• Title/Summary/Keyword: scoring system of assessment

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Genetic Polymorphism of Interleukin-1A (IL-1A), IL-1B, and IL-1 Receptor Antagonist (IL-1RN) and Prostate Cancer Risk

  • Xu, Hua;Ding, Qiang;Jiang, Hao-Wen
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8741-8747
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    • 2014
  • Purpose: We aimed to investigate the associations between polymorphisms of interleukin-1A (IL-1A), IL-1B, and IL-1 receptor antagonist (IL-1RN) and prostate cancer (PCa) risk. Materials and Methods: A comprehensive search for articles of MEDLINE and EMBASE databases and bibliographies of retrieved articles published up to August 3, 2014 was performed. Methodological quality assessment of the trials was based on a standard quality scoring system. The meta-analysis was performed using STATA 12.0. Results: We included 9 studies (1 study for IL-1A, 5 studies for IL-1B, and 3 studies for IL-1RN), and significant association was found between polymorphisms of IL-1B-511 (rs16944) as well as IL-1B-31 (rs1143627) and PCa risk. IL-1B-511 (rs16944) polymorphism was significantly associated with PCa risk in homozygote and recessive models, as well as allele contrast (TT vs CC: OR, 0.74; 95%CI, 0.58-0.94; P=0.012; TT vs TC+CC; OR, 0.79; 95%CI, 0.63-0.98; P=0.033; T vs C: OR, 0.86; 95%CI, 0.77-0.96; P=0.008). The association between IL-1B-31 (rs1143627) polymorphism and PCa risk was weakly significant under a heterozygote model (OR, 1.35; 95%CI, 1.00-1.80; P=0.047). Conclusions: Sequence variants in IL-1B-511 (rs16944) and IL-1B-31 (rs1143627) are significantly associated with PCa risk, which provides additional novel evidence that proinflammatory cytokines and inflammation play an important role in the etiology of PCa.

Bone Cement-Augmented Percutaneous Screw Fixation for Malignant Spinal Metastases : Is It Feasible?

  • Kim, Pius;Kim, Seok Won
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.189-194
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    • 2017
  • Objective : We evaluated the validity of bone cement-augmented percutaneous screw fixation for treating malignant spinal metastases. Methods : Between 2011 and 2015, 14 patients (eight men and six women) who underwent bone cement-augmented percutaneous screw fixation for malignant spinal metastases were enrolled in this study. Their life expectancy was considered to be more than one month and less than one year, based on the revised Tokuhashi scoring system. Clinical findings including the back pain scale score, functional outcome, procedure related complications, and survival were assessed preoperatively, postoperatively, and then six months after the procedure. Results : Twelve of the patients (86%) survived up to six months after the procedure. Three required mini-open decompressive laminectomy for severe epidural compression. Bone cement-augmented percutaneous screw fixation was performed one level above, one level below, and at the pathologic level itself. The mean operation time was 60 minutes (45-180) and blood loss was less than 100 mL. Prior to surgery, the mean pain score on the visual analogue scale was 8.8, while one month after the procedure, it had reduced to 3.0; this improvement was maintained until the six-month assessment in the surviving patients. All patients were able to sit within the first two days after surgery, and no patient experienced neurological deterioration at the one-month follow up after the surgery. No patient experienced screw loosening during the six months of follow-up. Asymptomatic cement leakage into the epidural space was observed in two patients, but no major complications were observed. Conclusion : For selected patients with malignant spinal metastases, bone cement-augmented percutaneous screw fixation can provide significant pain relief and improve quality of life.

Analysis of Performance on Activities in Critical Pathway of Total Hip Replacement Surgery (고관절 전치환술 환자의 임상관리도 수행 정도)

  • Lim, You Jin;Jeong, Kyung In;Jeong, Ha Yun;Sun, JeongJu;Kim, Yun Kyung;Choi, Ji Kyung;Lee, Kum Lae;Kim, Jeong Suk;Yang, Jin Ju;Kim, Hye Ja;Jang, Keum Seong;Choi, Ja Yun
    • Korean Journal of Adult Nursing
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    • v.18 no.5
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    • pp.819-827
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    • 2006
  • Purposes: The purpose of this study was to evaluate the extent of performance on activities in critical pathway (CP) according to eight domains and six admission days on nursing records of patients who received total hip replacement surgery. Methods: We reviewed 90 nursing records of patients who received total hip replacement surgery from June, 2004 to July, 2005 at C University Hospital. Data were collected using Hong's CP (2002) and were analyzed using ANOVA. Results: The domain of diet was valued the highest in CP performance scoring, followed by the domains of assessment, activities, and test. There were differences in the performance scores according to the period of admission in all of the domains. Among 132 activities in the CP, 18 activities were completely performed, of which most included activities belonging to the domain of assessment on the admission day. Twelve activities were never performed, of which most included activities belonging to the domain of treatment on the day of operation and the first day after operation. Conclusions: Therefore, further studies on the development of a new system to increase CP utilization and on updating the contents of CP from the best practice based on evidence is recommended.

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Development of the Construction Waste Management Performance Evaluation Tool (WMPET): Quantification of Waste Management Performance Factors and Establishment of Waste Management Performance Evaluation Tool (건설현장의 폐기물 관리 성과 평가 툴 개발 : 2단계 - 폐기물 관리 성과 요인의 전량화 및 평가 툴 구축)

  • Kim, Jee-Hye;Shin, Dong-Woo;Cha, Hee-Sung
    • Korean Journal of Construction Engineering and Management
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    • v.8 no.4
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    • pp.128-136
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    • 2007
  • As the international-level concern has been focused on the environmental sustainability in recent years, many researches emphasized the needs for methods and techniques that would facilitate sustainability assessment at the various project level interfaces. As part of methods and techniques to facilitate sustainability assessment, this paper provides 'Computerized Waste Management Performance Evaluation Tool' for the purpose of assessing the level of management system in dealing with the onsite construction wastes. This tool applies twenty-three waste management performance factors for the purpose of evaluating the level of waste management performance by scoring those factors which were identified in the previous research. These twenty-three factors are classified into four categories: manpower, material, method, and management based on their characteristics. In order to quantitatively evaluate the effectiveness of waste management performance, the levels of actions executed in a site by each waste management performance factor were identified and their weight were analyzed throughout the expert interview and survey. Furthermore, an excel-based computerized tool was developed in order to facilitate the evaluation process. If this tool can be developed in more detail and be used as the method to control waste management at a project level for the future, it is expected that this tool can play an important role in the body of knowledge of environmental management in construction industry.

Evaluation of Biochemical Recurrence-free Survival after Radical Prostatectomy by Cancer of the Prostate Risk Assessment Post-Surgical (CAPRA-S) Score

  • Aktas, Binhan Kagan;Ozden, Cuneyt;Bulut, Suleyman;Tagci, Suleyman;Erbay, Guven;Gokkaya, Cevdet Serkan;Baykam, Mehmet Murat;Memis, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2527-2530
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    • 2015
  • Background: The cancer of the prostate risk assessment (CAPRA) score has been defined to predict prostate cancer recurrence based on the pre-clinical data, then pathological data have also been incorporated. Thus, CAPRA post-surgical (CAPRA-S) score has been developed based on six criteria (prostate specific antigen (PSA) at diagnosis, pathological Gleason score, and information on surgical margin, seminal vesicle invasion, extracapsular extension and lymph node involvement) for the prediction of post-surgical recurrences. In the present study, biochemical recurrence (BCR)-free probabilities after open retropubic radical prostatectomy (RP) were evaluated by the CAPRA-S scoring system and its three-risk level model. Materials and Methods: CAPRA-S scores (0-12) of our 240 radical prostatectomies performed between January 2000-May 2011 were calculated. Patients were distributed into CAPRA-S score groups and also into three-risk groups as low, intermediate and high. BCR-free probabilities were assessed and compared using Kaplan-Meier analysis and Cox proportional hazards regression. Ability of CAPRA-S in BCR detection was evaluated by concordance index (c-index). Results: BCR was present in 41 of total 240 patients (17.1%) and the mean follow-up time was $51.7{\pm}33.0$ months. Mean BCR-free survival time was 98.3 months (95% CI: 92.3-104.2). Of the patients in low, intermediate and high risk groups, 5.4%, 22.0% and 58.8% had BCR, respectively and the difference among the three groups was significant (P = 0.0001). C-indices of CAPRA-S score and three-risk groups for detecting BCR-free probabilities in 5-yr were 0.87 and 0.81, respectively. Conclusions: Both CAPRA-S score and its three-risk level model well predicted BCR after RP with high c-index levels in our center. Therefore, it is a clinically reliable post-operative risk stratifier and disease recurrence predictor for prostate cancer.

The SOFA Score to Evaluate Organ Failure and Prognosis in the Intensive Care Unit Patients (중환자실에 입원한 환자의 장기부전 및 예후 평가를 위한 SOFA 점수체계의 의의)

  • Kim, Su Ho;Lee, Myung Goo;Park, Sang Myeon;Park, Young Bum;Jang, Seung Hun;Kim, Cheol Hong;Jeon, Man Jo;Shin, Tae Rim;Eom, Kwang Seok;Hyun, In-Gyu;Jung, Ki-Suck;Lee, Seung-Joon
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.4
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    • pp.329-335
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    • 2004
  • Background : The Sequential Organ Failure Assessment (SOFA) score can help to assess organ failure over time and is useful to evaluate morbidity. The aim of this study is to evaluate the performance of SOFA score as a descriptor of multiple organ failure in critically ill patients in a local unit hospital, and to compare with APACHE III scoring system. Methods : This study was carried out prospectively. A total of ninety one patients were included who admitted to the medical intensive care unit (ICU) in Chuncheon Sacred Heart Hospital from May 1 through June 30, 2000. We excluded patients with a length of stay in the ICU less than 2 days following scheduled procedure, admissions for ECG monitoring, other department and patients transferred to other hospital. The SOFA score and APACHE III score were calculated on admission and then consecutively every 24 hours until ICU discharge. Results : The ICU mortality rate was 20%. The non-survivors had a higher SOFA score within 24 hours after admission. The number of organ failure was associated with increased mortality. The evaluation of a subgroup of 74 patients who stayed in the ICU for at least 48 hours showed that survivors and non-survivors followed a different course. In this subgroup, the total SOFA score increased in 81% of the non-survivors but in only 21% of the survivors. Conversely, the total SOFA score decreased in 48% of the survivors compared with 6% of the non-survivors. The non-survivors also had a higher APACHE III score within 24 hours and there was a correlation between SOFA score and APACHE III score. Conclusion : The SOFA score is a simple, but effective method to assess organ failure and to predict mortality in critically ill patients. Regular and repeated scoring enables patient's condition and clinical course to be monitored and better understood. The SOFA score well correlates with APACHE III score.

Preoperative Assessment of Renal Sinus Invasion by Renal Cell Carcinoma according to Tumor Complexity and Imaging Features in Patients Undergoing Radical Nephrectomy

  • Ji Hoon Kim;Kye Jin Park;Mi-Hyun Kim;Jeong Kon Kim
    • Korean Journal of Radiology
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    • v.22 no.8
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    • pp.1323-1331
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    • 2021
  • Objective: To identify the association between renal tumor complexity and pathologic renal sinus invasion (RSI) and evaluate the usefulness of computed tomography tumor features for predicting RSI in patients with renal cell carcinoma (RCC). Materials and Methods: This retrospective study included 276 consecutive patients who underwent radical nephrectomy for RCC with a size of ≤ 7 cm between January 2014 and October 2017. Tumor complexity and anatomical renal sinus involvement were evaluated using two standardized scoring systems: the radius (R), exophytic or endophytic (E), nearness to collecting system or sinus (N), anterior or posterior (A), and location relative to polar lines (RENAL) nephrometry and preoperative aspects and dimensions used for anatomical classification (PADUA) system. CT-based tumor features, including shape, enhancement pattern, margin at the interface of the renal sinus (smooth vs. non-smooth), and finger-like projection of the mass, were also assessed by two independent radiologists. Univariable and multivariable logistic regression analyses were performed to identify significant predictors of RSI. The positive predictive value, negative predictive value (NPV), accuracy of anatomical renal sinus involvement, and tumor features were evaluated. Results: Eighty-one of 276 patients (29.3%) demonstrated RSI. Among highly complex tumors (RENAL or PADUA score ≥ 10), the frequencies of RSI were 42.4% (39/92) and 38.0% (71/187) using RENAL and PADUA scores, respectively. Multivariable analysis showed that a non-smooth margin and the presence of a finger-like projection were significant predictors of RSI. Anatomical renal sinus involvement showed high NPVs (91.7% and 95.2%) but low accuracy (40.2% and 43.1%) for RSI, whereas the presence of a non-smooth margin or finger-like projection demonstrated comparably high NPVs (90.0% and 91.3% for both readers) and improved accuracy (67.0% and 73.9%, respectively). Conclusion: A non-smooth margin or the presence of a finger-like projection can be used as a preoperative CT-based tumor feature for predicting RSI in patients with RCC.

Prioritizing Management Ranking for Hazardous Chemicals Reflecting Aggregate Exposure (통합노출을 고려한 유해물질 관리의 우선순위 선정)

  • Jeong, Ji-Yoon;Jung, Yoo-Kyung;Hwang, Myung-Sil;Jung, Ki-Kyung;Yoon, Hae-Jung
    • Journal of Food Hygiene and Safety
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    • v.27 no.4
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    • pp.349-355
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    • 2012
  • In this study, we configured a system which ranks hazardous chemicals to determine their management priorities based on experts' opinions and the existing CRS (chemical ranking and scoring). Aggregate exposure of food, health functional food, oriental/herbal medicine and cosmetics have been taken into account to determine management priority. In this study, 25 hazardous chemicals were selected, such as cadmium, lead, mercury, and arsenic, etc. These 25 materials were ranked according to their 1) risk (exposure or hazard) indexes, 2) exposure source-based weight, and 3) public interests, which were also formed based on the existing priority ranking system. Cadmium was scored the highest (178.5) and bisphenol A the lowest (56.8). Ten materials -- cadmium, lead, mercury, arsenic, tar, acrylamide, benzopyrene, aluminium, benzene, and PAHs -- scored higher than 100. Eight materials -- aflatoxin, manganese, phthalate, chromium, nitrate/nitrite, ethylcarbamate, formaldehyde, and copper -- recorded scores in the range from 70 to 100. Also evaluated as potential risks were 7 materials; sulfur dioxide, ochratoxin, dioxins, PCBs, fumonisin, methyl mercury, and bisphenol A, and these materials were scored above 50. Then we compared risk index and correlation coefficient of total scores to confirm the validity of the total scores; we analyzed correlation coefficient of parameter and indicator. We discovered that the total score and weight, which has incorporated public interests, were high and statistically significant. In conclusion, the result of this study contributes to strengthening risk assessment and risk management of hazardous chemicals.

Evaluation of Surgical Outcome with Pre-and Post-operative Rest/Acetazolamide Tc-99m HMPAO SPECT in Children with Moyamoya Disease (어린이 모야모야병에서 휴식/아세타졸아미드 Tc-99m-HMPAO SPECT를 이용한 수술결과 평가)

  • Lee, D.S.;Hyun, I.Y.;Wang, K.C.;Cho, B.K.;Chung, J.K.;Lee, M.C.
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.4
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    • pp.314-324
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    • 1998
  • Purpose: This study was performed to evaluate the outcome of encephalo-duro-arterio-synangiosis (EDAS) surgery with rest/acetazolamide Tc-99m HMPAO SPECT in moyamoya disease. Materials and Methods: Rost/acetazolamide subtraction SPECT with consecutive acquisition were done before and 2 months after 21 EDAS surgeries in 18 patients. Perfusion decrease was graded visually for 14 areas of each hemisphere as 0 (normal) to 3 (defect) using 4 point scoring system. Postoperative rest perfusion or perfusion reserve was compared with preoperative ones. Results: Among 294 areas of 21 hemispheres, rest perfusion abnormality was found in 91 areas of 15 hemispheres. Decrease of perfusion reserve was found in 146 areas of 18 hemispheres. Six hemispheres having normal rest perfusion and 12 of 15 hemispheres having rest perfusion abnormality showed reserve decrease. Three having rest perfusion defect did not change after acetazolamide in preoperative SPECT. After operation, 16 patients (89%) demonstrated clinical improvement. Fifteen among 18 hemispheres (83%) with decreased reserve improved. Rest perfusion abnormality improved in 6 among the 15 hemispheres (40%). The areas having rest perfusion and/or reserve decrease improved in 87 among 146 areas (60%). Decrease of reserve, improved in 85% (68/80). However, areas without reserve decrease also improved in 29% (19/66). The better was preoperative rest perfusion in involved areas or the more decreased vascular reserve, the more improved perfusion and reserve after operation. Conclusion: We conclude that assessment of perfusion and Perfusion reserve using rest/acetazolamide brain perfusion SPECT predict the surgical outcome in patients with moyamoya disease.

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Acute Type V Acromioclavicular Injury Treated by the Modified Bosworth Technique (급성 제 5형 견봉쇄골관절 탈구의 치료)

  • Kim Seung-Key;Yi Sang-Hoon;Park Jong Beom;Bahk, Won-Jong;Jang Il-Seok;Chang Han
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.126-132
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    • 1999
  • Purpose : To evaluate the functional and radiographic outcome of the modified Bosworth method in the surgical treatment of acute type V acromioclavicular joint dislocation. Materials and Methods: From June 1995 to May 1998, 20 patients were operated on for acute and complete acromioclavicular dislocation(Rockwood type V). The operative technique includes fixation of the coracoclavicular joint with Bosworth screw or 6.5mm cancellous screw and imbrication of trapezius and deltoid muscles. The average age was 34 years(range, 19 to 51 years). These 20 patients with an average follow-up of 18months, were evaluated clinically using the UCLA scoring system. Additional radiographical assessment was performed with stress radiographs. Results: Excellent or good clinical results were obtained in 95%(19 cases). And the average coracoclavicular interval ratio was decreased from 3.31(2.2-6.0) to 1.13(1-1.4) in stress radiographs. There were 4 cases of hetero­topic calcification postoperatively but there was no correlation with clinical result. Posttraumatic A-C joint arthritis was developed in one case. In that case, the distal clavicular resection was done under the arthroscopic technique. Conclusion: The severe displacement observed with type V injuries is incompatible with normal shoulder function if the shoulder is left in its displaced position. In type V injuries, significant damage to the deltoid and trapezius musculature and overlying fascia occurs, therefore open reduction and good fixation must be obtained with imbrication of trapezius and deltoid muscles. In our type V acute complete acromioclavicular dislocation, the modified Bosworth technique provides excellent results with a low complication rate.

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