• Title/Summary/Keyword: clinical evaluation

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An Analysis of Prognostic Factors in the Uterine Cervical Cancer Patients (자궁경부암 환자의 예후인자에 관한 분석)

  • Yang, Dae-Sik;Yoon, Won-Sub;Kim, Tae-Hyun;Kim, Chul-Yong;Choi, Myung-Sun
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.300-308
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    • 2000
  • Purpose :The aim of this study is to analysis of suwival and recurrence rates of the uterine cervical carcinoma patients whom received the radiation therapy respectively. The prognostic factors, such as Papanicolaou (Pap) smear, carcinoembriogenic antigen (CEA) and squamous cell carcinoma (SCC) antigen has been studied. Methods and Materials : From January 1981 to December 1998, eight-hundred twenty-seven uterine carvical cancer patients were treat with radiation therapy. All of the patients were divided into two groups : the radiation therapy only (S2l patients) group and the postoperative radiation therapy (326 patients) group. The age, treatment modality, clinical stage, histopathology, recurrence, follow-up Pap smears, CEA and SCC antigen were used as parameters for the evaluation. The prognostic factors such as survival and recurrence rates were peformed with the Kaplan-Meier method and the Cox hazard model, respectively. Median rollow-up was 38.6 months. Results :On the radiation therapy only group, 314 patients (60$\%$) achieved complete response (CR), 47 patients (9$\%$) showed local recurrence (LR), 78 patients (15$\%$) developed distant metastasis (DM). On the Postoperative radiation therapy group, showed 276 Patients (85$\%$) CR, 8 Patients (2$\%$) LR, 37 Patients (11$\%$) DM. The 5-year survival and recurrence rates was evaluated for all parameters. The statistically significant factors for the survival rate in univariate analysis were clinical stage (p=0.0001), treatment modality (p=0.0010), recurrence (p=0.0001), Pap smear (p=0.0329), CEA (p=0.0001) and SCC antigen (p=0.0001). Conclusion: This study indicated that after treatment, the follow-up studies of Pap smear, CEA and SCC antigen were significant parameter and prediction factors for the survival and recurrence of the uterine cervical carcinoma.

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A study on the smile according to age and esthetic evaluation by the degree of dental knowledge (연령에 따른 미소형태분석과 치과지식 정도에 의한 심미성 평가)

  • Kim, Seong-Jin;Kim, Moon-Gwan;Park, So-Min;Ban, Jae-Sam;Park, Sang-Won
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.4
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    • pp.249-257
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    • 2012
  • Purpose: This study was designed to help to provide the criteria of the esthetic smile in oromaxillary region on twenties, fifties and sixties. Materials and methods: The facial straight photographs of 33 adults (male 15, female 18, mean age 27.2 years old) and 20 seniors (male 7, female 13, mean age 55.6 years old) in resting and smile position were taken. The measurements and proportion of lip-teeth relation during smile were statistically analyzed, and survey of freshmen and seniors who belong to School of Dentistry, Chonnam National University were taken to select the best esthetic smile among the photographs. Results: In the relationship between the upper lip and the teeth, average smile was the most frequent, and mean of smile line ratio was 1.090 in young group and 0.90 in old group. The correlation between the buccal corridor ratio and exposed teeth count was inversed. At smile, most frequently exposed tooth was the second premolar (63.64%) in young gourp and the first premolar (35.00%) in old group. The correlation between the upper lip change ratio and exposed clinical crown length of maxillary central incisor was inverse, but there was no correlation between the lower lip change ratio and exposed clinical crown length of maxillarycentral incisor. Conclusion: In the result of survey, the students selected the case exposed to the first premolar as the most esthetic smile. The most esthetic smile between full facial photograph and the lip only photograph by the freshmen was different, but that by seniors was identical.

Clinical Significance of a Pylorus-preserving Gastrectomy for Early Gastric Cancer (조기 위암에서 유문 보존 위절제술의 의의)

  • Chu, U-Min;Seo, Kyoung-Won;Kim, Hyoung-Soo;Joo, Jai-Kyun;Park, Young-Kyu;Ryu, Seong-Yeob;Kim, Hyeong-Rok;Kim, Dong-Yi;Kim, Shin-Kon;Kim, Young-Jin
    • Journal of Gastric Cancer
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    • v.6 no.1
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    • pp.11-17
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    • 2006
  • Purpose: The five-year survival rate is over 95% for radically resected early gastric cancer. The development of diagnostic techniques enables early detection of gastric cancer, so the life expectancy of patients with early gastric cancer is prolonged. Therefore, a limited number of surgeries are performed these days for the purpose of increasing the quality of life. The purpose of this study is to assess the postoperative quality of life after a pylorus-preserving gastrectomy (PPG) compared with that after a subtotal gastrectomy with gastroduodenal anastomosis (B-I). Materials and Methods: One hundred seven (107) patients who underwent gastric surgery for early gastric cancer from January 1999 to December 2003 at the Department of Surgery of Chonnam National University Hospital were selected. We compared patients who underwent a PPG with those who underwent a B-I. The clinical results were compared by using the chi-square test and the Student's T-test. The data were considered to be significant when the P value was less than 0.05. Results: Twenty-nine patients (29) underwent a PPG, and the other seventy-eight (78) patients underwent a B-I. There was no significant difference between the two groups on sex, age, and postoperative abdominal symptoms. The patients who underwent a PPG showed shorter operation times and less reflux gastritis and esophagitis on endoscopic evaluation than the patients who underwent a B-I. Conclusion: The pylorus-preserving gastrectomy (PPG) is a more physiologic operation than the subtotal gastrectomy with gastroduodenal anastomosis (B-I) and improves the postoperative quality of life.

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DIRECT PULP CAPPING WITH BONDING RESIN (접착용 레진을 이용한 유치의 직접 치수복조술에 관한 연구)

  • Cho, Hae-Sung;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.2
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    • pp.165-172
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    • 2006
  • A direct pulp capping with different medicaments has been attempted for a long time. The most commonly used among those is the calcium hydroxide. In primary teeth, however, a success rate of direct pulp capping with calcium hydroxide has been reported to be lower than that of pulpotomy. The disappointing results of calcium hydroxide have prompted the search for other capping materials. Lately, several researchers suggested an application of adhesive resin-based composite systems as a capping material. They claimed that when an exposed vital pulp is capped directly with bonding resin, the pulp tissue is free of inflammation or necrosis without clinical symptoms. The aim of this study was to compare short-term effects of the bonding resin which was applied on the mechanically exposed vital pulp tissue and those of direct pulp capping with calcium hydroxide. The second objective was to compare success rates of the primary teeth which already underwent physiologic root resorption and those of the teeth which had not undergone physiologic root resorption yet, in each capping material groups. The vital, healthy pulp of forty-one primary teeth were exposed mechanically during a cavity preparation. They were divided into two groups: Group 1(n=21) underwent capping with bonding resin, and group 2(n=20) underwent capping with calcium hydroxide. Then these two groups were subdivided into two groups in each : the teeth which show physiologic root resorption and the teeth without root resorption. All of the sample teeth were restored with composite resin. Clinical evaluations such as percussion test, ice test, EPT, were recorded and also before- and after- standard x-ray films were compared and evaluated to decide whether the case was successful or not. Evaluation was performed at least 3 months after the capping materials. The results were as follows 1. There was no difference in success rate between group 1 and group 2. 2. Success rate of the teeth with physiologic root resorption was higher than that of the teeth without physiologic root resorption in group 1 and group 2. 3. There was no difference in success rate between anterior teeth and posterior teeth.

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The Effects of Weighted Vest During Task-Oriented Training on Gross Motor Performance and Balance Abilities of Children With Spastic Diplegia : A Randomized Clinical Trial Study (경직형 양마비 아동의 과제지향훈련 시 무게조끼 적용이 대동작 수행력과 균형 능력에 미치는 영향: 무작위배정 위약비교 연구)

  • Kwon, Hae-Yeon
    • The Journal of Korean Academy of Sensory Integration
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    • v.15 no.2
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    • pp.46-65
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    • 2017
  • Objective : The purpose of this research is to find clinical effects of application of weighted vest during task-oriented training focused on gross motor performance and balance abilities of children with spastic diplegia. Methods : 34 subjects were divided by simple random sampling into two groups; experimental group (male : 9, female : 8, average age : 8.12) and placebo group (male : 9, female : 9, average age : 7.53). Both two groups underwent to 40 minute intervention, twice a week for 12 weeks. The intervention was task-oriented training focused on facilitating closed kinematic chain and multi-joint functional movement pattern. During the training, the experimental group received loaded-resistance weighted vest and placebo group also received weighted vest but without loaded-resistance. Participants in both groups underwent 8 to 10 reps of the task-oriented training and there were 3 minutes break time between tasks. There were pre-test of gross motor performance and balance abilities, and two times of post-tests were performed upon 6 weeks and 12 weeks after the intervention completed. And in final, an additional follow-up test was performed 12 weeks after the evaluation was finished in order to find any difference between the two groups over time. Results : There was significant difference in Gross Motor Performance Measure (GMPM) between two groups. It is found that average score of the experimental group increased more than the placebo group after 6 weeks and 12 weeks intervention (p<.05). There was significant difference in Pediatric Berg's Balance Scale (PBS) between two groups. It is found that average score of the experimental group increased more than the placebo group after 6 weeks and 12 weeks intervention (p<.05). Conclusion : Based on the results in this study, it is proposed that application of weighted vest into task-oriented training to facilitating closed kinematic chain and multi-joint movement can improve gross motor performance and balance abilities of children with cerebral palsy.

Added Value of Magnetic Resonance Imaging in Staging of Malignant Pleural Mesothelioma (악성흉막중피종의 병기판정에서 자기공명영상의 진단적 유용성 평가)

  • Lee, Eunsol;Chae, Eun Jin;Kang, Sunji;Yeom, Yoo Kyeong;Lee, Hyun Joo;Park, Jong Chun;Shin, So Youn;Choi, Yoon Young;Choi, Joon Ho;Do, Kyung-Hyun
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.3
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    • pp.232-238
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    • 2013
  • Purpose : We investigated the possible added value of magnetic resonance imaging (MR) in staging of malignant pleural mesothelioma (MPM) compared to computed tomography (CT). Materials and Methods: We retrospectively enrolled 20 patients (M;F = 14:6; mean age, 53.5 yrs) who diagnosed as MPM by histology and underwent CT and MR at initial evaluation from Jan 1997 to Dec 2012. Two radiologists performed clinical staging by using CT alone or MR alone in consensus. In patients underwent surgery (n = 13), we evaluated the diagnostic accuracy of CT and MR in terms of staging compared to surgical staging. In all patients, we compared clinical staging of CT only and CT with MR. Results: The diagnostic accuracy for T staging of CT only was 23.1% (3/13) and that of combined CT and MR was 38.5% (5/13), respectively. Among 13 patients underwent surgery, surgical stage was higher than combined CT and MR stage in 5 patients, but lower in 3 patients. CT only and combined CT and MR agreed in 85.0% (17/ 20). In cases of disagree (15.0%, 3/20), combined CT and MR showed higher stage than CT only. Conclusion: Combined CT and MR increases the diagnostic accuracy in staging of MPM compared to CT only and is important in determining the appropriate treatment in patients being considered for surgery.

Clinical Evaluation on Transbronchial Needle Aspiration (TBNA) of Subcarinal Lymph Node in Lung Cancer (폐암에서 기관 분기부하 림프절의 경기관지 침흡인 세포검사에 관한 연구)

  • Kang, Yu-Ho;Choi, In-Seon;Jung, Ik-Ju;Park, Jai-Hee;Lee, Shin-Seok;Lee, Min-Su;Kim, Young-Cheol;Park, Kyung-Ok;Jung, Sang-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.2
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    • pp.177-184
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    • 1993
  • Background: Accurate staging of bronchogenic carcinoma is important in determining resectability and metastasis of tumor to the subcarinal nodes is generally believed to indicate poor prognosis. The technique of Transbronchial needle aspiration (TBNA) has offered a safe & effective way to asscess mediastinal lymph node involvement in the staging of lung cancer. We performed TBNA in patients who were suspected lung cancer to evaluate the clinical usefulness of the TBNA. Method: TBNA of the subcarinal lymph node was performed at the time of initial diagnostic bronchoscopy in 60 patients with suspected lung cancer, and 42 cases of histologically proved bronchogenic cancer were analized. Results: The frequency of adequate samples by transbronchial needle aspiration (TBNA) was 81% and the positive rate of malignant cells by TBNA was 14.7%. There were no differences in positive rates by tumor cell types. In patients with thickened carina on bronchoscopy, the TBNA was positive in 33.3% as compared to 5.3% of normal carina on bronchoscopy, and the difference was statistically significant (p<0.05). In patients with enlarged subcarinal lymph node on chest CT, the positive rate of malignant cells (50.0%) was higher than that of normal sized subcarinal lymph node on chest CT (4.8%) (p<0.01). There were no specific complications in the TBNA procedure. Conclusion: TBNA is a relatively safe procedure and it offers the possibility of avoiding the cost and morbidity of surgical staging in patients especially whose carina is thickened on bronchoscopy and whose subcarinal LN was enlarged on chest CT.

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Bronchial Hyperresponsiveness in Liver Cirrhosis (간경변증 환자에서 기관지 반응성에 대한 연구)

  • Kim, Ki-Ryang;Kim, Min-Gu;Lee, Sang-Kab;Jang, Se-Ho;Park, Jong-Hwa;Lee, Jong-Deog;Hwang, Yung-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.639-648
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    • 1997
  • Background : Arterial hypoxemia has been noted in patients with liver cirrhosis because of bronchial vessel dilatation. Cabenes et al. reported that bronchial hyperresponsiveness to the metacholine inhalation was observed in patients of left side heart failure, he suggested that one of the mechanism was bronchial vessel dilatation. We hypothesized that patients of liver cirrhosis might have bronchial hyperresponsiveness to metacholine inhalation due to portal hypertension. We evaluate the relationship between bronchial responsiveness and severity of liver cirrhosis, severity of portal hypertension. Methods : In the 22 patients of the liver cirrhosis with clinical portal hypertension, metacholine provocation test was done and determined $PC_{20}FEV1$. We classified liver cirrhosis according to Pugh-Child classification. Esophagogastroscopies were performed for the evaluation of the relationship between bronchial hyperresponsiveness and severity of esophageal varix. Results : In the 22 cases of the liver cirrhosis with clinical portal hypertension. The causes of liver cirrhosis, alcoholic hepatitis was 9 cases, hepatitis B virus was 12 cases, hepatitis C virus was 1 case, and 151 cases (68.18%) of total 22 cases were positive in metacholine provocation test. In positive cases. There was no significant relationship between $PC_{20}FEV1$ and severity of liver cirrhosis which were classified by Pugh-Child classification or severity of esophageal varix(p<0.05). Conclusion : we observed that bronchial responsiveness to metacholine increased in the patients of liver cirrhosis and there was no significant relationship between the severity of liver cirrhosis and the severity of esophageal varix.

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AN EXPERIMENTAL STUDY OF NEWLY DESIGNED IMPLANT WITH RBM SURFACE IN THE RABBIT TIBIA : RESONANCE FREQUENCY ANALYSIS AND REMOVAL TORQUE STUDY

  • Won Mi-Kyoung;Park Chan-Jin;Chang Kyoung-Soo;Kim Chang-Whe;Kim Yung-Soo;Isa Zakiahbt Mohd;Ariffin Yusnidar Tajul
    • The Journal of Korean Academy of Prosthodontics
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    • v.41 no.6
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    • pp.720-731
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    • 2003
  • Statement of problem. The importance of fixture design and surface treatment. Purpose. The clinical success of dental in plants is affected by many factors such like as degree of osseointegration, the effective load dispersion for the prostheses, and a lot of attempts have been made to overcome the difficulties. In this study, efforts were made to find the possibility of clinical acceptance of the dental implants of newly designed surface and resorbable blast media surcace. Materials and methods. In this study, two groups of custom-made, screw-shaped implants were prepared. The first with the consisting of Branemark clone design and the other with the new design. These implants were divided into four groups according to the kinds of surface treatment. Four implants($AVANA^{(R)}$, Osstem, Busan, Korea)of each group were installed in twenty rabbits. Group A was consisted of Branemark done implant left as machined, Group B with Branemark clone implants with RBM(Resorbable blast media) surface, Group C with newly designed implants left as machined and Group D with newly designed implants with RBM surface. One of the twenty rabbits died from inflammation and the observation was made for six weeks. Specimens from four groups were observed using scanning electron microscopy with 40, 100, 1000 magnification power and microsurface structures were measured by white-light scanning interferometry for three dimensional surface roughness measurements(Accura $2000^{(R)}$, Intek-Plus, Korea.). Removal torque was measured in 17 rabbits using digital torque gauge(MGT 12R, Mark-10 corp., NY, U.S.A.) immediately after the sacrifice and two rabbits were used for the histologic preparation(EXAKT $310^{(R)}$, Heraeus Kulzer, wehrheim, Germany) of specimens and observed under light microscope. Resonance frequency measurement($Osstell^{(R)}$) was taken with the 19 rabbits at the beginning of the implant fixation and immediately after the sacrifice. Results. Following results were taken from the experiment. 1. The surface of the RBM implants as seen with SEM had rough and irregular pattern with reticular formation compared to that of fumed specimens showing different surface topographies. 2. The newly designed implant with RBM surface had high removal torque value among four groups with no statistical significance. The average removal torque was $49.95{\pm}6.70Ncm$ in Group A, $51.15{\pm}4.40Ncm$ in Group B, $50.78{\pm}9.37Ncm$ in Group C, $51.09{\pm}4.69Ncm$ in Group D. 3. The RFA values were $70.8{\pm}4.3Hz$ in Group A, $71.8{\pm}3.1Hz$ in Group B, $70.9{\pm}2.5Hz$, $72.7{\pm}2.5Hz$ in Group D. Higher values were noted in the groups which had surface treatment compared to the untreated groups with no statistical significance. 4. The results from the histomorphometric evaluation showed a mean percentage of bone-to-implant contact of $45{\pm}0.5%$ in Group A, $55{\pm}3%$ in Group B, $49.5{\pm}0.5%$ in Group C, and $55{\pm}3%$ in Group D. Quite amount of newly formed bone were observed at the surface RBM-treated implants in bone marrow space.

Evaluation of Psychosocial Impact and Quality of Life in BRCA Mutation Family (BRCA 돌연변이 가계의 심리상태 및 삶의 질 평가)

  • Han, Sang-Ah;Kim, Sai-Rhee;Kang, Eun-Young;Kim, Jeong-Hyun;Ha, Tae-Hyeon;Yang, Eun-Joo;Lim, Jae-Young;Han, Won-Shik;Noh, Dong-Young;Kim, Sung-Won
    • Journal of Genetic Medicine
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    • v.7 no.1
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    • pp.67-77
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    • 2010
  • Purpose: The aims of this study are to evaluate psychological impact and quality of life according to the cancer diagnosis and mutation status in Korean families with BRCA mutations. Materials and Methods: Seventeen affected carriers (AC), 16 unaffected carriers (UC) and 13 healthy non carriers (NC) from 13 BRCA mutation families were included in the study. Outcomes were compared with regard to depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory, STAI), optimism (Reevaluation of the Life Orientation test, LOT-R), knowledge of hereditary ovarian cancer, and quality of life (QoL) (SF-36v2 Health Survey, physical component score [PCS], mental component score [MCS]) among three groups. Result: Level of depression, optimism, and PCS were similar in AC, UC, and NC. Anxiety score was elevated in all three groups. MCS was significantly low in AC than in UC and NC (P=0.009, P=0.017). Knowledge of hereditary breast and ovarian cancer was high in AC than NC (P=0.001). MCS was significantly related to whether patient was affected by cancer (P=0.043) and has occupation (P=0.008) or not in multivariable analysis. Conclusion: From this cross sectional study, psychological adverse effect was not related to the carrier status of BRCA mutation. Elevated anxiety in BRCA family members was observed but, independent to affection and the type of genetic mutation. AC showed low mental QoL. Further effort to understand psychological impact and QoL of genetic testing in BRCA family members is required for follow-up in clinical aspects.