• Journal of Pharmacopuncture
• /
• v.6 no.1
• /
• pp.35-36
• /
• 2003

Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented briefly here in치uding 1) Quality of Life of liver cancer patients after 8 Constitutional acupuncture; 2) Developing a Korean version of Measuring yourself Medical Outcome profile (MYMOP); and 3) Survey on 5 Shu points: a pilot In the first study, we have included 4 primary or secondary liver cancer patients collecting their diagnostic X-ray film and clinical data f개m their hospital, and asked them to fill in the European Organization Research and Treatment of Cancer, Quality of Life Questionnaire before the commencement of the treatment. The acupuncture treatment is set up format but not disclosed yet. The translation and developing a Korean version of outcome measures that is Korean clinician friendly has been sought for MYMOP is one of the most appropriate one. The permission was granted, the translation into Korean was done, then back translated into English only based on the Korean translation by the researcher who is bilingual in both languages. The back translation was compared by the original developer of MYMOP and confirmed usable. In order to test the existence of acupoints and meridians through popular forms of Korean acupuncture regimes, we aim at collecting opinions from 101 Korean clinicians that have used those forms. The questions asked include most effective symptoms, 5 Shu points, points those are least likely to use due to either adverse events or the lack of effectiveness, theoretical reasons for the above proposals, proposing outcome measures, and the time from insertion to be effective. The questionnaire is posted on the virtual notice board of the homepage of the communication KOMA (The official tool of Association of Korean Oriental Medicine).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.44 no.4
• /
• pp.174-181
• /
• 2018

Objectives: The number of patients with medication-related osteonecrosis of the jaw (MRONJ) is increasing, but treatment remains controversial. Published papers and systematic reviews have suggested that surgical treatment is effective in patients with MRONJ. The purpose of this study was to determine whether preoperative University of Connecticut Osteonecrosis Numerical Scale (UCONNS), other serologic biomarkers, and size of necrosis are prognostic factors for outcome of surgical treatment in MRONJ. Materials and Methods: From January 2008 to December 2016, 65 patients diagnosed with MRONJ at the Department of Oral and Maxillofacial Surgery in College of Dentistry, Dankook University who required hospitalization and surgical treatment were investigated. Patient information, systemic factors, and UCONNS were investigated. In addition, several serologic values were examined through blood tests one week before surgery. The size of osteolysis was measured by panoramic view and cone-beam computed tomography in all patients. With this information, multivariate logistic regression analysis with backward elimination was used to examine factors affecting postoperative outcome. Results: In multivariate logistic analysis, higher UCONNS, higher C-reactive protein (CRP), larger size of osteolysis, and lower serum alkaline phosphate were associated with higher incidence of incomplete recovery after operation. This shows that UCONNS, CRP, serum alkaline phosphate, and size of osteolysis were statistically significant as factors for predicting postoperative prognosis. Conclusion: This study demonstrated that CRP, UCONNS, serum alkaline phosphate, and size of osteolysis were statistically significant factors in predicting the prognosis of surgical outcome of MRONJ. Among these factors, UCONNS can predict the prognosis of MRONJ surgery as a scale that includes various influencing factors, and UCONNS should be used first as a predictor. More aggressive surgical treatment and more definite surgical margins are needed when the prognosis is poor.

• The Journal of Pediatrics of Korean Medicine
• /
• v.30 no.1
• /
• pp.32-39
• /
• 2016

Objectives To evaluate the effectiveness of allergic rhinitis treatment, and to set the ground in clinical studies, adequate outcome measures must be established. Thus, this study was designed to develop useful criteria based on those that have been suggested, and those that we are using today. Methods To assess outcome measures used in allergic rhinitis in Korean medicine, related articles found in Korea Traditional Knowledge Portal from 2000-2015 were evaluated. Then pattern identification and outcome measures were reviewed in each study. Results Among 27 studies, we have found 24 studies used subjective symptoms as outcome measures, 9 studies used quality of life, and most of allergic rhinitis were caused by Spleen-Gi deficiency. Conclusions It is necessary to develop outcome measures that directly reflect pattern identifications in Korean medicine, and those measures need to be further evaluated for their applicability, validity and sensitivity.

• Clinical and Experimental Pediatrics
• /
• v.60 no.5
• /
• pp.129-137
• /
• 2017

The event-free survival (EFS) for pediatric acute lymphoblastic leukemia (ALL) has shown remarkable improvement in the past several decades. In Korea also, a recent study showed 10-year EFS of 78.5%. Much of the improved outcome for pediatric ALL stems from the accurate identification of prognostic factors, the designation of risk group based on these factors, and treatment of appropriate duration and intensity according to risk group, done within the setting of cooperative clinical trials. The schema of first-line therapy for ALL remains mostly unchanged, although many groups have now reported on the elimination of cranial irradiation in all patients with low rates of central nervous system relapse. Specific high risk subgroups, such as Philadelphia chromosome-positive (Ph+) ALL and infant ALL continue to have significantly lower survival than other ALL patients. The introduction of tyrosine kinase inhibitors into therapy has led to enhanced outcome for Ph+ ALL patients. Infant ALL patients, particularly those with MLL rearrangements, continue to have poor outcome, despite treatment intensification including allogeneic hematopoietic cell transplantation. Relapsed ALL is a leading cause of mortality in pediatric cancer. Recent advances in immunotherapy targeting the CD19 of the ALL blast have shown remarkable efficacy in some of these relapsed and refractory patients. With improved survival, much of the current focus is on decreasing the long-term toxicities of treatment.

• Journal of Korean Physical Therapy Science
• /
• v.5 no.4
• /
• pp.831-836
• /
• 1998

Object: We evaluated the efficacy of chest physical therapy in pediatric patients with pneumonia. Method: Retrospective study was performed in 89 pneumonia patients admitted to pediatric unit. The subjects were divided into two groups: control group; treatment group. Control group included 42 patients who didn't receive chest physical therapy. Treatment group included 47 patients who received chest physical therapy. The chest physcial therapy employed were postural drainage, chest percussion, deep breathing training and enhancement of coughings. The efficacy was evaluated by x-ray outcome before discharge. Results: There were no significant difference in age, sex, type of pneumonia, and symptom duration between two groups. However the duration of fever after admission, duration of antibiotic use and hospital stay were longer in treatment group. In treatment group, longer the day to initiate chest physical therapy, longer the hospital stay. The final outcome was not different between groups. Conclusion: The results suggest that the referred patients for chest physical therapy tends to be of severe cases. Nevertheless, the result that the outcome was not different in two groups means that the chest physical therapy could be used as a effective treatment method in pediatric patient with pneumonia.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.4
• /
• pp.500-506
• /
• 2000

Objective : To determine the role of preoperative embolization on postoperative neurological outcome in the treatment of cerebral AVMs, we retrospectively evaluated an effectiveness of combining preoperative embolization and microsurgery for arteriovenous malformations(AVM) of the brain. Method : Two groups(10 patients who underwent preoperative superselective embolization and surgery versus 27 patients who underwent surgery only) were compared and categorized by Spetzler-Martin grade, the size of AVM and postoperative clinical outcome using Glasgow Outcome Scale. The 37 patients included 23 males and 14 females, ranging in age from 11 to 74 years(mean 36 years). Results : The arteriovenous malformations in preoperative embolization and surgery group had a larger average greatest diameter(4.45cm versus 3.83cm) and were of higher Spetzler-Martin grade(80% versus 52% grade III through V). At 1 week after surgery, the preoperative embolization and surgery group represented a better outcome(60% versus 44% with Glasgow Outcome Scale score of 5). And over 6 months after surgery, the embolization and surgery group displayed more favorable clinical outcome(80% versus 63% with Glasgow Outcome Scale score of 5). Conclusion : Combined treatment with superselective preoperative embolization using N-butyl cyanoacrylate and direct surgery may help neurosurgeon treating the high grade AVMs thus improving the postsurgical outcome.

• The korean journal of orthodontics
• /
• v.47 no.6
• /
• pp.401-413
• /
• 2017

Objective: The aim of this systematic review was to assess the occlusal outcome and duration of fixed orthodontic therapy from clinical trials in humans with the Objective Grading System (OGS) proposed by the American Board of Orthodontics. Methods: Nine databases were searched up to October 2016 for prospective/retrospective clinical trials assessing the outcomes of orthodontic therapy with fixed appliances. After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of the mean OGS score and treatment duration were performed and 95% confidence intervals (CIs) were calculated. Results: A total of 34 relevant clinical trials including 6,207 patients (40% male, 60% female; average age, 18.4 years) were identified. The average OGS score after treatment was 27.9 points (95% CI, 25.3-30.6 points), while the average treatment duration was 24.9 months (95% CI, 24.6-25.1 months). There was no significant association between occlusal outcome and treatment duration, while considerable heterogeneity was identified. In addition, orthodontic treatment involving extraction of four premolars appeared to have an important effect on both outcomes and duration of treatment. Finally, only 10 (39%) of the identified studies matched compared groups by initial malocclusion severity, although meta-epidemiological evidence suggested that matching may have significantly influenced their results. Conclusions: The findings from this systematic review suggest that the occlusal outcomes of fixed appliance treatment vary considerably, with no significant association between treatment outcomes and duration. Prospective matched clinical studies that use the OGS tool are needed to compare the effectiveness of orthodontic appliances.

• Journal of Oral Medicine and Pain
• /
• v.22 no.1
• /
• pp.7-13
• /
• 1997

In order to evaluate the outcome of conservative treatment for acute or chronic closed lock, 127 patients were subjected at the Dept. of Oral Medicine, PNUH, from 1991. All the symptoms were analyzed and the results according to treatment modalities were compared before and after treatment. 1. Closed lock patients were more often seen in women of twenty and thirty. 2. The most common reasons for treatment were functional pain, limitation of mouth opening, restricted laterotrusion to non-effected side, deflection on opening but, on the contrary, noise was the least. 3. Most of closed lock patients were curedin six months. 4. Conservative treatment including stabilization splint produced better results. 5. Functional pain and limitation of mouth opening were relieved and maximumm comfortable opening was expanded, but joint noise decreased in the chronic and increased in the acute.

• Journal of Korean Neurosurgical Society
• /
• v.62 no.5
• /
• pp.551-560
• /
• 2019

Objective : Intracranial aneurysms are not common in young age patients. We sought to find the characteristics of the intracranial aneurysms in patients under 20 years of age. Methods : We reviewed 23 consecutive patients ${\leq}20$ years of age treated for their intracranial aneurysms during the period from 1995 to 2017. From medical records and imaging studies, we gathered data on age, sex, presentation, associated medical condition, location and characteristics of aneurysms, treatment and clinical outcomes. Results : The patients' ages ranged from 13 months to 20 years (median, 14 years). There were 16 males and seven females (male to female ratio, 2.3 : 1) with 31 aneurysms. Clinical presentations included sudden severe headache in 61%, followed by altered mentality in 17% and seizure in 17%. More than one-fourth patients had specific medical conditions related to the development of the cerebral aneurysms. The majority of aneurysms occurred in the anterior circulation (71%), and were saccular (71%). There were each three patients with false aneurysms (13%) and giant aneurysms (13%), and only one patient with multiple aneurysms (4%). We treated 22 patients : 21 aneurysms with the endovascular methods, three with open surgery, and one with combined treatment. Good functional outcome could be achieved in 86% during the follow-up period. Conclusion : In this series, the young-age patients with intracranial aneurysms were characterized by male predominance, related specific medical conditions, low incidence of multiple aneurysms, high incidence of giant aneurysms and good functional outcome after treatment.

• The Korean Journal of Applied Statistics
• /
• v.36 no.4
• /
• pp.323-335
• /
• 2023

In causal analysis of high dimensional data, it is important to reduce the dimension of covariates and transform them appropriately to control confounders that affect treatment and potential outcomes. The augmented inverse probability weighting (AIPW) method is mainly used for estimation of average treatment effect (ATE). AIPW estimator can be obtained by using estimated propensity score and outcome model. ATE estimator can be inconsistent or have large asymptotic variance when using estimated propensity score and outcome model obtained by parametric methods that includes all covariates, especially for high dimensional data. For this reason, an ATE estimation using an appropriate dimension reduction method and semiparametric model for high dimensional data is attracting attention. Semiparametric method or sparse sufficient dimensionality reduction method can be uesd for dimension reduction for the estimation of propensity score and outcome model. Recently, another method has been proposed that does not use propensity score and outcome regression. After reducing dimension of covariates, ATE estimation can be performed using matching. Among the studies on ATE estimation methods for high dimensional data, four recently proposed studies will be introduced, and how to interpret the estimated ATE will be discussed.