• Title/Summary/Keyword: Introduction to Medicine

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The Use of Calcium Sulfate as a Treatment of Benign Bone Tumor (양성 골종양 치료시 calcium sulfate의 이용)

  • Han, Chung-Soo;Yoon, Kyung-Ho;Ha, Jeong-Han
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.31-37
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    • 2003
  • Introduction: The purpose of this study is to assess the efficacy of calcium sulfate as a bone graft substitute in the treatment of benign bone tumor. Materials and Method: Between December 2000 and November 2001, 18 patients with a benign bone tumor were treated with crettage and the defects were filled with calcium sulfate (Osteoset$^{(R)}$:Wright Medical Co. USA) as a bone graft substitute. Average age was 28.4 years and mean follow up period was 12.3 months. Calcium sulfate mixed with autograft was used in 6 cases, calcium sulfate with allograft in 2 cases, and calcium sulfate alone was used in 10 cases. The degree of absorption of calcium sulfate and new bone formation at plain radiograph was analyzed at immediate postoperative and postoperative 3 months and 6 months follow up. Results: At 3 months postoperatively, 92% of calcium sulfate was absorbed, and at 6 months postoperatively, 89% of new bone formation was observed. There was no difference in the resorption and new bone formation between the group using bone graft and the group osteoset$^{(R)}$ alone, different preoperative diagnosis and even different locations. There was no complication. Conclusion: Calcium sulfate(Osteoset$^{(R)}$) is a safe and effective bone graft substitute in the treatment of benign bone tumors, especially for the children in whom autograft is not recommandable.

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Statistical Data Extraction and Validation from Graph for Data Integration and Meta-analysis (데이터통합과 메타분석을 위한 그래프 통계량 추출과 검증)

  • Sung Ryul Shim;Yo Hwan Lim;Myunghee Hong;Gyuseon Song;Hyun Wook Han
    • The Journal of Bigdata
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    • v.6 no.2
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    • pp.61-70
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    • 2021
  • The objective of this study was to describe specific approaches for data extraction from graph when statistical information is not directly reported in some articles, enabling data intergration and meta-analysis for quantitative data synthesis. Particularly, meta-analysis is an important analysis tool that allows the right decision making for evidence-based medicine by systematically and objectively selects target literature, quantifies the results of individual studies, and provides the overall effect size. For data integration and meta-analysis, we investigated the strength points about the introduction and application of Adobe Acrobet Reader and Python-based Jupiter Lab software, a computer tool that extracts accurate statistical figures from graphs. We used as an example data that was statistically verified throught an previous studies and the original data could be obtained from ClinicalTrials.gov. As a result of meta-analysis of the original data and the extraction values of each computer software, there was no statistically significant difference between the extraction methods. In addition, the intra-rater reliability of between researchers was confirmed and the consistency was high. Therefore, In terms of maintaining the integrity of statistical information, measurement using a computational tool is recommended rather than the classically used methods.

Treatment and Prognosis for an Esthesioneuroblastoma over a 20-Year Period: Impact of Treatment Era (감각신경모세포종의 20년에 걸친 치료와 예후 분석: 치료 시기에 따른 차이)

  • Song, Chang-Hoon;Kim, Il-Han;Wu, Hong-Gyun;Kim, Dong-Wan;Rhee, Chae-Seo
    • Radiation Oncology Journal
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    • v.27 no.4
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    • pp.189-193
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    • 2009
  • Purpose: To report on the changes in the patterns of care and survival over time for esthesioneuroblastoma. Materials and Methods: We retrospectively analyzed 42 previously untreated and histologically confirmed esthesioneuroblastoma patients seen between March 1989 and June 2007. According to Kadish's classification, 3 patients (7%) were stage A, 6 (14%) at stage B, and 33 (79%) at stage C. Of the 33 Kadish C patients, 19 and 14 patients were treated from 1989 through 2000 and from 2001 through 2007, respectively. Treatment included surgical resection, radiotherapy, chemotherapy, or a combination of these methods. Chemotherapy was administered to 8 of 19 patients (42%) seen from 1989 through 2000, whereas all of the 14 patients seen from 2001 through 2007 received chemotherapy (p<0.001). No patient was treated by three-dimensional conformal radiotherapy (3D-CRT) from 1989 through 2000, however 8 of 14 patients (67%) seen from 2001 through 2007 underwent 3D-CRT (p<0.001). The median follow-up time for surviving patients was 6.5 years (range, 2.2~15.8 years). Results: The 5-year overall survival (OS) and progression-free survival (PFS) rates for the entire cohort were 53% and 39%, respectively. The 5-year OS was 100% for Kadish stages A or B and 39% for stage C (p=0.007). For patients with stage C disease who were treated from 1989 to 2000 and from 2001 to 2007, the 5-year OS rate was 26% and 59% (p=0.029), respectively and the corresponding 5-year PFS rate was 16% and 46% (p=0.001), respectively. Intraorbital extension and treatment era (1989~2000 vs. 2001~2007) were found as independent factors for OS and PFS in a multivariate analyses. Conclusion: The results of this study suggest that treatment era, which features a distinction in treatment modality and technique with the introduction of 3D-CRT, may be the cause of improved OS and PFS in Kadish stage C patients. To achieve better outcomes for patients with Kadish stage C, combined chemoradiotherapy, especially 3D-CRT, is recommended in addition to surgery.

An Introduction to Quantitative Analyses of Sleep EEG Via a Wavelet Method (뇌Wavelet 방법론을 이용한 수면뇌파분석 고찰)

  • Kim, Jong-Won
    • Sleep Medicine and Psychophysiology
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    • v.19 no.1
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    • pp.11-17
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    • 2012
  • Objective: Among various methods developed to quantitatively explore electroencephalograms (EEG), we focused on a wavelet method that was known to yield robust results under nonstationary conditions. The aim of this study was thus to introduce the wavelet method and demonstrate its potential use in clinical sleep studies. Method: This study involved artificial EEG specifically designed to validate the wavelet method. The method was performed to obtain time-dependent spectral power and phase angles of the signal. Synchrony of multichannel EEG was analyzed by an order parameter of the instantaneous phase. The standard methods, such as Fourier transformation and coherence, were also performed and compared with the wavelet method. The method was further validated with clinical EEG and ERP samples available as pilot studies at academic sleep centers. Result: The time-frequency plot and phase synchrony level obtained by the wavelet method clearly showed dynamic changes in the EEG waveforms artificially fabricated. When applied to clinical samples, the method successfully detected changes in spectral power across the sleep onset period and identified differences between the target and background ERP. Conclusion: Our results suggest that the wavelet method could be an alternative and/or complementary tool to the conventional Fourier method in quantifying and identifying EEG and ERP biomarkers robustly, especially when the signals were nonstationary in a short time scale (1-100 seconds).

A Study of the status of Dental technicians' leisure activities (치과기공사의 여가활동 실태에 관한 연구)

  • Kwon, Soon-Suk;Kim, Yoon-Shin
    • Journal of Technologic Dentistry
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    • v.30 no.1
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    • pp.83-96
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    • 2008
  • This study aims to analyze the major factors in their working conditions affecting the enlargement of leisure activities of dental technicians. We also present a need for dental technicians to assign more time many different kinds of leisure activities for their quality life. To this end, we examined the status and the characteristics of dental technicians' leisure activities among the randomly selected subjects who are working in the area of Seoul, Gyonggido, and Gangwon-do through the analysis of the 311 sheets of self-administered questionnaires. The conclusions from this analysis are as follows; 1. On weekdays, non participants in leisure activities were found to be 64.0%, and in the case of weekends, the participants were reached to 70.7%. Those who enjoy any leisure activities in either of weekdays and weekends were 34.1%, 27.3% of the dental technicians did not have any leisure activities. Therefore, statistical significance was shown in the participations of leisure activities between weekdays and weekends. 2. Of the types of leisure activities in both weekdays and weekends, sports activities were ranked at the top 33.4%, 29.6% respectively, which is followed by going to the cinema/theatre/exhibitions, etc 21.9%, 26.0%, games/entertainment 14.5%, 14.8%, hobbies/cultural activities 14.1%, 12.5%, sightseeing/picnic 6.4%, 7.4%. 3. Of the differences in the characteristics of leisure activities, the types of leisure activities between weekdays and weekends showed difference in gender, company and information regarding leisure activities in age, company and the place of leisure activities, and leisure information in the marital status, career and monthly income in company, company and leisure information in the job position, which is statistically significant (p<.001). However, no statistical significance was found among the other general items of the characteristics of leisure activities. Considering only works on weekdays policy is currently permeating into almost every business sector, dental business owners or managers are advised to consider more effective time management or human resources management, such as keeping reasonable manufacturing time through cooperations with the dentists, regularity of working hours, incentive system, introduction of credible over time payment. Which will provide their staff with more times and opportunities to enjoy their leisure activities. Additionally, the concrete and feasible ways of motivating and activating the leisure activities of dental technicians are in need of further researches and studies.

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Economic Evaluation and Budget Impact Analysis of the Surveillance Program for Hepatocellular Carcinoma in Thai Chronic Hepatitis B Patients

  • Sangmala, Pannapa;Chaikledkaew, Usa;Tanwandee, Tawesak;Pongchareonsuk, Petcharat
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8993-9004
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    • 2014
  • Background: The incidence rate and the treatment costs of hepatocellular carcinoma (HCC) are high, especially in Thailand. Previous studies indicated that early detection by a surveillance program could help by down-staging. This study aimed to compare the costs and health outcomes associated with the introduction of a HCC surveillance program with no program and to estimate the budget impact if the HCC surveillance program were implemented. Materials and Methods: A cost utility analysis using a decision tree and Markov models was used to compare costs and outcomes during the lifetime period based on a societal perspective between alternative HCC surveillance strategies with no program. Costs included direct medical, direct non-medical, and indirect costs. Health outcomes were measured as life years (LYs), and quality adjusted life years (QALYs). The results were presented in terms of the incremental cost-effectiveness ratio (ICER) in Thai THB per QALY gained. One-way and probabilistic sensitivity analyses were applied to investigate parameter uncertainties. Budget impact analysis (BIA) was performed based on the governmental perspective. Results: Semi-annual ultrasonography (US) and semi-annual ultrasonography plus alpha-fetoprotein (US plus AFP) as the first screening for HCC surveillance would be cost-effective options at the willingness to pay (WTP) threshold of 160,000 THB per QALY gained compared with no surveillance program (ICER=118,796 and ICER=123,451 THB/QALY), respectively. The semi-annual US plus AFP yielded more net monetary benefit, but caused a substantially higher budget (237 to 502 million THB) than semi-annual US (81 to 201 million THB) during the next ten fiscal years. Conclusions: Our results suggested that a semi-annual US program should be used as the first screening for HCC surveillance and included in the benefit package of Thai health insurance schemes for both chronic hepatitis B males and females aged between 40-50 years. In addition, policy makers considered the program could be feasible, but additional evidence is needed to support the whole prevention system before the implementation of a strategic plan.

Effect of Short Term Treatment with Different Dosage of Inhaled Flucatisone Propionate on Basal Cortisol Concentration (단기간 Fluticasone Propionate 투여 용량에 따른 가저 코르티솔 농도의 변화)

  • Kim, Hyun-Jung;Kim, Hyoung-Sik;Lee, Hong;Moon, Sung-Gi;Lim, Seok-Tae;Park, Ji-Hyun;Lee, Heung-Bum;Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1063-1071
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    • 1997
  • Backgroung : The efficacy of oral corticosteroids in the treatment of chronic asthma is undisputed, but their long-term use is associated with adverse side-effects, including supression of the hypothalamic-pituitary adrenal axis function, osteoporosis, weight gain, hypertension and impaired glucose tolerance. The introduction of inhaled corticosteroids in the early 1970's represented a significant therapeutic advance in the management of asthma, since these compounds combined high topical potency with low systemic activity. Fluticasone propionate is a new topically active synthetic glucocorticosteroid that combinds a high degree of efficacy with negligible systemic bioavailability. This study was perfomed to determine the effect of inhaled fluticasone propionate on the adreocortical supression in patients with bronchial asthma or chronic obstructive pulmonary disease. Method : The adrenocortical function was assessed by measurement of plasma cortisol concentration at 8 o'clock in morning and free cortisol in 24 hour urine collection at interval. Absolutely, no steroid was taken during pretreatment period of 10days. There after each subject inhaled fluticasone aerosol, in daily doses of 500 or 1000micrograms for 12days. The dose was delivered by metered dose inhaler(MDI). Results : The serum cortisol and 24hour urinary free cortisol were not decreased during the treatment period in patients with inhaled fluticasone propionate in daily doses of 500 micrograms. In contrast, serum cortisol was significantly decreased on 9th and 12th day(p less than 0.05). And, 24hour urinary free cortisol was also significantly decreased on 3rd and 12th day of treatement period(p less than 0.05) in patients with inhaled fluticasone in daily doses of 1000 micrograms. Conclusion : These results suggested that endogenous cortisol secretion was not supressed after short-term inhalation of fluticasone in daily dose of 500 micrograms, but in daily dose of 1000 micrograms, the endogenous cortisol secretion was supressed.

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A Study on the Relationship between Sleep Duration and Suicidal Idea in an Urban Area of South Korea (일 도시지역 주민들의 수면시간과 자살사고의 연관성에 관한 연구)

  • Lee, Yu-Jin;Kim, Seog-Ju;Cho, In-Hee;Kim, Jong-Hoon;Bae, Seung-Min;Koh, Seung-Hee;Cho, Seong-Jin
    • Sleep Medicine and Psychophysiology
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    • v.16 no.2
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    • pp.85-90
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    • 2009
  • Introduction: There has been an increasing interest in the relationship between sleep and suicidality. In addition, suicidal patients habitually report their sleep problems. Although sleep-related complaints and electroencephalographic changes are generally encountered in psychiatric disorders, sleep complaints such as insomnia, hypersomnia and nightmares are more common in suicidal patients. In current study, we aimed at investigating the relationship between self-reported sleep duration and suicidality in general population. Methods: One thousand general population (male:female=500:500, mean age=$39.6{\pm}11.6$ years, ranged age=20-77 years) completed Center for Epidemiologic Study-Depression (CES-D), Beck Suicide Intent scale (BSI), Spielberger State-Trait Anger Expression Inventory (STAXI), Barratt Impulsiveness Scale (BIS), Morningness-Eveningness Scale (MES) and brief questionnaire of sleep habits. Results: After controlling for age and sex, score of BSI was correlated positively with the score of CES-D, STAXI and BIS on partial correlation analysis ($r_p$=0.251; p<0.001, $r_p$=0.352; p<0.001, and $r_p$=0.175; p<0.001, respectively). In addition, score of BSI was inversely correlated with the score of MES (rp=-0.066; p=0.037). However, score of BSI showed no significant correlation with sleep duration. However, regression analysis revealed that short (<6 hrs) or long (>10 hrs) sleep duration, the family history of psychiatric illness, the score of CES-D, and the score of STAXI predicted higher score of BSI significantly in total subjects (F=17.837, adjusted $R^2$=0.166; p=0.003, p=0.003, p<0.001, and p=0.003, respectively). This model was explained better in depressed subjects with 16 or higher score of CES-D (F=9.920, adjusted $R^2$=0.298). Conclusion: Current result suggested that not only short sleep duration (<6 hrs) but also long sleep duration (>10 hrs) might be related to suicidality.

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Bacterial Meningitis in Children in One Tertiary Hospital (소아의 세균성 수막염)

  • Oh, Ji Eun;Chang, Ji Yeon;Kwon, Young Se;Kim, Soon Ki;Son, Byong Kwan;Hong, Young Jin
    • Pediatric Infection and Vaccine
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    • v.10 no.2
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    • pp.208-214
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    • 2003
  • Purpose : We performed a retrospective study on bacterial meningitis in children, pertaining to the causative organisms, bacterial resistance to antibiotics and the effect of recent introduction of Haemophilus influenzae type b(Hib) vaccine. Methods : We analysed the forty-three cases of bacterial meningitis which had been treated at the Inha University Hospital from June 1996 to June 2003. Results : Nineteen cases(44.2%) of them were infants younger than 2 months of age, and 29 cases(67.5%) younger than 1 year of age. The common causative organisms under 2 months of age were group B streptococcus(GBS)(47.4%), E. coli(21.1%), and Klebsiella pneumoniae(21.1%). In the age group beyond 2 months of age, S. pneumoniae were seen in 50 %, H. influenzae in 16.7% and N. meningitidis in 16.7%. All of the five cases of Hib meningitis had not been vaccinated for Hib. There has been no Hib meningitis cases since 2001. Overall fatality rate was 4.5%, and complication occurred in 39%. Complications was significantly less frequent in patients resumed to be treated within 48 hours after onset compared to after 48 hours after onset. Penicillin resistance of S. pneumoniae and GBS isolated among bacterial meningitis cases was high. Conclusion : Timing of treatment after the onset of the disease appeared the most important factor for prognosis of bacterial meningitis. The cases of H. influenzae meningitis have decreased probably due to Hib vaccination.

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Characteristics of Sleep Pattern among Korean College Students (한국 대학생의 수면 양상 특징)

  • Kim, Seog-Ju;Lyoo, In-Kyoon;Won, Chang-Yeon;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.13 no.1
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    • pp.15-21
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    • 2006
  • Introduction: The objective of the present study was to investigate bedtime, rise time and time-in-bed of Korean college students, separately on weekday and on weekend and to compare them. In addition, this study also aimed to evaluate the influence of gender, age and grade on the above sleep parmeters in Korean college students. Methods: Information regarding bedtime and rise time, separately on weekday and on weekend, of Korean college students were obtained by self-administered questionnaire. Questionnaires of 1,825 students (1,416 females and 409 males, age 18-30;mean age $21.1{\pm}2.2$) were used for statistical analyses. Results: Korean college students retired to bed 50 minutes later (00:49 on weekday;01:40 on weekend;t=39.67, p<0.001), rose 1 hour 58 minutes later (07:52 on weekday;09:50 on weekend;t=39.46, p<0.001), and slept 1 hour 8 minutes longer (t=13.33, p<0.001) on weekend. Compared to male students, female students had earlier rise time (t=8.96, p<0.01;t=3.89, p<0.01) and earlier bedtime both on weekday and weekend (t=7.10, p<0.01;t=6.04, p<0.01), and shorter time-in-bed on weekday (t=1.99, p<0.01). In addition, rise time delay and time-in-bed increase on weekend were more prominent in female students than in male students (t=3.41, p<0.01; t=3.68, p<0.01). Grade was correlated with bedtime and rise time on weekday (${\beta}=0.1022$, p<0.01;${\beta}=0.1009$, p<0.01), bedtime and time-in-bed on weekend (${\beta}=0.1096$, p<0.01;${\beta}=-0.0990$, p<0.01), and differences between week-day and weekend of the rise time and the time-in-bed (${\beta}=-0.0906$, p<0.01;${\beta}=-0.1115$, p=0.02). Conclusions: In this study, Korean college students had earlier bedtime/rise time and shorter time-in-bed on weekday than on weekend. These findings suggest that weekday sleep-wake schedule of Korean college students may be advanced relative to their biological sleep-wake cycle and that this discrepancy may be associated with weekday sleep deprivation. In addition, differences of sleep patterns between weekday and weekend were more prominent in female students and students with lower grade. Therefore, discrepancy between weekday sleep-wake schedule and biological sleep-wake cycle, as well as weekday sleep deprivation, might be more serious in female or lower-grade students.

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