%, higher in males). The Child-Pugh score paralleled with advanced disease stage amd also a high level of AFP. Conclusions: According to our findings the viral etiology (hepatitis B and hepatitis C infections) in the Turkish population was the most important factor in HCC development, with alcohol abuse as the third risk factor. The Child-Pugh classification and AFP levels were determined to be important prognostic factors in HCC patients.

Clinicopathological Features of Patients with Malignant Mesothelioma in a Multicenter, Case-Control Study: No Role for ABO-Rh Blood Groups

  • Utkan, Gungor;Urun, Yuksel;Cangir, Ayten Kayi;Kilic, Dalokay;Ozdemir, Nuriye Yildirim;Oztuna, Derya Gokmen;Bulut, Erhan;Arslan, Ulku Yalcintas;Kocer, Murat;Kavukcu, Sevket;Icli, Fikri
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.249-253
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    • 2013
  • Background: Malignant mesothelioma (MM) is an aggressive tumor of mesothelial surfaces. Previous studies have observed an association between ABO blood groups and risk of certain malignancies, including pancreatic and gastric cancer; however, no information on any association with MM risk is available. The aim of this study was to investigate possible associations amoong MM clinicopathological features and ABO blood groups and Rh factor. Materials and Methods: In 252 patients with MM, the ABO blood group and Rh factor were examined and compared with the control group of 3,022,883 healthy volunteer blood donors of Turkish Red Crescent between 2004 and 2011. The relationship of blood groups with various clinicopathological features were also evaluated in the patient group. Results: The median age was 55 (range: 27-86) and 61.5% of patients were male. While 82.8% of patients had a history of exposure to asbestos, 60.7% of patients had a smoking history. Epithelioid (65.1%) was the most common histology and 18.7% of patients had mixed histology. Overall, the ABO blood group distribution of the 252 patients with MM was comparable with the general population. The median overall survival (OS) was 14 months (95% confidence interval, 11.3-16.6 months). The median OS for A, B, AB, and O were 11, 15, 16, and 15 months respectively (p=0.396). First line chemotherapy was administered to 118 patients. The median OS of patients on pemetrexed or gemcitabine was longer than patient who was not administered chemotherapy [17 months (95%CI, 11.7-22.2) vs. 9 months (95%CI, 6.9-11.0); p<0.001]. Conclusions: The results of this study suggest that patients with MM can benefit from treatment with pemetrexed or gemcitabine in combination with cisplatin. We did not observe a statistically significant association between ABO blood group and risk of MM.

The efficacy and safety of Montelukast sodium in the prevention of bronchopulmonary dysplasia

  • Kim, Sang Bum;Lee, Jang Hoon;Lee, Juyoung;Shin, Seung Han;Eun, Ho Sun;Lee, Soon Min;Sohn, Jin A;Kim, Han Suk;Choi, Byung Min;Park, Min Soo;Park, Kook In;Namgung, Ran;Park, Moon Sung
    • Clinical and Experimental Pediatrics
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    • v.58 no.9
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    • pp.347-353
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    • 2015
  • Purpose: The purpose of this study was to evaluate the efficacy and safety of Montelukast sodium in the prevention of bronchopulmonarydysplasia (BPD). Methods: The Interventional study was designed as a multicenter, prospective, and randomized trial, with open labeled and parallel-experimental groups, 66 infants were enrolled and allocated to either the case group (n=30) or the control group (n=36) based on gestational age (GA). Infants in the case group were given Montelukast sodium (Singulair) based on their body weight (BW). Zero week was defined as the start time of the study. Results: The incidence of moderate to severe BPD was not different between the groups (case group: 13 of 30 [43.3%] vs. control group: 19 of 36 [52.8%], P=0.912). Additionally, secondary outcomes such as ventilation index, mean airway pressure and resort to systemic steroids were not significantly different. There were no serious adverse drug reactions in either group, and furthermore the rate of occurrence of mild drug related-events were not significantly different (case group: 10 of 42 [23.8%] vs. control group: 6 of 48 (15.8%), P=0.414). Conclusion: Montelukast was not effective in reducing moderate or severe BPD. There were no significant adverse drug events associated with Montelukast treatment.

Score System for Operative Risk Evaluation in Coronary Artery Bypass Surgery (관상동맥 우회로술의 수술 위험인자에 대한 스코어 시스템)

  • Kang Joon-Kyu;Kim Chong-Wook;Sheen Seung-Soo;Chung Cheol-Hyun;Lee Jae-Won;Song Meong-Gun;Lee Jung-Sook;Song Hyun
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.749-753
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    • 2006
  • Background: The purpose of this study is to assess a score system for operative risk evaluation of CABG. Material and Method: From January 2001 to September 2005, retrospective study for various perioperative factors of 2993 cases was done. Result: The early operative mortality was 2.4% and the beta coefficients of 7 core variables related to it (preoperative LV dysfuction, preoperative renal failure, MI within 1 week, reoperation, combined surgery, preoperative atrial fibrillation, preoperative IABP) were adjusted to score system. ROC curve and Hosmer and Lemeshow goodness of fit test was done. Conclusion: This score system was effective in assessing operative risk of CABG. But It is necessary to gather larger volume of case and perform multicenter study.

Prospective Multicenter Study of the Challenges Inherent in Using Large Cell-Type Stents for Bilateral Stent-in-Stent Placement in Patients with Inoperable Malignant Hilar Biliary Obstruction

  • Yang, Min Jae;Kim, Jin Hong;Hwang, Jae Chul;Yoo, Byung Moo;Lee, Sang Hyub;Ryu, Ji Kon;Kim, Yong-Tae;Woo, Sang Myung;Lee, Woo Jin;Jeong, Seok;Lee, Don Haeng
    • Gut and Liver
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    • v.12 no.6
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    • pp.722-727
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    • 2018
  • Background/Aims: Although endoscopic bilateral stent-instent placement is challenging, many recent studies have reported promising outcomes regarding technical success and endoscopic re-intervention. This study aimed to evaluate the technical accessibility of stent-in-stent placement using large cell-type stents in patients with inoperable malignant hilar biliary obstruction. Methods: Forty-three patients with inoperable malignant hilar biliary obstruction from four academic centers were prospectively enrolled from March 2013 to June 2015. Results: Bilateral stent-in-stent placement using two large cell-type stents was successfully performed in 88.4% of the patients (38/43). In four of the five cases with technical failure, the delivery sheath of the second stent became caught in the hook-cross-type vertex of the large cell of the first stent, and subsequent attempts to pass a guidewire and stent assembly through the mesh failed. Functional success was achieved in all cases of technical success. Stent occlusion occurred in 63.2% of the patients (24/38), with a median patient survival of 300 days. The median stent patency was 198 days. The stent patency rate was 82.9%, 63.1%, and 32.1% at 3, 6, and 12 months postoperatively, respectively. Endoscopic re-intervention was performed in 14 patients, whereas 10 underwent percutaneous drainage. Conclusions: Large cell-type stents for endoscopic bilateral stent-in-stent placement had acceptable functional success and stent patency when technically successful. However, the technical difficulty associated with the entanglement of the second stent delivery sheath in the hook-cross-type vertex of the first stent may preclude large cell-type stents from being considered as a dedicated standard tool for stent-in-stent placement.

Efficacy and safety of vitamin D3 B.O.N intramuscular injection in Korean adults with vitamin D deficiency

  • Choi, Han Seok;Chung, Yoon-Sok;Choi, Yong Jun;Seo, Da Hea;Lim, Sung-Kil
    • Osteoporosis and Sarcopenia
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    • v.2 no.4
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    • pp.228-237
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    • 2016
  • Objective: There has been no prospective study that examined intramuscular injection of high-dose vitamin D in Korean adults. The aim of this study was to assess the efficacy and safety of high-dose vitamin $D_3$ after intramuscular injection in Korean adults with vitamin D deficiency. Method: This study was a 24-week, prospective, multicenter, randomized, double-blind, placebo-controlled trial. A total of 84 subjects ${\geq}19$ and <65 years of age were randomly allocated to either the vitamin $D_3$ or placebo group in a 2:1 ratio. After randomization, a single injection of plain vitamin $D_3$ 200,000 IU or placebo was intramuscularly administered. If serum 25-hydroxyvitamin D (25[OH]D) concentrations were <30 ng/mLon week 12 or thereafter, a repeat injection was administered. Results: After a single intramuscular injection of vitamin $D_3$ to adults with vitamin D deficiency, the proportion of subjects with serum 25(OH)D concentrations ${\geq}30ng/mL$ within 12 weeks was 46.4% in the vitamin $D_3$ group and 3.6% in the placebo group (p<0.0001). The proportion of subjects with serum 25(OH)D concentrations ${\geq}30ng/mL$ within 24 weeks was 73.2% in the vitamin $D_3$ group and 3.6% in the placebo group (p<0.0001). Mean change in serum 25(OH)D concentrations at weeks 12 and 24 after vitamin $D_3$ injection was $12.8{\pm}8.1$ and $21.5{\pm}8.1ng/mL$, respectively, in the vitamin $D_3$ group, with no significant changes in the placebo group. Serum parathyroid hormone concentrations showed a significant decrease in the vitamin $D_3$ group but no change in the placebo group. Conclusion: Intramuscular injection of vitamin $D_3$ 200,000 IU was superior to placebo in terms of its impact on serum 25(OH)D concentrations, and is considered to be safe and effective in Korean adults with vitamin D deficiency.

Effects of Beraprost Sodium Evaluated by Digital Infrared Thermal Imaging in Diabetic Patients with Peripheral Arterial Disease (당뇨병성 말초혈관병증 환자에게 Beraprost Sodium이 미치는 영향에 대한 적외선 체열검사를 통한 연구)

  • Park, Hyun Woo;Soh, Jae Wan;Park, Seong Hyeon;Jeong, Jae Jung
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.3
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    • pp.105-110
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    • 2018
  • Purpose: This study examined the effects of beraprost sodium on digital infrared thermal images in patients with peripheral arterial disease caused by type 2 diabetes mellitus. Materials and Methods: Twenty-five diabetic patients with peripheral arterial disease were treated with beraprost sodium in a prospective, multicenter, cohort study from February 2013 to December 2014. Beraprost sodium ($40{\mu}g$) was administered orally 3 times daily ($120{\mu}g/day$) for 6 months. The visual analogue scale (VAS) and digital infrared thermal imaging (DITI) were performed to compare the blood flow improvement between before and after dosing. Results: Among the 25 patients included in the evaluation, 22 patients completed the study. A significant increase in body temperature was observed in the front and left side, particularly in the plantar side in DITI compared to that before and after administration. An increase in body temperature was observed at the frontal part from $28.1^{\circ}C{\pm}2.3^{\circ}C$ to $29.1^{\circ}C{\pm}2.1^{\circ}C$ (p=0.021), at the left side from $27.8^{\circ}C{\pm}2.4^{\circ}C$ to $28.6^{\circ}C{\pm}1.9^{\circ}C$ (p=0.028), at the plantar part at $24.0^{\circ}C{\pm}1.5^{\circ}C$, and at the plantar part at $27.1^{\circ}C{\pm}2.4^{\circ}C$ (p<0.01). The VAS decreased significantly from $5.4{\pm}1.3$ to $2.7{\pm}2.0$ after 6 months of treatment (p<0.01). Conclusion: Beraprost sodium is a safe and easy-to use oral medication for diabetes peripheral arterial disease. It can be expected to increase the blood flow and decrease the lower extremity pain statistically after being taken for 6 months.

Calcific tendinitis of the shoulder in the Korean population: demographics and its relation with coexisting rotator cuff tear

  • Yoo, Yon-Sik;Park, Jin-Young;Kim, Myung-sun;Cho, Nam-Su;Lee, Yong-Beom;Cho, Seung-Hyun;Park, Kyoung Jin;Cho, Chul-Hyun;Lee, Bong Gun;Shin, Dong Joo;Kim, Han-Hoon;Lim, Tae Kang
    • Clinics in Shoulder and Elbow
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    • v.24 no.1
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    • pp.21-26
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    • 2021
  • Background: To evaluate the demographics, clinical and radiographic features of calcific tendinitis of the shoulder in the Korean population, specifically focusing on the incidence of coexisting rotator cuff tear. Methods: Between October 2014 and January 2015, we performed a prospective multicenter study with 506 patients from 11 training hospitals in Korea. We collected data of demographics and radiographic analysis based on simple radiographs, clinical assessments based on visual analog scale (VAS) and the American Shoulder Elbow Surgeons (ASES) score, and treatment modalities that are used currently. We also evaluated coexisting rotator cuff tear by ultrasonography (US) or magnetic resonance imaging (MRI) images. Results: There were 402 female patients (79%) with mean age of 55 years (range, 31-87 years). Mean duration of symptoms was 16 months. Mean size of calcific materials was 11.4 mm (range, 0-35 mm). Mean value of VAS and ASES scores were 6.5 (range, 1-10) and 47 (range, 8-95), respectively. Of 383 patients (76%), 59 (15%) had rotator cuff tear including 15 full-thickness tears on US or MRI. Patients with rotator cuff tears were significantly associated with older age, recurrent symptoms, menstrual disorders in females, and having undergone calcification removal surgery and rotator cuff repair (all p<0.05). Conclusions: This study reported demographic, radiographic, and clinical features of calcific tendinitis of the shoulder in Korean population, which were not different from those of Western population. Coexisting rotator cuff tear was found with 15% incidence in this large series, suggesting that further radiographic study to evaluate rotator cuff tear might be needed in some calcific tendinitis patients of older age and presenting with recurrent symptoms.