• Title/Summary/Keyword: Clinical value

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Controversies in Usefulness of EEG for Clinical Decision in Epilepsy: Cons. (간질 치료에서 뇌파의 임상적 유용성에 관한 논란: 부정적 관점에서)

  • Lee, Seo-Young;Lee, Sang-Kun;Kim, Nam Hee
    • Annals of Clinical Neurophysiology
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    • v.9 no.2
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    • pp.69-74
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    • 2007
  • Electroencephalogram (EEG) is a representative diagnostic tool in epilepsy. However, there are several points of debate on the role of EEG in diagnosis and management of epilepsy. We suggest that EEG has some limitations for differential diagnosis from nonepileptic episodic diseases, classification of epilepsy, prediction of recurrence, and evaluation of treatment response. Interictal EEG cannot diagnose or exclude epilepsy because interictal epileptic discharge (IED) is frequently absent in epilepsy and can appear in nonepileptic conditions. Although EEG is helpful in classification of epilepsy, focal spikes in generalized epilepsy and secondary bilateral synchrony in localization related epilepsy cause interrater disagreement. It is controversial whether EEG predicts recurrence after the first seizure in adults. The predictive value of EEG in antiepileptic drug (AED) withdrawal is not absolute. The prognosis after AED withdrawal depends on epilepsy syndrome. Many studies could not confirm the value of EEG in assessing the treatment response. After all, epilepsy is clinically diagnosed and assessed. Interictal EEG alone does not provide decisive information and routine follow-up of EEG is not recommended.

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Sample size determination for conducting a pilot study to assess reliability of a questionnaire

  • Mohamad Adam Bujang;Evi Diana Omar;Diana Hui Ping Foo ;Yoon Khee Hon
    • Restorative Dentistry and Endodontics
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    • v.49 no.1
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    • pp.3.1-3.8
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    • 2024
  • This article is a narrative review that discusses the recommended sample size requirements to design a pilot study to assess the reliability of a questionnaire. A list of various sample size tables that are based on the kappa agreement test, intra-class correlation test and Cronbach's alpha test has been compiled together. For all calculations, type I error (alpha) was set at a maximum value of 0.05, and power was set at a minimum value of 80.0%. For the kappa agreement test, intra-class correlation test, and Cronbach's alpha test, the recommended minimum sample size requirement based on the ideal effect sizes shall be at least 15, 22, and 24 subjects respectively. By making allowances for a non-response rate of 20.0%, a minimum sample size of 30 respondents will be sufficient to assess the reliability of the questionnaire. The clear guideline of minimum sample size requirement for the pilot study to assess the reliability of a questionnaire is discussed and this will ease researchers in preparation for the pilot study. This study provides justification for a minimum requirement of a sample size of 30 respondents specifically to test the reliability of a questionnaire.

Pharmacokinetic Properties and Bioequivalence of Cefcapene Pivoxil Hydrochloride 75 mg in Korean Healthy Volunteers (건강한 한국인 피험자에서 Cefcapene Pivoxil Hydrochloride 75 mg 제제의 생물학적동등성시험)

  • Jeon, Ji-Young;Im, Yong-Jin;Hwang, Min-Ho;Kim, Yun-Jeong;Han, Su-Mi;Jo, Myeong-Jin;Kim, Hee-Sun;Kim, Sun-Young;Chae, Soo-Wan;Kim, Kang-Seog;Kim, Min-Gul
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.1
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    • pp.9-12
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    • 2012
  • Background: Cefcapene pivoxil hydrochloride, is an ester-type oral cephem antibiotic. This study was performed to compare the pharmacokinetics and evaluate the bioequivalence of two cefcapene pivoxil hydrochloride 75 mg formulations. Method: In a randomized $2{\times}2$ crossover study, sixty healthy male volunteers were randomly assigned into two groups. After a single dose of 75 mg cefcapene pivoxil hydrochloride oral administration, blood samples were collected at specific time intervals from 0-12 hours. The plasma concentrations of cefcapene pivoxil hydrochloride were determined by LC-MS/MS. The pharmacokinetic parameters were determined from the plasma concentration-time profiles of both formulations. The pharmacokinetic parameters such as $AUC_{last}$, $AUC_{inf}$ and $C_{max}$, were calculated and the 90% confidence intervals for test/reference ratio for pharmacokinetic parameters were obtained by analysis of variance on logarithmically transformed data. Results: The mean value for $AUC_{last}$ in test and reference drug was $4053.1{\pm}876.5\;ng{\cdot}hr/mL$ and $3595.7{\pm}1029.1\;ng{\cdot}h/mL$, respectively. The mean value for $C_{max}$ in test and reference drug was $1324.9{\pm}321.4$ ng/mL and $1159.1{\pm}335.9$ ng/mL, respectively. The 90% confidence intervals of the $AUC_{last}$ and $C_{max}$ ratio for test drug and reference drug were log 1.09-log1.22 and log 1.09-log1.24, respectively. No adverse events were reported by subjects or found on analysis of vital signs or laboratory tests. Conclusion: This single dose study found that the test and reference products met the regulatory criteria for bioequivalence in these health volunteers. Both formulations were safe and well tolerated in 75 mg of cefcapene pivoxil hydrochloride.

A study of the relationship between clinical phenotypes and plasma iduronate-2-sulfatase enzyme activities in Hunter syndrome patients

  • Lee, Ok-Jeong;Kim, Su-Jin;Sohn, Young-Bae;Park, Hyung-Doo;Lee, Soo-Youn;Kim, Chi-Hwa;Ko, Ah-Ra;Yook, Yeon-Joo;Lee, Su-Jin;Park, Sung-Won;Kim, Se-Hwa;Cho, Sung-Yoon;Kwon, Eun-Kyung;Han, Sun-Ju;Jin, Dong-Kyu
    • Clinical and Experimental Pediatrics
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    • v.55 no.3
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    • pp.88-92
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    • 2012
  • Purpose: Mucopolysaccharidosis type II (MPS II or Hunter syndrome) is a rare lysosomal storage disorder caused by iduronate-2-sulfatase (IDS) deficiency. MPS II causes a wide phenotypic spectrum of symptoms ranging from mild to severe. IDS activity, which is measured in leukocyte pellets or fibroblasts, was reported to be related to clinical phenotype by Sukegawa-Hayasaka et al. Measurement of residual plasma IDS activity using a fluorometric assay is simpler than conventional measurements using skin fibroblasts or peripheral blood mononuclear cells. This is the first study to describe the relationship between plasma IDS activity and clinical phenotype of MPS II. Methods: We hypothesized that residual plasma IDS activity is related to clinical phenotype. We classified 43 Hunter syndrome patients as having attenuated or severe disease types based on clinical characteristics, especially intellectual and cognitive status. There were 27 patients with the severe type and 16 with the attenuated type. Plasma IDS activity was measured by a fluorometric enzyme assay using 4-methylumbelliferyl- ${\alpha}$-iduronate 2-sulphate. Results: Plasma IDS activity in patients with the severe type was significantly lower than that in patients with the attenuated type ($p$=0.006). The optimal cut-off value of plasma IDS activity for distinguishing the severe type from the attenuated type was 0.63 $nmol{\cdot}4hr^{-1}{\cdot}mL^{-1}$. This value had 88.2% sensitivity, 65.4% specificity, and an area under receiver-operator characteristics (ROC) curve of 0.768 (ROC curve analysis; $p$=0.003). Conclusion: These results show that the mild phenotype may be related to residual lysosomal enzyme activity.

왕실의 의약(議藥)

  • Hong, Seyoung
    • The Journal of Korean Medical History
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    • v.23 no.1
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    • pp.105-113
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    • 2010
  • Seungjeongwon Ilgi["承政院日記"], the Diaries of Royal Secretariat of the Joeson Dynasty is the most massive compilation of records in Korean history. Medical records in Seungjeongwon Ilgi have been studied but the procedures of clinical discussion[議藥] have not yet been studied. In this paper, main agents of clinical discussion, formation of participant doctor system, particularity of clinical discussion in Royal Court and problems derived from it will be discussed. Main agents of clinical discussion were court doctors[內醫], royal doctors[御醫] and participant doctors[議藥同參]. The king himself decided ultimately as a matter of form. Head of the Medical Dpt. of the Palace[藥房都提調] was in charge of attending to king, but head of the court doctor[首醫] led the actual discussion of deciding treatment. The Medical Dpt. of the Palace[內醫院] was divided into three sectors-court doctor division, acupuncture doctor division and participant doctor division. Palace doctors payed a great attention to avoid serious error. This tendency led them occasionally to passive management. Sometimes aggressive treatment is needed in the course of treating disease, but palace doctors tended to choose slow and gradual methods. It induced minor conflict between palace doctors and participant doctors from outside palace, because doctors from outside palace subordinated effectiveness. Their opinion had not been always recognized by court doctors. However, their role was meaningful because they provided flexibility to the rigidity of clinical discussion in the palace. It is important to evaluate clinical records in Seungjeongwon Ilgi["承政院日記"]. If we have broader eye on the clinical procedure in the palace, we can estimate the value of the contents more objectively and accurately.

Nurses' Perception and Willingness to Pay for Nursing Career Ladder System in General Hospital (상급종합병원 간호사의 임상경력개발시스템에 대한 인식과 지불의사)

  • Lee, Mi-Joon
    • Korea Journal of Hospital Management
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    • v.24 no.3
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    • pp.61-71
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    • 2019
  • Purposes: The purpose of this study is to analyze nurses' perception on the clinical career ladder system which was introduced to enhance the nursing capabilities in general hospital. Methods: Research data has been collected for approximately 30 days since March 28, 2017 from 171 nurses who had been involved in the clinical career ladder system, 177 nurses who had not participated, and a total of 348. Finding: The study results showed that nurses' perception on the cost effectiveness of clinical career ladder system is significantly different depending on the sex, age, program experience, personal stage in the clinical career ladder system and the individual's health condition. In addition, the nurses' willingness to pay for the clinical career ladder system was significantly associated with their department and the needs for the system. With adjusted age, gender, position, education and marital status, nursing competency was 8.71(95% Confidence Interval; 4.79 to 12.63) in the presence of system experience, but the perception on clinical career ladder system was 4.34(95% Confidence Interval; -6.84 to -1.84). Practical Implications: Based on the study results, we expect that more hospitals introduce the clinical career ladder system and also use these study results as basic data for securing excellent nurses.

Analysis on Early Detection of Lung Cancer by PET/CT Scan

  • Wang, Huo-Qiang;Zhao, Long;Zhao, Juan;Wang, Qiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2215-2217
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    • 2015
  • Background: This systemic analysis was conducted to to evaluate the application value of positron emission tomography/computed tomography (PET/CT) in early diagnosis of lung cancer. Methods: Clinical studies evaluating the application value of PET/CT for patients underwent PET/CT imaging. The histological diagnosis served as the standard of truth. Results: Four clinical studies which including 1330 patients with pulmonary spaceoccupying lesions were considered eligible for inclusion. Systemic analysis suggested that, in all 1330 patients, pooled sensitivity was 98.7% (1313.2/1330) and specificity was 58.2%(276.85/476). Conclusion: This systemic analysis suggests that integrated PET/CT imaging provides high sensitivity, and reasonably high specificity, and could be applied for early diagnosis of lung cancer.

The Clinical Efficacy of Chungpyesagan-tang on Acute Stroke (급성기 중풍 환자에 대한 청폐사간탕의 임상적 효능)

  • 최동준;정우상;문상관;조기호;김영석;배형섭
    • The Journal of Korean Medicine
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    • v.23 no.4
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    • pp.9-14
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    • 2002
  • To assess the clinical efficacy of Chungpyesagan-tang on acute stroke, we prescribed this medicine to 88 acute stroke patients without thrombolytic treatment. The rate of progressive stroke type was 2.3%, remarkably lower than in previous reports. 1.1 % felt an itching sensation, and 17.0% complaxined of loose stool and diarrhea. Chungpyesagan-tang decreased Stroke-Pattern Identification and National Institute of Health Stroke Scale (NIHSS), and increased Modified Barthel Index (MBI). Thus, we could suggest that this medicine has a desirable effect to reduce the severity of stroke and improve functional recovery. As to the laboratory findings, ALT had anupward tendency and increased over normal value in 16 cases (18.2%). However, the mean serum level 2 weeks later was within the normal value and the other hepatic enzymes did not increase.

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Nonlinear Regression Analysis of Acid-Base Titration System (산-염기 적정 시스템의 비선형 회귀분석에 관한 고찰)

  • Park, Chung-Oh;Hong, Jae-Jin
    • Korean Journal of Clinical Laboratory Science
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    • v.40 no.1
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    • pp.18-25
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    • 2008
  • In classical titrimetric analyses, the major concern is the concentration of titrant, usually the aqueous solution of hydrochloric acid or sodium hydroxide, that could be changed as time goes by and it is accompanied with the inaccuracy of the resulting data. And the statistical approach, the nonlinear regression analysis, which is a well-known statistical method, was introduced to determine the accurate concentration of the titrant and the exact value of parameters, $K_a$, r, $C_a$, $C_b$, for 0.01 M aqueous solutions of analytes, sodium pyruvate, sodium acetate, sodium bicarbonate, ammonium hydroxide, ammonium chloride and acetic acid at $25^{\circ}C$. We used Gauss-Newton method for the linearlization of the nonlinear titration system and the two-parameter fitting showed appreciable convergent data for the parameters of the analytes set with the various range of $K_a$ value.

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H.P.L. Value in Abnormal Pregnancy by Hemagglutination-Inhibition Reaction (비정상임산부(非正常妊産婦)의 혈청중(血淸中) H.P.L.의 혈구응집조지반응(球凝集阻止反應)에 의한 측정(測定)에 관(關)한 연구(硏究))

  • Kim, Dong-Jin;Shin, Myon-Woo
    • Clinical and Experimental Reproductive Medicine
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    • v.4 no.1
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    • pp.27-32
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    • 1977
  • Serum levels of human placental lactogen were measured by hemagglutination inhibition reaction in 26 normal pregnant state and in patients with 16 toxemia and 6 F.D.I.U. beyond their thirtieth week of gestation to evaluate their clinical usefulness. It was realized that HPL-HAIR Test Kit was easy to use and produced reliable results. The general conclusion were as follows: 1) HPL value was $6{\sim}8$ug/ml in normal pregnancy. 2) The levels in mild toxemia were similar in the normal state. 3) The levels in severe toxemia were similar or slightly lower than in the normal and mild toxemia. 4) The levels in F.D.I.U. were lower than in the normal state.

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