• Title/Summary/Keyword: intended death

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DESIGN AND ANALYSIS OF RANDOMIZED CLINICAL TRIALS REQUIRING PROLONGED OBSERVATION OF EACH PATIENT I. INTRODUCTION AND DESIGN

  • Peto R.;Pike M.C.;Armitage P.;Breslow N.E.;Cox D.R.;Howard S.V.;Mantel N.;Mcpherson K.;Peto J.;Smith P.G.
    • 대한예방의학회:학술대회논문집
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    • 1994.02b
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    • pp.206-233
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    • 1994
  • The Medical Research Council has for some years encouraged collaborative clinical trials in leukaemia and other cancers, reporting the results in the medical literature. One unreported result which deserves such publication is the development of the expertise to design and analyse such trials. This report was prepared by a group of British and American statisticians, but it is intended for people without any statistical expertise. Part!, which appears in this issue, discusses the design of such trials; Part II, which will appear separately in the January 1977 issue of the Journal, gives full instructions for the statistical analysis of such trials by means of life tables and the logrank test, including a worked example, and discusses the interpretation of trial results, including brief reports of particular trials. Both parts of this report are relevant to all clinical trials which study time to death, and would be equally relevant to clinical trials which study time to other particular classes of untoward event: first stroke, perhaps, or first relapse, metastasis, disease recurrence, thrombosis, transplant rejection, or death from a particular cause. Part I, in this issue, collects together ideas that have mostly already appeared in the medical literature, but Part II, next month, is the first simple account yet published for non-statistical physicians of how to analyse efficiently data from clinical trials of survival duration. Such trials include the majority of all clinical trials of cancer therapy; in cancer trials, however, it may be preferable to use these statistical methods to study time to local recurrence of tumour, or to study time to detectable metastatic spread, in addition to studying total survival. Solid tumours can be staged at diagnosis; if this, or any other available information in some other disease is an important determinant of outcome, it can be used to make the overall logrank test for the whole heterogeneous trial population more sensitive, and more intuitively satisfactory, for it will then only be necessary to compare like with like, and not, by chance, Stage I with Stage III.

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A prediction of overall survival status by deep belief network using Python® package in breast cancer: a nationwide study from the Korean Breast Cancer Society

  • Ryu, Dong-Won
    • Korean Journal of Artificial Intelligence
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    • v.6 no.2
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    • pp.11-15
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    • 2018
  • Breast cancer is one of the leading causes of cancer related death among women. So prediction of overall survival status is important into decided in adjuvant treatment. Deep belief network is a kind of artificial intelligence (AI). We intended to construct prediction model by deep belief network using associated clinicopathologic factors. 103881 cases were found in the Korean Breast Cancer Registry. After preprocessing of data, a total of 15733 cases were enrolled in this study. The median follow-up period was 82.4 months. In univariate analysis for overall survival (OS), the patients with advanced AJCC stage showed relatively high HR (HR=1.216 95% CI: 0.011-289.331, p=0.001). Based on results of univariate and multivariate analysis, input variables for learning model included 17 variables associated with overall survival rate. output was presented in one of two states: event or cencored. Individual sensitivity of training set and test set for predicting overall survival status were 89.6% and 91.2% respectively. And specificity of that were 49.4% and 48.9% respectively. So the accuracy of our study for predicting overall survival status was 82.78%. Prediction model based on Deep belief network appears to be effective in predicting overall survival status and, in particular, is expected to be applicable to decide on adjuvant treatment after surgical treatment.

Jeong YagYong's Perceptions of Sea Refugees and Maritime borderlines (다산 정약용의 표류민과 해상국경에 대한 인식)

  • Shin, Jae-Hoon
    • Strategy21
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    • s.36
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    • pp.215-240
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    • 2015
  • Jeong YagYong, who are the SilHak Scholar during 18th to 19th century, wrote the Sadaegore with his pupil Lee Cheong. This work is the guide of diplomacy, which are asked to write from King Jeongjo. Although this book was completed after King Jeongjo's death, it harbors the King's thoughts about diplomacy or the relationship with China. Haebanggo, one chapter of the book, is about marine policy and how to treat the castaways. In this chapter, Jeong YagYong provides various ways to deal with these problems in marine area and sea refugee I will examine the Jeong YagYong's thought about the problems and ways to address these problems. Futhermore, I will inquire Jeong's opinion on the boundary in marine area. He recognized that many border transgressions happened in marine area at that time and considered that as urgent political affairs. Haebanggo consists of two parts. First part of the book is about protect own island from other countries. The rest part is about cases of dealing with castaways and their transgression. I argue that Jeong YagYong intended to make distinct borderlines in marine area and empathized the necessity of protecting Joseon's islands from other countries.

A Case of Clinical Improvement after Enzyme Replacement Therapy in Pompe Disease (효소 보충 치료로 호전을 보인 Pompe병 1례)

  • Jeon, You Hoon;Eun, Baik Lin;Lee, Dong Hwan
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.5 no.1
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    • pp.18-22
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    • 2005
  • Pompe disease is a genetic disorder caused by a deficiency of acid ${\alpha}$-glucosidase (GAA). This enzyme defect results in lysosomal glycogen accumulation in multiple tissues and cell types, with cardiac, skeletal, and smooth muscle cells the most seriously affected. Infantile-onset Pompe disease is uniformly lethal. Affected infants present in the first few months of life with hypotonia, generalized muscle weakness, and a hypertrophic cardiomyopathy, followed by death from cardiorespiratory failure or respiratory infection, usually by 1 year of age. Late-onset forms is characterized by a lack of severe cardiac involvement and a less severe short-term prognosis. Enzyme replacement therapy for Pompe disease is intended to address directly the underlying metabolic defect via intravenous infusions of recombinant human GAA to provide the missing enzyme. We experienced one case of Pompe disease in 3-years old boy that has improved his exercise ability and cardiac function after GAA enzyme replacement therapy.

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A review of pathophysiological mechanism of Bisphosphonate-related osteonecrosis of the jaw (임상가를 위한 특집 1 - 비스포스포네이트 관련 골괴사의 병태생리학적 기전에 대한 검토)

  • Kwon, Tae-Geon
    • The Journal of the Korean dental association
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    • v.52 no.4
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    • pp.192-202
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    • 2014
  • Bisphosphonate(BP) significantly influence the hone remodeling process. Increasing number of patients with osteoporosis and metastatic bone disease need high dose or long term bisphosphonate therapy. Major adverse effect is jaw bone necrosis and now the bisphosphonate-related necrosis of the jaw(BRONJ) is the major concern of dental practitioner. This study intended to perform the review of the current understandings concerning the pathophysiology of BRONJ. Even though pathophysiological mechanism of BRONJ is not clearly elucidated but now suggested as largely two different concepts; so-called "inside-out" or "outside-in" theory. Inside-out theory emphasize the osteonecrosis of the jaw is the initial major event and subsequent infection and inflammation is the second event that accompanies bone exposure and death of overlying mucosa. However, in "outside-in" theory, infection or inflammation initiated by traumatized oral epithelium is the major event of BRONJ. Both theory would be partially explain BRONJ. Recent research reveals the immune modulating effect and influence of microcrack accumulation by BP. These findings and those of others might explain the missing part of outside-in theory.

Death in the Neonatal Intensive Care Unit (신생아 중환자실의 사망에 관한 연구)

  • Koo, So-Eun;Kim, Hee-Young;Park, Kyoung-A;Lim, Gin-A;Park, Hye-Won;Lee, Byoung-Sop;Kim, Ellen Ai-Rhan;Kim, Ki-Soo;Pi, Soo-Young
    • Neonatal Medicine
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    • v.16 no.2
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    • pp.154-162
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    • 2009
  • Purpose: Death is an important problem for physicians and parents in neonatal intensive care unit. This study was intended to evaluate the mortality rate, causes of death, and the change of mortality rate by year for infants admitted to the neonatal intensive care unit. Methods: We retrospectively surveyed the medical records of the infants who were admitted to the neonatal intensive care unit at Asan Medical Center and who died before discharge between 1998 and 2007. Gestational age, birth weight, gender, time to death and the underlying diseases related to the causes of infant deaths and obtained from the medical records and analyzed according to year. Results: A total of 6,289 infants were admitted and 264 infants died during the study period. The overall mortality rate was 4.2%. For very low and extremely low birth weight infants, the mortality rate was 10.6% and 21.4%, respectively. There was no significant change in the mortality rate during the study period. Prematurity related complications and congenital anomalies were the conditions most frequently associated with death in the neonatal intensive care unit. of the infant deaths 37.1% occurred within the first week of life. Conclusion: Even though a remarkable improvement in neonatal intensive care has been achieved in recent years, the overall mortality rate has not changed. To reduce the mortality rate, it is important to control sepsis and prevent premature births. The first postnatal week is a critical period for deaths in the neonatal intensive care unit.

A Study on Maternity Aids Utilization in the Maternal and Child Health and Family Planning (농촌(農村)에 있어서 분만개조요원(分娩介助要員)의 봉사(奉仕)에 의(依)한 모자보건(母子保健)rhk 가족계획(家族計劃)에 관(關) 연구(硏究))

  • Yeh, Min-Hae;Lee, Sung Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.5 no.1
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    • pp.57-95
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    • 1972
  • This study was conducted to assess the effectiveness of service by maternity aids concerning maternal and child health in improving simultaneously infant mortality, contraception and vital registration among expectant mothers in rural Korea, where there is less apportunity for maternal and child health care. It is unrealistic to expect to solve this problem in rural Korea through professional persons considering the situation of medical facilities and the socioeconomic condition of residents. So, we intended to adopt a system of services by maternity aids who were educated formally among indigenous women. After the women were trained in maternal and child health, contraception, and registration for a short period, they were assigned as a maternity aids to each village to help with various activities concerning maternal and child health, for example, registration of pregnant women, home visiting to check for complications, supplying of delivery kits, attendance at delivery, persuasion of contraception, and invitation for registration and so on. Mean-while, four researchers called on the maternity aids to collect materials concerning vital events, maternal child health, contraception and registration, and to give further instruction and supervision as the program proceeded. A. Changes of women's attitude by services of maternity aid. Now, we examined to what extent' such a service system to expectant mothers affected a change in attitude of women residing in the study area as compared to women of the control area. 1) In the birth and death places, there were no changes between last and present infants, in study or control area. 2) In regard to attendants at delivery, there were no changes except for a small percentage of attendance (8%) by maternity aid in study area. But, I expect that more maternity sids could be used as attendants at delivery if they would be trained further and if there was more explanation to the residents about such a service. 3) Considering the rate of utilization of sterilized delivery kit, I am sure that more than 90 percent would be used if the delivery kit were supplied in the proper time. There were significant differences in rates between the study and the control areas. 4) Taking into consideration the utilization rate of the clinic for prenatal care and well baby care, if suck facilities were installed, it would probably be well utilized. 5) In the contraception, the rate of approval was as high as 89 percent in study area as compared to 82 percent in the control area. 6) Considering the rate of pre-and post-partum acceptance on contraception were as much as 70 percent or more, if motivation to use contraception was given to them adequately, the government could reach the goals for family planning as planned. 7) In the vital registration, the rate of birth registration in the study area was some what improved compared to that of the control area, while the rate of death registration was not changed at all. Taking into account the fact that the rate of confirmation of vital events by maternity aids was remarkably high, if the registration system changed to a 'notification' system instead of formal registration ststem, it would be improved significantly compared to present system. B. Effect of the project Thus, with changes in the residents' attitude, was there a reduction in the infant death rate? 1) It is very difficult problem to compare the mortality of infants between last and present infants, because many women don't want to answer accurately about their dead children especially the infants that died within a few days after birth. In this study the data of present death comes from the maternity aides who followed up every pregnancy they had recorded to see what had happened. They seem to have very reliable information on what happened in first few weeks with follow up visitits to check out later changes. From these calculaton, when we compared the rate of infant death between last and present infant, there was remarkable reduction of death rate for present infant compare to that of last children, namely, the former was 30, while the latter 42. The figure is the lowest rate that I have ever heard. As the quality of data we could assess by comparing the causes of death. In the current death rate by communicable disease was much lower compare to the last child especially, tetanus cases and pneumonia. 2) Next, how many respondents used contraception after birth because of frequent contact with the maternity aid. In the registered cases, the respondents showed a tendency to practice contraception at an earlier age and with a small number of children. In a comparison of the rate of contraception between the study and the control area, the rate in the former was significantly higher than that of the latter. What is more, the proportion favoring smaller numbers of children and younger women rose in the study area as compared to the control area. 3) Regarding vital registration, though the rate of registration was gradually improved by efforts of maternity aid, it would be better to change the registration system. 4) In the crude birth rate, the rate in the study area was 22.2 while in the control area was 26.5. Natural increase rate showed 15.4 in the study area, while control area was 19.1. 5) In assessment of the efficiency of the maternity aids judging by the cost-effect viewpoint, the workers in the Medium area seemed to be more efficiency than those of other areas.

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A Study on the Analysis of Industrial Accident Deaths in Public Institutions and the Awareness Survey of Safety Enhancement Measures for Public Institutions (공공기관 산재 사고사망 분석 및 공공기관 작업장 안전강화 대책의 인식도 조사에 관한 연구)

  • Kim, Sang Hyun;Hwang, In Sung;Kang, Chan Kyu
    • Journal of the Korean Society of Safety
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    • v.35 no.3
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    • pp.64-71
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    • 2020
  • Safety is not a service provided selectively by the country, and it is a basic right that human beings should enjoy. However, as the recent expansion of outsourcing due to the efficient corporate management, fatal accidents such as the Taean Power Plant where subcontractors are pinched on conveyors continued to occur. In addition, public safety concerns have been widespread as there are constant safety-related accidents in public institutions such as KTX trains derailing. As public institutions require safety as a top priority for management rather than profit, the government needs a leading role to enhance the level of private safety activities. The government announced the "Measures to strengthen the workplace safety of public institutions" and is promoting measures to protect the lives and safety of the people. The purpose of this study was to in-depth analysis of the accident and death situation in public institutions in the last 5 years from 2014 to 2018. A recognition survey was also conducted and the results were analyzed. As a result of the analysis of industrial accident death, it showed that the number of industrial accident deaths in public institutions was about 50 people per year, and it occupied about 6.1% of all industrial accidents. Following the government's public policy measures, positive changes as a result of the survey on awareness were detected in the order of rising safety awareness and participation of management (56.9%), safety and health organization and personnel composition (37.9%), and increasing safety awareness and participation of members (18.9%). However, the obstacles to the implementation of government measures were followings; 1) consciousness and lack of participation (42.1%), 2) indifference from other departments (35.1%), 3) absence, or lack of competency of safety manager (33.3%). In addition, safety investments and safety management of contractors and ordering works were analyzed to have remained largely unchanged even after the implementation of safety measures. Through this study, it is intended to provide basic data for strengthening the level and activities of safety in public institutions.

Growth Inhibition and Apoptosis Induction of Sulindac on Human Lung Cancer Cells (비소세포 폐암 세포주에서 Sulindac의 성장억제와 세포고사 유도)

  • Kim, Hak Ryul;Yang, Sei Hoon;Jeong, Eun Taik
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.5
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    • pp.514-522
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    • 2004
  • Background : Non-steroidal anti-inflammatory drugs (NSAID) are useful in chemoprevention of colorectal cancers. Continuous NSAID administation causes 40% to 50% reduction in relative risk for colorectal cancer. Sulindac possesses an antiproliferative effect and induces apoptosis and tumor regression on colon cancer and other types of cancers. We intended to analyze the effects of sulindac in three non-small cell lung cancer cell lines. Materials and Methods : The human lung cancer cell lines, A549, NCI-H157 and NCI-H460 were used for this study. Viability was tested by MTT assay, and cell death rate was measured by lactate dehydrogenase(LDH) release. Apoptosis was estimated by flow cytometric analysis and nuclear staining. Results: Sulindac was able to decrease the viability of non-small cell lung cancer cells in a dose- and time- dependent manner. In a parallel effect of sulindac on cell death rate, LDH release was increased in sulindac-treated lung cancer cells. Sulindac significantly increased apoptosis characterized by an increase of $sub-G_0/G_1$ fraction and morphological change of nuclei. The rate of apoptotic cells after sulindac treatment in lung cancer cells increased in a time- and dose- dependent manner in flow cytometric analysis. Apoptotic cells were defined as nuclear shrinkage, chromatin condensation and nuclear fragmentation of cells. Conclusion : Sulindac decreases viability and induces the apoptosis of lung cancer cells. Further studies will be needed to elucidate the potential mechanism of sulindac-induced apoptosis in lung cancer cells.

A Review of the Legal Responsibility of Dog Owners regarding Dog Bite Accidents - Focused on a Comparison with American Dog Bite Legislation - (개물림 사고에 대한 소유자의 법적 책임에 관한 소고 - 미국의 개물림 법제와의 비교를 중심으로 -)

  • Baek, Kyoung-Hee;Shim, Young-Joo
    • Journal of Legislation Research
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    • no.54
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    • pp.261-301
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    • 2018
  • In South Korea, the number of households that rear companion animal has been gradually increasing. With the rise of household dogs, the frequency of humans that are being bitten by another's dog has also increased. This type of accident, which is known as a dog bite accident throughout the United States. It can cause significant physical and emotional damage to the victims and may result in grave injuries or death. Dog bite accidents are serious public health problems and can cause immeasurable hidden costs to the community. South Korea has enacted several laws to address dog bite accidents, which include the Animal Protection Act, the Civil Act, and the Criminal Act. On March 20, 2018, the Animal Protection Act was amended to reinforce the current legislation. These amendments addressed the duty of care owed by a companion dog owner to society members and the punishment that an owner of a fierce dog would face in the event of a dog bite accident. Conversely, several states in the United States have enacted a single law that regulates the details regarding dog bite accidents, such as the type of dog or animal, the type of damage, the scope of compensation for damages, and the scope of recognition of liabilities. This paper is intended to review the present situation of dog bite legislation in several states in the United States, which have a variety of laws that address dog bite accidents, and compare them with current South Korean dog bite legislation. Through this research, this paper will discuss what issues may exist in South Korean's current dog bite laws, analyze the responsibility of companion dog owners, and provide solutions to any issues that are discovered.