• Title/Summary/Keyword: Cohort Analysis

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Study of The Diagnostic Indicators of Dampness-Phlegm Pattern Identification In Stroke Patients (중풍환자의 습담변증 진단지표에 관한 연구)

  • Kang, Byeong-Kab;Go, Ho-Yeon;Kang, Kyung-Won;Park, Sae-Wook;Kim, Jeong-Chul;Go, Mi-Mi;Kim, Bo-Young;Seol, In-Chan;Lee, In;Jo, Hyun-Kyung;Choi, Sun-Mi
    • Korean Journal of Oriental Medicine
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    • v.13 no.2 s.20
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    • pp.53-58
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    • 2007
  • Background and Purpose : The purpose of this study was to investigate that which symptoms are adequate indicator of the Dampness-Phlegm pattern in the stroke patients. Methods : In the time period Jul. 2005 to Sep. 2006, 136 patients with a first-ever stroke admitted in the department of Internal Medicine of Daejeon University Oriental Medical Hospital in Daejeon city, Wonkwang Oriental Medical Hospital in Iksan, JeonJu city were included. Patients were hospitalized within 3 months after the onset of stroke. Stroke patients had been interviewed by resident who studied standard operation procedures in Fundamental Study for Standardization and Objectification of Differentiation and Pattern Identification of Syndrome of Oriental Medicine for Stroke. Gi-deficiency patients was confirmed by medical specialist diagnosis, resident diagnosis, case report form analysis without a dissenting voice. Results : Dampness-Phlegm group included 37 case, Non Dampness-Phlegm group 45 case out of 136 patients. white tongue coating, slippery purse, yellowish complexion, enlarged tongue, swollen tongue were higher among Dampness-Phlegm group. Dampness-Phlegm and Non Dampness-Phlegm patients do not significantly differ in heavy sensation in the head, voice with sputum, teeth printed tongue, borborygmus, dizziness with nausea. Conclusions : This study was insufficiency because sample size is very small. More data from prospective cohort studies will help to Korean Standard Differentiation of the Symptoms and Signs for the Stroke.

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A multi-institutional analysis of sternoclavicular joint coverage following osteomyelitis

  • Othman, Sammy;Elfanagely, Omar;Azoury, Said C.;Kozak, Geoffrey M.;Cunning, Jessica;Rios-Diaz, Arturo J.;Palvannan, Prashanth;Greaney, Patrick;Jenkins, Matthew P.;Jarrar, Doraid;Kovach, Stephen J.;Fischer, John P.
    • Archives of Plastic Surgery
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    • v.47 no.5
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    • pp.460-466
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    • 2020
  • Background Sternoclavicular joint (SCJ) osteomyelitis is a rare pathology requiring urgent intervention. Several operative approaches have been described with conflicting reports. Here, we present a multi-institutional study utilizing multiple surgical pathways for SCJ reconstruction. Methods A multi-institutional retrospective cohort study was conducted to identify patients who underwent surgical repair for sternoclavicular osteomyelitis between 2008 and 2019. Patients were stratified according to reconstruction approach: single-stage reconstruction with advancement flap and delayed-reconstruction with flap following initial debridement. Demographics, operative approach, type of reconstruction, and postoperative outcomes were analyzed. Results Thirty-two patients were identified. Mean patient age was 56.2±13.8 years and 68.8% were male. The average body mass index (BMI) was 30.0±8.8 kg/㎡. The most common infection etiologies were intravenous drug use and bacteremia (both 25%). Fourteen patients (43.8%) underwent one-stage reconstruction and 18 (56.2%) underwent delayed two-staged reconstruction. Both single and delayed-stage groups had comparable rates of reinfection (7.1% vs. 11.1%, respectively), surgical site complications (21.4% vs. 27.8%), readmissions (7.1% vs. 16.6%), and reoperations (7.1% vs. 5.6%; all P>0.05). The single-stage reconstruction group had a significantly lower BMI (26.2±5.7 kg/㎡ vs. 32.9±9.1 kg/㎡; P<0.05) and trended towards shorter hospital length of stay (11.3 days vs. 17.9 days; P=0.01). Conclusions Both single and delayed-stage approaches are appropriate methods with comparable outcomes for reconstruction for SCJ osteomyelitis. When clinically indicated, a single-stage reconstruction approach may be preferable in order to avoid a second operation as associated with the delayed phase, and possibly shortening total hospital length of stay.

Comparison of Health Care Utilization and Morbidity of Children With and Without Disabilities in Korea (장애아동과 비장애아동의 의료이용 및 질병특성 비교)

  • Kim, Eu-Gene;Kim, Kyung-Mee;Yoo, Dong-Chul
    • The Journal of the Korea Contents Association
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    • v.17 no.7
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    • pp.696-706
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    • 2017
  • This study is to examine health care utilization and morbidity of disabled and non-disabled children in Korea to evaluate the health disparities. We used medical claim data of 2010 from the National Health Insurance Service-National Sample Cohort data. As a result of the analysis, the disabled children are not in good health condition because they have more frequency of medical service use, hospitalization rate, and more number of diseases and spent more on medical expenses than non-disabled children. Patterns of the most frequent disease differ from significantly between disable and non-disabled. Disabled children had a higher prevalence of selected birth defects and selected health conditions associated with physical disability and a lower prevalence of selected infection disease than children without disability. In conclusion, Health policy changes that would extend the access to health service for children with disabilities characterized by frequent medical care, hospitalization, excessive medical expenditure and complex diseases.

A Research on Design Direction for the Smart Walking Wear to Support Walking Exercise for the Baby Boomer Group (베이비부머 집단을 위한 보행 운동용 스마트 워킹웨어의 디자인 방향 연구)

  • Ban, Hyunsung;Hwang, Sujung;Kim, Sinhye;Lee, Joohyeon
    • Science of Emotion and Sensibility
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    • v.21 no.3
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    • pp.129-140
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    • 2018
  • This study aimed to analyze consumers' acceptance of sports applications and smart sportswear to better design technology-enhanced walking exercise wear for the Baby Boomer generation based on their cohort characteristics. A questionnaire with items related to acceptance of existing smart sportswear design, functionality, and usability as well as existing sports application design, functionality, and usability was sent to consumers aged 50-65. Of 163 questionnaires distributed, 150 were used for analysis. The results showed that middle-aged consumers were aware of smart sportswear's functional stability, but were concerned about care, durability, and convenience. Middle-aged consumers were also aware of sports applications as educational functions for obtaining new information. Additionally, they found sports applications to have lower perceived convenience and accessibility relative to the young generation, highlighting the need for simple instructions and explanations for sports application planning. Based on these results, we propose "Everyday design for general sportswear," "Functions based on consumer's preference," "Enhanced design for durability and management convenience" for designing and planning walking exercise wear for middle-aged consumers, and "Convenient application organization" and "Educational exercise contents" for application planning for walking exercises.

Association between Low Density Lipoprotein Cholesterol and Pulmonary Function among Premenopausal women in their 40s: a Retrospective Cohort study (40대 폐경 전 여성에서 저밀도 지단백 콜레스테롤과 폐 기능의 연관성: 후향적 코호트 연구)

  • Ko, Hae-Jin;Youn, Chang-Ho;Kim, Seong-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.11
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    • pp.6694-6701
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    • 2014
  • The aim of this study was to identify the correlation between low density lipoprotein (LDL) cholesterol and the pulmonary function. This study enrolled premenopausal women in their aged 40s, who visited the health promotion center of a general hospital more than two times. A total of 384 subjects were classified into four groups based on their LDL-cholesterol levels; A, LDL(mg/dL)<100 at both initial and follow-up; B, LDL<100 at initial but ${\geq}100$ at follow-up; C, $LDL{\geq}100$ at initial but <100 on follow-up; and D, $LDL{\geq}100$ at both the initial and follow-up test. The result showed no significant differences in the pulmonary function between the four groups. Multiple linear regression analysis, which was adjusted for age, body mass index, smoking, exercise, and follow-up duration, showed a significant negative relationship between the changes in the LDL and the changes in the $FEV_1/FVC$ (${\beta}=-0.109$, S.E.=0.029, P<0.001), but not in the $FEV_1$ and FVC. In conclusion, there was a significant but weak relationship between the LDL and pulmonary function. Further larger studies will be needed.

Breast Cancer in Tunisia: Association of Body Mass Index with Histopathological Aspects of Tumors

  • Bouguerra, Hichem;Guissouma, Hajer;Labidi, Soumaya;Stambouli, Nejla;Marrakchi, Raja;Chouaib, Salem;Elgaaied, Amel Ben Ammar;Boussen, Hammouda;Gati, Asma
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6805-6810
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    • 2014
  • Background: Previous studies have suggested a link between obesity and breast cancer (BC). However, there is no universal consensus, especially in population based studies. Because only few studies have been conducted on African women, we aimed here to assess the relationship between BMI at time of diagnosis and the BC histopathological features among Tunisian patients according to menopausal status using a hospital-based prospective cohort study. Materials and Methods: Clinical and pathological data were collected from 262 patients stratified on four groups according to their BMI. The relationship between BMI and histopathological features at diagnosis was analysed using univariate and multivariate analysis. Receiver-operating characteristic (ROC) curves were used to evaluate the performance of BMI in predicting of high tumor grade, in comparison to ki-67 index of proliferation. Results: Obesity was correlated with larger tumors, advanced grade and with ER-PR-Her2+ BC subtype. An association of BMI with tumor size and tumor grade was observed in both premenopausal and postmenopausal women. Additionally, a significant association between BMI and ER+, ER+PR+Her2+ and ER-PR-Her2+ status was revealed for premenopausal patients, while only ER+PR+Her2+ was associated with BMI for postmenopausal women. Finally, our results showed that compared to Ki67 proliferation index, BMI is a useful prognostic marker of high grade BC tumors. Conclusions: These data are the first to show that in Tunisia obese women suffering from BC have significantly larger tumors and advanced tumor grade and that higher BMI might influence tumor characteristics and behavior.

Modeling Age-specific Cancer Incidences Using Logistic Growth Equations: Implications for Data Collection

  • Shen, Xing-Rong;Feng, Rui;Chai, Jing;Cheng, Jing;Wang, De-Bin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9731-9737
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    • 2014
  • Large scale secular registry or surveillance systems have been accumulating vast data that allow mathematical modeling of cancer incidence and mortality rates. Most contemporary models in this regard use time series and APC (age-period-cohort) methods and focus primarily on predicting or analyzing cancer epidemiology with little attention being paid to implications for designing cancer registry, surveillance or evaluation initiatives. This research models age-specific cancer incidence rates using logistic growth equations and explores their performance under different scenarios of data completeness in the hope of deriving clues for reshaping relevant data collection. The study used China Cancer Registry Report 2012 as the data source. It employed 3-parameter logistic growth equations and modeled the age-specific incidence rates of all and the top 10 cancers presented in the registry report. The study performed 3 types of modeling, namely full age-span by fitting, multiple 5-year-segment fitting and single-segment fitting. Measurement of model performance adopted adjusted goodness of fit that combines sum of squred residuals and relative errors. Both model simulation and performance evalation utilized self-developed algorithms programed using C# languade and MS Visual Studio 2008. For models built upon full age-span data, predicted age-specific cancer incidence rates fitted very well with observed values for most (except cervical and breast) cancers with estimated goodness of fit (Rs) being over 0.96. When a given cancer is concerned, the R valuae of the logistic growth model derived using observed data from urban residents was greater than or at least equal to that of the same model built on data from rural people. For models based on multiple-5-year-segment data, the Rs remained fairly high (over 0.89) until 3-fourths of the data segments were excluded. For models using a fixed length single-segment of observed data, the older the age covered by the corresponding data segment, the higher the resulting Rs. Logistic growth models describe age-specific incidence rates perfectly for most cancers and may be used to inform data collection for purposes of monitoring and analyzing cancer epidemic. Helped by appropriate logistic growth equations, the work vomume of contemporary data collection, e.g., cancer registry and surveilance systems, may be reduced substantially.

A Clinical Analysis of Patients Who Visited Emergency Department due to Chemical Incident Occurred at Industrial Place: A Retrospective Study (산업장 화학 사고로 응급실에 내원한 환자의 임상적 고찰: 일개병원의 후향적 연구)

  • Shin, Hee Jun;Oh, Se Kwang;Yoo, Byeong Dai;Jun, Duck Ho;Lee, Dong Ha;Woo, Kuck Hyeun;Yoon, Seong Yong;Choi, Sung Yong
    • Journal of The Korean Society of Clinical Toxicology
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    • v.13 no.2
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    • pp.78-86
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    • 2015
  • Purpose: The purpose of this study is to understand what kinds of chemical substances have been used annually and to investigate incidents that occurred due to chemical hazard release and to analyze statistically clinically chemical injury patients who visited one regional emergency medical center in Gumi city with documented references review. Methods: Annual chemical waste emission quantity (Kg/Year) (Cwep) was reproduced using national web site data governed by the Ministry of Environment and 5 years (from 1 .Jan. 2010 to 31. Dec. 2014) of medical records of chemical injury patients who visited our emergency department were reviewed retrospectively. By applying exclusion criteria, 446 patients of 460 patients were selected. Results: Dichloromethane, Toluene, Trichloroethylene, and Xylene were always included within Top 5 of Cweq. Six cases of chemical incidents were reported and in 3 of 6 cases involving Hydrogen fluoride were included during the study period. Male gender and twenties were the most prevalent group. Injury evoking chemicals were Hydrogen fluoride, unknown, complex chemicals (over 2 substances) in sequence. The most frequent site of wounds and injuries was the respiratory tract. Gas among status, intoxication among diagnosis, and discharge among disposition was most numerous in each group. Conclusion: There have been no uniform clinical protocols for chemical wounds and injuries due to various kinds of chemicophysical properties and ignorance of antidotes. Therefore conduct of a multicenter cohort study and experiments for ruling out chemicals according to chemicophysical priority as well as development of antidotes and clinical protocols for chemical injury patients is needed.

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Comparative analysis of the amount of postoperative drainage after intraoral vertical ramus osteotomy and sagittal split ramus osteotomy

  • Kim, Hyunyoung;Chung, Seung-Won;Jung, Hwi-Dong;Park, Hyung-Sik;Jung, Young-Soo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.4
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    • pp.169-172
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    • 2014
  • Objectives: The purpose of this retrospective study was to compare the amount of postoperative drainage via closed suction drainage system after intraoral vertical ramus osteotomy (IVRO) and sagittal split ramus osteotomy (SSRO). Materials and Methods: We planned a retrospective cohort study of 40 patients selected from a larger group who underwent orthognathic surgery from 2007 to 2013. Mean age (range) was 23.95 (16 to 35) years. Patients who underwent bilateral IVRO or SSRO were categorized into group I or group II, respectively, and each group consisted of 20 patients. Closed suction drainage system was inserted in mandibular osteotomy sites to decrease swelling and dead space, and records of drainage amount were collected. The data were compared and analyzed with independent t-test. Results: The closed suction drainage system was removed at 32 hours postoperatively, and the amount of drainage was recorded every 8 hours. In group I, the mean amount of drainage was 79.42 mL in total, with 31.20 mL, 19.90 mL, 13.90 mL, 9.47 mL, and 4.95 mL measured at 0, 8, 16, 24, and 32 hours postoperatively, respectively. In group II, the mean total amount of drainage was 90.11 mL, with 30.25 mL, 25.75 mL, 19.70 mL, 8.50 mL, and 5.91 mL measured at 0, 8, 16, 24, and 32 hours postoperatively, respectively. Total amount of drainage from group I was less than group II, but there was no statistically significant difference between the two groups (P=0.338). There was a significant difference in drainage between group I and group II only at 16 hours postoperatively (P=0.029). Conclusion: IVRO and SSRO have different osteotomy design and different extent of medullary exposure; however, our results reveal that there is no remarkable difference in postoperative drainage of blood and exudate.

Conventional versus Doxorubicin-Eluting Beads Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma: a Tertiary Medical Centre Experience in Malaysia

  • Rahman, F Abdul;Naidu, J;Ngiu, CS;Yaakob, Y;Mohamed, Z;Othman, H;Jarmin, R;Elias, MH;Hamid, N Abdul;Mokhtar, N Mohd;Ali, RA Raja
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4037-4041
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    • 2016
  • Background: Hepatocellular carcinoma (HCC) is a common cancer that is frequently diagnosed at an advanced stage. Transarterial chemoembolisation (TACE) is an effective palliative treatment for patients who are not eligible for curative treatment. The two main methods for performing TACE are conventional (c-TACE) or with drug eluting beads (DEB-TACE). We sought to compare survival rates and tumour response between patients undergoing c-TACE and DEB-TACE at our centre. Materials and Methods: A retrospective cohort study of patients undergoing either treatment was carried out from January 2009 to December 2014. Tumour response to the procedures was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Kaplan-Meier analysis was used to assess and compare the overall survival in the two groups. Results: A total of 79 patients were analysed (34 had c-TACE, 45 had DEB-TACE) with a median follow-up of 11.8 months. A total of 20 patients in the c-TACE group (80%) and 12 patients in the DEB-TACE group (44%) died during the follow up period. The median survival durations in the c-TACE and DEB-TACE groups were $4.9{\pm}3.2$ months and $8.3{\pm}2.0$ months respectively (p=0.008). There was no statistically significant difference noted among the two groups with respect to mRECIST criteria. Conclusions: DEB-TACE demonstrated a significant improvement in overall survival rates for patients with unresectable HCC when compared to c-TACE. It is a safe and promising approach and should potentially be considered as a standard of care in the management of unresectable HCC.