Recently, along with technology development of endoscopic equipment, the stent technology has been developed for the convenience of operation, shortening of recovery times, and reduction of patient's pain. In this study, paclitaxel-eluting metal stents for treatment of biliary benign stenosis were developed through an electrospray-coating method. Polyether-based polyurethane (PELLETHANE 2363-80AE$^{(R)}$)) and paclitaxel were coated onto the surface of a metallic stent and Pluronic F127 was used as an additive. As a result, physicochemical characterization of paclitaxel via SEM, FTIR, contact angle and XRD techniques revealed the information of solid state of paclitaxel-loaded PU film. The in vitro release profile showed a slower release rate with a higher content of paclitaxel.
Background: Breast cancer is the most common type of cancer amongst women throughout the world. Currently, there are various follow-up strategies implemented in Iran, which are usually dependent on clinic policies and agreement among the resident oncologists. Purpose: A cost-effectiveness analysis was performed to assess the cost-effectiveness of intensive follow-up versus standard models for early breast cancer patients in Iran. Materials and methods: This cross sectional study was performed with 382 patients each in the intensive and standard groups. Costs were identified and measured from a payer perspective, including direct medical outlay. To assess the effectiveness of the two follow-up models we used a decision tree along with indicators of detection of recurrence and metastasis, calculating expected costs and effectiveness for both cases; in addition, incremental cost-effectiveness ratios were determined. Results: The results of decision tree showed expected case detection rates of 0.137 and 0.018 and expected costs of US$24,494.62 and US$6,859.27, respectively, for the intensive and standard follow-up models. Tornado diagrams revealed the highest sensitivity to cost increases using the intensive follow-up model with an ICER=US$148,196.2. Conclusion: Overall, the results showed that the intensive follow-up method is not cost-effective when compared to the standard model.
Objectives: In women, breast cancer is the most common cancer and the leading cause of cancer death. Screening tests are the basis for early diagnosis. In Iranian women, the mortality rate of breast cancer is high due to insufficient screening examinations and delayed visits for care. Therefore, this study aimed to determine the factors affecting breast self-examinations among Iranian women employed in medical careers. Methods: This cross-sectional study included 501 women working in the medical professions at Hamadan University of Medical Sciences in western Iran in 2018. The subjects were selected by stratified random sampling. Data were collected using a researcher-developed, self-report questionnaire that contained demographic information and questions based on protection motivation theory and social support theory. Descriptive data analysis was conducted using SPSS version 23 and model fitting with PLS version 2. Results: The mean age of the participants was $37.1{\pm}8.3years$, and most of the women (80.4%) were married. Most women had a bachelor's degree (67.5%). The findings of this study showed that the coping appraisal construct was a predictor of protection motivation (${\beta}=0.380$, p<0.05), and protection motivation (${\beta}=0.604$, p<0.05) was a predictor of breast self-examination behavior. Additionally, social support theory (${\beta}=0.202$, p<0.05) had a significant positive effect on breast self-examination behavior. Conclusions: The frequency of practicing self-examinations among women employees in the medical sector was low; considering the influence of social support as a factor promoting screening, it is necessary to pay attention to influential people in women's lives when designing educational interventions.
Dong-hyeon Kim;Jong-hee Kim;Ji-hye Park;Hwa-seung Yoo;So-jung Park
The Journal of Internal Korean Medicine
/
v.44
no.3
/
pp.466-484
/
2023
Objective: The purpose of this study was to provide data for the development of Korean medicine (KM) clinical practice guidelines (CPG) for gastric cancer (GC) by identifying the awareness and knowledge needs of KM doctors (KMD) through an online survey. Methods: A survey questionnaire was produced by referring to the previous recognition survey studies for clinical KMDs. The survey questionnaire was composed of questions regarding the current status of clinical care for GC, the knowledge level of clinicians about GC, and other details that clinicians use during practice. The survey was conducted from September 20 to October 22, 2021. An online survey was conducted with 195 KMDs from the Society of Korean Medicine and the Korean Association of Traditional Oncology of KM. Results: A total of 195 respondents participated in the online survey regarding the current status of GC treatment. Of this number, 10.3% of the respondents specialize in GC, but even if they do not currently specialize in GC, they are more likely to treat patients with GC in the future. In terms of the specifics of KM treatment, there was a demand for information on comprehensive KM treatment methods, such as herbal medicine, acupuncture, moxibustion, cupping, and chuna, as well as on analyzing the effectiveness of combined treatment with chemotherapy and radiation. Conclusion: In this study, we were able to understand the clinical KMDs' perception of GC, knowledge level, and requirements in the CPG. The results of this study will provide the basic data for the development of CPG for GC.
Despite improvements in operative techniques and perioperative care, post-hepatectomy liver failure (PHLF) remains the most serious cause of morbidity and mortality after surgery, and several risk factors have been identified to predict PHLF. Although volumetric assessment using imaging contributes to surgical simulation by estimating the function of future liver remnants in predicting PHLF, liver function is assumed to be homogeneous throughout the liver. The combination of volumetric and functional analyses may be more useful for an accurate evaluation of liver function and prediction of PHLF than only volumetric analysis. Gadoxetic acid is a hepatocyte-specific magnetic resonance (MR) contrast agent that is taken up by hepatocytes via the OATP1 transporter after intravenous administration. Gadoxetic acid-enhanced MR imaging (MRI) offers information regarding both global and regional functions, leading to a more precise evaluation even in cases with heterogeneous liver function. Various indices, including signal intensity-based methods and MR relaxometry, have been proposed for the estimation of liver function and prediction of PHLF using gadoxetic acid-enhanced MRI. Recent developments in MR techniques, including high-resolution hepatobiliary phase images using deep learning image reconstruction and whole-liver T1 map acquisition, have enabled a more detailed and accurate estimation of liver function in gadoxetic acid-enhanced MRI.
Ahn Sung Ja;Nam Taek Keun;Chung Woong Ki;Nah Byung Sik;Choi Ho Sun;Byun Ji Soo
Radiation Oncology Journal
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v.13
no.1
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pp.41-48
/
1995
Purpose : The adjuvant postoperative radiotherapy has been usually applied to the patients with unfavorable prognostic factors after radical operation in early cervical cancer. We focused on the evaluation of the survival status and failure patterns of the patients with postoperative radiotherapy. Materials and Methods : We retrospectively analyzed ninety patients with FIGO stage IB and IIA cervix cancer who received postoperative pelvic irradiation at Chonnam University Hospital between August 1985 and December 1988, Seventy-eight patients had adequate follow-up information for survival analysis. Median follow-up time of these patients was 64 months. Results : The 5 year overall and disease free survival rate of ninety patients was $80.0\%$ and $80.2\%$, respectively. The prognostic significance to the survival was determined by multivariate analysis. Adequacy of resection margin(p=0.005) and lymph node status(p=0.005) appeared to be independent prognostic factors. Recurrence occurred in 13 patients, 5 in the pelvis and 8 at distant sites. The median time to recurrence was 19 months(range:3-39 months). The pelvic recurrence was more prevalent in the group of patients with adenocarcinoma, depth of stromal invasion more than 10mm and use of chemotherapy. The distant failure was more prevalent in the group of positive resection margin or positive lymph node with statistical significance. Conclusion : Patients with pelvic lymph node or surgical margin involvement clearly constitute a high risk group in this analysis and should be considered as candidates for some form of adjuvant therapy.
This study attempts to provide basic information on overseas employment to the radiological technologists and students majoring in radiology in Korea who consider the overseas employment by investigating the job consciousness for radiological technologists in Canada and Australia which have a high level of interest for overseas employment and want to compare their status with that of Korean radiological technologists. This study was performed by visiting hospitals such as Prince George Regional Hospital, 1475 Edmonton Street, Prince George, BC, Canada on August 13, 2007, Alfred Hospital, Commercial Road Melbourne 3004, Australia on August 4, 2008, and other Korea hospitals that show the similar scale as Canada and Australia on September 10, 2007. The results were summarized as follows : 1. Differences were observed in this sexual composition, such as 18 males (90%) in Korea, 14 females (73.7%) in Canada, and 25 females in Australia (86.2%). 2. The item of 'aptitude' which is one of the most important criteria, showed the highest level in Korea, Canada, and Australia, and the second most considered item was 'salary'. 3. In the values in jobs, the items of 'economic self-sufficiency', 'recognized by others', and 'establishing a social position' represented high levels in Korea, and the items of 'like the job itself', 'establishing self-actualization', 'feel the meaning of life', and 'make new friends' showed high levels in Canada and Australia. 4. Regarding the item of 'a job is important as much as a marriage', 'Yes' showed high level in Korea, and 'No' showed high levels in Canada and Australia. 5. Radiological technologists in Korea demonstrated a low level in the job consciousness compared to those of Canada and Australia. Although this study shows some limitations for showing whole idea of radiological technologists due to the lack of the scope in samples for each country as a practical manner, this study can be regarded significant to compare some countries that have interests in overseas employment.
Pak, Elena;Choi, Seung Hong;Park, Chul-Kee;Kim, Tae Min;Park, Sung-Hye;Won, Jae-Kyung;Lee, Joo Ho;Lee, Soon-Tae;Hwang, Inpyeong;Yoo, Roh-Eul;Kang, Koung Mi;Yun, Tae Jin
Investigative Magnetic Resonance Imaging
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v.26
no.1
/
pp.10-19
/
2022
Purpose: To evaluate whether the added value of contrast leakage information from dynamic susceptibility contrast magnetic resonance imaging (DSC MRI) is a better prognostic imaging biomarker than the cerebral blood volume (CBV) value in distinguishing true progression from pseudoprogression in glioblastoma patients. Materials and Methods: Forty-nine glioblastoma patients who had undergone MRI after concurrent chemoradiotherapy with temozolomide were enrolled in this retrospective study. Twenty features were extracted from the normalized relative CBV (nCBV) and extraction fraction (EF) map of the contrast-enhancing region in each patient. After univariable analysis, we used multivariable stepwise logistic regression analysis to identify significant predictors for differentiating between pseudoprogression and true progression. Receiver operating characteristic (ROC) analysis was employed to determine the best cutoff values for the nCBV and EF features. Finally, leave-one-out cross-validation was used to validate the best predictor in differentiating between true progression and pseudoprogression. Results: Multivariable stepwise logistic regression analysis showed that MGMT (O6-methylguanine-DNA methyltransferase) and EF max were independent differentiating variables (P = 0.004 and P = 0.02, respectively). ROC analysis yielded the best cutoff value of 95.75 for the EF max value for differentiating the two groups (sensitivity, 61%; specificity, 84.6%; AUC, 0.681 ± 0.08; 95% CI, 0.524-0.837; P = 0.03). In the leave-one-out cross-validation of the EF max value, the cross-validated values for predicting true progression and pseudoprogression accuracies were 69.4% and 71.4%, respectively. Conclusion: We demonstrated that contrast leakage information parameter from DSC MRI showed significance in differentiating true progression from pseudoprogression in glioblastoma patients.
Han, Seunghee;Muller, Markus G.;Kang, Seunghee;Kang, Haejin
Progress in Medical Physics
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v.12
no.1
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pp.79-94
/
2001
The fluorescence emanating from a biological tissue contains information about scattering, absorption and the intrinsic fluorescence (fluorescence only due to fluorophores). Becaue fluorescence spectra of biological tissue are often significantly affected by the presence of tissue absorbers and scatterers, the measured tissue fluorescence cannot be interpreted as a linear combination of intrinsic fluorescence spectra of different tissue biochemical. We conducted experiments to examine the influence of scattering and absorption on the experimentally measured fluorescence of a turbid medium such as biological tissue. Therefore, we acquired fluorescence and reflectance spectra of tissue phantoms with a wide range of scatterer and absorber concentrations. By applying a photon migration model, which uses the scattering and absorption information contained in reflectance spectra to remove their distortion also present in fluorescence spectra, we extract the intrinsic fluorescence of these tissue models. We achieved excellent agreement between modeled and actual intrinsic fluorescence spectra. The motivation for this research is that intrinsic fluorescence spectra are expected to change with progression of disease in human tissue, due to changes in the tissue biochemical composition. It is not possible to distinguish the two tissue types by using only the measured fluorescence, however clear separation can be achieved with the intrinsic fluorescence in real time optical biopsy.
Park, Woo Sung;Park, Seok Gun;Jung, Chul Won;Kim, Woo Chul;Tak, Woo Taek;Kim, Boo Yeon;Seo, Sun Won;Kim, Kwang Hwan;Suh, Jin Sook;Pu, Yoo Kyung
Quality Improvement in Health Care
/
v.11
no.1
/
pp.4-14
/
2004
Background : To examine the problems involved in writing practice of death certificates, we compared the determination of underlying cause of death for vital statistics using recorded underlying cause of death in issued death statistics. Methods : We collected 688 mortality certificates issue in year of 2,000 from 3 university hospitals. And we also collected vital statistics from ministry of statistics. The causes of death were coded by experienced medical record specialists. And causes of death determined at ministry of statistics for national vital statistics were mapped to causes of death recorded at each death certificates. The rate that underlying causes of death for vital statistics were derived from underlying causes of death recorded at issued death certificates were analysed. Results : 64.5% of underlying cause of death for could be derived from underlying cause of death recorded at issued death certificates, 8.6% derived from intermediate cause of death, and 3.9% derived from direct cause of death. In 23% of cases, underlying cause of death could not be derived using issued death certificates. The rate that underlying cause of death for vital statistics could be derived from underlying cause of death recorded at death certificates was different between 3 university hospitals. And the rate was also different between death certificates and postmortem certificates. We classified the causes of death using 21 major categories. The rate was different between diseases or conditions that caused death too. Conclusion : When we examined the correctness of death certificate writing practice using above methods, correctness of writing could not be told as satisfactory. There was difference in correctness of writing between hospitals, between death certificates and postmortem certificates, and between diseases and conditions that caused death. With this results, we suggested some strategy to improve the correctness of death certificate writing practice.
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