• Title/Summary/Keyword: clinical stage

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Comparison of Clinical Menifestations between Adolescents and Unmarried Young Women with Endometriosis in Daegu (대구 지역 청소년 및 미혼 여성 자궁내막증 환자의 임상 특성에 관한 비교연구)

  • Kim, Yoon-Jeong;Choi, Min-Hye;Chung, Min-Ji;Lee, Jung-Ho;Lee, Taek-Hoo
    • Clinical and Experimental Reproductive Medicine
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    • v.34 no.3
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    • pp.167-172
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    • 2007
  • Objective: The purpose of this study is to find out the differences of clinical characteristics of endometriosis and to emphasize the significance of early diagnosis of endometriosis to protect disease progression in adolescents. Methods: A retrospective analysis was carried out. All cases (n=130) were diagnosed surgically as endometriosis between January 2000 and August 2007 in two university hospitals in Daegu. Adolescents were 23 cases and unmarried young women were 107 cases. Data were collected through review of medical records. Results: The predominant symptom in adolescents was cyclic pain. 52.2% of adolescent patients were stage I or II. And stage III was 47.8% but stage IV was none. The other side 82.2% of unmarried young women patients were stage II or III and stage IV was 15.8%. Serum CA-125 level was elevated in adolescents, also. But there was no significant difference between the two groups. Conclusions: Endometriosis is progressive disease. Early diagnosis is necessary for prevention of the disease progression and free from pain. Appropriate gynecologic examination and careful concerns about adolescents are mandatory.

Comparison of Eosinophil Markers between Acute and Recovery Stages in Children with Mycoplasma pneumoniae Pneumonia (Mycoplasma pneumoniae 폐렴 환아에서 급성기 및 회복기의 호산구 지표의 비교)

  • Nah, Kyu Min;Kang, Eun Kyeong;Kang, Hee;Park, Yang;Koh, Young Yull
    • Clinical and Experimental Pediatrics
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    • v.45 no.10
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    • pp.1227-1233
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    • 2002
  • Purpose : Several studies have shown that increases of eosinophil markers are common findings of asthma and Mycoplasma pneumoniae infection, and eosinophil markers reflect the clinical stage of asthma. The purpose of this study was to investigate the change of eosinophil markers according to the clinical stage of Mycoplasma pneumonia. Methods : The patient group consisted of 33 outpatient children with Mycoplasma pneumonia. Peripheral blood total eosinophil count(TEC) and serum eosinophilic cationic protein(ECP) level were measured at both acute and recovery stages and were compared between both stages. The patient group was subdivided into the wheezing(n=16) and the nonwheezing group(n=17), and the TECs and the ECPs of one group were compared with those of the other group. The correlation between Mycoplasma antibody titer and the eosinophil markers of acute stage were analyzed. Results : In the whole patient group, the TECs and the ECPs of the acute stage were significantly higher than those of the recovery stage(P=0.018, P=0.005), but there were no differences in the TEC and the ECP between the wheezing and the nonwheezing group. In the wheezing group, there were no significant differences in the TEC and the ECP between acute and recovery stages. There were no correlations between acute stage Mycoplasma antibody titer and the eosinophil markers. Conclusion : Eosinophil markers reflect the clinical stage of Mycoplasma pneumonia and eosinophilic inflammations may continue even after the acute stage in wheezing patients with Mycoplasma pneumonia.

Phase II two-stage single-arm clinical trials for testing toxicity levels

  • Kim, Seongho;Wong, Weng Kee
    • Communications for Statistical Applications and Methods
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    • v.26 no.2
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    • pp.163-173
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    • 2019
  • Simon's two-stage designs are frequently used in phase II single-arm trials for efficacy studies. A concern of safety studies is too many patients who experience an adverse event. We show that Simon's two-stage designs for efficacy studies can be similarly used to design a two-stage safety study by modifying some of the design parameters. Given the type I and II error rates and the proportion of adverse events experienced in the first stage cohort, we prescribe a procedure whether to terminate the trial or proceed with a stage 2 trial by recruiting additional patients. We study the relationship between a two-stage design with a safety endpoint and an efficacy endpoint as well as use simulation studies to ascertain their properties. We provide a real-life application and a free R package gen2stage to facilitate direct use of two-stage designs in a safety study.

The Effect of the Combined Stretching and Strengthening Exercise on the Clinical Symptoms in Posterior Tibial Tendon Dysfunction Patient (후방 경골 건 기능부전 환자의 임상 증상에 운동 치료가 미치는 영향)

  • Jeong, Tae-Ho;Oh, Jae-Kun;Lee, Hong-Jae;Yang, Yoon-Joon;Nha, Kyung-Wook;Suh, Jin-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.47-54
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    • 2008
  • Purpose: The isolated exercise therapy and its effect for the treatment of posterior tibial tendon dysfunction (PTTD) is not well known. The purpose of this study was to identify the clinical effect of stretching and strengthening exercise program on the patients' muscle function and range of motion, pain and gait in the management of the early stage PTTD. Materials and Methods: From October 2006 to March 2007, 14 patients with early stage PTTD (stage I or IIa) without surgical intervention were randomly assigned into two groups and we analyzed their clinical results. All patients were female and one who have sprained the same ankle during the program and one who withdrew from the program due to her private reason were excluded. At the last, the exercise group (EG) was seven and the control group (CG) was five. Mann-Whitney U test was used for the comparison of pain, ROM, muscle power, AOFAS score and 5 minute walking test of both groups. Wilcoxon-signed rank test was used for the comparison between the pre and post exercise program in EG. Results: The pain was significantly reduced in EG compare to CG and only the dorsiflexion was significantly increased in EG in the analysis of ROM. The dorsi flexion and plantar flexion power were significantly increased in EG. Conclusion: Our 6 weeks stretching and strengthening exercise program showed noticeably improved clinical result, and therefore it is recommended as one of the useful treatment option in the management of early stage PTTD.

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Development and Clinical Evaluation of the Upper Extremity Rehabilitation Game Program for Patients with Upper Extremity Hemiplegia After Stroke Using Smartphone: Preliminary Study (스마트폰을 이용한 뇌졸중 후 상지 편마비 환자의 상지 게임재활훈련 프로그램 개발 및 임상적 유용성 평가에 대한 예비연구)

  • Lim, Hyunmi;Choi, Yoon-Hee;Paik, Nam-Jong;Ku, Jeonghun
    • Journal of Biomedical Engineering Research
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    • v.36 no.5
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    • pp.155-161
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    • 2015
  • In the paper, we developed the mobile based rehabilitation system for patients with upper extremity hemiplegia after stroke and evaluated clinical usefulness and effectiveness of the system. The sensors built in the smartphone were used to track patients' upper limb motion and the movements was transferred to the tablet PC through bluetooth connection so that the game contents could be interact with the movements. The rehabilitation game contents was based on Brunnstrom stage(B-stage), and was designed to lead accurate movement of upper limb. For the clinical evaluation of the effectiveness, 11 patients were recruited and make them perform an exercise of their wrist, shoulder, and forearm using the system for two weeks. The change of upper limb motor function was measured using fugl-meyer assessment(FMA), Brunnstrom stage(B-stage). And the change of quality of life was measured using EuroQoL-5 Dimension(EQ-5D), Beck Depression Inventory(BDI). The results showed significant improvement in upper limb function but not in quality of life. We verified mobile based rehabilitation program could be useful and effective for the clinical use.

A Quantitative Analysis on Clinical Course of Acute Ischemic Stroke with National Institute of Health Stroke Scale (National Institutes of Health Stroke Scale을 이용한 급성기 허혈성 뇌졸중의 증상 경과에 대한 정량적 고찰)

  • Choi, Jin-Young;Cho, Gwon-Il;Shin, Hak-Soo;Shin, Sun-Ho;Kim, Dong-Woung;Han, Myoung-Ah
    • The Journal of Internal Korean Medicine
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    • v.23 no.1
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    • pp.5-13
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    • 2002
  • Purpose : Studies on stroke were conducted by using the scaling system to estimate, compare severity and to predict prognosis. National Institute of Health Stroke Scale is widely used for this purpose due to its accuracy in predicting clinical symptoms. According to previous studies, neurologic symptoms in acute stage of ischemic stroke did not disappear, and approximately 27% to 43% of them were aggravated, We conducted this study to define clinical aggravation and to improve ischemic stroke in its acute stage by using NIHSS. Methods and Subjects : Due to their acute ischemic stroke, twenty five patients visited Wonkwang Oriental Medicine in Cheonju within forty eight hours from its beginning stage. Two oriental medicine doctors checked NIHSS every six hours during the first ninety six hours and later every twenty four hours for twelve days from the beginning of the disease. Results : The Aggravated group consisted of nineteen out of twenty five cases, which is seventy six % and NIHSS on admissions were $5.88{\pm}0.63$ and it increased linearly over time by the equation of NIHSS on admissions was $8.50{\pm}2.02$ and it decreased linearly over time by the equation of NIHSS=-0.01 one hour+7.91. Conclusion : During the study, we defined the clinical courses of acute ischemic stroke. There have been no reports on this so far. Therefore, we hope that this study will be beneficial to expand the scope of oriental medicine in dealing with aggravating ischemic stroke in the acute stage.

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Expression of mRNAs and Proteins of Cyclin A and LATS Genes in Ovary (Cyclin A와 LATS 유전자들의 난소 내 mRNA 및 단백질 발현에 관한 연구)

  • Park, Chang-Eun;Kim, Dae-Jung;Hong, Sung-No
    • Korean Journal of Clinical Laboratory Science
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    • v.40 no.1
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    • pp.31-40
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    • 2008
  • Despite of the importance of the primordial follicle (PMF) recruitment, factors and mechanisms for process are poorly understood. To evaluate expression and role of the follicular transition from PMF to PMF/primary follicles (PMIF) in the present study, we evaluated expression of lats1, lats2, cyclin A1, and cyclin A2 mRNA and protein, and elucidated and role of lats1-cyclin A in the follicular transition from PMF to PRIF. To analysis of differential expression in PMF and PMIF, each stage follicles were collected by day1 and day5 of immuno-compromised rats (ICR) and analyzed by real-time PCR for the genes. For localization of mRNAs and proteins of the genes, in situ hybridization and immunohistochemistry were performed. We confirmed that the lats1, lats2, cyclin A1, and cyclin A2 mRNA were more expressed in PMF than PMIF. Localization of the four genes expression were observed in nuclei of oocytes from the arrested primordial, and in the surrounding granulosa cells of the growing follicles. The mRNA expressions were gradually decreased with follicular development. From immunohistochemistry studies, Cyclin A1 protein expression were observed in oocyte cytoplasmas of early stage follicles, while observed in granulose cells and oocyte nucleoli during growing follicles. This study suggested that the presence of lats gene family might perform negatively regulation of cell proliferation by modulation of the CDC2/Cyclin A complex activity. lats-cyclin A genes in oocytes of the early stage follicles might play a role in the meiotic cell cycle arrest of the primary oocytes at the primordial follicle stage as well as the follicular growth.

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Development of Clinical Terminology System for Human Body : Convergence Research of SNOMED CT (인체 골격의 좌표형 임상용어체계 표준 개발 : SNOMED CT 기반의 융복합 연구)

  • Choi, Byung-Kwan;Choi, Eun-A;Nam, Moon-Hee
    • Journal of Digital Convergence
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    • v.17 no.4
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    • pp.177-185
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    • 2019
  • This is a methodological study to develop standards for human body coordinate clinical terminology system. The Standard was developed through four stages: Stage 1 - research plan was developed through literature review and data collection. Stage 2 - preliminary standard was created. Stage 3 - the standard was revised in accordance with the consultation of experts through seminars. Stage 4 - Final version of the standard was presented after verification of the content level. 2D human body images are expressed as x, y axes, and 3D images are expressed as x, y, z axes. Concepts and definitions of coordinates were preassembled into FSN, synonyms and preferred names of SNOMED CT. The latter combination was defined through 18 relationships. The average index was 4.01 for the content validity of the developed relationship standard. This research suggests that subsequent standards should be developed for other parts of the human body such as the brain, organs, and tissues. Also, it suggests that methodological research should be continued to increase the utilization of the standard in clinical practice.

Clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients: a retrospective study

  • Han, Ji-Young;Park, Seo Hee;Kim, Joohyung;Hwang, Kyung-Gyun;Park, Chang-Joo
    • Journal of Periodontal and Implant Science
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    • v.51 no.3
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    • pp.163-178
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    • 2021
  • Purpose: The aim of this study was to evaluate clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients. Methods: In total, 52 patients with at least 2 years of follow-up after periodontal and orthodontic treatment were included in this study. After scaling and root planing, orthodontic treatment with fixed appliances or clear aligners was performed. Fixed retainers with twist-flex stainless steel wires were bonded to the palatal or lingual sides of anterior teeth. Changes in clinical parameters, including the plaque index, gingival index, calculus index (CI), probing pocket depth, and radiographic bone levels, were evaluated before bonding of fixed retainers and at a 12-month follow-up. Cumulative survival rates (CSRs) for retainer failure were evaluated according to sex, site, CI, stage of periodontitis, and the severity of the irregularity with the log-rank test and hazard ratios (HRs). Results: Twelve months after bonding of fixed retainers, improvements were observed in all clinical parameters except CI and radiographic bone gain. The overall CSR of the retainers with a CI <1 at the 12-month follow-up after bonding of fixed retainers was significantly higher than that of the retainers with a CI ≥1 at the 12-month follow-up (log-rank test; P<0.001). Patients with stage III (grade B or C) periodontitis had a higher multivariate HR for retainer failure (5.4; 95% confidence interval, 1.22-23.91; P=0.026) than patients with stage I (grade A or B) periodontitis. Conclusions: Although fixed retainers were bonded in periodontitis patients, periodontal health was well maintained if supportive periodontal treatment with repeated oral hygiene education was provided. Nonetheless, fixed retainer failure occurred more frequently in patients who had stage III (grade B or C) periodontitis or a CI ≥1 at 12-month follow-up after bonding of fixed retainers.

Colorectal Cancer Treatment and Survival: the Experience of Major Public Hospitals in South Australia over three Decades

  • Roder, David;Karapetis, Christos S;Wattchow, David;Moore, James;Singhal, Nimit;Joshi, Rohit;Keefe, Dorothy;Fusco, Kellie;Powell, Kate;Eckert, Marion;Price, Timothy J
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2431-2440
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    • 2015
  • Background: Registry data from four major public hospitals indicate trends in clinical care and survival from colorectal cancer over three decades, from 1980 to 2010. Materials and Methods: Kaplan-Meier productlimit estimates and Cox proportional hazards models were used to investigate disease-specific survival and multiple logistic regression analyses to explore first-round treatment trends. Results: Five-year survivals increased from 48% for 1980-1986 to 63% for 2005-2010 diagnoses. Survival increases applied to each ACPS stage (Australian Clinico-Pathological Stage), and particularly stage C (an increase from 38% to 68%). Risk of death from colorectal cancer halved (hazards ratio: 0.50 (0.45, 0.56)) over the study period after adjusting for age, sex, stage, differentiation, primary sub-site, health administrative region, and measures of socioeconomic status and geographic remoteness. Decreases in stage were not observed. Survivals did not vary by sex or place of residence, suggesting reasonable equity in service access and outcomes. Of staged cases, 91% were treated surgically with lower surgical rates for older ages and more advanced stage. Proportions of surgical cases having adjuvant therapy during primary courses of treatment increased for all stages and were highest for stage C (an increase from 5% in 1980-1986 to 63% for 2005-2010). Radiotherapy was more common for rectal than colonic cases. Proportions of rectal cases receiving radiotherapy increased, particularly for stage C where the increase was from 8% in 1980-1986 to 60% in 2005-2010. The percentage of stage C colorectal cases less than 70 years of age having systemic therapy as part of their first treatment round increased from 3% in 1980-1986 to 81% by 1995-2010. Based on survey data on uptake of adjuvant therapy among those offered this care, it is likely that all these younger patients were offered systemic treatment. Conclusions: We conclude that pronounced increases in survivals from colorectal cancer have occurred at major public hospitals in South Australia due to increases in stage-specific survivals. Use of adjuvant therapies has increased and the patterns of change accord with clinical guideline recommendations. Reasons for sub-optimal use of radiotherapy for rectal cases warrant further investigation, including the potential for limited rural access to impede uptake of treatments at metropolitan-based radiotherapy centres.