• Title/Summary/Keyword: course outcome

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Pretreatment Neutrophil/Lymphocyte Ratio as a Prognostic Aid in Colorectal Cancer

  • Ozdemir, Yavuz;Akin, Mehmet Levhi;Sucullu, Ilker;Balta, Ahmet Ziya;Yucel, Ergun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2647-2650
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    • 2014
  • Background: Colorectal cancers(CRC) are the third most common cancer in the western world, with surgery preferred for management of non-metastatic disease and post surgical treatment usually arranged according to the TNM staging system. However, there is still prognostic variation between patients who have the same stage. It is increasingly recognized that variations within disease course and clinical outcome in colorectal cancer patients are influenced by not only oncological characteristics of the tumor itself but also host response factors. Recent studies have shown correlation between the inflammatory response and clinical outcomes in various cancers. The neutrophil/lymphocyte ratio (NLR) has been described as a marker for immune response to various stimuli including cancer. Material-Methods: Two hundred eighty-one CRC patients were included in our retrospective analysis, separated into two groups according to a cut-off value for the NLR. Patient data including age, gender, vertical penetration, anatomic location, and differentiation of the tumor, TNM stage, survival rate, and disease-free survival were analyzed for correlations with the NLR. Results: Using ROC curve analysis, we determined a cut-off value of 2.2 for NLR to be best to discriminate between patient survival in the whole group. In univariate analysis, high pretreatment NLR (p=0.001, 95%CI 1.483-4.846), pathologic nodal stage (p<0.001, 95%CI 1.082-3.289) and advanced pathologic TNM stage (p<0.001, 95%CI 1.462-4.213) were predictive of shorter survival. In multivariate analysis, advanced pathologic TNM stage (p=0.001, 95%CI 1.303-26.542) and high pretreatment NLR (p=0.005, 95%CI 1.713-6.378) remained independently associated with poor survival. Conclusions: High pre-treatment NLR is a significant independent predictor of shorter survival in patients with colorectal cancer. This parameter is a simple, easily accessible laboratory value for identifying patients with poorer prognosis.

Convergent Research on Oral Health Beliefs in Some University Students (일부 대학생의 구강건강신념에 대한 융합연구)

  • Lim, Sun-A
    • Journal of Convergence for Information Technology
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    • v.8 no.5
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    • pp.37-43
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    • 2018
  • The study was implemented the convergence research on oral health beliefs G area S university convergence course. The final analysis of 168 students agreed to research purpose and method was conducted from March 26 to June 11, 2018. The benefits was highest at 3.99 points, and the severity was lowest at 2.01 about oral health belief. The t-test and ANOVA outcome about oral health improvement behavior and oral health belief were dental clinic visit was benefits and importance, scaling experience was sensitivity, benefits and importance, use of auxiliary oral care products was importance to be statistically significant. The imported oral health beliefs for oral health improve and a variety of programs for oral health education need to be developed within university to learn knowledge of oral health behavior and attitude changed for correct oral health beliefs.

A Study on System Development of School Health in Korea -Part II: Developmental Process and Foremost Tasks of School Health Education- (학교보건제도(學校保健制度) 개발(開發)에 관(關)한 연구 -제2부 학교보건교육의 발전과정과 향후 과제-)

  • Chung, Yeon-Kang;Chang, Chang-Gok;Park, In-Hwa;Shu, Sung-Jae
    • Journal of the Korean Society of School Health
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    • v.7 no.1
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    • pp.37-44
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    • 1994
  • This study is designed to shed light on the current status of school health education in Korea and identify its problems. The findings of this study among other things pointed out that health education should be awarded the status on an independent subject in a bid to activate school health education and cope with its problems. Thus for efforts focused on the needs for establishing health education as an independent course as well as for enhancing the awareness of its importance. At this stage further efforts are needed to develop in-depth discussions and add greater variety to the curriculum. Firstly efforts should be made to recognize the health status of students at all levels, i.d., from kindergarten through university. Particulary at this stage when the entire society is going through changes in the types of health problems and disease pattern, the outcome of analyses on the types of health problems and health-related behavior can be used as basic data for framing the contents of school health education. Secondly more active efforts are required to single out the contents of health education and develop health education curricula assessment based on the findings of surveys on that of health education needs. Thirdly the development of school health education curriculum should be accompanied by that of more effective educational methods and materials. In particular, further efforts should be made to develop educational methods designed to make wider use of audio-visual equipments or apply behavior modification techniques so that school health education will be adapted to changed educational environment and the characteristics of health education. Fourthly and most importantly the training and production competent health education teachers is needed. This should be preceded by the amendment of relevant laws and administrative systems.

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16 Cases of Anti-obesity Drug Intoxication Experienced in 4 Emergency Departments (4개 응급센터에 내원한 비만치료제 중독 환자들의 다양한 임상양상 경험: 16례)

  • Han, Sung Hoon;So, Byung Hak;Jung, Won Joong;Kim, Hyung Min
    • Journal of The Korean Society of Clinical Toxicology
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    • v.10 no.2
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    • pp.111-117
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    • 2012
  • Purpose: In Korea, few studies have examined the acute toxicity of anti-obesity drugs. The purpose of this study is to analyze the general characteristics and clinical aspect of acute anti-obesity drug intoxication. Methods: We retrospectively investigated patients admitted to the emergency department after anti-obesity drug intoxication between March, 2004 and February, 2012. The medical records of these patients were reviewed for demographic data, toxicologic history, time elapsed to presentation, clinical symptoms and signs, treatment, and outcome. Results: There were a total of 18 anti-obesity intoxication cases during the study period; of 16 which were included in our study. The purchasing route of the anti-obesity drug was mainly through a doctor's prescription (68.8%), however, some were obtained through the internet and the pharmacies. The mean time to The most commonly ingested antiobesity drug was sibutramine (31.3%) and many of the cases (62.5%) were multi-drug ingestions. The most common clinical manifestations were gastrointestinal symptoms (94%), but, CNS symptoms (75%) and cardiovascular symptoms (75%) were almost equally present. 13 patients (81%) were discharged after clearance of toxic symptoms and signs with a mean observational period of 7.0 hours. 3 patients were admitted for observation and treatment; of which 1 patient died due to fatal complications. Conclusion: Most anti-obesity intoxications show mild toxicity and a nonfatal clinical course. However, the recent trend toward prescribing psychostimulant anti-obesity medication, which can be fatal after an acute overdose, calls physicians' attention to treating of anti-obesity intoxications.

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White radish and swine scapular cartilage models for auricular framework carving training

  • Hwang, Kun
    • Archives of Craniofacial Surgery
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    • v.21 no.4
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    • pp.225-228
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    • 2020
  • Background: The aim of this study is to develop a two-stage training module using radish and swine scapular cartilage for carving ear cartilage. Methods: In the first stage, white radish was cut in 3-6 mm thick slices. The ear cartilage framework was carved using a graver and the helix and antihelix were fixed with pins. In the second stage, swine scapular cartilage was obtained. The thickness varied 3-6 mm. The ear cartilage framework was made. And triangular fossa and scaphoid fossa were carved with graver. A curvilinear cartilage for helix was assembled to the framework by pin fixing. Six participants were recruited for an ear reconstruction training workshop and figures of the cartilage framework were provided. Participants were asked answer the pre-workshop questionnaire and post-workshop questionnaire on a Likert scale to rate their satisfaction with the outcome. Results: On the pre-workshop questionnaire, participants indicated that they did not have sufficient knowledge and skill for fabricating the ear cartilage framework (1.5±0.5 using white radish; 1.3±0.5 using swine scapular cartilage). On the post-workshop questionnaire, participants responded that they had learned useful knowledge from this workshop, reflecting a significant improvement (3.8±1.0 using white radish; 4.0±1.1 using swine scapular cartilage). They also indicated that they had become somewhat confident in this skill (4.2±0.8 using white radish; 4.3±0.5 using swine scapular cartilage. The participants generally found the workshop satisfactory (practically helpful, 4.7±0.5; knowledge improved, 4.8±0.4; satisfied with course, 4.5±0.5; would recommend to others, 4.8±0.4). Conclusion: This model can be useful for ear reconstruction training for medical personnel.

A Study on a Student's General Recognition of Web-Based PBL and Learning Activity of Students by Their Reflective Thinking Level (웹 기반 문제중심학습에 대한 학습자의 인식, 성찰수준, 학습활동에 관한 연구 - 간호학 대학원 학생을 중심으로 -)

  • Lee, Sun-Oak;Park, Young-Suk
    • The Journal of Korean Academic Society of Nursing Education
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    • v.15 no.2
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    • pp.194-204
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    • 2009
  • Purpose: Level of reflective thinking of students are important factors in the area of nursing studies on web-based PBL. These factors were used as a component of learning strategies. One was to understand general recognition to web-based PBL and reaction to the use of reflective journal. The other was to investigate the level of reflective thinking was related to learning activity. Method: PBL was adopted for an online course titled 'Nursing Assessment and Intervention'. Twenty graduate students were evaluated from questionnaire, reflective journals, and individual assignments. Result: Web-based PBL was strong for self-directed learning, team activity, creative thinking, diversity of thinking, and diverse process of learning while hard time, lack of cooperation, uncertainty of outcome, and lack of time were considered as weakness. Reflective journal gave moderate help to learning activities. The learners' learning activities was the lowest in the middle level of reflective thinking. Conclusion: Generally, graduate students in college of nursing showed slightly positive attitude to PBL experience and slightly positive reaction to the learning effect of reflective journal. PBL was estimated to be valuable and meaningful. There was no relationship between the level of reflective thinking and learning activities.

Clinical outcome of acute necrotizing encephalopathy in related to involving the brain stem of single institution in Korea

  • Lee, Cha Gon;Kim, Ji Hye;Lee, Munhyang;Lee, Jeehun
    • Clinical and Experimental Pediatrics
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    • v.57 no.6
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    • pp.264-270
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    • 2014
  • Purpose: Acute necrotizing encephalopathy (ANE) is a fulminant disease of the brain characterized by bilateral thalamic lesions, and is prevalent among children in East Asia. The prognosis of ANE is usually poor with a high mortality rate and neurological sequelae. This study aimed to delineate the clinical characteristics and prognostic factors of ANE. Methods: We retrospectively analyzed clinical data of 399 pediatric patients with encephalitis who were admitted to Samsung Medical Center from December 1998 to March 2011. We enrolled ten patients (11 cases) with ANE and analyzed their demographic, clinical, and neuroimaging data. The location and extent of the brain regions were checked based on fluid-attenuated inversion recovery, T1-, and T2-weighted imaging findings; the presence of contrast enhancement, restricted diffusion, and hemorrhage. Results: Ten patients were identified, including one patient with two episodes. The median age of onset was 1.5 years (0.4-8.4 years). The mortality rate was 40%, and only 30% of patients survived without neurological sequelae. The definite involvement of the brainstem on brain magnetic resonance imaging was significantly correlated with mortality (P =0.04). Conclusion: Broad and extensive brainstem involvement suggested the fulminant course of ANE. Early diagnosis of ANE before brainstem involvement, through careful identification of symptoms of brain dysfunction, may be the best way to achieve better neurological outcomes.

CSF Leakage through a Subarachnoid-pleural Fistula after Resection of a Malignant Solitary Fibrous Tumor (악성 고립성 섬유종 제거술 후 발생한 뇌척수액의 흉강내로의 유출)

  • Choi, Kwang-Ho;Lee, Yang-Haeng;Hwang, Youn-Ho;Yoon, Young-Chul;Cho, Kwang-Hyun;Jung, Yong-Tae
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.332-335
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    • 2010
  • Solitary fibrous tumor is an uncommon submesothelial mesenchymal neoplasm that primarily arises from the pleura. Most solitary fibrous tumors have a benign course, and the single most important predictor of the clinical outcome is the ability to excise the entire lesion. We experienced a case of CSF leakage through a subarachnoid-pleural fistula after resection of a malignant solitary fibrous tumor and the involved rib. We detected CSF leakage via performing CT myelography and we treated this case with hemilaminectomy and dura repair.

Drug Use Evaluation of Clostridium difficile Infection in Elderly Patients and Risk Factors of Non-improving Group (노인층에서 Clostridium difficile 감염 약물사용평가 및 비호전군에 대한 영향인자)

  • Noh, Hyun Jeong;Ham, Jung Yeon;Lee, Ja Gyun;Rhie, Sandy Jeong
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.3
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    • pp.174-180
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    • 2018
  • Objective: Clostridium difficile Infection (CDI) is one of the common nosocomial infections. As elderly population increases, the proper treatment has been emphasized. We investigated the risk factors associated with CDI unimprovement in elderly patients. Furthermore, we performed drug use evaluation of old CDI patients and oldest-old CDI patients. Methods: It was a retrospective study using electronic medical record at Kangbuk Samsung Medical Center (KBSMC) from January 2016 to December 2017. Seventy three patients aged 65 years or older, diagnosed with CDI by Clostridium difficile Toxin B Gene [Xpert] were screened and they were assessed for risk factors regarding unimprovement status. We also evaluated drug use evaluation in old patients ($65{\leq}age$<80) and oldest-old patients ($80{\leq}age$) by assessing the use of initial therapy, severity, dose, route, treatment course, days of use, total days of use and treatment outcome of initial therapy. Results: Out of 73 patients aged over 65 years, four patients were excluded because they did not receive any treatment. There were 31 improved patients and 38 unimproved patients after initial therapy. We were able to find out patients with surgical comorbidity or endocrine comorbidity (especially, diabetes mellitus) had 2.885 more risk of becoming unimproved than those patients without surgical comorbidity or endocrine comorbidity. Drug use evaluation for CDI was generally fair, but vancomycin as initial therapy is more recommended than metronidazole. Conclusion: Although age, antibiotics exposure, use of antacids are all important risk factors for CDI, our result did not show statistical significance for these risk factors. However, the study is meaningful because the number of elderly population keeps increasing and recently updated guideline suggests the use of vancomycin as drug of choice for CDI.

Space and Time in the Architectures of the East and the West (동서양 건축에서의 공간과 시간)

  • Kim, Sung-woo
    • Journal of architectural history
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    • v.13 no.3
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    • pp.97-117
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    • 2004
  • The tradition of architecture in the East and the West are different in many ways. One of the basic cause of such difference, however, is the different ways of perception of space and time. This paper aims to identify the attitude of perception of space and time in the cultures of the East and the West, and its influence on architecture. Degrees of importance placed on either space or time, as well as the modes of perception of space and time are discussed in relation to architecture. Basically, the architecture of the West seems to be more spatially oriented than the East, and this have much to do with the fact that the tradition of Western architecture is visually oriented. On the other hand, East Asian architecture have been more conscious on bodily feeling and its movement in architecture. Spatial units of traditional Eastern architecture, are arranged in such a way in which man can experience the change of space that is supposed to be organized to form a sequential message. Thus, in the East, temporal dimension is more deliberately included in the course of architectural experience compared to the cases of the West. Although it is not easy to attempt any kind of value judgment on such aspects, it is necessary to understand how the different perception of space and time influenced architectural outcome, especially when one wants to understand the cultural cause that have made the architectures of the East and the West very different. Such understanding is particularly important in East Asia where their future of architecture depends much on how they harmonize the Eastern and Western background which are already built up as two cultural structure in their consciousness to be able to create more desirable architecture for themselves.

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