Communications for Statistical Applications and Methods
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v.25
no.3
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pp.321-328
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2018
In clinical trials with repeated measurements, the time-averaged difference (TAD) may provide a more powerful evaluation of treatment efficacy than the rate of changes over time when the treatment effect has rapid onset and repeated measurements continue across an extended period after a maximum effect is achieved (Overall and Doyle, Controlled Clinical Trials, 15, 100-123, 1994). The sample size formula has been investigated by many researchers for the evaluation of TAD in two treatment groups. For the evaluation of TAD in multi-arm trials, Zhang and Ahn (Computational Statistics & Data Analysis, 58, 283-291, 2013) and Lou et al. (Communications in Statistics-Theory and Methods, 46, 11204-11213, 2017b) developed the sample size formulas for continuous outcomes and count outcomes, respectively. In this paper, we derive a sample size formula to evaluate the TAD of the repeated binary outcomes in multi-arm trials using the generalized estimating equation approach. This proposed sample size formula accounts for various correlation structures and missing patterns (including a mixture of independent missing and monotone missing patterns) that are frequently encountered by practitioners in clinical trials. We conduct simulation studies to assess the performance of the proposed sample size formula under a wide range of design parameters. The results show that the empirical powers and the empirical Type I errors are close to nominal levels. We illustrate our proposed method using a clinical trial example.
Purpose : The main purpose of this study was to investigate the effect on Balance Ability of Knee Osteoarthritis(OA) by Lower Extremity Patterns with dynamic reverse in Proprioceptive Neuromuscular Facilitation(PNF). Methods : The subjects were consisted of 30 women patients with knee OA. All subjects were randomly assigned to PNF group. Each group had a treatment for 30 minutes per day and three times a week during 8 weeks period. Was used to measure recovery or worse of patient's condition, muscle assessment questionnaire(MAQ) was used to measure patient' s muscular strength, Endurance, coordination/balance, KWOMAC was used to pain, stiffness, and physical function, and BPM was used to measure path, anterior-posterior. Results : This study results in following conclusons. 1. MAQ score was significantly decreased in PNF group(p<.05). 2. KWOMAC score was significantly decreased in PNF group(p<.05). 3. BPM were score was significantly decreased in PNF group(p>.05). Conclusion : From this result the PNF treatment retrogression characteristic will be effective in treatment of patient, with the arthritis and widely may be applied at a therapist.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.26
no.4
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pp.91-100
/
2013
Background and Objective : Dyshidrotic Eczema is characterized by a pruritic vesicular eruption on the fingers, palms, and soles. It is an acute, chronic, or recurrent dermatosis. The causes of dyshidrosis are unknown. There are many treatments available for dyshidrosis including topical steroids but long term treatment of streoids may have side effects. The purpose of this study is to find out the effect of Fulinggancao-Tang on Dyshidrotic Eczema. Methods : We have diagnosed the patients through the Shanghanlun six meridian patterns diagnostic system and we treated the patients with Fulinggancao-Tang. The severity of Dyshidrotic Eczema was evaluated by visual analogue scale(VAS). Results : After the treatment itching and vesicles of hands and foots were all disappeared in both patients. Conclusions : Fulinggancao-Tang have improved the signs and symptoms of Dyshidrotic Eczema case. It is considered that Fulinggancao-Tang is considerably effective on the treatment of skin disease that especially vulnerable to water.
Autism or autism spectrum disorder (ASD) is a behavioral syndrome characterized by persistent deficits in social interaction, and repetitive patterns of behavior, interests, or activities. The gene encoding Methyl-CpG binding protein 2 (MeCP2) is one of a few exceptional genes of established causal effect in ASD. Although genetically engineered mice studies may shed light on how MeCP2 loss affects synaptic activity patterns across the whole brain, such studies are not considered practical in ASD patients due to the overall level of impairment, and are technically challenging in mice. For the first time, we show that hippocampal MeCP2 knockdown produces behavioral abnormalities associated with autism-like traits in rats, providing a new strategy to investigate the efficacy of therapeutics in ASD. Ketamine, an N-Methyl-D-aspartate (NMDA) blocker, has been proposed as a possible treatment for autism. Using the MeCP2 knockdown rats in conjunction with a rat model of valproic acid (VPA)-induced ASD, we examined gene expression and ASD behaviors upon ketamine treatment. We report that the core symptoms of autism in MeCP2 knockdown rats with social impairment recovered dramatically following a single treatment with ketamine.
Sharma, Kanika;Ahlawat, Parveen;Gairola, Munish;Tandon, Sarthak;Sachdeva, Nishtha;Sharief, Muhammed Ismail
Radiation Oncology Journal
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v.37
no.2
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pp.73-81
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2019
Purpose: There is sparse literature on treatment outcomes research on resectable oral tongue squamous cell carcinoma (OTSCC). The aim of this study was to measure the treatment outcomes, explore the failure patterns, and identify the potential clinicopathological prognostic factors affecting treatment outcomes for resectable OTSCC. Materials and Methods: It is a retrospective analysis of 202 patients with resectable OTSCC who underwent upfront primary surgical resection followed by adjuvant radiotherapy with or without concurrent chemotherapy if indicated. Results: The median follow-up was 35.2 months (range, 1.2 to 99.9 months). The median duration of locoregional control (LRC) was 84.9 months (95% confidence interval, 67.3-102.4). The 3- and 5-year LRC rate was 68.5% and 58.3%, respectively. Multivariate analysis showed that increasing pT stage, increasing pN stage, and the presence of extracapsular extension (ECE) were significantly associated with poorer LRC. The median duration of overall survival (OS) was not reached at the time of analysis. The 3- and 5-year OS rate was 70.5% and 66.6%, respectively. Multivariate analysis showed that increasing pT stage and the presence of ECE were significantly associated with a poorer OS. Conclusion: Locoregional failure remains the main cause of treatment failure in resectable OTSCC. There is scope to further improve prognosis considering modest LRC and OS. Pathological T-stage, N-stage, and ECE are strong prognostic factors. Further research is required to confirm whether adjuvant therapy adds to treatment outcomes in cases with lymphovascular invasion, perineural invasion, and depth of invasion, and help clinicians tailoring adjuvant therapy.
Objectives: There has been a growing interest in glass ceramic systems with good esthetics, high fracture resistance and bonding durability, and simplified fabrication techniques using CAD/CAM. The aim of this study is to compare flexural strength before and after heat treatment of two lithium disilicate CAD/CAM blocks, IPS e.max CAD (Ivoclar Vivadent) and Rosetta SM (Hass), and to observe their crystalline structures. Materials and Methods: Biaxial flexural strength was tested according to ISO 6872 with 20 disc form specimens sliced from each block before and after heat treatment. Also, the crystalline structures were observed using field-emission scanning microscopy (FE-SEM, Hitachi) and x-ray diffraction (XRD, Rigaku) analysis. The mean values of the biaxial flexural strength were analyzed by the Mann-Whitney U test at a significance level of p = 0.05. Results: There were no statistically significant differences in flexural strength between IPS e.max CAD and Rosetta SM either before heat treatment or after heat treatment. For both ceramics, the initial flexural strength greatly increased after heat treatment, with significant differences (p < 0.05). The FE-SEM images presented similar patterns of crystalline structure in the two ceramics. In the XRD analysis, they also had similar patterns, presenting high peak positions corresponding to the standard lithium metasilicate and lithium disilicate at each stage of heat treatment. Conclusions: IPS e.max CAD and Rosetta SM showed no significant differences in flexural strength. They had a similar crystalline pattern and molecular composition.
Yoon, Jee-Hyun;Park, Su Bin;Kim, Eun Hye;Lee, Jee Young;Yoon, Seong Woo
Journal of Korean Traditional Oncology
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v.26
no.1
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pp.17-27
/
2021
Objective: This study aimed to evaluate which information of cancer patients should be collected for the Korean medicine cancer registry in order to assess the efficacy and safety of Korean medicine (KM) treatment and to identify Korean medical prognostic predictors. Methods: A total of fifteen Korean medical specialists completed an online survey questionnaire including items about general characteristics of cancer patients and clinical practice patterns. Results: The four main types of cancer at Korean medical hospitals were breast, lung, stomach, and colorectal cancer. The majority of patients with cancer at Korean medical hospitals were in the advanced or metastatic stage (50.0%). The prominent purposes of KM treatment were to alleviate cancer-related symptoms, reduce the side effects of conventional therapy, and improve quality of life. The major options for treatment were traditional herbal medicine (THM), acupuncture, moxibustion, thermotherapy, pharmacoacupuncture, and meditation, with THM being the most frequently used (35.7%). Almost all Korean medical specialists (93.9%) used syndrome differentiation in clinical practice and identified over half the cancer patients as deficiency syndrome (57.2%). Conclusion: Physicians considered the primary goal of KM treatment for cancer patients to be symptom management since advanced or metastatic stage patients were the majority at Korean medical hospitals. THM were the most common treatment option and syndrome differentiation was used by almost all physicians. Further research is needed to monitor and ensure optimal KM treatment for patients with cancer.
Objectives : This paper examines the medical treatise and treatment methods of Zhang Jiebin on the depressive pattern, for clinical application today. Methods : The Zazhengmo/Yuzheng chapter of the Jingyue Quanshu, related texts and annotations of the Huangdineijing, and related contents among the medical texts of the JinYuan masters were analyzed. Developmental process of the medical theories were compared and examined. Results : Zhang focused on the mechanism in which emotion affects Qi leading to a disease state, and categorized Yu[鬱, depressed state] into three: anger depression, contemplative depression and comprehensive depression. The concept of the Five Depressive Patterns and its treatment from the Huangdineijing·Suwen which was considered as excess pattern was expanded to include deficiency pattern based on comparison with annotations of Wangbing, Hwashou, and Wang Andao. Treatment methods centered on purging was also expanded to include tonifying to restore the damaged Jing Qi. The depressive patterns anger depression, contemplative depression and comprehensive depression were subdivided according to excess and deficiency, for which formulas such as Shenxiangsan, Shoupijian, Guipitang were suggested. As the depressive pattern is caused by emotions and thus the Heart, the Yiqingbianqi method that directly deals with emotions was suggested. Zhang adopted Zhu Zhenheng's opinion which expands the category of Yu, and in the perspective of excess/deficiency, it is most similar to that of Li Dongyuan. Conclusions : Before Zhang, the depressive pattern was discussed in terms of it being excess pattern. However, Zhang's discussion on depressive pattern based on anger depression, contemplative depression and comprehensive depression focuses on emotional stagnation while suggesting the possibility of deficient stagnation, expanding previous understanding. In terms of treatment, tonifying methods for deficiency pattern was added, while consideration of emotion itself became necessary in treatment.
Baade, Peter D.;Yu, Xue Qin;Smith, David P.;Dunn, Jeff;Chambers, Suzanne K.
Asian Pacific Journal of Cancer Prevention
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v.16
no.3
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pp.1259-1275
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2015
Background: This study reviewed the published evidence as to how prostate cancer outcomes vary across geographical remoteness and area level disadvantage. Materials and Methods: A review of the literature published from January 1998 to January 2014 was undertaken: Medline and CINAHL databases were searched in February to May 2014. The search terms included terms of 'Prostate cancer' and 'prostatic neoplasms' coupled with 'rural health', 'urban health', 'geographic inequalities', 'spatial', 'socioeconomic', 'disadvantage', 'health literacy' or 'health service accessibility'. Outcome specific terms were 'incidence', 'mortality', 'prevalence', 'survival', 'disease progression', 'PSA testing' or 'PSA screening', 'treatment', 'treatment complications' and 'recurrence'. A further search through internet search engines was conducted to identify any additional relevant published reports. Results: 91 papers were included in the review. While patterns were sometimes contrasting, the predominate patterns were for PSA testing to be more common in urban (5 studies out of 6) and affluent areas (2 of 2), higher prostate cancer incidence in urban (12 of 22) and affluent (18 of 20), greater risk of advanced stage prostate cancer in rural (7 of 11) and disadvantaged (8 of 9), higher survival in urban (8 of 13) and affluent (16 of 18), greater access or use of definitive treatment services in urban (6 of 9) and affluent (7 of 7), and higher prostate mortality in rural (10 of 20) and disadvantaged (8 of 16) areas. Conclusions: Future studies may need to utilise a mixed methods approach, in which the quantifiable attributes of the individuals living within areas are measured along with the characteristics of the areas themselves, but importantly include a qualitative examination of the lived experience of people within those areas. These studies should be conducted across a range of international countries using consistent measures and incorporate dialogue between clinicians, epidemiologists, policy advocates and disease control specialists.
Chung, Il Yong;Lee, Jihyoun;Park, Suyeon;Lee, Jong Won;Youn, Hyun Jo;Hong, Jung Hwa;Hur, Ho
Journal of Korean Medical Science
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v.33
no.44
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pp.276.1-276.10
/
2018
Background: The National Health Insurance Service (NHIS) established a healthcare claim database for all Korean citizens. This study aimed to analyze the NHIS data and investigate the patterns of breast cancer treatments. Methods: We constructed a retrospective female breast cancer cohort by analyzing annual incident cases. The annual number of newly diagnosed female breast cancer was compared between the NHIS data and Korea National Cancer Incidence Database (KNCIDB). The annual treatment patterns including surgery, chemotherapy, radiation therapy, endocrine therapy and targeted therapy were analyzed. Results: A total of 148,322 women with newly diagnosed invasive breast cancer during 2006-2014 was identified. The numbers of newly diagnosed invasive breast cancer cases were similar between the NHIS data and KNCIDB, which demonstrated a strong correlation (r = 0.995; P < 0.001). The age distribution of the breast cancer cases in the NHIS data and KNCIDB also showed a strong correlation (r = 1.000; P < 0.001). About 85% of newly diagnosed breast cancer patients underwent operations. Although the proportions of chemotherapy use have not changed during 2006-2014, the total number of chemotherapy prescriptions sharply increased during this period. The proportions of radiotherapy and anti-hormonal therapy increased. Among the anti-hormonal agents, tamoxifen was the most frequently prescribed medication, and letrozole was the most preferred endocrine treatment in patients aged ${\geq}50$ years. Conclusion: Along with the increased breast cancer incidence in Korea, the frequencies of breast cancer treatments have increased. The NHIS data can be a feasible data source for future research.
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