• Title/Summary/Keyword: Prospective approach

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Factors Influencing Changes in Quality of Life in Patients undergoing Hematopoietic Stem Cell Transplantation: A Longitudinal and Multilevel Analysis (다층모형을 적용한 조혈모세포이식 환자의 삶의 질 변화 영향요인)

  • Song, Chi Eun;So, Hyang Sook
    • Journal of Korean Academy of Nursing
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    • v.45 no.5
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    • pp.694-703
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    • 2015
  • Purpose: This study was a prospective longitudinal study to identify changes in quality of life in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). It was based on Roy's adaptation model. Methods: The questionnaires were administered before HSCT, 30 and 100 days after HSCT. Of the 48 potentially eligible patients, 44 (91.7%) participated in the study and 40 (90.9%) completed the questionnaires at 100 days after HSCT. Multilevel analysis was applied to analyze changes in quality of life. Results: Overall, quality of life showed a decreasing tendency from pre-HSCT to 100 days after HSCT. The adaptation level of participants was compensatory. Type of conditioning was the significant factor influencing quality of life before HSCT (${\beta}_{00}$=79.92, p <.001; ${\beta}_{01}$= - 12.64, p <.001) and the change rate of quality of life (${\beta}_{10}$= - 1.66, p =.020; ${\beta}_{11}$=2.88, p =.014). Symptom severity (${\beta}_{20}$= - 1.81, p =.004), depression (${\beta}_{30}$= - 0.58, p =.001), social dependency (${\beta}_{40}$= - 0.35, p =.165), and loneliness (${\beta}_{50}$= - 0.23, p =.065) had a negative effect on changes in quality of life. Symptom severity and depression were statistically significant factors influencing changes in quality of life. Conclusion: According to the results of this study, the development of nursing intervention is needed to improve quality of life in patients undergoing allogeneic hematopoietic stem cell transplantation in the early immune reconstruction period. The interventions should include programs to enhance coping capacity and programs to help control symptom severity and depression. Also these interventions need to be started from the beginning of HSCT and a multidisciplinary approach would be helpful.

Association of Human Epidermal Growth Factor Receptor-2 Expression and Clinicopathological Findings in Patients with Colorectal Cancer

  • Karaca, Halit;Deniz, Kemal;Berk, Veli;Inanc, Mevlude;Ozkan, Metin
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6221-6225
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    • 2012
  • Background: To determine the frequency of HER-2 overexpression in colorectal cancer (CRC) patients, and to explore the relationship between clinicopathological prognostic factors and their effects on survival, based on immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH) analysis. Materials and Methods: The study included 80 patients with a histologically proven diagnosis of CRC that received adjuvant FOLFOX-4 chemotherapy at our department between March 2006 and September 2010. Patient data were analyzed retrospectively. Results: The median follow-up period and age of the patients were 24 months and 59 years, respectively. In immunohistochemical staining, 3+ staining was found in 2 patients (2.5%) while 2+ was in 13 (16%). FISH for HER-2 was performed for all of these 15 patients; samples which were 3+ showed positivity but the ones with 2+ were negative. There was no significant correlation between HER-2 expression and age, gender, tumor localization, histological subtype, grade, lymphovascular and perineural invasion, or pTN stage (P>0.05), even when the patients with HER-2 overexpression were analyzed separately. There was also no significant relationship between progression-free survival (PFS) and overall survival (OS), and HER-2 expression, gender, tumor localization, obstruction-perforation, bleeding, histological type, grade, lymphovascular and perineural invasion, or pT staging (P>0.05); however, there was a significant relationship between lymph node involvement, and PFS and OS (P<0.05). Conclusions: Evaluation of HER-2 overexpression in a more comprehensive, multi-center, prospective trial with standardized methods will be an appropriate approach.

Comparison of Pre-Operation Diagnosis of Thyroid Cancer with Fine Needle Aspiration and Core-needle Biopsy: a Meta-analysis

  • Li, Lei;Chen, Bao-Ding;Zhu, Hai-Feng;Wu, Shu;Wei, Da;Zhang, Jian-Quan;Yu, Li
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7187-7193
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    • 2014
  • Background: The aim of this meta-analysis was to compare sensitivities and specificities of fine needle aspiration (FNA) and core needle biopsy (CNB) in the diagnosis of thyroid cancer. Materials and Methods: Articles were screened in Medline, the Cochrane Library, EMBASE and Google Scholar, and subsequently included and excluded based on the patient/problem-intervention-comparison-outcome (PICO) principle. Primary outcome was defined in terms of diagnostic values (sensitivity and specificity) of FNA and CNB for thyroid cancer. Secondary outcome was defined as the accuracy of diagnosis. Compiled FNA and CNB results from the final studies selected as appropriate for meta-analysis were compared with cases for which final pathology diagnoses were available. Statistical analyses were performed for FNA and CNB for all of the selected studies together, and for individual studies using the leave-one-out approach. Results: Article selection and screening yielded five studies for meta-analysis, two of which were prospective and the other three retrospective, for a total of 1,264 patients. Pooled diagnostic sensitivities of FNA and CNB methods were 0.68 and 0.83, respectively, with specificities of 0.93 and 0.94. The areas under the summary ROC curves were 0.905 (${\pm}0.030$) for FNA and 0.745 (${\pm}0.095$) for CNB, with no significant difference between the two. No one study had greater influence than any other on the pooled estimates for diagnostic sensitivity and specificity. Conclusions: FNA and CNB do not differ significantly in sensitivity and specificity for diagnosis of thyroid cancer.

The hidden X suture: a technical note on a novel suture technique for alveolar ridge preservation

  • Park, Jung-Chul;Koo, Ki-Tae;Lim, Hyun-Chang
    • Journal of Periodontal and Implant Science
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    • v.46 no.6
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    • pp.415-425
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    • 2016
  • Purpose: The present study investigated the impact of 2 different suture techniques, the conventional crossed mattress suture (X suture) and the novel hidden X suture, for alveolar ridge preservation (ARP) with an open healing approach. Methods: This study was a prospective randomized controlled clinical trial. Fourteen patients requiring extraction of the maxillary or mandibular posterior teeth were enrolled and allocated into 2 groups. After extraction, demineralized bovine bone matrix mixed with 10% collagen (DBBM-C) was grafted and the socket was covered by porcine collagen membrane in a double-layer fashion. No attempt to obtain primary closure was made. The hidden X suture and conventional X suture techniques were performed in the test and control groups, respectively. Cone-beam computed tomographic (CBCT) images were taken immediately after the graft procedure and before implant surgery 4 months later. Additionally, the change in the mucogingival junction (MGJ) position was measured and was compared after extraction, after suturing, and 4 months after the operation. Results: All sites healed without any complications. Clinical evaluations showed that the MGJ line shifted to the lingual side immediately after the application of the X suture by $1.56{\pm}0.90mm$ in the control group, while the application of the hidden X suture rather pushed the MGJ line slightly to the buccal side by $0.25{\pm}0.66mm$. It was demonstrated that the amount of keratinized tissue (KT) preserved on the buccal side was significantly greater in the hidden X suture group 4 months after the procedure (P<0.05). Radiographic analysis showed that the hidden X suture had a significant effect in preserving horizontal width and minimizing vertical reduction in comparison to X suture (P<0.05). Conclusions: Our study provided clinical and radiographic verification of the efficacy of the hidden X suture in preserving the width of KT and the dimensions of the alveolar ridge after ARP.

Reirradiation with Robotic Stereotactic Body Radiotherapy for Recurrent Nasopharyngeal Carcinoma

  • Dizman, Aysen;Coskun-Breuneval, Mehtap;Altinisik-Inan, Gonca;Olcay, Gokce Kaan;Cetindag, Mehmet Faik;Guney, Yildiz
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3561-3566
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    • 2014
  • Background: Recurrent nasopharyngeal carcinoma (NPC) after previous radiotherapy is challenging. There is no standard approach for salvage treatment. Here we present toxicity and treatment results for recurrent NFC patients who underwent fractionated stereotactic radiotherapy (FSRT) as second line radiotherapy (RT). Materials and Methods: Between April 2009 and July 2012, 24 patients, with a male to female ratio of 3:1, were treated with CykerKnife$^{(R)}$ FSRT for recurrent NFC in our institution. Seven out of 24 patients had metastatic recurrent disease. Median age was 53 years (range, 20-70 years). Initial RT dose was 70Gy. The time period between initial RT and FSRT was a median of 33.2 months. The median prescription dose for FSRT was 30Gy (range, 24-30 Gy) in a median of 5 fractions (range, 4-6). Results: The median follow-up for all patients was 19.5 months (IQR: 12.2.-29.2 months). The locoregional control; progression free survival and overall survival (OS) rates for 1-, 2- and 3-year were 64%, 38%, 21%; 60%, 30%, 17% and 83%, 43%, 31%, respectively. Median OS for the entire cohort was 22 months (95% CI: 16.5-27.5). On multivariate analysis recurrent tumor stage was the only prognostic factor for OS (p=0.004). One patient exhibited grade III temporal lobe necrosis. One died because of grade IV mucositis and overlapping infection. Conclusions: The treatment of recurrent NPC is controversial. Fractionated stereotactic radiotherapy is promising. However, the published trials are heterogeneous with respect to the selection criteria and treatment details. Prospective studies with long term follow-up data are warranted.

A Research on Derivation of Strategic Brain Research Areas by the AHP Approach (AHP를 이용한 뇌융합 전략분야 발굴 연구)

  • Kim, Junhuck;Suh, Dukrok;Choi, Jee Hyun;Kim, Han-Gook
    • The Journal of the Korea Contents Association
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    • v.16 no.4
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    • pp.36-44
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    • 2016
  • This article serves as a guideline to the policy on Korea brain science program. Given limited resources within Korea, setting priorities in brain science topics is important in science policy. In this study, we determined the priorities of important brain science topics based on the frontier properties, innovativeness, and prospective outcome. Firstly, the significant topics were chosen after the interview with the top nationwide brain scientists, which were neuroglia, brain precision medicine, neuromorphic engineering, neuroepigenetics, and brain oscillation. Secondly, the analytic hierarchy process (AHP) survey were conducted to prioritize and assign the important weight for not only the criteria but also the research topics in pair choice evaluation. In regards to the importance among the criteria, prospects of the topic was determined to be the top criterion to ranked criterion to consider in the government investment. The priority of the research topics was determined by the order for the project to be considered in national science policy in a comparative way.

A Study on the Development of Convergence Educational Program for Children - Focus on Convergence hand-on Education between Design and Robot Science - (어린이를 위한 융·복합 디자인 교육 프로그램 개발연구 - 디자인과 로봇공학의 융·복합 체험교육을 중심으로 -)

  • Han, Hae-Ryon;Jo, Hye-Gyeong;Jang, Yon-Hwa;Ban, Ja-Yuen;Lee, Yun-Hee
    • Korean Institute of Interior Design Journal
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    • v.22 no.1
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    • pp.222-230
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    • 2013
  • The convergence progress in science technology and ensuing changes in educational environments require another huge change in education programs in the 21st century defined as a knowledge-based information society. But nowadays, prospective college students are increasingly avoiding natural science and engineering. So, educational fields in korea need suitable convergence educational programs (STEAM: science, technology, engineering, arts, mathematics) for creative competent person who is training and experiencing. In addition, environmental design fields are predicting about spread of Kinetic architecture. Therefore the aim of this study is developing convergence hand-on educational program which is incorporate robot science into environmental design for children. The program and teaching materials were developed by mapping between robot science and environmental design process leading the Design Promote Committee in KIID(Korea Institute of Interior Design) supported research teams in Hansung University. And then, For utility of the program, we had a 3 times of demonstration of empirical education. First, graduate students of design and robot major, and small group of children who are selected, at last, 63 children who are applying the program randomly. For more high quality program, we were conducting survey of post-empirical education evaluation for children and their parents. In conclusion, we found out highly satisfaction of the program those two groups. Also they need more organized places, time, task and so on. And the convergence educational program would develop by systematic approach and empirical research. At last, various and series convergence programs and teaching materials would develop creative competency based for regular and irregular courses of whole educational period.

Comparative Study of Vertical Axillary Muscle Sparing and Posterolateral Thoracotomy (수직액와 근육보존 개흉술과 후측방개흉술의 비교연구)

  • Seong, Suk-Hwan;Won, Tae-Hui
    • Journal of Chest Surgery
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    • v.27 no.12
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    • pp.1008-1014
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    • 1994
  • Increased interest in alternative approach to thoractomy has developed because of the considerable morbidity associated with the standard posterolateral thoracotomy[ST]. Muscle sparing thoracotomy is appeared as excellent alternative because of less postoperative pain and morbidity than standard posterolateral one. Vertical axillary muscle sparing thoracotomy[VM] is the newly revised modified muscle sparing thoracotomy that overcomes the disadvantages of previous lateral muscle sparing thoracotomy such as seroma, cosmetic problems, and need of subcutaneous drains. We conducted a prospective study of 45 consecutive patients to compare postoperative pain, muscle strength of serratus anterior and latissimus dorsi, and range of motion of the shoulder girdle between ST and VM group. There were no difference in preoperative status, surgical procedure, morbidity, mortality and hospital stay between two groups. But there were significant less postoperative narcotics requirements, more preserved latissimus dorsi and serratus anterior muscle strength, nd larger range of motion of shoulder girdle [ especially flexion and internal rotation in VM group. The opening time was prolonged[p<0.01] but closing time was less in VM group [p<0.01]. The sum of opening and closing time was not different in two group. The length of incision line was shorter in VM group. The vertical skin incision was concealed by the upper arm.In conclusion vertical axillary muscle sparing thoracotomy is good alternative for various intrathoracic procedures with less postoperative pain, well preserved muscle strength,increased range of motion of the shoulder girdle and impressive cosmetic outcome.

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Policy Elites' Perception of Health Policy Governance: Findings from In-depth Interviews of Korean New Diagnosis Related Group Payment (정책 전문가의 인식을 통해 본 한국 보건의료정책 거버넌스: 신포괄수가제 사례에 관한 심층면접 결과)

  • Shon, Changwoo;Kwon, Soonman;You, Myoungsoon
    • Health Policy and Management
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    • v.23 no.4
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    • pp.326-342
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    • 2013
  • Background: Engaging and Involving stakeholders who have different interests in changing health care policies are difficult task. As the literature on the governance in Korean health care field is rare, this study aims to provide empirical evidence of 'governing health policy'-the ways health care policy is made, implemented, and evaluated from a political perspective. Methods: The authors of this study conducted interviews with elites in policy and clinical areas, which was considered to be the most effective approach to gather in-depth information about the background of changing payment policy as well as the barriers or contributors for making the policy sustainable. A total of 14 experts (3 government officials, 2 representatives from medical profession, 3 professors form academic field, and 6 healthcare providers from New DRG pilot program hospitals) participated in 2 hour long interviews. Results: There was a perception gap of the feasibility and substantiality of new payment system among elites. The score was higher in government officers than those in scholars or clinical experts. Next, the interviewees indicated that Korean New DRG might not sustain without significant efforts to improving democratic aspects of the governance. It is also notable that all interviewees except healthcare providers provided negative expectation of the contribution of new payment system to increase administration efficiency. For clinical efficiency, every stakeholders perceived there was no increased efficiency after introduction of New DRG payment. Like general perception, there was a wide gap between the perception of stakeholders in quality change after implementing the new payment system. Finally, interview participants negatively assumed about the likelihood of New DRG to remain a case of successful reforms. Conclusion: This study implied the importance of social consensus and the governance of health policy.

Pedagogical Approach of the Nine Chapters on the Mathematical Art and Nam Byung Gil's GuJangSulHae (<구장산술九章算術>과 남병길의 <구장술해九章術解>의 교육적 활용 방안)

  • Jung, Hae-Nam
    • Education of Primary School Mathematics
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    • v.14 no.2
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    • pp.103-116
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    • 2011
  • 'The nine chapters on the mathematical art' has dominated the history of Chinese mathematics. It contains 246 problems and their solutions, which fall into nine categories that are firmly based on practical needs. But it has been greatly by improved by the commentary given Liu Hui and it was transformed from arithmetic text to mathematics. The improved book served as important textbook in China but also the East Asian countries for the past 2000 years. Also It is comparable in significance to Euclid's Elements in the West. In the middle of 19th century, Chosun mathematicians Nam Byung Gil(南秉吉) and Lee Sang Hyuk(李尙爀) studied mathematical structures developed in Song(宋) and Yuan(元) eras on top of their early on 'The nine chapters' and 'ShuLiJingYun(數理精蘊)'. Their studies gave rise to a momentum for a prominent development of Choson mathematics in the century. Nam Byung Gil is also commentator on 'The Nine Chapters'. His commentary is 'GuJangSulHae(九章術解)'. This book provides figures and explanations of how the algorithms work. These are very helpful for prospective elementary teachers. We try to plan programs of elementary teacher education on the basis of 'The Nine Chapters' and 'GuJangSulHae'.