• Title/Summary/Keyword: outcome evaluation

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The evaluation for Clinical usefulness and Safety of Sirolimus-eluting stent and Paclitaxel-Eluting Stents In Patients With Acute Myocardial Infarction (급성심근경색증 환자의 일차적 관동맥 스텐트 삽입술 시 삽입된 Sirolimus-eluting stent 와 Paclitaxel-eluting stent의 임상적 안정성 및 유용성 평가)

  • Min, Gye-Sik;Han, Man-Seok
    • Journal of the Korean Society of Radiology
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    • v.6 no.1
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    • pp.5-10
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    • 2012
  • There is a still unsettled issue about the comparison of long-term clinical effects between sirolimus-(SES) and paclitaxel-eluting stents (PES) for the patients with acute myocardial infarction (AMI). Therefore, we performed a retrospective analysis to evaluate the 4-year clinical outcome of SES as compared with PES after percutaneous coronary intervention (PCI) in patients with AMI. From January 2004 to August 2006, all consecutive patients with acute ST-segment elevation myocardial infarction (STEMI) underwent primary PCI and acute NSTEMI underwent PCI by implantation either SES or PES were enrolled. The occurrence of death, cardiac death, recurrent infarction, target vessel revascularization (TVR) and stent thrombosis were analyzed. The composite of major adverse cardiac events (MACE; death, recurrent infarction and TVR) were also analyzed. During the study period, total 668 AMI patients had visited. Of them, total 522 patients (299 with SES and 223 with PES) were enrolled. During 4-year clinical follow-up, there were similar occurrences of death ($18.3{\pm}3.0%$ vs. $14.6{\pm}2.2%$, p=0.26), cardiac death ($11.2{\pm}2.6%$ vs. $6.8{\pm}1.52%$, p=0.39), re-infarction ($6.4{\pm}1.8%$ vs. $3.3{\pm}1.1%$, p=0.31), and stent thrombosis ($5.4{\pm}1.7%$ vs. $3.2{\pm}1.1%$, p=0.53) between the two groups, consecutively. The occurrences of TVR ($10.0{\pm}3.0%$ vs. $4.0{\pm}1.2%$, p=0.008) and MACE ($29.4{\pm}3.5%$ vs. $19.4{\pm}2.5%$, p=0.003) were significantly higher in patients treated with PES than SES. In AMI patients treated with either SES or PES implantation, SES had a significantly lower risk of TVR and MACE during 4-year clinical follow-up. Rates of death, cardiac death or recurrent infarction, and stent thrombosis were similar.

Acute Kidney Injury Models: Focus on the Therapeutic Effects of Stem Cell in Preclinical Approach (줄기세포 연구를 위한 급성신장손상 모델)

  • Nam, Hyun-Suk;Woo, Jae-Seok;Woo, Heung-Myong
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.533-539
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    • 2010
  • Stem cell-based therapy is under intensive investigation to treat acute renal failure (ARF). The purpose of this study was to evaluate available ARF models, and suggest a model appropriate to therapeutic evaluation of the stem cells in preclinical approach by determining the optimum concentration of nephrotoxic agents and duration of ischemia induction. Three different types of available acute kidney injury (AKI) animal models were analyzed using rats: Cisplatin (saline, 5 and 7.5 mg/kg, IP) or glycerol (saline, 8 and 10 ml/kg, IM)-induced nephrotoxicity as toxic models and ischemia-induced (sham, 35 and 45 minutes) nephropathy as an ischemic model. The relevance and applicability to investigate especially the regenerative ability of stem cells were evaluated regarding morphology, renal function and survival at this time point. In the point of renal function, 10 ml glycerol/kg and 7.5 mg cisplatin/kg model in toxic models and 45 min model in ischemia models showed significant decrease for the longer observation time compared to 8 ml glycerol/kg, 5 mg cisplatin/kg and the 35 min ischemia models, respectively. All groups were observed no mortality except 45 min-ischemia model with 50% survival. Histological significant alterations including cast formation in the tubular lumen, tubular necrosis and apoptosis were revealed on the second day in either ischemiaor glycerol-induced models, and on day 5 in cisplatin-induced models. The results indicate that ischemia 35 min-, cisplatin 7.5 mg/kg- and glycerol 10 ml/kg-induced AKI would be ideal animal models to monitor a outcome parameter related to the therapeutic effects on renal function with noninvasive techniques in the same animal at multiple time points. Our findings also suggest that the best time points for the functional or histological interpretation of renal will be on day 2 in both glycerol- and ischemia-induced AKI models and on day 5 in cisplatin-induced AKI.

A Study on the Development of an Instrument for Knowledge Contribution Assessment (조직 구성원의 지식기여도 평가 도구 개발에 관한 연구)

  • Na, Mi-Ja;Kym, Hyo-Gun
    • Information Systems Review
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    • v.6 no.2
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    • pp.113-135
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    • 2004
  • This paper defines appraisal items and weights of the items for the purpose of developing an appraisal instrument that objectively measures employee's effectiveness of knowledge contribution. Deductive research is used for the development of appraisal items and delphi method for the development of weights of the items. In the deductive research the term, "effectiveness of knowledge contribution" is first defined. Then knowledge contribution activities are classified as "dimension of explicit contribution" and " dimension of tacit contribution" due to the characteristics of knowledge. Each dimension is divided again by components. The dimension of explicit contribution is divided according to the content of knowledge, and the dimension of tacit contribution is divided according to the extent of tacitness of knowledge contribution. The total components of dimensions are 7. The dimension of explicit contribution is composed of factual knowledge and procedural knowledge. The factual knowledge is made up of "procedural knowledge outcome" and "other factual knowledge". The procedural knowledge is made up of "procedural knowledge manual" and "lessons-learned procedural knowledge". The dimension of tacit contribution is composed of "agency", "model" and "Q&A". The basic framework for measuring 7 components of knowledge contribution is quantitative and qualitative approach. This paper is premised on the assumption that the outcomes of employee's knowledge contribution activities are recorded in the knowledge management systems in order to evaluate them objectively. The appraisal items are defined as follows: at the dimension of explicit contribution, in quantitative approach, "the upload number" or "performance number", and in qualitative approach, other employee's "referred number" and other employee's "content and format satisfaction evaluation"; at the dimension of tacit contribution, "demanded number of performance" After the development of appraisal items by the deductive method, delphi method was used for the analysis of the weights of the items with the total degree of knowledge contribution, 100. This research does not include the standard marks of the appraisal items. It is because when companies apply this appraisal instrument, they could use their own standard appraisal marks of the appraisal items considering their present situations and companies' goals. Through this almost desert-like research about the appraisal instrument of employee's knowledge contribution effectiveness, it proposes a cornerstone in the research field of appraisal instrument, which provides a standard for employee's knowledge contribution appraisal, and appraisal items that make organizational knowledge to be managed more systemically in business sites.

Post-natal Outcome of Fetal Hydronephrosis Detected with Prenatal Ultrasonography (산전 초음파로 진단된 태아 수신증의 생후 경과 관찰)

  • Park, Youn Jin;Mun, Soon Jung;Bae, Chong Woo;Lee, Bum Ha;Kim, Jin Il
    • Clinical and Experimental Pediatrics
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    • v.45 no.10
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    • pp.1213-1218
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    • 2002
  • Purpose : Hydronephrosis constitutes a great portion of fetal anomalies screened by prenatal sonogram. The present authors made an attempt to access its natural courses through follow up neonatal hydronephrosis diagnosed by prenatal sonogram. Methods : The study was composed of 23 neonates(36 renal units) who were diagnosed with hydronephrosis through prenatal sonogram screening and confirmed 3-7 days after birth with sonographic evaluation at Kyung Hee University Hospital. The neonates were closely monitored for 12-24 months with renal sonogram, diuretic renogram, intravenous pyelography(IVP) and voiding cystoureterography(VCUG). Results : The underlying diseases were composed of 16 cases(44%) of functional abnormalities, 14 cases(39%) of ureteropelvic junction(UPJ) obstruction, three cases(8%) of vesicoureteral reflux (VUR) and on case each of multicystic dysplastic kidney, UPJ obstruction with ureteral stenosis and ureterovesical junction(UVJ) obstruction with VUR. The degree of hydronephrosis was divided into three classes according to its severity. In 30 renal units with UPJ obstruction and functional abnormalities, 26(87%) showed mild hydronephrosis, while four(13%) were moderate. During the follow up period, six cases(20%) showed natural resolution of hydronephrosis, 15 cases(50%) showed improvement while two cases(7%) were aggravated with improvement only after surgery of the underlying disease. The cases which showed natural resolution were all mild hydronephrosis at diagnosis and the cases which underwent surgery due to continuous aggravation were mild one case and moderate one case. Conclusion : Those with cases of mild hydronephrosis show rapid natural improvement. On the other hand, in some cases, follow up monitoring reveal aggravation of the situation, emphasizing the necessity for thorough follow up for a long period of time.

Preliminary Study on Actuated Signal Control at Rural Area of Cheon-an City (천안시 외곽지역의 감응식 신호운영을 위한 기초연구)

  • Park, Soon-Yong;Kim, Dong-Nyong
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.8 no.3
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    • pp.52-63
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    • 2009
  • Recently in Korea, in the case of metropolis, the urban signalized intersections are controlled by traffic information center or ITS center. Cheon-an City also established traffic information center through the 1st.-$\sim$3rd. ITS public construction and has managed this center that includes bus information service, traffic information collection and providing service, parking information service, and traffic responsive control system. In the Cheon-an metropolitan traffic signal operation, traffic signal controllers were grouped by the each main traffic flow axes and performed with coordinated signal timing for the signalized arterials, and also cycle and split changed by realtime traffic demands. Cheon-an urban traffic responsive control system was evaluated by intersection delay and speed, then it was verified that the delay decreased and vehicle speed improved. However, the rural signal control system to connect adjacency town was evaluated to have lower status than urban area due to the unimproved TOD (Time of day) plan. Therefore actuated signal control was examined for substitutive control system in isolated signal intersection. The aim of this article is to compare actuated signal control with TOD mode in the rural intersection of Cheon-an and to fine superiority of these two control mode, with evaluation of vehicle delay by using HCM(2000) method and by micro-simulation CORSlM. The result of field test show that actuated signal control gave better performance in delay comparison than the existing TOD signal control. And simulation outcome verified that non-optimized TOD has higher delay than optimized TOD mode, non-optimal actuated mode, and optimal actuated signal control mode. Particularly, these three modes delays had not different values according to the paired sample t-test. This is because small traffic demands were loaded in each links. This suggested actuated signal control is expected to be more effective than TOD mode in some rural isolated intersections which frequently need to survey for traffic volume.

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Clinical effects of additional use of erythritol powder air polishing device on non-surgical periodontal treatment in moderate chronic periodontitis (중등도 만성 치주염 환자에서 erythritol 공기분말 연마기구를 부가적으로 이용하는 비외과적 치주치료의 임상적 효과)

  • Lee, Mun-Young;Park, Eon-Jeong;Kwon, Eun-Young;Kim, Hyun-Joo;Lee, Ju-Youn;Joo, Ji-Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.1
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    • pp.39-45
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    • 2018
  • Purpose: The purpose of this study was to evaluate the clinical effects of erythritol powder air polishing device (EPAP) in addition to scaling and root planing (SRP) in non-surgical periodontal treatment in moderate chronic periodontitis patients. Materials and Methods: Clinical evaluation was performed at 21 sites treated with SRP (control) and 21 sites treated with the addition of SRP+EPAP (test). All examinations were performed before treatment, 1 month after treatment, and 3 months after treatment. Depth of the periodontal pocket, gingival recession, clinical attachment level, plaque index, and bleeding of probing were measured as clinical parameters. Results: In both test and control groups, there was a significant decrease in the depth of the periodontal pocket, plaque index, bleeding of probing, increased gingival recession, and gain of clinical attachment level at 1 month and 3 months after treatment. However, there was no significant clinical difference between the test group and the control group. Clinical result was improved after 1 month compared to the baseline; in contrast, results at 3 months after treatment were worse than at 1 month after treatment. Conclusion: In this study, we cannot suggest that SRP + EPAP is clinically more effective than SRP alone as non-surgical periodontal treatments. Periodic periodontal therapy, at intervals of at least every three months, is important for sustaining effects of this treatment.

A Study on Location Selection for Rainwater Circulation System Elements at a City Level - Focusing on the Application of the Environmental and Ecological Plan of a Development - (도시차원의 빗물순환체계 요소별 입지선정에 관한 연구 - 개발예정지역의 환경생태계획 적용방안을 중심으로 -)

  • Kim, Hyo-Min;Kim, Kwi-Gon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.3
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    • pp.1-11
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    • 2012
  • This study focused on establishing a natural rainwater circulation system using rainwater meant for relatively large urban development projects such as a new town development. In particular, when the location selection techniques for individual elements of a natural rainwater circulation system are developed for the integrated rainwater management, changes in hydrological environment will be minimized and the natural water circulation would be restored to realize the low impact development (LID). In that case, not only the excess will be reduced but water space and green areas in a city would also increase to improve the urban sustainability. First of all, there were five elements selected for the location selection of a rainwater circulation system intended for the integrated rainwater management: rainwater collection, infiltration, filtration, retention and movement spaces. After generating these items, the location selection items and criteria were defined for each of the five elements. For a technique to apply the generated evaluation items and criteria, a grid cell analysis was conducted based m the suitability index theory, and thematic maps were overlapped through suitability assessment of each element and graded based on the suitability index. The priority areas were identified for each element. The developed technique was applied to a site where Gim-cheon Innovation City development is planned to review its feasibility and limitations. The combined score of the overlapped map for each element was separated into five levels: very low, low, moderate, high and very high. Finally, it was concluded that creating a rainwater circulation system conceptual map m the current land use plan based on the outcome of the application would be useful in building a water circulation system at the de1ailed space planning stage after environmental and ecological planning. Furthermore, we use the results of this study as a means for environment-friendly urban planning for sustainable urban development.

Clinical Result of Arthroscopic Partial Repairs in Massive Rotator Cuff Tears (광범위 회전근 개 파열의 관절경하 부분 봉합술의 임상적 결과)

  • Yoo, Jae-Chul;Ko, Kyung-Hwan;Woo, Kyung-Jea
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.150-158
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    • 2009
  • Purpose: With the better understanding of cuff function, partial repair or "force couple repair" for treating massive irreparable rotator cuff tear has gained some popularity. However, there were few reports on the results of partial repair. The purpose of this study was to report the clinical outcome of massive irreparable rotator cuff tears who received arthroscopic force-couple repair or partial repair. Materials and Methods: From June 2005 to Feb 2008, arthroscopic partial repairs were performed for 16 irreparable rotator cuff tears among the 101 large to massive rotator cuff tears that were operated on. Clinical and radiographic evaluation were done at the final follow-up. Results: There were 7 men and 9 women with a mean age of 66.6 years. The mean follow-up period was 27.3 month (range: 15-46). The pain VAS improved from 4.4 ($\pm2.50$) to 2.1 ($\pm2.26$) and the functional VAS improved from 46.9 ($\pm16.64$) to 70.0 ($\pm22.80$). The ASES score improved from 39.0 ($\pm10.80$) to 80.3 ($\pm16.78$) and the KSS score was 81.9 ($\pm16.74$) at the final follow-up. The acromio-humeral distance was 6.6 cm ($\pm1.74$) preoperatively and 6.2 cm ($\pm1.69$) postoperatively without significant change (p=0.3874). The degenerative changes had no statistically progressed (p=0.2663). Conclusion: Partial repair for massive rotator cuff injury patients showed improvement in the clinical score without progression of arthritic change at a mean of 2.3 years follow-up.

Clinical Outcomes After Arthroscopic Double-Row Rotator Cuff Repair and Evaluation of Cuff Integrity by CT Arthrography (관절경적 2열 고정 회전근개 복원술 후의 임상 결과 및 CT 관절조영술을 이용한 건의 치유 평가)

  • Jo, Chris H.;Kim, Je-Kyoon;Yoon, Kang-Sup;Lee, Ji-Ho;Kang, Seung-Baek;Lee, Jae-Hyup;Han, Hyuk-Soo;Rhee, Seung-Whan
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.199-206
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    • 2009
  • Purpose: Our goal for this study was to prospectively evaluate the functional & structural outcomes, by means of CT arthroscopy, of arthroscopic double-row fixation for treating rotator cuff tear. We also attempted to determine the variants that affect the functional & structural outcomes. Materials and Methods: Twenty seven consecutive patients underwent arthroscopic rotator cuff repair with double-row fixation. The average age at the time of the operation was fifty six years. The preoperative and postoperative examinations consisted of determining the Constant score, the score for the visual analogue scale for pain, the UCLA score, the American Shoulder and Elbow Surgeons (ASES) score, as well as a full physical examination of the shoulder. Preoperative MR arthrography was used to evaluate the integrity and atrophy of the rotator cuff. We measured the intraoperative tear size in the sagittal and coronal planes. Postoperative CT arthrography was used at one year postoperatively to evaluate the integrity and atrophy of the repaired tendons and muscles. Results: Preoperative MR arthrography revealed an average 29.22 mm tear size in the sagittal plane and an average 22.72 mm tear size in the coronal plane. Twelve cases of supraspinatus muscle atrophy and two cases of infraspinatus atrophy were observed on the preoperative MR arthrography. The average clinical outcome scores all significantly improved at the time of follow-up. At a mean of one year postoperatively, CT arthrography revealed 48.1% of the shoulders had healed, 11.1% showed incomplete healing and 40.7% showed retear of the repaired tendon. Conclusion: Arthroscopic double-row repair can result in improved clinical outcomes and good patient satisfaction. However, the problems about how to enhance healing of the repaired tendon still remain.

Long-Term Results for Repair of Pulmonary Atresia with Intact Ventricular Septum (온전한 심실중격를 가진 폐동맥 폐쇄증에 대한 수술적 치료의 장기 결과)

  • Lee Chang-Ha;Hwang Seong Wook;Lim Hong Gook;Kim Woong-Han;Kim Chong Whan;Lee Cheul
    • Journal of Chest Surgery
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    • v.38 no.6 s.251
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    • pp.403-409
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    • 2005
  • Pulmonary atresia with intact ventricular septum is morphologically heterogeneous, and the surgical outcome remains suboptimal compared to other complex congenital heart defects. We evaluated the long-term results for repair of pulmonary atresia with intact ventricular septum, Material and Method: Between January 1992 and June 2004, 38 patients underwent repair of pulmonary atresia with intact ventricular septum. The average age was 18 days $(2\~382\;days)$. The average Z-value of the tricuspid annulus diameter was -3.1$(-5.6\~0.8)$. Thirteen $(36\%)$ patients had right ventricle-to-coronary artery fistulas, and $4(11\%)$ patients had right ventricle-dependent coronary circulation. Average follow-up was 55 months $(3\;months\~2.2\;years)$, Result: Twenty-four patients under-went initial right ventricle (RV) decompression and 14 patients underwent systemic-to-pulmonary arterial shunt only. The average size of the tricuspid annulus of the patients who underwent RV decompression was significantly larger than that of the patients who underwent systemic-to-pulmonary arierial shunt only (Z-value -2.2 vs. -4.8, p=0.000). There were $5(13\%)$ early and 1 late deaths. Early deaths occurred in 3 patients who had undergone RV decompression, and in 2 patients who had undergone systemic-to-pulmonary arterial shunt only (p=1.0). Biventricular repair was achieved in $12(32\%)$ patients, single ventricular repair in $8(21\%)$, and one and a half ventricular repair in $4(l1\%)$ patients. Nine $(24\%)$ patients are waiting for the definitive repair. Kaplan-Meier survival at 5 and 8 years was $83.2\%$, respectively. Conclusion: Most of the deaths occurred after the initial palliation. Overall long-term survival was satisfactory. Early mortality should be reduced with careful preoperative evaluation and proper surgical strategy.