Introduction: Many studies have reported that microRNA-21 (miR-21) mihght predict the survival outcome in non-small cell lung cancers (NSCLCs) but the opposite opinion has also been expressed. The aim of this study was to summarize the evidence for a prognostic role of miR-21. Materials and Methods: All the eligible studies was searched by Medline and EMBASE and patients' clinical characteristics and survival outcome were extracted. Then a meta-analysis was performed to clarify the prognostic role of the miR-21 expression in different subgroups. Results: A total of 8 eligible articles were yielded covering survival outcomes or clinical characteristics. The combined hazard ratio (HR) and 95% confidence interval (95% CI) for overall survival (OS) was 2.19 [0.76, 6.30], while the combined HR (95% CI) of Asian group for OS had a significant result, 5.49 [2.46, 12.27]. The combined HR (95% CI) for recurrence free survival or disease free survival (RFS/DFS) was 2.31 [1.52, 3.49]. Odds ratios (ORs) showed that the miR-21 expression was associated with lymph node status and histological type. Conclusion: miR-21 expression could predict the prognostic outcome of NSCLC in Asians, despite some deficiencies in the study data.
Introduction : The Functional muscle transfer is used to reconstruct the injuried muscle and paralysis of the shoulder. Especially transfer of the trapezius has been the treatment of choice but it has disadvantages of inadequate function and deformed contour, and instability of humeral head in case of acromion resection. We report an operation for shoulder reconstruction after wide resection of malignant fibrous histiocytoma, using rotational latissimus dorsi flap and review the operation method and clinical outcome. Materials and Methods : A patient, 53 year old, with malignant fibrous histiocytoma in the acromioclavicular joint area had been underwent wide excision, including the deltoid, clavicular head of pectoralis major, part of trapezius, lateral 1/3 of clavicle and acromion including scapular spine. The rotational latissimus dorsi flap with its neurovascular pedicle was dissected and then placed over the resected area and transfer of muscle attached at coracoid process was done to achieve stability of the humeral head. The range of motion of the shoulder and test of muscle power were evaluated for functional outcome. Total follow-up period is 2 years 11 months. Results : At last follow-up, the range of motion of the shoulder is abduction $90^{\circ}$, flexion $90^{\circ}$, internal rotation $40^{\circ}$, external rotation $50^{\circ}$ and the muscle power is 4 grade in all direction and then we obtained good functional results. There are no complications such as instability or subluxation of the humeral head and deformed contour and he is a disease-free survival state. Conclusions : The transfered latissimus dorsi flap provides adequate lever arm and stabilization and covering of the humeral head by sufficient muscle volume and width. This procedure can be useful not only for the paralysed deltoid reconstruction but also for use in reconstructive surgery after wide resection of the shoulder for malignant tumor.
Objective : To investigate the efficacy of extracranial-intracranial (EC-IC) bypass surgery using a radial artery interposition graft (RAIG) for surgical management of cerebrovascular diseases. Methods : The study involved a retrospective analysis of 13 patients who underwent EC-IC bypass surgery using RAIG at a single neurosurgical institute between 2003 and 2009. The diseases comprised intracranial aneurysm (n=10), carotid artery occlusive disease (n=2), and delayed stenosis in the donor superficial temporal artery (STA) following previous STA-middle cerebral artery bypass surgery (n=1). Patients were followed clinically and radiographically. Results : Bypass surgery was successful in all patients. At a mean follow-up of 53.4 months, the short-term patency rate was 100%, and the long-term rate was 92.3%. Twelve patients had an excellent clinical outcome of Glasgow Outcome Scale (GOS) 5, and one case had GOS 3. Procedure-related complications were a temporary dysthesia on the graft harvest hand (n=1) and a hematoma at the graft harvest site (n=1), and these were treated successfully with no permanent sequelae. In one case, spasm occurred which was relieved with the introduction of mechanical dilators. Conclusion : EC-IC bypass using a RAIG appears to be an effective treatment for a variety of cerebrovascular diseases requiring proximal occlusion or trapping of the parent artery.
Kim, Byung-Soo;Moon, Suk-Bae;Lee, Seong-Cheol;Jung, Sung-Eun;Park, Kwi-Won
Advances in pediatric surgery
/
v.14
no.2
/
pp.164-172
/
2008
The survival rate for rhabdomyosarcoma (RMS) has significantly improved after the introduction of combined multimodality treatment. We report the 20-year treatment outcome of pediatric rhabdomyosarcoma in a single institution. The medical records of 16 patients treated for rhabdomyosarcoma between December 1986 and August 2007 at the Department of Pediatric Surgery, Seoul National University Children's Hospital, were retrospectively reviewed. Mean age at diagnosis was 7.1 years (range: 1.3 -14.2 years). Retroperitoneum was the most common primary site (n=7, 43.8 %), and embryonal type was predominant (n=11, 6 %). Before the treatment, most patients were in advanced TNM stage (stage III 50 %, IV; 25 %). The patient distribution according to the Intergroup Rhabdomyosarcoma Study Clinical Grouping System (IRS-CGS) was as follows; Group I 31.3 %, Group II 12.5 %, Group III 31.3 % and Group IV 25 %. Patients were classified into three groups according to the extent of resection of the primary tumor; complete resection (CR, n=5; 31.3 %), gross total resection (GTR, n=7; 43.8 %) and incomplete resection (IR, n=4; 25 %). Recurrence was observed in 9 patients (56.3 %) while there was no recurrence in CR patients. All patients with recurrence were identified as moderate or high-risk according to the IRS-V Risk Group. Pre-treatment TNM stage of RMS in our institution was advanced with aggressive clinical feature, however postsurgical conditions according to IRS-CGS were similar to the previous reports by IRS. This suggests that down-staging of IRS-CGS was achieved with multimodality treatment with CR or GTR. It also suggests that complete resection is the most important prognostic factor in the treatment of RMS in children. Patients classified as moderate or high-risk need close follow-up due to high recurrence rate. In case of localized recurrence, better outcome may be achieved with multimodality treatment including limited surgery.
Background and Objective: Since the introduction of hospital pharmacy residency programs in 1983, hospital pharmacists in South Korea have been expected to expand their roles. However, their services and the outcomes have not been fully understood. In this study, we conducted a systematic review of Korean hospital pharmacist-provided interventions with regard to intervention type, intervention consequences, and target patient groups. Methods: A literature search of the following databases was performed: Embase, PubMed, Medline, KoreaMed, RISS, KMbase, KISS, NDSL, and KISTI. The search words were "hospital pharmacist", "clinical pharmacist", and "Korea". Articles reporting clinical or economic outcome measures that resulted from hospital pharmacist interventions were considered. Numeric measures for the acceptance rate of pharmacist recommendations were subjected to meta-analysis. Results: Of the 1,683 articles searched, 44 met the inclusion selection criteria. Most articles were published after 2000 (81.8%) and focused on clinical outcomes. Economic outcomes had been published since 2011. The interventions were classified as patient education, multidisciplinary team work, medication assessment, and guideline development. The outcome measures were physicians' prescription changes, clinical outcomes, patient adherence, economic outcomes, and quality of life. The acceptance rate was 80.5% (p < 0.005). Conclusion: Studies on pharmacist interventions have increased and showed increased patient health benefits and reduced medical costs at Korean hospital sites. Because pharmacists' professional competency would be recognized if the economic outcomes of their work were confirmed and justified, studies on their clinical performance should also include their economic impact.
In the past, ERP had been applied to large company mainly, but recently, in order to exist from global business environment, most of smaller businesses are using or planing to introduce ERP. However, introduction of ERP requires considerable expense and effort, before ERP come into being, it is needed to measure the expense of introducing and the outcome expected. Previous analytical frameworks (according to introduction of ERP) have been focused on measuring improvement of performance by introducing ERP. This study carries out a survey on priority analysis of information system with small businesses which produce displayer parts. To derive the user's priorities which have been disregarded beside the improvement of performance on information system, this study rearranges the analysis indices by using BSC model and it analyzes the priorities of importance according to the stakeholder(manager group, middle manager group, worker group) by using ANP method.
The 1993 U.S. Supreme Court decision on Daubert v. Merrel Dow Chemical, Inc. has changed the ways in which scientific evidence is evaluated for legal purposes. A new set of guidelines, called thereafter the Daubert Standard, that was intended to increase the judge's authority in determining the admissibility of scientific evidence in the court, turns out to have increased the burden of proof on the part of plaintiffs and have also considerably influenced the outcome of policy decisions in the regulatory areas. This paper analyzes the changes made in the relationship between science and law after the introduction of the Daubert Standard, examining the epistemological differences between its proponents and opponents. The judge's dilemma as a gatekeeper, this paper argues, is not simply that of an 'amateur scientist' seeking to learn and practice scientific knowledge per se. Rather, the dilemma ought to be that of an 'legal expert,' faithful to ethos of social justice without succumbing to the practical convenience of the Daubert Standard. This paper also suggests that there is much room for STS scholars to make contributions to the use of science in legal settings by conducting in-depth studies on court cases in the broad social and political context.
This study explores the characteristics of the delivery system of the New Deal, with a particular attention to the partnerships and welfare governance. The study analyzes the partnerships of the New Deal policy in Britain, which consist of two dimensions of partnerships. The results are: First, the method of the transformation of delivery in central government dimension is the unity of the governmental organizations, Another outcome of reform in the central government dimension is the establishment of the Jobcentre Plus. Second, the characteristic of delivery system in public-private dimension is the contract through competition, which means the introduction of market paradigm. Especially, the reform of the delivery system in the local dimension is to deliver integrated services through the introduction of labour market paradigm in demand-side. The central government also supports the reform in the local level. This study also explores the forms of welfare governance in these dimensions, This study suggests the importance of united services in the Korean welfare to work.
Li, Cong;Lu, Hua-Jun;Na, Fei-Fei;Deng, Lei;Xue, Jian-Xin;Wang, Jing-Wen;Wang, Yu-Qing;Li, Qiao-Ling;Lu, You
Asian Pacific Journal of Cancer Prevention
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v.14
no.6
/
pp.3607-3612
/
2013
Introduction: Reported prognostic roles of hypoxic inducible factor (HIF) expression in non-small cell lung cancer (NSCLC) have varied. This meta-analysis aimed to examine the relationship between HIF expression and clinical outcome in NSCLC patients. Methods: PubMed were used to identify relevant literature with the last report up to December $20^{th}$, 2012. After careful review, survival data were collected from eligible studies. We completed the meta-analysis using Stata statistical software (Version 11) and combined hazard ratio (HR) for overall survival (OS). Subgroup specificity, heterogeneity and publication bias were also assessed. All of the results were verified by two persons to ensure accuracy. Results: Eight studies were finally stepped into this meta-analysis in which seven had available data for HIF-$1{\alpha}$ and three for HIF-$2{\alpha}$. Combined HRs suggested that higher expression of $HIF1{\alpha}$ had a negative impact on NSCLC patient survival (HR=1.50; 95%CI=1.07-2.10; p=0.019). The expression of HIF-$2{\alpha}$ was also relative to a poorer survival (HR=2.02; 95%CI=1.47-2.77; p=0.000). No bias existed in either of the two groups. Conclusion: This study suggests that elevations of HIF-$1{\alpha}$ and HIF-$2{\alpha}$ expression are both associated with poor outcome for patients with NSCLC. The data support further and high quality investigation of HIF expression for predicting poor outcome in patients with NSCLC.
Sales force automation (SFA) technologies are increasingly used to support customer relationship management (CRM) strategies. However, the popular press reports mixed results among companies incorporating SFA technologies and the previous studies have less interested in relationship quality between sales person and customer as an outcome of SFA. Actually the improved quality of the salesperson-customer relationship may be the most important outcome of SFA usage. This outcome is especially meaningful in today's marketplace given the increasing focus placed on customer retention and other customer related performance such as customer lifetime value. Therefore, this study seeks to further examine the impact of SFA usage within two different firms using SFA technologies to examine the impact of SFA usage on both customer relationship quality and sales performance. Additionally, the moderating roles of perceived managerial support and salesperson experience on the outcomes of SFA usage are examined. The results shows that direct effect of SFA usage on performance was not significant but highlight the mediating role of customer relationship quality in the SFA usage - sales performance relationship. Also, this research examines a number of moderating effects of both management supports for SFA and salesperson's sales work experience. The results indicate that management support has a significant direct influence on relationship quality and salesperson performance, but not a significant moderating effect on the relationship between SFA usage and the outcomes (relationship quality and performance). Thus moderating effects were not supported but find significant main effects. First of all, finding of this study suggest that a formula for successful SFA implementation must be one that highlights a SFA usage → relationship quality → sales performance sequence. This means when sales person use SFA they must build relationship with customer first then will return some long term performance. Second, the implications of not considering the introduction of big technology initiatives in terms of fit within the company's culture, strategy, structure, and environment may in many cases be quite noteworthy. Therefore, the launching of a new technology in the firm, such as SFA, may have a nonlinear impact upon overall firm performance, depending on the presence of other complimentary resources and capabilities. Finally the authors offer a number of implications for research and practice, and suggest directions for future SFA research that may further improve our understanding of this increasingly relevant topic.
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