• Title/Summary/Keyword: Clinical implication

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Clinical Implication of Aortic Wall Biopsy in Aortic Valve Disease with Bicuspid Valve Pathology

  • Kim, Yong Han;Kim, Ji Seong;Choi, Jae-Woong;Chang, Hyoung Woo;Na, Kwon Joong;Kim, Jun Sung;Kim, Kyung-Hwan
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.443-450
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    • 2016
  • Background: Although unique aortic pathology related to bicuspid aortic valve (BAV) has been previously reported, clinical implications of BAV to aortopathy risk have yet to be investigated. We looked for potential differences in matrix protein expressions in the aortic wall in BAV patients. Methods: Aorta specimens were obtained from 31 patients: BAV group (n=27), tricuspid aortic valve (TAV) group (n=4). The BAV group was categorized into three subgroups: left coronary sinus-right coronary sinus (R+L group; n=13, 42%), right coronary sinus-non-coronary sinus (R+N group; n=8, 26%), and anteroposterior (AP group; n=6, 19%). We analyzed the expression of endothelial nitric oxide synthase (eNOS), matrix metalloproteinase (MMP)-9, and tissue inhibitor of matrix metalloproteinase (TIMP)-2. Results: Based on the mean value of the control group, BAV group showed decreased expression of eNOS in 72.7% of patients, increased MMP-9 in 82.3%, and decreased TIMP in 79.2%. There was a higher tendency for aortopathy in the BAV group: eNOS $(BAV:TAV)=53%{\pm}7%:57%{\pm}11%$, MMP-9 $(BAV:TAV)=48%{\pm}10%:38%{\pm}1%$. The AP group showed lower expression of eNOS than the fusion (R+L, R+N) group did; $48%{\pm}5%$ vs. $55%{\pm}7%$ (p=0.081). Conclusion: Not all patients with BAV had expression of aortopathy; however, for patients who had a suspicious form of bicuspid valve, aortic wall biopsy could be valuable to signify the presence of aortopathy.

Implication of embB Gene Mutation in Ethambutol-Susceptible Clinical Isolates of Mycobacterium tuberculosis (임상에서 분리된 에탐부톨 감수성균에서의 embB 유전자 돌연변이에 대한 고찰)

  • Park, Young Kil;Shin, Sonya;Kim, Sang Jae;Koh, Won-Jung;Kwon, O Jung;Kim, Bum Jun;Kook, Yoon Ho;Cho, Sang Nae;Lew, Woo Jin;Bai, Gill Han
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.3
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    • pp.266-271
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    • 2005
  • Background : Ethambutol(EMB) is one of the first-line drugs included in short-course anti-tuberculosis therapy. The point mutations in embB gene have been speculated to be associated EMB resistance. However, detection of embB mutations at these positions have been observed in both EMB-susceptible isolates; thus, it remains controversial whether these mutations are associated with EMB resistance Methods : The 36 M. tuberculosis isolates were selected from clinical isolates which tested susceptible to EMB and resistant to at least one drug. DNA extracted from the isolates was analyzed by amplifying embB gene. The PCR products were purified and directly sequenced. We reviewed the history of past drug susceptibility test results. Results : Out of 36 EMB-susceptible strains, 3 strains (8.3%) had a mutation in codon 306 or 406 of the embB gene. These three strains had at least isoniazid resistance. They grew at 1.0 mcg/ml of EMB in Lowenstein-Jensen media. The patients of the strains were continuously smear-positive for over 3 years despite taking TB therapy. One strain had been EMB-resistant in past drug susceptibility tests. Conclusion : EMB-susceptible strains containing embB mutation may be caused by decreased viability in vitro test not by itself.

Clinical Implications of High Definition Multileaf Collimator (HDMLC) Dosimetric Leaf Gap (DLG) Variations

  • Chang, Kyung Hwan;Ji, Yunseo;Kwak, Jungwon;Kim, Sung Woo;Jeong, Chiyoung;Cho, Byungchul;Park, Jin-hong;Yoon, Sang Min;Ahn, Seung Do;Lee, Sang-wook
    • Progress in Medical Physics
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    • v.27 no.3
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    • pp.111-116
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    • 2016
  • This study is to evaluate the dosimetric impact of dosimetric leaf gap (DLG) and transmission factor (TF) at different measurement depths and field sizes for high definition multileaf collimator (HD MLC). Consequently, its clinical implication on dose calculation of treatment planning system was also investigated for pancreas stereotactic body radiation therapy (SBRT). The TF and DLG were measured at various depths (5, 8, 10, 12, and 15 cm) and field sizes ($6{\times}6$, $8{\times}8$, and $10{\times}10cm^2$) for various energies (6 MV, 6 MV FFF, 10 MV, 10 MV flattening filter free [FFF], and 15 MV). Fifteen pancreatic SBRT cases were enrolled in the study. For each case, the dose distribution was recomputed using a reconfigured beam model of which TF and DLG was the closest to the patient geometry, and then compared to the original plan using the results of dose-volume histograms (DVH). For 10 MV FFF photon beam, its maximum difference between 2 cm and 15 cm was within 0.9% and it is increased by 0.05% from $6{\times}6cm^2$ to $10{\times}10cm^2$ for depth of 15 cm. For 10 MV FFF photon beam, the difference in DLG between the depth of 5 cm and 15 cm is within 0.005 cm for all field sizes and its maximum difference between field size of $6{\times}6cm^2$ and $10{\times}10cm^2$ is 0.0025 cm at depth of 8 cm. TF and DLG values were dependent on the depth and field size. However, the dosimetric difference between the original and recomputed doses were found to be within an acceptable range (<0.5%). In conclusion, current beam modeling using single TF and DLG values is enough for accurate dose calculation.

Perceived Social Support as a Predictor on Adaptation of Family Who has a Child with Pediatric Cancer (소아암 환아 가족이 인지한 사회적 지지가 적응에 미치는 영향)

  • Tak Young-Ran;Yun E-Hwa;Chon Young-Shin;An Ji-Yeon
    • Child Health Nursing Research
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    • v.9 no.1
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    • pp.9-17
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    • 2003
  • Families of children with cancer face many illness-related demands. The perceived social support is a critical resource for the family adaptation process. And the patterns of family adaptation to childhood cancer varies as characteristics of disease, which is prognosis, the influence of cognition function, and treatment process. The conceptual definition of social support is not unidimensional. However, most studies focus on general aspect of mediating effects on adaptation. Diverse dimensions of perceived social support should be considered in its effectiveness for intervention. Therefore, this study was undertaken to determine whether family's perceived social support influences the family adaptation of family with pediatric cancer and what dimension influences mostly in family adaptation as the characteristics of disease in the family of children with cancer. The subject was consisted of 102 families with pediatric cancer who had been diagnosed as leukemia or brain tumor last 2 years. Those families had participated in the education program or meetings for family who have with pediatric cancer children. The measurement for this study were Personal Resource Questionnaire (PRQ) Part-Ⅱ developed by Brandt and Weinert to measure parents' perceived social support, and the McCubbin's Coping Health Inventory for Parents (CHIP) to measure family coping. The results of this study can be summarized as follows; Regression analysis showed that perceived social support has effect on family adaptation with β=.43, p<.01. In the group of family of child with leukemia, social support as general has effect on adaptation (β=.40, p<.01) and specially, social support perceived as intimacy was strongly effect on family adaptation. And In the group of brain tumor, Social support has effect on adaptation(β=.46, p<.01) and among the social support domains, the self esteem dimension was most predictable to family adaptation. In conclusion, the perceived social support is a predictor on family adaptation and useful vehicle to help family who has child with pediatric cancer. An important clinical implication is that specified support program for intervention may be useful and critical for the family who has diverse pediatric conditions of childhood cancer. Further studies should stress the effects of family support for clinical intervention and is needed with diverse stage of development and pediatric conditions.

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Effects of recycling on the mechanical properties and the surface topography of Nickel-Titanium alloy wires (재생 과정이 니켈-티타늄 호선의 물리적 성질과 표면 거칠기에 미치는 영향)

  • Lee, Sung-Ho;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.30 no.4 s.81
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    • pp.453-465
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    • 2000
  • The purpose of this study was to investigate the change of mechanical properties, surface topography and frictional force of various nickel titanium wires after recycling. Three types of nickel-titanium wires and one type of stainless steel wire were divided to three groups: as-received condition(T0:control group), treated in artificial saliva for four weeks(T1) and autoclaved after being treated in artificial saliva(T2). Some changes were observed for the selected mechanical properties in tensile test, surface topography by means of SEM and 3D profilogram, and frictional coefficient. The findings suggest that: 1. Nickel-titanium wires demonstrated no statistically significant differences in maximum tensile strength, elongation rate and modulus of elasticity, but stainless steel wire demonstrated statistically significant differences in maximum tensile strength, elongation rate and modulus of elasticity between the groups(p<0.05). 2. NiTi, Optimalloy, Stainless Steel wires demonstrated increased pitting and corrosion in SEM finding. 3. Recycled NiTi, Optimalloy and stainless steel wires demonstrated significantly greater surface roughness(Ra and Rq) through 3D profilogram when compared with the control wires(p<0.05), but Sentalloy didn't demonstrate significant difference. 4. Recycled NiTi, Optimalloy and stainless steel wires demonstrated significantly greater maximum frictional coefficient when compared with the control wires(p<0.05), but Sentalloy didn't demonstrate significant difference The changes of surface roughness and frictional coefficient in NiTi and Optimalloy had no clinical implication. Consequently recycled nickel titanium wires demonstrated no clinical problem in tensile properties, surface topography and frictional coefficient.

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Characteristics of Respiration and Phonation in Normal Health Elderly (정상 노년층의 호흡 및 발성 특성)

  • Woo, Mee-Ryung;Choi, Hong-Shik;Baek, Seung-Jae;Nam, Chung-Mo;Choi, Yae-Lin
    • Phonetics and Speech Sciences
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    • v.2 no.4
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    • pp.245-252
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    • 2010
  • Korea does not have a certain criteria on the respiratory ability and phonation of the normal aged, and also has no clear standard to examine the boundaries of geriatric diseases. This study analyzed the characteristics in respiration and phonation of the aged in normal healthy elderly from diverse angles with different variables. Thirty-three participants in total, seven males and eight females in the age group 55-64 participated in the study. Seven males and eleven females in the age group 65-74 were selected for the respiration and phonation experiments, and 10 different variables such as FVC, $FEV_1$, $FEV_1$/FVC, MPT, MFR, Psub, f0, jitter, shimmer and NHR were comparatively analyzed for each group of different age and gender. To see the difference in respiration and phonation by age and gender, the study conducted a two-way ANOVA. First, from the result of the analysis on respiratory ability, FVC of male appeared to be significantly greater than female. In both age groups of 55-64 and 65-74, male displayed greater FVC than female did. Second, as for $FEV_1$, $FEV_1$/FVC, the age group of 55-64 showed greater values than the values measured in the age group of 65-74. Third, MFR showed a significant difference by gender. In both age groups, male showed significantly higher MFR than female. Fourth, for different gender, a significant difference in MFR was observed. In both age groups of 55-64 and 65-74, male exhibited higher MFR than female. This study has a clinical implication in that it analyzed the criteria on respiration and phonation in normal healthy elderly according to gender and age. The normal aged showed a difference in their respiratory and phonatory functions by age and gender, it was closely related to the decline of pulmonary function due to the physical aging and the weak respiration coming from weakness of respiratory muscles. Also, the physical differences in height, weight, and the muscles in laryngeal and respiratory system between males and females had an influence on the performance. These results from this study might be a helpful guideline for the clinical criterion in the future.

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Sequence Variations of Hepatitis B Virus Promotor Regions in Vertically Transmitted Mother-child Pairs (수직 감염된 B형 간염 바이러스 Promoter 유전자의 변이 분석)

  • Lee, Choong-Won;Han, Young-Na;Lee, Jung-Hwa;Lee, Kwang-Chul;Ha, Young-Mee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.1
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    • pp.39-50
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    • 2002
  • Hepatitis B viral infection which affect about 10% of Korean population manifests asymptomatic carrier, chronic hepatitis and liver cirrhosis and even associates with hepatocellular carcinoma. Clinical manifestations induced by hepatitis B virus vary depending on the degree of immune response by cytotoxic T cells against viral epitope-presenting liver cells. Since hepatitis B virus presents high rate of mutaton that might change the presented epitope and eventually alter immune response, viral mutations, especially in promoters and enhancers, have an important implication in hepatic inflammation and viral replication. To identify mutations related to the hepatic inflammation, we investigated sequence variations of hepatitis B viral promotor regions in the presence or absence of symptoms in hepatitis B carriers. For this, sera from persistently hepatitis B virus-infected mother-child pairs were collected. After PCR amplifiation of all hepatitis B viral promoters (C promoter, S1 promoter, S2/S promoter, X promoter) using serum DNA from each pair, viral promotors were sequenced by automatic sequencer and then sequence data were analyzed by ClustalW. In most cases, the dominant type of maternal virus was transmitted to the child. However, in some children, some new host specific viral variants could be observed in Cp, S1p and S2/Sp. The mutations in C promoter did not seem to be vertically transmitted but arose in new host independently after the wild type had been transmitted. Enhancer I containing X promoter revealed high host specific variations as has been reported before. Two S promoters, S1p and S2/Sp, have shown some point mutations in children, but no deletion mutations were detected as in chronic hepatitis patients in whom deletion mutations are frequently found. In conclusion, the children with the vertically transmitted hepatitis B virus mostly retain the dominant type virus that had been transmitted. However, host specific variants tended to accumulate over time, possibly as clinical symptoms develop.

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An Analysis of Master's and Doctoral Thesis in Nursing - Centered on a Nursing, an Education, and a Public Health Graduate College - (간호학 석.박사 학위논문의 분석)

  • Chon, S.J.;Hong, K.P.;Yang, W.Y.;Lee, J.J.;Lee, B.S.;Hur, H.K.;Kim, J.I.;Yim, J.Y.;In, J.Y.
    • The Korean Nurse
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    • v.33 no.2
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    • pp.45-58
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    • 1994
  • This study was conducted for the purpose of identifying the trends of nursing research and to suggest the direction of future research in the graduate levels of the study. The data was collected from 469 abstracts of master's and doctoral rapers from three graduate schools, one in Nursing, another in Education, and the other in Public Health Graduate College. The results of the study are as follows: The number of research was increased from 102 to 286 between the 1970 s and 1980's. The most frequently employed research design was descriptive studies in the master's level, but there was some balance between descriptive and experimental studies along with some qualitative approaches in the doctoral thesis. Patients were the most often studied sample group reaching 42% of the cases, though it Was noted that there was steady shift: toward the non-ratient population. With this shifting of the study sample, the places of the study also have showed some changes moving toward community. The most widely studied area was in clinical practice. Chronic illness, preventive, and health promoting areas of studies also increased in numbers. However, most of them were at the descriptive level of phenomena and only a few were concerned with cost/effective measures of nursing intervention. The number of variables studied repeatedly more than five times was 43. They were not only physical but also psychosocial aspects which imply the efforts to incorporate the whole person in nursing discipline. However, most researches with repeated studies showed little relation to previous studies, and thus little accumulation in knowledge. There was also little evidence of linkage to nursing theory in most studies of master's level. For the doctoral rapers, 17 out of 51 rapers showed specific theories related to the researches. Based on the above findings, the following suggestions were made. Various research design should be employed including case studies, historical studies, as well as qualitative approaches. There should be more effort to establish linkage between theory and research. The areas needing more attention are Korean Nursing History, Ethics in our Culture, Cost/Effective Measures of Nursing Intervention, Concept and Thory Development, and the Strategies for the Implication of the Research Results in clinical practice.

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Clinical implication of adjuvant chemotherapy according to mismatch repair status in patients with intermediate-risk stage II colon cancer: a retrospective study

  • Kang, Byung Woog;Baek, Dong Won;Chang, Eunhye;Kim, Hye Jin;Park, Su Yeon;Park, Jun Seok;Choi, Gyu Seog;Baek, Jin Ho;Kim, Jong Gwang
    • Journal of Yeungnam Medical Science
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    • v.39 no.2
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    • pp.141-149
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    • 2022
  • Background: The present study evaluated the clinical implications of adjuvant chemotherapy according to the mismatch repair (MMR) status and clinicopathologic features of patients with intermediate- and high-risk stage II colon cancer (CC). Methods: This study retrospectively reviewed 5,774 patients who were diagnosed with CC and underwent curative surgical resection at Kyungpook National University Chilgok Hospital. The patients were enrolled according to the following criteria: (1) pathologically diagnosed with primary CC; (2) stage II CC classified based on the 7th edition of the American Joint Committee on Cancer staging system; (3) intermediate- and high-risk features; and (4) available test results for MMR status. A total of 286 patients met these criteria and were included in the study. Results: Among the 286 patients, 54 (18.9%) were identified as microsatellite instability-high (MSI-H) or deficient MMR (dMMR). Although all the patients identified as MSI-H/dMMR showed better survival outcomes, T4 tumors and adjuvant chemotherapy were identified as independent prognostic factors for survival. For the intermediate-risk patients identified as MSI-low (MSI-L)/microsatellite stable (MSS) or proficient MMR (pMMR), adjuvant chemotherapy exhibited a significantly better disease-free survival (DFS) but had no impact on overall survival (OS). Oxaliplatin-containing regimens showed no association with DFS or OS. Adjuvant chemotherapy was not associated with DFS in intermediate-risk patients identified as MSI-H/dMMR. Conclusion: The current study found that the use of adjuvant chemotherapy was correlated with better DFS in MSI-L/MSS or pMMR intermediate-risk stage II CC patients.

Effect of Perfluorobutane Microbubbles on Radiofrequency Ablation for Hepatocellular Carcinoma: Suppression of Steam Popping and Its Clinical Implication

  • Dong Young Jeong;Tae Wook Kang;Ji Hye Min;Kyoung Doo Song;Min Woo Lee;Hyunchul Rhim;Hyo Keun Lim;Dong Hyun Sinn;Heewon Han
    • Korean Journal of Radiology
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    • v.21 no.9
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    • pp.1077-1086
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    • 2020
  • Objective: To evaluate the effect of perfluorobutane microbubbles (Sonazoid®, GE Healthcare) on steam popping during radiofrequency (RF) ablation for treating hepatocellular carcinoma (HCC), and to assess whether popping affects treatment outcomes. Materials and Methods: The institutional review board approved this retrospective study, which included 90 consecutive patients with single HCC, who received percutaneous RF ablation as the first-line treatment. The patients were divided into two groups, based on the presence or absence of the popping phenomenon, which was defined as an audible sound with a simultaneous sudden explosion within the ablation zone as detected via ultrasonography during the procedure. The factors contributing to the popping phenomenon were identified using multivariable logistic regression analysis. Local tumor progression (LTP) and disease-free survival (DFS) were assessed using the Kaplan-Meier method with the log-rank test for performing comparisons between the two groups. Results: The overall incidence of the popping phenomenon was 25.8% (24/93). Sonazoid® was used in 1 patient (4.2%) in the popping group (n = 24), while it was used in 15 patients (21.7%) in the non-popping group (n = 69). Multivariable analysis revealed that the use of Sonazoid® was the only significant factor for absence of the popping phenomenon (odds ratio = 0.10, p = 0.048). There were no significant differences in cumulative LTP and DFS between the two groups (p = 0.479 and p = 0.424, respectively). Conclusion: The use of Sonazoid® has a suppressive effect on the popping phenomenon during RF ablation in patients with HCC. However, the presence of the popping phenomenon may not affect clinical outcomes.