• Title/Summary/Keyword: Multicenter

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Score System for Operative Risk Evaluation in Coronary Artery Bypass Surgery (관상동맥 우회로술의 수술 위험인자에 대한 스코어 시스템)

  • Kang Joon-Kyu;Kim Chong-Wook;Sheen Seung-Soo;Chung Cheol-Hyun;Lee Jae-Won;Song Meong-Gun;Lee Jung-Sook;Song Hyun
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.749-753
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    • 2006
  • Background: The purpose of this study is to assess a score system for operative risk evaluation of CABG. Material and Method: From January 2001 to September 2005, retrospective study for various perioperative factors of 2993 cases was done. Result: The early operative mortality was 2.4% and the beta coefficients of 7 core variables related to it (preoperative LV dysfuction, preoperative renal failure, MI within 1 week, reoperation, combined surgery, preoperative atrial fibrillation, preoperative IABP) were adjusted to score system. ROC curve and Hosmer and Lemeshow goodness of fit test was done. Conclusion: This score system was effective in assessing operative risk of CABG. But It is necessary to gather larger volume of case and perform multicenter study.

Literature Review of Studies Related with Injinho in Korea (인진호(茵蔯蒿) 관련 국내 연구 동향 고찰)

  • Na, Ran-Hee;Bang, Chang-Ho;Jang, Seok-Oh;Choi, Ji-Hye;Ko, Ha-Neul;Kim, Lae-Hee;Rhee, Yun-Jin;Kim, Kang-San
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.3
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    • pp.361-366
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    • 2010
  • This study was practiced to investigate the existing study trends for Injinho that is numerously used for hepatobiliary diseases in oriental medicine. The studies selected from the domestic academic database included the following keywords in the title or abstract; 'Artemisia capillaris', 'Artemisia iwayomogi', 'Artemisia scoparia'. The studies considered were those published from January 1990 to May 2009. 198 studies were found to include the keywords related to the study subjects either in their title of contents or abstracts, and 104 studies among them were finally selected as subjects for this study. 81 studies among 104 studies(78%) were published between 2000 and 2009, while 23 studies(22%) were published between 1990 and 1999. Classification was proceeded according to study subjects as followed; 23 studies confirming hepatoprotective effect after artificial liver damage in a number of cells or the organ itself, 18 studies on anti-tumor effect, 12 studies on hyperlipidemia and fatty liver disease, and 4 studies on liver cirrhosis and hepatocyte regeneration. Furthermore, classification was conducted according to study methods as followed; 56 studies practicing in vitro, 33 studies practicing in vivo, 11 studies practicing both in vitro and in vivo. 2 studies on specific cases and 1 study on documentary records. The majority of studies report the affirmative effects of Injinho. However most study methods were restricted to in vitro and in vivo. Hereafter, case reports on various fields and multicenter clinical trials on Injinho is necessary.

The Assessment Tools in Palliative Medicine (완화 의학에서의 평가도구)

  • Gwak, Jung-Im;Suh, Sang-Yeon
    • Journal of Hospice and Palliative Care
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    • v.12 no.4
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    • pp.177-193
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    • 2009
  • The assessment of patient status in palliative medicine is essential for determining treatments and for clinical outcomes. The objective of assessment tools is to raise the quality of care for individual patients and their families. There are a number of tools available to assess pain, non-pain symptoms and quality of life. The tools are either uni-dimensional or multi-dimensional measures. Unfortunately, however, no single tool is recommended to be a superior to others in symptoms or quality of life assessment. Therefore, to select an appropriate assessment tool, one should consider the time frame and unique characteristics of tools depending on purpose and setting. The combination of prognostic index is highly recommended in prognostication, and web-based prognostic tools are available. Recently, a new objective prognostic score has been constructed through multicenter study in Korea. It does not include clinicalestimates of survival, but includes new objective prognostic factors, therefore, anyone can easily use it. For beginners in palliative medicine, relatively easy-to-use tools would be convenient. We recommend Eastern Cooperative Oncology Group performance status to assess functional status, numeric rating scale for pain assessment and the Korean version of brief pain inventory for initial pain assessment. Asking directly with numeric rating scale or the Korean version of MD Anderson Symptom Inventory would be desirable to assess various symptoms together. We think that European Organization Research and Treatment Quality of Life Questionnaire Core 15 for Palliative Care is good to assess the quality of life, while Objective Prognostic Score is convenient as prognostic index for beginners.

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Protocol of a Nationwide Observational Study among Patients with Nontuberculous Mycobacterium Pulmonary Disease in South Korea (NTM-KOREA)

  • Kwak, Nakwon;Choi, Hongjo;Jeon, Doosoo;Jhun, Byung Woo;Jo, Kyung-Wook;Kang, Young Ae;Kwon, Yong-Soo;Lee, Myungsun;Mok, Jeongha;Shim, Tae-Sun;Shin, Hong-Joon;Whang, Jake;Yim, Jae-Joon
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.2
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    • pp.141-146
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    • 2020
  • Background: The burden of nontuberculous mycobacterial (NTM) pulmonary disease (PD) is increasing globally. To understand the treatment outcomes and prognosis of NTM-PD, a unified registry is needed. In this project, we aim to construct a multicenter prospective observational cohort with NTM-PD in South Korea (NTM-KOREA). Methods: The primary objective of this study is to analyze treatment outcomes according to the species. In addition, recurrence rate, adverse events, the impact of each drug on treatment outcomes as well as the impact of characteristics of mycobacteriology will be analyzed. The inclusion criteria for the study are as follows: fulfilling the criteria for NTM-PD having one of the following etiologic organisms: Mycobacterium avium complex, M. abscessus subspecies abscessus, M. abscessus subspecies massiliense, or M. kansasii; receiving the first treatment for NTM-PD after enrollment; age >20 years; and consenting to participate in the study. Seven institutions will participate in patient enrollment and about 500 patients are expected to be enrolled. Participants will be recruited from 1 March 2020 until 19 March 2024 and will be observed through 19 March 2029. During the follow-up period, participants' clinical course will be tracked and their clinical data as well as NTM isolates will be collected. Conclusion: NTM-KOREA will be the first nationwide observational cohort for NTM-PD in South Korea. It will provide the information to optimize treatment modalities and will contribute to deeper understanding of the treatment outcomes and long-term prognosis of patients with NTM-PD in South Korea.

Safety and tolerability of Korean Red Ginseng in healthy adults: a multicenter, double-blind, randomized, placebo-controlled trial

  • Song, Sang-Wook;Kim, Ha-Na;Shim, Jae-Yong;Yoo, Byeong-Yeon;Kim, Dae-Hyun;Lee, Sang-Hyun;Park, Joo-Sung;Kim, Moon-Jong;Yoo, Jun-Hyun;Cho, BeLong;Kang, Hee-Cheol;Kim, Kwang-Min;Kim, Sung-Soo;Kim, Kyung-Soo
    • Journal of Ginseng Research
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    • v.42 no.4
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    • pp.571-576
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    • 2018
  • Background: Korean Red Ginseng (KRG) has been used in Asia for its various biological effects, but no studies have investigated the safety of its long-term intake. Therefore, the present study evaluated the safety of KRG intake for 24 weeks. Methods: We randomized 1,000 participants in a 1:1 ratio into two groups, which were treated daily with 2 g of KRG or a placebo for 24 weeks. The primary endpoint was all adverse events and adverse drug reactions (ADRs) that occurred after KRG or placebo administration, which were reported at week 4, 12, and 24 after the baseline visit. Results: In total, 192 and 211 participants experienced adverse events in the KRG and placebo groups (39.2% and 42.0%, respectively; p = 0.361), and 59 and 57 KRG- and placebo-treated individuals reported ADRs (12.0% and 11.4%, respectively; p = 0.737). The frequently occurring ADRs were pruritus (2.0%), headache (1.6%), diarrhea (1.4%), and dizziness (1.2%) in the KRG group and pruritus (2.0%), headache (1.8%), dizziness (1.6%), rash (1.4%), and diarrhea (1.2%) in the placebo group. Discontinuation of drug administration due to ADRs was reported in 13 participants, six (1.2%) and seven (1.4%) in the KRG and placebo groups, respectively (p = 0.814). No significant abnormal changes were revealed by anthropometric, laboratory, and vital sign measurements in the KRG group compared with those in the placebo group. Conclusion: The present study confirms the safety and tolerability of daily intake of 2 g of KRG for 24 weeks by healthy adults.

Preoperative Chemotherapy in Gastric Cancer (위암의 선행화학 요법)

  • Hong, Young-Seon;Park, Cho-Hyun
    • Journal of Gastric Cancer
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    • v.5 no.3 s.19
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    • pp.139-145
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    • 2005
  • Gastric cancer is the most prevalent cancer in Korea and comprises the second cause of cancer death. Surgery only can provide chance of cure, but most locally advanced cancers recur after a curative resection, even though important advances in the surgical and nonsurgical treatments of gastric cancer have taken place. Preoperative chemotherapy theoretically can provide the advantages of reducing the bulk of tumor, which might improve the R0 resection rate, and of treating micrometastases early. Also, preoperative chemotherapy is expected to render unresectable tumors resectable without increasing postoperative morbidity and mortality. There are many new chemo-therapeutic agents available for the treatment of advanced gastric cancer, but still the most effective agent, the optimal time and number of cycle for administration are still not known. The addition of postoperative chemotherapy through an intraperitoneal route and/or radiotherapy might affect the outcome of surgery favorably, but that hasn't been proved yet. A multicenter prospective randomized phase III trial should be peformed to answer for those questions and to improve the curability of gastric cancer treatment.

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A Study about a Short-form of the Sasang Constitution Questionnaire for Patient (SSCQ-P) (환자용 사상체질설문지(SSCQ-P) 축소화에 관한 연구)

  • Jeong, Jong-Hun;Jeon, Soo-Hyung;Na, Young-Ju;Kang, Seok-Hwan;Dong, Sang-Oak;Lee, Si-Woo;Kim, Kyu-Kon;Kim, Jong-Won;Kim, Sang-Hyuk
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.4
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    • pp.339-349
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    • 2014
  • Objectives This study was performed to make a short-form of Sasang Constitution Questionnaire for Patient(SSCQ-P). Methods In order to select important questions of SSCQ-P, we got advice from 10 professors of Oriental Medicine. As a result, we chose 37 questions. In addition, we selected 69 questions which had been used more than 12 times in SSCQ-P as the variable. We used some statistical methods to reduce questions. Finally, a total of 40 questions were selected. To find diagnostic accuracy rate of this short-form, discriminant analysis was performed. We used 1378 cases which was collect ed from February 2008 to June 2013 by online system(Sasang-medi data which has selected by web site, http://www.sasangmedi.or.kr), and 68 cases which was collected from November 2006 to September 2007 by the research "Construction of a biological information collection system for the Constitutional scientific diagnosis"(Korea Constitutional Multicenter Bank data, KCMB data) Results We made a short-form of SSCQ-P consisting of 40 questions. Diagnostic accuracy rate of short-form is 66.18% using Sasang-medi data, and 42.65% using KCMB data. Conclusions More cases are needed to improve the diagnostic accuracy rate of this short-form.

Serial Magnetic Resonance Imaging to Determine the Progression of Neglected Recalcitrant Rotator Cuff Tears: A Retrospective Multicenter Study

  • Yoo, Yon-Sik;Park, Jin-Young;Choi, Chang-Hyuk;Cho, Nam-Su;Cho, Chul-Hyun;Lim, Tae-Gang;Sim, Sang-Don;Rhie, Tae-Yon;Lee, Ho Won;Jung, Jong Ho;Lee, Yong-Beom
    • Clinics in Shoulder and Elbow
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    • v.20 no.3
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    • pp.133-137
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    • 2017
  • Background: To determine the natural progression of conservatively treated rotator cuff tears, we evaluated changes in radiologic and clinical parameters in patients whose recalcitrant tears were neglected after conservative treatment. Methods: A total of 73 patients with recalcitrant rotator cuff tears in spite of conservative treatment were included in this study. We measured changes in tear size and in the extent of fatty infiltration of the rotator cuff by comparing the initial and final follow-up magnetic resonance imagings (MRIs). To determine factors influencing the change in tear size, we collected the medical history of patients taken at the time of initial admission. Results: The average follow-up period was 20.1 months, and the average increase in tear size across this period was 6.2 mm. In terms of steroid injection, we found that the increases in tear size of the steroid injection group (p=0.049) and of the sub-group that had received more than three steroid injections (p=0.010) were significantly greater than that of the non-steroid injection group. Conclusions: We found that the increase in cuff tear size was on average 6.2 mm across the follow-up period, indicating that neglecting cuff tears may cause them to progress into more severe tears. We also observed that a history of steroid injection might be a possible risk factor for a worse prognosis of cuff tears. Therefore, we suggest that patients with rotator cuff tears and a history of steroid injection are recommended aggressive modes of treatment such as surgery.

Epidemiology and Clinical Severity of the Hospitalized Children with Viral Croup (바이러스성 크루프로 입원하는 소아 환자의 역학적 특성과 임상적 중증도 평가)

  • Jeon, In Soo;Cho, Won Je;Lee, Jeongmin;Kim, Hwang Min
    • Pediatric Infection and Vaccine
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    • v.25 no.1
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    • pp.8-16
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    • 2018
  • Purpose: In this study, the clinical and epidemiological characteristics of patients admitted for viral croup were analyzed to evaluate disease severity based on the organism that caused the infection. Methods: We retrospectively reviewed the medical records of 302 patients who were admitted to the Department of Pediatrics at the Wonju Severance Hospital between May 2013 and December 2016 for viral croup. Patients who showed positive results on multiplex polymerase chain reaction were subsequently diagnosed with respiratory virus infection. The Westley scoring system was used to evaluate the severity of viral croup. Results: Of the 302 patients, 149 were admitted due to severe viral croup, including 88 boys and 61 girls, with a boy-to-girl ratio of 1.44:1. About 110 cases of parainfluenza virus infection have been reported, which accounted for almost half of the total cases. The other identified viruses included influenza virus, human rhinovirus, and respiratory syncytial virus. Analysis of the association between severe viral croup and causative pathogen revealed that only parainfluenza type 2 virus showed a significantly high risk. Parainfluenza type 2 virus did not show an age-based difference in frequency but showed relatively a higher frequency of infections during the summer and fall. Conclusions: In this study, parainfluenza virus type 2 was the only virus associated with severe viral croup. To facilitate proper preventive management, treatment, and prognosis evaluation of viral croup, prospective and multicenter studies should assess the additional variables and the severity of the virus. Additionally, further studies should be conducted to assess age-dependent influences, as well as the regional and seasonal incidence of viral infection.

A Multicenter Survey on the Current Status of Pediatric Blood Cultures in Korea (소아 대상 혈액배양검사 현황 파악을 위한 국내 다기관 설문조사)

  • Lee, Young Joon;Lee, Ji Young;Kong, Seom Kim;Yeon, Gyu Min;Hong, Yoo Rha;Oh, Chi Eun
    • Pediatric Infection and Vaccine
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    • v.25 no.1
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    • pp.17-25
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    • 2018
  • Purpose: Blood culture is an essential diagnostic tool and requires clear indications, proper techniques, and quality control. We aimed to investigate whether blood cultures in children are appropriate for indications, are performed correctly, and receive proper quality control. Methods: We conducted an online survey targeting pediatric infectious diseases (ID) specialists working in general hospitals and neonatologists (Neo) working at hospitals operating a neonatal intensive care unit in Korea. Results: Approximately 81.1% (30/37) of pediatric ID specialists and 72.2% (52/72) of Neo responded to the survey. Some of the respondents (33.3% of ID and 59.6% of Neo) performed blood culture as a regular test irrespective of the indication. Approximately 40% of ID and 65.4% of Neo ordered only one set of blood culture in patients suspected with bacteremia. The most commonly used disinfectant for skin preparation was povidone-iodine, while the skin preparation method varied by institution. Approximately two-thirds of the institutions were monitoring the blood culture contamination rate, whereas relatively few provided staff with feedback on that rate. In addition, less than half of the institutions were providing regular staff training on blood culture (40% of ID and 28.8% of Neo). Conclusions: The indication and methods of blood culture for children varied according to institution, and few hospitals exert effort in improving the quality of blood culture. Institutions have to strive constantly toward improvement of blood culture quality and evidence-based recommendations for pediatric blood cultures should be standardized.