• Title/Summary/Keyword: Utility Evaluation

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Distraction Techniques for Children Undergoing Procedures: A Critical Review of Korean Intervention Research (아동기 처치관련 관심전환요법: 국내 아동 중재연구의 비평적 고찰)

  • Im, Eun Seon;Kim, Jin Sun
    • Child Health Nursing Research
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    • v.20 no.4
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    • pp.340-349
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    • 2014
  • Purpose: The purpose of this study was to provide a critical assessment of evidence-based Korean pediatric research that can inform clinical practicability of, and future research on distraction interventions for pediatric procedural pain management. Methods: A critical review of evidence-based Korean pediatric research was conducted. Databases were searched to identify research that included an evaluation of a distraction intervention as an intervention for pediatric procedural pain management. The search yielded 68 studies. Results: From these studies, 14 were included for this review and all were recently published (2003-2014). Quasi experimental designs were most frequently used (n=12) and for 71.4% the focus was preschoolers. Audiovisual techniques were the most common form of distraction. In most studies clinical utility of the distraction intervention was not examined. Fairly consistent reductions in behavioral measures of pain in association with the distraction intervention were found but less consistent results were found for physiological measures. Conclusion: Lack of methodological rigor limits the evidence for distraction interventions to reduce pain and fear experienced by children during painful procedures. Further research to analyze the cost and time-effectiveness and to identify consumer and provider satisfaction with distraction interventions is needed to determine whether distraction interventions are clinically relevant.

Evaluation of convergence Elasticity of Liver Fibroscan used measurement with Ultrasonography (초음파를 이용한 간 섬유화 스캔 검사의 융합 탄성도 측정 평가)

  • Kim, Min-Jeong;Han, Man-Seok;Jang, Jae-Uk
    • Journal of the Korea Convergence Society
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    • v.8 no.5
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    • pp.79-85
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    • 2017
  • The purpose of this research was to evaluate the clinical and the instrument of convergence utility of transient elastography (FibroScan(R):electromagnetic wave) in diagnosing and treating liver ailments through a comparison and an analysis between liver function blood test and transient elastography (FibroScan(R)) in patients with chronic hepatitis B virus infection. Of all the patients with chronic hepatitis B virus infection who visited clinic B in Daejeon City between July 1, 2015, and February 28, 2016, 75 who underwent a FibroScan(R) test were selected for this study. Their laboratory and liver function test results were compared for a correlation analysis before constructing an ROC (Receiver Operation Characteristic) curve. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were 0.572 and 0.502, respectively, and showed highest correlation with fibrosis score, with statistical significance (p<0.000). Gamma glutamyltranspeptidase, total bilirubin, and alkaline phosphatase levels also showed relatively significant correlations in this order of sequence, while -fetoprotein and total protein levels did not show any statistically significant values. Albumin (-0.449) and platelet levels (-0.373) showed negative correlations with each other and no correlation with fibrosis score (p < 0.000). As liver fibrosis worsened, the accuracy of the ROC curve increased. At the F4 stage, which is the cirrhotic stage, the largest area under the curve was observed. FibroScan(R) showed significant correlation with the ALT (serum glutamic pyruvic transaminase) and AST (serum glutamic oxaloacetic transaminase) levels in the liver function test, which is a routine test for patients with chronic liver ailments. This implies that fibrosis correlates with liver inflammation severity.

An Outbreak of Mumps in a High School, Seoul, 2013 (2013년 서울의 일개 고등학교에서 발생한 유행성 이하선염 집단발병)

  • Kang, Ha Ra;Kim, Sung Yoon;Cha, Hyo Hyun;An, Young Min;Park, In Ah;Kang, Hae Ji;Eun, Byung Wook
    • Pediatric Infection and Vaccine
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    • v.22 no.1
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    • pp.1-6
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    • 2015
  • Purpose: This study investigated an outbreak of mumps affecting students in a high school (S high school) in Seoul, with an evaluation of the diagnostic utility of the mumps polymerase chain reaction (PCR) assay. Methods: S high school students that presented to health care providers with mumps symptoms between April 2013 and July 2013 were surveyed for the monthly distribution of symptom onset and their grade level. Mumps PCR assays were performed using buccal swabs from some of these students. Results: During the survey period, 77 students presented with suspected cases of mumps. The monthly distribution of symptom onset was as follows: one in April, 17 in May, 54 in June, and five in July. With regard to grade level, 26 students were in their first year, 28 were in their second year, and 23 were in their third year. Of the 18 students tested with PCR assays, five had positive results. Samples were collected within 3 days of symptom onset in 15 of the 18 students, and positive PCR results were obtained in five of these 15 students. The PCR results of the remaining three students from whom samples were collected more than 3 days after the onset of symptoms were negative (P=0.24). Conclusions: We evaluated the epidemiological aspects of an outbreak of mumps in a high school. Mumps PCR might be epidemiologically useful if performed within 3 days of the onset of symptoms in suspected cases.

Seismic performance evaluation of middle-slab vibration damping rubber bearings in multi-layer tunnel through full-scale shaking table (실대형 진동대 시험을 통한 복층터널 중간 슬래브 진동 감쇠 고무받침 내진성능 평가)

  • Jang, Dongin;Park, Innjoon
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.22 no.4
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    • pp.337-346
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    • 2020
  • Traffic jam and congestion in urban areas has caused the need to improve the utility of underground space. In response, research on underground structures is increasingly being conducted. Notably, a double-deck tunnel is one of the most widely used of all those underground structures. This double-deck tunnel is separated by the middle slab into the upper and lower roadways. Both vehicle load and earthquake load cause the middle slab to exhibit dynamic behavior. Earthquake-related response characteristics, in particular, are highly complex and difficult to interpret in a theoretical context, and thus experimental research is required. The aim of the present study is to assess the stability of a double-deck tunnel's middle slab of the Collapse Prevention Level and Seismic Category 1 with regard to the presence of vibration-damping Rubber Bearings. In vibration table tests, the ratio of similitude was set to 1/4. Linings and vibrating platforms were fixed during scaled model tests to represent the integrated behavior of the ground and the applied models. In doing so, it was possible to minimize relative behavior. The standard TBM cross-section for the virtual double-deck tunnel was selected as a test subject. The level of ground motion exerted on the bedrock was set to 0.154 g (artificial seismic wave, Collapse Prevention Level and Seismic Category 1). A seismic wave with the maximum acceleration of 0.154 g was applied to the vibration table input (bedrock) to analyze resultant amplification in the models. As a result, the seismic stability of the middle slab was evaluated and analyzed with respect to the presence of vibration-damping rubber bearings. It was confirmed that the presence of vibration-damping rubber bearings improved its earthquake acceleration damping performance by up to 40%.

Development and Application d A Comprehensive Case Management Model for Helping North Korean Refugees' Psycho-Social Adjustment in South Korea (탈북자의 사회적응 지원을 위한 종합형 사례관리 모형의 제시와 그 실천)

  • Um, Myung-Yong
    • Korean Journal of Social Welfare
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    • v.37
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    • pp.271-306
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    • 1999
  • This study aimed to present a comprehensive case management model which might be helpful for social workers in community social welfare agencies who works with North Korean refugees for their psychosocial adjustment in South Korea. After being constructed, the model was put into practice upon North Korean refugees. This article described the whole process of model construction and its application. Detail steps taken in this research include: (a) The researcher had 20 unstructured individual interviews with 11 North Korean refugees in order to identify psychosocial problems that need social workers' intervention; (b) Based upon the problems identified through interviews and previous literature review, program components were identified and sorted out into two phases, one of which is therapeutic phase, the other is case management phase; (c) By interlocking the two phases, the researcher proposed a comprehensive case management model whereby North Korean refugees can get psychosocial services as well as linkage services in an interactive fashion; (d) The utility of the proposed model was examined by using a couple of North Korean refugees who initially showed complicated psycho-social-economic problems. The therapeutic phase employed a cognitive-behavioral approach. The case management phase consists of: assessment and diagnosis; service planning and resource identification; linking of clients to needed services; monitoring of service delivery; and evaluation. Although the program could not go through with because of the limited contacts with North Korean refugees for security reasons, the program was turned out to be very useful in helping North Korean refugees' settling-down in South Korea. Implications for the application of the proposed model was discussed along with limitations of this study.

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Establishment of a [18F]-FDG-PET/MRI Imaging Protocol for Gastric Cancer PDX as a Preclinical Research Tool

  • Bae, Seong-Woo;Berlth, Felix;Jeong, Kyoung-Yun;Suh, Yun-Suhk;Kong, Seong-Ho;Lee, Hyuk-Joon;Kim, Woo Ho;Chung, June-Key;Yang, Han-Kwang
    • Journal of Gastric Cancer
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    • v.20 no.1
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    • pp.60-71
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    • 2020
  • Purpose: The utility of 18-fluordesoxyglucose positron emission tomography ([18F]-FDG-PET) combined with computer tomography or magnetic resonance imaging (MRI) in gastric cancer remains controversial and a rationale for patient selection is desired. This study aims to establish a preclinical patient-derived xenograft (PDX) based [18F]-FDG-PET/MRI protocol for gastric cancer and compare different PDX models regarding tumor growth and FDG uptake. Materials and Methods: Female BALB/c nu/nu mice were implanted orthotopically and subcutaneously with gastric cancer PDX. [18F]-FDG-PET/MRI scanning protocol evaluation included different tumor sizes, FDG doses, scanning intervals, and organ-specific uptake. FDG avidity of similar PDX cases were compared between ortho- and heterotopic tumor implantation methods. Microscopic and immunohistochemical investigations were performed to confirm tumor growth and correlate the glycolysis markers glucose transporter 1 (GLUT1) and hexokinase 2 (HK2) with FDG uptake. Results: Organ-specific uptake analysis showed specific FDG avidity of the tumor tissue. Standard scanning protocol was determined to include 150 μCi FDG injection dose and scanning after one hour. Comparison of heterotopic and orthotopic implanted mice revealed a long growth interval for orthotopic models with a high uptake in similar PDX tissues. The H-score of GLUT1 and HK2 expression in tumor cells correlated with the measured maximal standardized uptake value values (GLUT1: Pearson r=0.743, P=0.009; HK2: Pearson r=0.605, P=0.049). Conclusions: This preclinical gastric cancer PDX based [18F]-FDG-PET/MRI protocol reveals tumor specific FDG uptake and shows correlation to glucose metabolic proteins. Our findings provide a PET/MRI PDX model that can be applicable for translational gastric cancer research.

Radioaerosol Inhalation Imaging in Bronchial Asthma (기관지 천식의 연무흡입 폐환기스캔 소견)

  • Kim, Bum-Soo;Park, Young-Ha;Park, Jeong-Mi;Chung, Myung-Hee;Chung, Soo-Kyo;Shinn, Kyung-Sub;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.1
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    • pp.46-52
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    • 1991
  • Radioaerosol inhalation imaging (RII) has been used in radionuclide pulmonary studies for the past 20 years. The method is well accepted for assessing regional ventilation because of its usefulness, easy fabrication and simple application system. To evaluate its clinical utility in the study of impaired regional ventilation in bronchial asthma, we obtained and analysed RIIs in 31 patients (16 women and 15 men; age ranging 21-76 years) with typical bronchial asthma at the Department of Radiology, Kangnam St. Mary's Hospital, Catholic University Medical college, from January, 1988 to August, 1989. Scintiscans were obtained with radioaerosol produced by a BARC(Bhabha Atomic Reserch Center, India) nebulizer with 15 mCi of $^{99m}Tc-phytate$. The scanning was peformed in anterior, posterior and lateral projections following 5-minute inhalation of radioaerosol on sitting position. The scans were analyzed and correlated with the results of pulmonary function study and the findings of chest radiography. Fifteen patients had concomitant lung perfusion image with $^{99m}Tc-MAA$. Follow-up scans were obtained in 5 patients after bronchodilator therapy. The patients were divided into (1) attack type (4 patients), (2) resistant type (5 patients), (3) remittent type (10 patients) and (4) bronchitic type (12 patients). Chest radiography showed hyperinflation, altered pulmonary vascularity, thickening of the bronchial wall and accentuation of basal interstitial markings in 26 of the 31 patients. Chest radiographs were norma! in the remaining 5 patients. Regardless of type, the findings of RII were basically the same, and characterized by the deposition of radioaerosol in the central parts or in the main respiratory air ways along with mottled nonsegmental ventilation defects in the periphery. Peripheral parenchymal defects were more extensive than that of expected findings from clinical symptoms, pulmonary function test and chest radiograph. Broomstick sign was present in 17 patients. The abnormality of RII was poorly correlated with perfusion scans. In all 5 patients treated with bronchodilators, follow-up study demonstrated a decrease in the degree of radioaerosol deposition in the central air way with improved ventilation defects. This study indicates that RII is a useful technique for the evaluation of regional ventilation abnormality and the effect of treatment with bronchodilators in patients with bronchial asthma.

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A Route Search of Urban Traffic Network using Fuzzy Non-Additive Control (퍼지 비가법 제어를 이용한 도시 교통망의 경로 탐색)

  • 이상훈;김성환
    • Journal of Korean Society of Transportation
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    • v.21 no.1
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    • pp.103-113
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    • 2003
  • This paper shows alternative route search and preference route search for the traffic route search, and proposes the use of the fuzzy non-additive controller by the application of AHP(analytic hierarchy process). It is different from classical route search and notices thinking method of human. Appraisal element, weight of route is extracted from basic of the opinion gathering for the driving expert and example of route model was used for the finding of practice utility. Model evaluation was performed attribute membership function making of estimate element, estimate value setting, weight define by the AHP, non additive presentation of weight according to $\lambda$-fuzzy measure and Choquet fuzzy integral. Finally, alternative route search was possible to real time traffic route search for the well variable traffic environment, and preference route search showed reflection of traffic route search disposition for the driver individual. This paper has five important meaning. (1)The approach is similar to the driver's route selection decision process. (2)The approach is able to control of route appraisal criteria for the multiple attribute. (3)The approach makes subjective judgement objective by a non additive. (4)The approach shows dynamic route search for the alternative route search. (5)The approach is able to consider characteristics of individual drivers attributed for the preference route search.

Postural Control in Brain Damage Patients According to Moving Surround (뇌기능 장애 환자의 가상영상(Moving Sorround) 자극에 따른 자세 균형 제어)

  • 김연희;최종덕;이성범;김종윤;이석준;박찬희;김남균
    • Proceedings of the Korean Society for Emotion and Sensibility Conference
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    • 2002.11a
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    • pp.233-244
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    • 2002
  • The purpose of this study is to assess the ability of balance control in moving surround using head mount device and force platform and to examine the clinical usefulness of COP parameters. Fifteen patients with stroke and healthy persons were participated. COP parameters were obtained as total path distance, frequency of anterior-posterior and medial-lateral component by FFT analysis, weight-spectrum analysis in the two different conditions; (1) in comfortable standing with opened or closed eyes, (2) in virtual moving surround delivered using HMD to four different moving pattern. In virtual moving surround setting, moving pattern was composed of close-far, superior-inferior tilting(pitch), right-left tilting(roll) and horizontal rotation(yaw) movement. In all parameters, the reliebility of COP analysis system was significantly high. Also, the construct validity compared between fifteen patients with stroke and normal persons was excellent in virtual moving surround condition(p

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Utility of Integrated Analysis of Pharmacogenomics and Pharmacometabolomics in Early Phase Clinical Trial: A Case Study of a New Molecular Entity

  • Oh, Jaeseong;Yi, Sojeong;Gu, Namyi;Shin, Dongseong;Yu, Kyung-Sang;Yoon, Seo Hyun;Cho, Joo-Youn;Jang, In-Jin
    • Genomics & Informatics
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    • v.16 no.3
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    • pp.52-58
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    • 2018
  • In this report, we present a case study of how pharmacogenomics and pharmacometabolomics can be useful to characterize safety and pharmacokinetic profiles in early phase new drug development clinical trials. During conducting a first-in-human trial for a new molecular entity, we were able to determine the mechanism of dichotomized variability in plasma drug concentrations, which appeared closely related to adverse drug reactions (ADRs) through integrated omics analysis. The pharmacogenomics screening was performed from whole blood samples using the Affymetrix DMET (Drug-Metabolizing Enzymes and Transporters) Plus microarray, and confirmation of genetic variants was performed using real-time polymerase chain reaction. Metabolomics profiling was performed from plasma samples using liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. A GSTM1 null polymorphism was identified in pharmacogenomics test and the drug concentrations was higher in GSTM1 null subjects than GSTM1 functional subjects. The apparent drug clearance was 13-fold lower in GSTM1 null subjects than GSTM1 functional subjects (p < 0.001). By metabolomics analysis, we identified that the study drug was metabolized by cysteinylglycine conjugation in GSTM functional subjects but those not in GSTM1 null subjects. The incidence rate and the severity of ADRs were higher in the GSTM1 null subjects than the GSTM1 functional subjects. Through the integrated omics analysis, we could understand the mechanism of inter-individual variability in drug exposure and in adverse response. In conclusion, integrated multi-omics analysis can be useful for elucidating the various characteristics of new drug candidates in early phase clinical trials.