• Title/Summary/Keyword: Prospectively

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A Comparative Study on Clinical Effectiveness of Human Chorionic Gonadotropin and Progesterone on Luteal Support in Controlled Ovarian Hyperstimulatian far IVF (체외수정 시술시 과배란 유도에서 Luteal Phase Support에 Human Chorionic Gonadotropin과 Progesterone의 효용성에 관한 비교 연구)

  • Nah, O-Soon;Lee, Sang-Hoon;Bae, Do-Whan
    • Clinical and Experimental Reproductive Medicine
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    • v.21 no.3
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    • pp.233-240
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    • 1994
  • This study was conducted to compare the endocrine milieu, and pregnancy rates in In Vitro Fertilization and Embryo Transfer(IVF-ET) program employing combined with gonadotropin releasing hormone agonist(GnRH-a) and pergonal(LH 75lU+FSH 75lU) when either human chorionic gonadotropin(HCG) or progesterone were used for luteal phase support. A total number of 40 IVF-ET treatment cycles were prospectively studied. Ovarian hyperstimulation method was modified ultrashort protocol using GnRH-a. All patients started Decapeptyl at menstrual cycle day # 2, and HMG was started at # 3 days. When leading follicle was ${\geqq}$18mm or at least two follicles were ${\geqq}$14mm in diameter, HCG 10000lU intramuscularly was injected. After 36 hours HCG administration, oocytes were retrieved as usual guided by transvaginal ultrasound. Embryo were transfered 36-48 hours later. The patient's cycles were prospectively randomized to receive HCG(20cycles) or Progesterone (20cycles) for luteal support. The progesterone group received 25mg 1M starting from the day of ET. The HCG group received 1500IU 1M. on days 0, +2, +5 after ET. Estadiol($E_2$) and Progesterone($P_4$) were measured on the day of oocyte aspiration, ET day, and every 6 days thereafter. Results were follows as; 1. Estradiol, progesterone and LH levels on the day of HCG trigger, retrieved oocytes and number of transfered embryo were not significantly different in both groups. 2. On the day of aspiration and embryo transfered day, $E_2$, $P_4$ level were significantly higher in progesterone group than HCG group(p<0.01). 3. $E_2$, $P_4$ level on 6 days after ET were significantly higher in progesterone group than HCG group(p<0.01). But, $P_4/E_2$ ratio was not different in both groups. 4. $E_2$, $P_4$ level 12 days after ET were decreased abruptly in both groups and higher hormonal level appeared in HCG group(P<0.01). 5. The total pregnancy rate in the HCG group was 40% (8/20) and in the progesterone group 15%(3/20). 6. Comparing the pregnant and nonpregnant cases progesterone group was not different the hormonal status. In HCG group, pregnant cases appeared in higher $P_4$, $P_4/E_2$ ratio than nonpregnanct cases(P<0.01).

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Two-Dimensional-Shear Wave Elastography with a Propagation Map: Prospective Evaluation of Liver Fibrosis Using Histopathology as the Reference Standard

  • Dong Ho Lee;Eun Sun Lee;Jae Young Lee;Jae Seok Bae;Haeryoung Kim;Kyung Bun Lee;Su Jong Yu;Eun Ju Cho;Jeong-Hoon Lee;Young Youn Cho;Joon Koo Han;Byung Ihn Choi
    • Korean Journal of Radiology
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    • v.21 no.12
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    • pp.1317-1325
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    • 2020
  • Objective: The aim of this study was to prospectively evaluate whether liver stiffness (LS) assessments, obtained by two-dimensional (2D)-shear wave elastography (SWE) with a propagation map, can evaluate liver fibrosis stage using histopathology as the reference standard. Materials and Methods: We prospectively enrolled 123 patients who had undergone percutaneous liver biopsy from two tertiary referral hospitals. All patients underwent 2D-SWE examination prior to biopsy, and LS values (kilopascal [kPa]) were obtained. On histopathologic examination, fibrosis stage (F0-F4) and necroinflammatory activity grade (A0-A4) were assessed. Multivariate linear regression analysis was performed to determine the significant factors affecting the LS value. The diagnostic performance of the LS value for staging fibrosis was assessed using receiver operating characteristic (ROC) analysis, and the optimal cut-off value was determined by the Youden index. Results: Reliable measurements of LS values were obtained in 114 patients (92.7%, 114/123). LS values obtained from 2D-SWE with the propagation map positively correlated with the progression of liver fibrosis reported from histopathology (p < 0.001). According to the multivariate linear regression analysis, fibrosis stage was the only factor significantly associated with LS (p < 0.001). The area under the ROC curve of LS from 2D-SWE with the propagation map was 0.773, 0.865, 0.946, and 0.950 for detecting F ≥ 1, F ≥ 2, F ≥ 3, and F = 4, respectively. The optimal cut-off LS values were 5.4, 7.8, 9.4, and 12.2 kPa for F ≥ 1, F ≥ 2, F ≥ 3, and F = 4, respectively. The corresponding sensitivity and specificity of the LS value for detecting cirrhosis were 90.9% and 88.4%, respectively. Conclusion: The LS value obtained from 2D-SWE with a propagation map provides excellent diagnostic performance in evaluating liver fibrosis stage, determined by histopathology.

Postoperative Delirium in Elderly Patients with Osteoarthritis Surgery: Incidence and Risk Factors (노인 환자의 골관절염 수술 후 발생한 섬망과 섬망 위험요인)

  • Park, Eun A;Kim, Min Young
    • Journal of muscle and joint health
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    • v.22 no.2
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    • pp.57-66
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    • 2015
  • Purpose: The purpose of this study was to evaluate the incidence of postoperative delirium in elderly patients with osteoarthritis surgery and identify risk factors for its development. Methods: This study enrolled 288 patients who underwent osteoarthritis surgery in a hospital between May and November 2014. Data were collected prospectively. The Nursing Delirium Screening Scale was used to detect delirium. Multivariable logistic regression analysis was used to identify independent risk factors for postoperative delirium. Patients were also followed for outcome. Results: Postoperative delirium developed in 42 patients (14.6%). Logistic regression analysis identified old age, low physical activity, antipsychotic agents, number of catheters, and intensive care unit admission as risk factors. Worse outcomes, including increased hospital mortality, reoperation, and discharge at care facilities, occurred in subjects who developed delirium. Conclusion: Osteoarthritis surgery in elderly patients was associated with a high incidence of postoperative delirium. The results of the this study regarding patient populations vulnerable to delirium should be taken into account so that such patients could be identified preoperatively or in the immediate postoperative period.

Identification of Superior Single Nucleotide Polymorphisms (SNP) Combinations Related to Economic Traits by Genotype Matrix Mapping (GMM) in Hanwoo (Korean Cattle)

  • Lee, Yoon-Seok;Oh, Dong-Yep;Lee, Yong-Won;Yeo, Jung-Sou;Lee, Jea-Young
    • Asian-Australasian Journal of Animal Sciences
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    • v.24 no.11
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    • pp.1504-1513
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    • 2011
  • It is important to identify genetic interactions related to human diseases or animal traits. Many linear statistical models have been reported but they did not consider genetic interactions. Genotype matrix mapping (GMM) has been developed to identify genetic interactions. This study uses the GMM method to detect superior SNP combinations of the CCDC158 gene that influences average daily gain, marbling score, cold carcass weight and longissimus muscle dorsi area traits in Hanwoo. We evaluated the statistical significance of the major SNP combinations selected by implementing the permutation test of the F-measure. The effect of g.34425+102 A>T (AA), g.8778G>A (GG) and g.4102+36T>G (GT) SNP combinations produced higher performance of average daily gain, marbling score, cold carcass weight and the longissimus muscle dorsi area traits than the effect of a single SNP. GMM is a fast and reliable method for multiple SNP analysis with potential application in marker-assisted selection. GMM may prospectively be used for genetic assessment of quantitative traits after further development.

The Relationship of Risk Assessment Using Braden Scale and Development of Pressure Sore in Neurologic Intensive Care Unit (Braden scale을 이용한 신경외과 중환자의 욕창 위험 요인 사정과 욕창 발생과의 관계)

  • Lee, Jong-Kyung
    • Korean Journal of Adult Nursing
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    • v.15 no.2
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    • pp.267-277
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    • 2003
  • Purpose: The purpose of this study was to evaluate the applicability of braden scale to assess pressure ulcer risk patients and to identify additional risk factors of pressure sores in an neurologic intensive care unit. Method: The subjects of this study were 66 patients in neurologic intensive care units. Data was prospectively collected from Sep. to Dec., 2002. Data were analyzed by mean, percentage, t-test, chi-square, discriminant analysis using Spss pc+. Result: The results of this study were as follows: 1) There was a significant difference between scoring of braden scale and pressure ulcer development. The subscales that predicted pressure ulcer development using braden scale only were sensory perception, moisture, mobility, friction & shear. By using these subscales, sensitivity was 86.7%, and specificity was 61.1%, and total hit ratio was 72.7%. 2) Additional pressure ulcer risk factors which showed significance for discriminating two group were protein, albumin, gender, level of consciousness, pattern of bowel elimination. By using the combination of these additional risk factors in addition to the braden scale, total hit ratio increased to 84.8%. Conclusion: This data suggest that albumin, protein, gender, level of consciousness, pattern of bowel elimination in addition to the braden scale should be included in the pressure sore assessment tool.

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Musculoskeletal Disorders in Northeast Lobstermen

  • Fulmer, Scott;Buchholz, Bryan;Scribani, Melissa;Jenkins, Paul
    • Safety and Health at Work
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    • v.8 no.3
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    • pp.282-289
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    • 2017
  • Background: The objective of this study was to report on the prevalence of musculoskeletal pain in lobstermen in the northeast USA. Methods: Crews were randomly selected from those licensed to fish in Maine and Massachusetts and followed prospectively. The survey used a Nordic Musculoskeletal Questionnaire format to characterize musculoskeletal disorders. Results: A total of 395 individuals participated. One half of the respondents reported low back pain. Back pain was attributed to or exacerbated by lobstering. Low back pain was prevalent among both captains and sternmen, while sternmen reported more hand/wrist pain than captains. Multiple locations for pain were common in individual participants. Conclusion: Equipment or technology to assist material handling should be a priority, as the body segments with high prevalence of pain (back, hand/wrists, shoulders, knees) are all affected by the repetitive and forceful handling of the lobster traps.

Relationship of Nutritional Status at the Time of Admission to Length of Hospital Stay ( LOS ) and Mortality : A Prospective Study Based on Computerized Nutrition Screening (입원당시의 영양상태가 재원일수와 사망률에 미치는 영향 : 전산영양검색을 이용한 전향적 연구)

  • Kim, Yeong-Hye;Kim, Mi-Gyeong;Seo, Ae-Ri;Lee, Yeon-Mi
    • Journal of the Korean Dietetic Association
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    • v.5 no.1
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    • pp.48-53
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    • 1999
  • This study was prospectively conducted to investigate any relationship of nutritional status at the time of admission to length of hospital stay and mortality. All patients admitted to the Asan Medical Center between October 13 and November 12, 1997 who met the study criteria were included in the study. Patients were classified as Not-at-risk, At-risk Ⅰ or At-risk Ⅱ based on the levels of serum albumin and total lymphocyte count in a computerized nutrition screening program. Sixty three percent of the patients were classified as Not-at-risk Group, 29% as At-risk Group Ⅰ and 8% as At-risk Group Ⅱ. Significant correlation was observed between nutritional status and LOS (P<0.01) as well as mortality rate (P<0.05). The more the patient had the nutritional risk factors, the longer the LOS and the higher the mortality rate were. Further studies have to be done in order to demonstrate cost-effectiveness of medical therapy for the malnourished hospitalized patients.

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Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy as Treatment Options for Peritoneal Metastasis of Advanced Gastric Cancer

  • Kim, Dong-Wook;Park, Dong-Guk;Song, Sanghyun;Jee, Ye Seob
    • Journal of Gastric Cancer
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    • v.18 no.3
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    • pp.296-304
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    • 2018
  • Purpose: This study aimed to examine the outcomes of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal metastasis (PM) of advanced gastric cancer (AGC). Materials and Methods: Between May 2015 and June 2017, 38 CRS and HIPEC procedures were performed in patients with PM of AGC at the Dankook University Hospital. We prospectively collected and analyzed data regarding PM grade, morbidity and mortality rates, and short-term follow-up results (median, 13.5 months). Results: The mean peritoneal cancer index was 15 (range, 0-39). Complete cytoreduction was achieved in 21 patients (55.2%), whereas complications occurred in 16 (42.1%) and 2 (5.7%) patients died. The overall median patient survival time was 19 months. The patients who underwent complete cytoreduction had a median survival time of 26 months, which was significantly longer than the median survival time of 16 months in the patients who did not undergo complete cytoreduction (P=0.006). Conclusions: CRS with HIPEC may have a beneficial effect in patients with PM of AGC. However, the rates of complications and mortality associated with this combined therapeutic approach are high. Therefore, this treatment should be performed only in selected patients by surgeons experienced in the field of gastric cancer with PM.

A Prospective Study of Lumbar Spinal Root Block (요추부 신경근 차단술의 추적조사)

  • Yoo, Byung-Hoon;Kim, Kyung-Tae;Kim, Young-Jin;Song, Chan-Woo;Hong, Kee-Hyek
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.77-81
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    • 1997
  • Background : We studied the effects of lumbar spinal root block (RB) prospectively in 21 patients who had suffered from low back pain with radiating pain even treated epidural steroid injection three times. Method : RB was performed under the fluoroscopic C-arm guide. When the needle was in correct position, we confirmed the needle placement and expected drug spreading by injection of contrast medium ($Isovist^{(R)}$-300, Sobering, Germany). Next 2% mepivacaine 1 ml mixed to 40 mg of Depomedrol was injected. Pain assessment was carried out 7 days after RB by numeric pain score regarding the pain just before RB was 10. Remained pain after RB was graded as excellent; 0-2, good; 3-5, bad; 6-8 and poor 9-10. Results : Mean age of the patients was 52.3 years. 38.1% and 47.6% of the patients showed excellent and goo dresults after RB, respectively. Conclusion : We concluded that RB is easy and safe procedure to perfirm and effective for the treatment of remnant pain following epidural steroid injection, especially in the patients who had spinal stenosis.

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Preservative Effect of Leukocyte-Depleted Blood Cardioplegic Myocardium during Cardiac Surgery

  • Park, Seok-Cheol
    • Biomedical Science Letters
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    • v.7 no.2
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    • pp.91-98
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    • 2001
  • The present study was prospectively designed to assess the clinical effect of leukocyte-depleted blood cardioplegic solution (BCS) on myocardium during cardiac surgery with cardiopulmonary bypass (CPB). 30 adult patients scheduled for elective cardiac surgery were divided into control group (n=15), which infused routine BCS, and leukocyte-depleted (LD) group (n=15), which infused leukocyte-depleted BCS. Total and differential leukocyte counts in BCS, malondialdehyde (MDA) and troponin-T (TnT) concentrations in coronary sinus blood, and cardiac index (CI) were measured at preoperative and postoperative period. The BCS in LD group had less total leukocyte counts with neutropenia than that in control group (P<0.01). MDA (3.70$\pm$0.35 vs 5.90$\pm$0.57 $\mu$mol/L, p<0.05) and TnT (0.42$\pm$0.03 vs 0.60$\pm$0.09 ng/mL, p<0.05) were significantly low in LD group compared with control group, while LD group had higher CI (3.28$\pm$0.16 L/min/$m^2$, p<0.05) than control group (2.69$\pm$0.18 L/min/$m^2$). These results suggest that leukocyte-depleted blood cardioplegic solution has a better myocardial protective effect with less generations of oxygen free radicals and ischemia/reperfusion injury.

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