• 수면정신생리
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• 제27권1호
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• pp.8-15
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• 2020

Sleep disorder in chronic obstructive pulmonary disease (COPD) is common and typically is associated with oxygen desaturation. The mechanisms of desaturation include hypoventilation and ventilation to perfusion mismatch. Despite the importance of sleep in patients with COPD, this topic is under-assessed in clinical practice. Impaired sleep quality is associated with more severe COPD and may contribute to worse clinical outcomes. Recent data have indicated that specific respiratory management of patients with COPD and sleep disordered breathing improves clinical outcomes. Clinicians managing patients with COPD should pay attention to and actively manage symptoms of comorbid sleep disorders. Management of sleep-related problems in COPD should particularly focus on minimizing sleep disturbance.

• Journal of the Korean Data and Information Science Society
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• 제19권4호
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• pp.1429-1440
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• 2008

In a meta-analysis combining the results from different clinical trials, it is important to consider the possible heterogeneity in outcomes between trials. Such variations can be regarded as random effects. Thus, random-effect models such as HGLMs (hierarchical generalized linear models) are very useful. In this paper, we propose a HGLM framework for analyzing the binominal response data which may have variations in the odds-ratios between clinical trials. We also present the prediction intervals for random effects which are in practice useful to investigate the heterogeneity of the trial effects. The proposed method is illustrated with a real-data set on 22 trials about respiratory tract infections. We further demonstrate that an appropriate HGLM can be confirmed via model-selection criteria.

• Communications for Statistical Applications and Methods
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• 제22권5호
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• pp.401-413
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• 2015

In this article, we review the statistical methods and theory for dose finding in early phase clinical trials, where the primary objective is to identify an acceptable dose for further clinical investigation. The dose finding literature is initially motivated by applications in phase I clinical trials, in which dose finding is often formulated as a percentile estimation problem. We will present some important phase I methods and give an update on new theoretical developments since a recent review by Cheung (2010), with an aim to cover a broader class of dose finding problems and to illustrate how the general dose finding theory may be applied to evaluate and improve a method. Specifically, we will illustrate theoretical techniques with some numerical results in the context of a phase I/II study that uses trinary toxicity/efficacy outcomes as basis of dose finding.

• 대한족부족관절학회지
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• 제27권1호
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• pp.7-11
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• 2023

Rotational ankle fractures are one of the most common injuries of lower limbs treated by orthopedic surgeons. Open reduction and internal fixation (ORIF) is considered a gold standard treatment for unstable ankle fractures, though adjunct ankle arthroscopy is being increasingly used in cases of ankle trauma. Although the role and use of ankle arthroscopy are expanding, the clinical outcomes and cost-effectiveness of arthroscopy remain undefined. Furthermore, despite the number of clinical research studies performed on arthroscopically assisted surgery for ankle fractures, no definite guidelines have been agreed, and no consensus has been reached regarding indications. This article reviews the role, indications, operative techniques, and complications of ankle arthroscopy and compares the clinical outcomes of conventional ORIF and arthroscopically assisted ORIF.

• 대한불안의학회지
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• 제20권1호
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• pp.1-7
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• 2024

This review article summarizes the main research findings on the presence of anxiety disorders in individuals with bipolar disorder. It examines the prevalence of comorbid anxiety disorders in bipolar disorder, which is generally high. Moreover, it explores the variations in comorbid anxiety across different subtypes of bipolar disorder. The article also investigates the clinical features, treatment, and prognosis associated with comorbid anxiety in bipolar disorder. It reveals that bipolar patients with comorbid anxiety exhibit complex clinical features, worse treatment outcomes, and a poorer prognosis. Given the significant impact of comorbid anxiety on clinical features, treatment outcomes, and prognosis, it is crucial to address this issue when treating individuals with bipolar disorder. Therefore, further research on the treatment of co-occurring anxiety in bipolar disorder patients is warranted.

• Clinics in Shoulder and Elbow
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• 제21권1호
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• pp.22-29
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• 2018

Background: This study is performed to evaluate anchor-related outcomes and complications after arthroscopic rotator cuff repair using 30% ${\beta}$-tricalcium phosphate (${\beta}$-TCP) with 70% poly lactic-co-glycolic acid (PLGA) biocomposite suture anchors. Methods: A total of 78 patients (mean age, $61.3{\pm}6.9years$) who underwent arthroscopic medium-to-large full-thickness rotator cuff tear repair were enrolled. The technique employed 30% ${\beta}$-TCP with 70% PLGA biocomposite suture anchors at the medial row (38 patients, Healix $BR^{TM}$ anchor [Healix group]; 40 patients, Fixone anchor B [Fixone group]). The radiologic outcomes (including perianchor cyst formation or bone substitution) and anatomical outcomes of the healing failure rate were evaluated using magnetic resonance imaging at least 6 months after surgery, the pain visual analogue scale at 3, 6 months, and final follow-up visit, and American Shoulder and Elbow Surgeons scores at least 1 year postoperatively. Anchor-related complications were also evaluated. Results: The perianchor cyst formation incidence was similar for both groups (60.5%, Healix group; 60.0%, Fixone group; p=0.967), although severe perianchor cyst incidence was slightly lower in the Fixone group (15.0%) than in the Healix group (21.1%). There was no occurrence of anchor absorption and bone substitution. No differences were observed in the healing failure rate (13.2%, Healix group; 15.0%, Fixone group; p=0.815) and functional outcome between groups (all p>0.05). Anchor breakage occurred in 5 patients (2 Healix anchors and 3 Fixone anchors); however, there were no major anchor-related complications in either group. Conclusions: No differences were observed in the clinical outcomes of the Healix and Fixone groups, neither were there any accompanying major anchor-related complications.

• 한국산학기술학회논문지
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• 제11권9호
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• pp.3398-3405
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• 2010

본 논문에서는 임상콘텐츠모형(Clinical Contents Model; CCM) 산출물의 효율적인 개발과 배포 및 홍보를 지원하는 관리시스템인 CCM Manager를 개발했다. CCM의 개발과정에서부터 산출물 관리 및 배포까지의 업무 프로세스를 분석하여 관리자 기능과 사용자 기능을 도출했고, CCM 아키텍처를 기반으로 데이터베이스를 설계하였으며 각 사용자들이 쉽게 접근하여 내용을 검색할 수 있도록 하기 위해 웹 기반으로 개발하였다. CCM Manager는 모델 개발자 상호간의 개발된 결과물이 잘 공유될 수 있게 지원하고, 관리자가 수작업으로 산출물을 패키지화하여 배포하지 않아도 일반 사용자에게 CCM의 모델 형식의 산출물을 배포하고 홍보할 수 있도록 하였다. 본 연구는 다양한 검색 기능과 시각화된 모델 브라우징 방식을 제공하고, 관리자 기능까지 포함한다는 측면에서 타 임상정보모델 지원시스템에 비해 우수함을 보인다. 본 연구에서 개발된 CCM Manager는 현재 CCM 개발 프로세스에서 활용되고 있으며, 그 결과를 바탕으로 향후 CCM Manager 활용에 대한 효용성 분석이 이루어질 전망이다.

• Journal of Korean Neurosurgical Society
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• 제29권2호
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• pp.217-221
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• 2000

Objective : Brainstem hemorrhages usually result in much higher mortality and morbidty than any other intracranial vascular lesions. The purpose of the study is to evaluate the relationship of the radiological classification of the lesions and the clinical outcomes, and to evaluate the value of such classification on the choice of management modality. Method : Thirty seven patients with primary brainstem hemorrhage were managed medically or surgically between Oct. 1995 and Mar. 1998. The lesions were classified as two groups based on radiological findings as follows : Focal subependymal hematoma(group I, n＝7) and diffuse tegmentobasilar hemorrhage(group II, n＝30). The outcomes at discharge were retrospectively reviewed according to such classification. Result : The most common clinical pictures and radiological findings in each group were as followings : 1) Group I : focal compressive lesion which displaces rather than destroys brain tissue. It occurs in a younger age group and causes neurological deficits which are often partially reversible. Operative hematoma evacuation was performed in 43.3%. Their mean improved Glasgow Coma Scale(GCS) score was 4.7. 2) Group II : hypertensive brain stem hemorrhage. It usually causes a diffuse lesion occurring in an older age group and most often associated with profound irreversible neurological deficits which are often fatal. Operative hematoma evacuation was performed in 16.7%. Their mean improved GCS score was 1.4. In both conservatively treated group I and II has no siginificant clinical improvement. Conclusion : Although there is an overlap among them and the size of the group is small, the pathophysiologic classification of this lesion based on clinical features and radiological findings may be useful for decision of treatment method.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2905-2909
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• 2014

Background: To study the incidence of non-endometrioid carcinoma of endometrium and compare the clinical characteristics and treatment outcomes with endometrioid carcinoma patients. Materials and Methods: This study included 236 patients with endometrial carcinoma at Siriraj Hospital whom were diagnosed and treated from 2003 through 2006. The clinical characteristics, pathological features, treatment and clinical outcomes were collected from the medical records. The 5-year survival was calculated according to 2009 FIGO staging. Results: Non-endometrioid carcinoma of endometrium accounted for 10.2% of all endometrial carcinomas (24/236 patients). The 5-year survival rate was significantly lower in the non-endometrioid group compared to the endometrioid group (77.3% vs 96%, p<0.001) and clinical data pointed to greater malignancy. Conclusions: Non-endometrioid carcinoma of endometrium is relative rare but is more aggressive, has more distant metastasis at diagnosis with a worse survival rate than endometrioid carcinoma. Only patients in stage IA with no residual disease on a hysterectomy specimen may not need adjuvant treatment.

• Journal of Korean Neurosurgical Society
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• 제51권1호
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• pp.8-13
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• 2012

Objective : This is prospective study of clinical outcomes of percutaneous plasma disc coagulation Therapy (PDCT) in patients with herniated lumbar disc disease (HLD) to evaluate the safety and efficacy in its clinical application and usefulness as a reliable alternative to microscopic discectomy. Methods : Forty-six patients were enrolled in this study from April 2006 to June 2010. All patients had one-level HLD. Disc degeneration was graded on routine T2-weighted magnetic resonance Image (MRI) using the Pfirrmann's grading system and all index levels were grade 3 and grade 4. Indications for surgery were radiculopathy caused by disc protrusion with soft consistency. MRI was done at one month after the procedure in all patients to check post-PDCT change. The clinical outcomes were evaluated using Visual Analog Scales (VAS) score and MacNab's criteria. Results : This study was approved by the Institutional Review Board of our institution. The age of the study population ranged from 16 to 59 years with a mean age of 37.2 years. There were 29 males and 17 females in this study. The mean period of clinical follow-up was 21 months. The average preoperative VAS score for radiculopathy was $7.4{\pm}1.4$, while the final follow-up VAS score was $1.4{\pm}0.7$ (p<0.001). In MacNab's criteria, 41 patients (89.1%) had achieved favorable improvement (excellent and good) until later follow-up. There were one patient from infection and two patients who needed to convert to open discectomy. Conclusion : PDCT is a safe and efficient treatment modality in a selective patient with HLD.