Objective : To compare the efficacy between SKI306X and Diclofenac by using generalized estimating equations (GEE) methodology in the analysis of correlated bivariate binary outcome data in Osteoarthritis (OA) diseases. Methods : A randomized, double-blind, active comparator-controlled, non-inferiority clinical trial was conducted at 5 institutions in Korea with the random assignment of 248 patients aged 35 to 75 years old with OA of the knee and clinical evidence of OA. Patients were enrolled in this study if they had at least moderate pain in the affected knee joint and a score larger than 35mm as assessed by VAS (Visual Analog Scale). The main exposure variable was treatment (SKI 306X vs. Diclofenac) and other covariates were age, sex, BMI, baseline VAS, center, operation history (Yes/No), NSAIDS (Y/N), acupuncture (Y/N), herbal medicine (Y/N), past history of musculoskeletal disease (Y/N), and previous therapy related with OA (Y/N). The main study outcome was the change of VAS pain scores from baseline to the 2nd and 4th weeks after treatment. Pain scores were obtained as baseline, 2nd and 4th weeks after treatment. We applied GEE approach with empirical covariance matrix and independent(or exchangeable) working correlation matrix to evaluate the relation of several risk factors to the change of VAS pain scores with correlated binary bivariate outcomes. Results : While baseline VAS, age, and acupuncture variables had protective effects for reducing the OA pain, its treatment (Joins/Diclofenac) was not statistically significant through GEE methodology (ITT:aOR=1.37, 95% CI=(0.8200, 2.26), PP:aOR=1.47, 95% CI=(0.73, 2.95)). The goodness-of-fit statistic for GEE (6.55, p=0.68) was computed to assess the adequacy of the fitted final model. Conclusions : Both ANCOVA and GEE methods yielded non statistical significance in the evaluation of non-inferiority of the efficacy between SKI306X and Diclofenac. While VAS outcome for each visit was applied in GEE, only VAS outcome for the fourth visit was applied in ANCOVA. So the GEE methodology is more accurate for the analysis of correlated outcomes.
Song, Joon Ho;Kim, Young Seok;Jung, Bok Ki;Lee, Dong Won;Song, Seung Yong;Roh, Tai Suk;Lew, Dae Hyun
Archives of Plastic Surgery
/
v.44
no.6
/
pp.516-522
/
2017
Background Implant-based breast reconstruction is being performed more frequently, and implants are associated with an increased risk of infection. We reviewed the clinical features of cases of implant infection and investigated the risk factors for breast device salvage failure. Methods We retrospectively analyzed 771 patients who underwent implant-based breast reconstruction between January 2010 and December 2016. Age, body mass index, chemotherapy history, radiation exposure, and smoking history were assessed as potential risk factors for postoperative infection. We also evaluated the presence and onset of infection symptoms, wound culture pathogens, and other complications, including seroma, hematoma, and mastectomy skin necrosis. Additionally, we examined the mastectomy type, the use of acellular dermal matrix, the presence of an underlying disease such as hypertension or diabetes, and axillary node dissection. Results The total infection rate was 4.99% (58 of 1,163 cases) and the total salvage rate was 58.6% (34 of 58). The postoperative duration to closed suction drain removal was significantly different between the cellulitis and implant removal groups. Staphylococcus aureus infection was most frequently found, with methicillin resistance in 37.5% of the cases of explantation. Explantation after infection was performed more often in patients who had undergone 2-stage expander/implant reconstruction than in those who had undergone direct-to-implant reconstruction. Conclusions Preventing infection is essential in implant-based breast reconstruction. The high salvage rate argues against early implant removal. However, when infection is due to methicillin-resistant S. aureus and the patient's clinical symptoms do not improve, surgeons should consider implant removal.
Digital radiography has been replacing rapidly the analog radiography for diagnosis of pneumoconiosis. The purpose of this study is to compare quality control of digital radiography (DR) and analog radiography (AR) for chest radiography in medical institution for pneumoconiosis (MIP) For the first time, we visited MIP to evaluate the chest radiography which is used for patients with pneumoconiosis, including equipment, technical parameters and reading environment. There were 33 institutions. DR and AR were installed in 24 and 9 institutions, respectively. Between DR and AR, we compared the radiological technique (RT), image quality (IQ) and reading environment (RE) to use the guideline published by Occupational Safety and Health Research Institute (OSHRI). The image quality was rated by two experienced chest radiologists for pneumoconiosis with certified from OSHRI. The chest radiography equipment was not significantly difference between AR and DR, but there were significantly difference in tube voltage and grid ratio used for chest radiography except to tube current, exposure time. Statistically, DR is significantly higher in RT(70.3 vs. 43.8, p = 0.009), RE(77.7 vs. 33.3, p = 0.004) than AR, but it's not significantly difference in IQ (65.6 vs. 52.8, p = 0.050). AR and DR in RT were passed 33.3%, 75.0% respectively (p = 0.044) and 44.4%, 79.2% (p = 0.090) in IQ and 44.4%, 91.7% (p = 0.009) in RE. In MIP, DR needs to replace AR in diagnosis of pneumoconiosis.
This study was aimed to investigate factors that affected the status of wearing personal protective equipment (PPE) for handling poultry carcasses with potential exposure to virulent avian infectious agents. A large outbreak of high pathogenic avian influenza (HPAI) occurred in South Korea in 2014. Many public officers participated for euthanizing and handling livestock carcass. However, several safety issues with using PPE were revealed. Therefore, a questionnaire survey was conducted for 340 people who participated euthanasia and carcass disposal in the place where HPAI mainly occurred in 2014. It was found that 31.8% of the respondents had ever taken off their protective equipment during operations because of its inconvenience. The most inconvenient PPE was goggles (54.6%), followed by mask (20.2%), latex gloves (11.6%), shoe covers (5.9%) and protective clothing (5.3%). The main complaints about this individual PPE was unclear sight, damp emitted toward eye, sweating, tearing easily and sweating, respectively. Considering such problems of PPE, new possible directions for improvement of gloves and goggles were suggested. With newly developed rubber coating fabric gloves and conventionally using latex and fabric gloves, H3N2 influenza virus transmission experiment was conducted. Rubber coating fabric gloves showed similar efficiency for blocking virus transmission with latex laboratory gloves and were not easily torn by sharp claws of chicken. In addition, air flow control safety eyewear was suggested to minimize moisture formation. The air flow control system efficiently suppressed moisture formation inside the goggles. Therefore our study will provide more specific directions about new PPE development for safety protection of actual wearers.
The most remarkable aspect in the hormesis law is that dose of harmful agents can produce effect that are diametrically opposite to the effect found with high doses of the same agent. Minute quantities of a harmful agent bring about very small change in the organism and control mechanisms appear to subjugate normal processes to place the organism in a state of albert and repair. The stimulated organism in more responsive to changes in environmental factors than it did before being alerted. Routine functions, including repair and defense, have priority for available energy and matetial. The alerted organism utilizes nutrients more efficiently, grows faster, shows improved defense, and lives longer. Accelerated germination, sprouting, growth, development, blooming and ripening, and increased crop yield and resistance to disease are found in plants. Another concept supported by the data in that low doses of ionizing radiation provide increased resistance to subsequent high doses of radiation. The hormesis varies with subject plant, variety, state of seed, environmental and cultural conditions, physiologic function measured, dose rate and total exposure. The results of hormesis are less consistently found, probably due to the great number of uncontrolled variables in the experiments. The general dosage for radiation homlesis in about 100 (10 to 1,000) times ambient or 100 (10 to 1,000) times less than a definitely harmful dose, but these must be modified to the occasion. Although little is known about most mechanisms of homzesis reaction, overcompensation of repair mechanism is offered as one mechanism.
$Salmonella$ spp. and $Brucella$ spp. have caused a considerable disease of farmed animals and economic loss in animal farming and food industry. In this study, the disinfection efficacy of Vital-$Oxidel^{(R)}$, a commercial disinfectant, composed to chlorine dioxide, betaine hydrochloride, and propylene glycol was evaluated against $S.$$typhimurium$ and $Brucella$$ovis$. A bactericidal efficacy test by broth dilution method was used to determine the lowest effective dilution of the disinfectant following exposure to test bacteria for 30 min at $4^{\circ}C$. Vital-$Oixdel^{(R)}$ and test bacteria were diluted with distilled water (DW), hard water (HW) or organic matter suspension (OM) according to treatment condition. On OM condition, the bactericidal activity of Vital-$Oixdel^{(R)}$ against S. typhimurium and Brucella ovis was lowered compared to that on HW condition. As Vital-$Oxidel^{(R)}$ possesses bactericidal efficacy against animal pathogenic bacteria such as $S.$$typhimurium$ and $Brucella$$ovis$, this disinfectant solution can be used to control the spread of bacterial diseases.
Kim, Im-Soon;Oh, Hong-Sok;Lee, Kwan-Hyung;Kim, Choong-Gon
Journal of Environmental Impact Assessment
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v.27
no.3
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pp.241-250
/
2018
Recently, negative effects on human health such as disease caused by harmful environment have been dealt with seriously. In particular, studies on the effect of radon exposure, which is known as a primary carcinogen in lung cancer due to radioactive materials, have been actively studied. In Korea, since January 1, 2018, radon measurement is mandatory when building a new apartment, so it is necessary to measure the radon concentration and submit it to the local government and it should be posted where residents can see it. Radon has only recommended standards for multi-use facilities, but now it has decided to set recommendation standards for private homes. Therefore, it should now be possible to manage the radon in the environmental impact assessment phase as well as in the Post-environmental Impact Assessment. It should be possible to share health information such as the radon concentration and the risk of radon, and participation of health experts in the environmental impact assessment stage is required. Soil, air quality, hygiene and aerial items should be improved to take into account the effects of radon on human health during the environmental impact assessment process. If the level value of conncentration of radon shows above the recommended level, then alternative measures should be prepared and mitigation measures should be prepared as well.
Na Kyung-Sang;Kwon Eui-Kwang;Soo Yeung-Hyung;Suh Eun-Mi;Han Jong-Hyun
Korean Journal of Acupuncture
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v.18
no.1
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pp.157-164
/
2001
Radix Asteris has been used in Korea for many centuries as a treatment for respiratory disease. The effect of Radix Asteris on tracheal smooth muscle is not known. The purpose of the present study is to determine the effect of Radix Asteris on histamine induced tracheal smooth muscle contraction in rats and guinea pigs. Guinea pig(500g, male) and Sprague Dawley rats (250g, male) were killed by $CO_2$ exposure and a segment (8-10mm) of the thoracic trachea from each rat and guinea pig was cut into equal segments and mounted 'in pairs' in a tissue bath. Contractile force was measured with force displacement transducers under 0.5g loading tension. The dose of histamine (His) which evoked 50% of maximal response ($ED_{50}$) was obtained from cumulative dose response curves for histamine $(10^{-7}{\sim}10^{-4}M)$. Contractions evoked by His ($ED_{50}$) were inhibited significantly by Radix Asteris. In guinea pig tracheal smooth muscle, the mean percent inhibition of histamine induced contraction was 120.5% (p<0.01) after $100{\mu}l/ml$ Radix Asteris. In rat tracheal smooth muscle, the mean percent inhibition of histamine induced contraction was 135.4% (p<0.01) after $100{\mu}l/ml$ Radix Asteris. Propranolol $(10^{-7}M)$ slightly but significantly attenuated the inhibitory effects of Radix Asteris. Following treatment with propranolol, the mean percent inhibition caused by $100{\mu}l/ml$ Radix Asteris fell to 44.6% in guinea pig induced by histamine contraction and by $100{\mu}l/ml$ Radix Asteris fell to 18.7% (p<0.05) in rat induced by histamine contraction. Indomethacin and methylene blue$(10^{-7}M)$ did not significantly alter the inhibitory effect of Radix Asteris. These results indicate that Radix Asteris can relax histamine induced contraction of guinea pig and rat tracheal smooth muscle, and that this inhibition involves sympathetic effects.
Park, Ju-Un;Kim, Byung-Ock;Park, Joo-Cheol;Jang, Hyun-Seon
Journal of Periodontal and Implant Science
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v.36
no.1
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pp.27-37
/
2006
Although the main purpose of periodontal treatment to regenerate is the complete regeneration of periodontal tissue due to periodontal disease, most of the treatment cannot meet such purpose because healing by long epithelial junction. Therefore, diverse materials of resorbable and non-resorbable have been used to regenerate the periodontal tissue. Due to high risk of exposure and necessity of secondary surgical procedure when using non-resorbable membrane, guided tissue regeneration using the resorbable membrane has gain popularity, recently. However, present resorbable membrane has the disadvantage of not having sufficient time to regenerate date to the difference of resorption rate according to surgical site. Meanwhile, other than the structure stability and facile manipulation, acellular dermal matrix has been reported to be a possible scaffold for cellular proliferation due to rapid revascularization and favorable physical properties for cellular attachment and proliferation. The purpose of this study is to estimate the influence of acellular dermal matrix on periodontal ligament, cementum and alveolar bone when acellular dermal matrix is implanted to 1-wall alveolar bone defect. 4 dogs of 12 to 16 month old irrelevant to sex , which below 15Kg of body weight, has been used in this study. ADM has been used for the material of guided tissue regeneration. The 3rd premolar of the lower jaw was extracted bilaterally and awaited for self-healing. subsequently buccal and lingual flap was elevated to form one wall intrabony defect with the depth and width of 4mm on the distal surface of 2nd premolar and the mesial surface of 4th premolar. After the removal of periodontal ligament by root planing. notch was formed on the basal position. Following the root surface treatment, while the control group had the flap sutured without any treatment on surgically induced intrabony defect. Following the root surface treatment, the flap of intrabony defect was sutured with the ADM inserted while the control group sutured without any insertion. The histologic specimen was observed after 4 and 8 weeks of treatment. The control group was partially regenerated by periodontal ligament, new cementum and new alveolar bone. the level of regeneration is not reached on the previous formed notch. but, experimental group was fully regenerated by functionally oriented periodontal ligament fiber. new cementum and new alveolar bone. In conclusion, we think that ADM seems to be used by scaffold for periodontal ligament cells and the matrix is expected to use on guided tissue regeneration.
Epithelial-mesenchymal interaction plays a important role in cell growth and differentiation. This interaction is already well known to have an importance during the organ development as well as cell growth and differentiation. However, in vitro experimental model is not well developed to reproduce in vivo cellular microenvironment which provide a epithelial-mesenchymal interaction. Because conventional monolayer culture lacks epithelial-mensenchymal interaction, cultivated cells have an morphologic, biochemical, and functional characteristics differ from in vivo tissue. Moreover, it's condition is not able to induce cellular differention due to submerged culture condition. Therefore, the aims of this study were to develop and evaualte the in vitro experimental model that maintains epithelial-mesenchymal interaction by organotypic raft culture, and to characterize biologic properties of three-dimensionally reconstituted oral keratinocytes by histological and immunohistochemical analysis. The results were as follow; 1. Gingival keratinocytes reconstituted by three-dimensional organotypic culture revealed similar morphologic characteristics to biopsied patient specimen showing stratification, hyperkeratinosis, matutation of epithelial architecture. 2. Connective tissue structure was matured, and there is no difference during stratification period of epithelial 3-dimensional culture. 3. The longer of air-exposure culture on three-dimensionally reconstituted cells, the more epithelial maturation, increased epithelial thickness and surface keratinization 4. In reconstitued mucosa, the whole epidermis was positively stained by anti-involucrin antibody, and there is no difference according to air-exposured culture period. 5. The Hsp was expressed in the epithelial layer of three-dimensionally cultured cells, especially basal layer of epidermis. The change of Hsp expression was not significant by culture stratification. 6. Connexin 43, marker of cell-cell communication was revealed mild immunodeposition in reconstitued epithelium, and there is no significant expression change during stratification. These results suggest that three-dimensional oragnotypic co-culture of normal gingival keratinocytes with dermal equivalent consisting type I collagen and gingival fibroblasts results in similar morphologic and immunohistochemical characteristics to in vivo patient specimens. And this culture system seems to provide adequate micro-environment for in vitro tissue reconstitution. Therefore, further study will be focused to study of in vitro gingivitis model, development of novel perioodntal disease therapeutics and epithelial-mensenchymal interaction.
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