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Using of the "Consolidated Standards of Reporting Trials:CONSORT" to heighten quality of Medical Education study (의학교육연구의 질을 향상시키기 위한 '연구보고의 표준' 의 활용)

  • Yoo, Ji-Soo
    • Korean Medical Education Review
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    • v.10 no.2
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    • pp.25-44
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    • 2008
  • Objectives: Through using of the strong research method like a Randomized Controlled Trial: RCT, we have to heighten quality of Medical Education study. I'd like to introduce "CONSORT", which stands for Consolidated Standards of Reporting Trials. Contents: Preventive Service Task Force(200l) in USA proposed Levels of evidence for enlarging evidence-based Practice: EBP. And the CONSORT was introduced, which encompasses various initiatives developed by the CONSORT Group to alleviate the problems arising from inadequate reporting of randomized controlled trials (RCTs). the CONSORT has 13 guides like these: 1. How participants were allocated to interventions 2. Scientific background and explanation of rationale 3. Eligibility criteria for participants. The settings and locations where the data were collected. 4. Precise details of the interventions intended for each group and how and when they were actually administered 5. Specific objectives and hypotheses 6. Clearly defined primary and secondary outcome measures, When applicable. any methods to enhance the quality of measurements (e.g., multiple observations, training of assessors) 7. How sample size was determined. When applicable, explanation of any interim analyses and stopping rules 8. Method used to generate the random allocation sequence, Details of any restriction [of randomization] 9. Method used to implement the random allocation sequence 10. Who generated the allocation sequence, who enrolled participants. and who assigned participants to their groups 11. Whether or not participants, those administering the interventions, and those assessing the outcomes were blinded to group assignment. If done, how the success of blinding was evaluated 12. Statistical methods used to compare groups for primary outcome(s), Methods for additional analyses, such as subgroup analyses and adjusted analyses 13. Flow of participants through each stage (a diagram is strongly recommended) Specifically, for each group report the numbers of participants randomly assigned. receiving intended treatment, completing the study protocol. and analyzed for the primary outcome. Results and Conclusion: Randomized Controlled Trial: RCT guided of CONSORT will contribute to do stronger evidence-based medical studies.

Incidence and Survival Rates among Pediatric Osteogenic Sarcoma Cases in Khon Kaen, Thailand, 1985-2010

  • Wiromrat, Pattara;Jetsrisuparb, Arunee;Komvilaisak, Patcharee;Sirichativapee, Winai;Kamsa-Ard, Supot;Wiangnon, Surapon
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4281-4284
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    • 2012
  • Background: Osteosarcoma is the most common bone cancer in children, responsible for a high rate of amputation and death. This is the first long-term, population-based, epidemiologic and survival study in Thailand. Objective: To study the incidence and survival rates of pediatric osteosarcoma in Khon Kaen. Method: Childhood osteosarcoma cases (0-19 years) diagnosed between 1985-2010 were reviewed. The data were retrieved from the population-based data set of the Khon Kaen Cancer Registry and medical records from Srinagarind Hospital, Faculty of Medicine, Khon Kaen University. All cases were censored until the end of April 2012. The age-standardized incidence rate (ASR) was calculated using the standard method. Survival experience was analyzed using the standard survival function (STATA 9.0) and presented with a Kaplan-Meier curve. Results: 58 cases were enrolled. The overall ASR was 14.1 per million. Males and females were equally affected. The peak incidence was for 15-19 year-olds in both sexes (ASR=10.4 per million in males and 8.5 in females). The 5-year overall survival rate was 27.6% (95% CI: 15.8-40.8%). The median survival time was 1.6 years (95% CI: 1.2-2.1). In a subgroup analysis, the patients who received only chemotherapy survived longer (5-year survival 45.7%, median survival time 4.1 years, p=0.12). Conclusion: The incidence rate for childhood osteosarcoma was slightly less than those reported for Western countries. The survival rate was also lower than reports from developed countries. Further evaluation of the treatment protocol and risk factor stratification is needed.

Clinical Outcomes of Spontaneous Spinal Epidural Hematoma : A Comparative Study between Conservative and Surgical Treatment

  • Kim, Tackeun;Lee, Chang-Hyun;Hyun, Seung-Jae;Yoon, Sang Hoon;Kim, Ki-Jeong;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.52 no.6
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    • pp.523-527
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    • 2012
  • Objective : The incidence of spontaneous spinal epidural hematoma (SSEH) is rare. Patients with SSEH, however, present disabling neurologic deficits. Clinical outcomes are variable among patients. To evaluate the adequate treatment method according to initial patients' neurological status and clinical outcome with comparison of variables affecting the clinical outcome. Methods : We included 15 patients suffered from SSEH. Patients were divided into two groups by treatment method. Initial neurological status and clinical outcomes were assessed by the American Spinal Injury Association (ASIA) impairment scale. Also sagittal hematoma location and length of involved segment was analyzed with magnetic resonance images. Other factors such as age, sex, premorbid medication and duration of hospital stay were reviewed with medical records. Nonparametric statistical analysis and subgroup analysis were performed to overcome small sample size. Results : Among fifteen patients, ten patients underwent decompressive surgery, and remaining five were treated with conservative therapy. Patients showed no different initial neurologic status between treatment groups. Initial neurologic status was strongly associated with neurological recovery (p=0.030). Factors that did not seem to affect clinical outcomes included : age, sex, length of the involved spinal segment, sagittal location of hematoma, premorbid medication of antiplatelets or anticoagulants, and treatment methods. Conclusion : For the management of SSEH, early decompressive surgery is usually recommended. However, conservative management can also be feasible in selective patients who present neurologic status as ASIA scale E or in whom early recovery of function has initiated with ASIA scale C or D.

A STUDY ON THE INFLUENCE OF PRETREATMENT ON THE BOND STRENGTHS OF SOME PIT AND FISSURE SEALANTS (수종의 치면열구 전색재의 전처리가 결합강도에 미치는 영향)

  • Min, Yun-Kyung;Jeong, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.2
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    • pp.277-284
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    • 1998
  • For the purpose of comparing the shear bond strengths of pit and fissure sealants, and finding out the more efficient method of tooth surface treatment when the etched surface is contaminaed by saliva or moisture, an experiment was performed on 3 types of pit and fissure sealants. 120 extracted human molars were divided into 3 groups, each of which was composed of 40 specimens sealed with Helioseal, Teethmate-F and Fuji III respectively. And each groups was again divided into 4 subgroups according to tooth surface treatment. The shear bond strengths of each groups and subgroup was measured and statistically analyzed. The results obtained were as follows : 1. Shear bond strengths of nonfluoridated resin sealant, Helioseal were shown to be higher than those of fluoridated resin sealant, Teethmate-F, but, not significantly different. 2. Shear bond strengths of GI sealant, Fuji III were to be markedly lower than those of two resin sealants. 3. When there is moisture contamination, applying primer under sealant(Group IV) results in a significantly stronger bond strength of sealant to enamel than when using sealant alone(Group II) in case of all sealants. 4. When there is no moisture contamination, using primer under sealant (Group III) results in bond strength equivalent to bond strength on using sealant alone (Group I). 5. Based on the results above, it was demonstrated that the bond of sealant to tooth surface is greatly affected by saliva contamination and that the complete tooth isolation method should be fully emphasized. The application of primer is recommended when performing sealant under the environment very susceptible to saliva contamination.

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Feedback Cancellation Based on Partitioned Time-Domain Pilots for T-DMB Repeaters (시간영역 파일럿 분할을 통한 T-DMB 중계기에서의 궤환신호 제거기법)

  • Lee, Ji-Bong;Kim, Wan-Jin;Park, Sung-Ik;Lee, Yong-Tae;Kim, Hyoung-Nam
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.33 no.3A
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    • pp.327-334
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    • 2008
  • Conventional on-channel-repeaters (OCRs) have a crucial problem that the power of a re-transmitted signal is highly limited by a feedback signal due to antenna coupling. The power limitation problem in OCRs has been solved by incorporating a demodulation-type feedback canceller which eliminates unwanted feedback signals by estimating a feedback channel. In applying the demodulation-type feedback canceller to T-DMB repeaters, there is a troublesome problem of unfrequent known pilot symbols, resulting in poor convergence performance of channel estimation. To solve this problem and enhance the accuracy of estimation, we propose a partitioning method of the Phase Reference Symbol (PRS) transformed in time domain. Since filter coefficients are updated every one partitioned subgroup, the number of updates is increased by the number of partitioned subgroups and thus the convergence speed is enhanced. The improved performance of feedback-channel estimation is directly connected with the feedback-cancellation performance. Simulation result shows that the feedback canceller incorporating the proposed partitioning method has a good performance in terms of residual feedback power.

The Diagnostic Performance of the Length of Tumor Capsular Contact on MRI for Detecting Prostate Cancer Extraprostatic Extension: A Systematic Review and Meta-Analysis

  • Tae-Hyung Kim;Sungmin Woo;Sangwon Han;Chong Hyun Suh;Soleen Ghafoor;Hedvig Hricak;Hebert Alberto Vargas
    • Korean Journal of Radiology
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    • v.21 no.6
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    • pp.684-694
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    • 2020
  • Objective: The purpose was to review the diagnostic performance of the length of tumor capsular contact (LCC) on magnetic resonance imaging (MRI) for detecting prostate cancer extraprostatic extension (EPE). Materials and Methods: PubMed and EMBASE databases were searched up to March 24, 2019. We included diagnostic accuracy studies that evaluated LCC on MRI for EPE detection using radical prostatectomy specimen histopathology as the reference standard. Quality of studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity were pooled and graphically presented using hierarchical summary receiver operating characteristic (HSROC) plots. Meta-regression and subgroup analyses were conducted to explore heterogeneity. Results: Thirteen articles with 2136 patients were included. Study quality was generally good. Summary sensitivity and specificity were 0.79 (95% confidence interval [CI] 0.73-0.83) and 0.67 (95% CI 0.60-0.74), respectively. Area under the HSROC was 0.81 (95% CI 0.77-0.84). Substantial heterogeneity was present among the included studies according to Cochran's Q-test (p < 0.01) and Higgins I2 (62% and 86% for sensitivity and specificity, respectively). In terms of heterogeneity, measurement method (curvilinear vs. linear), prevalence of Gleason score ≥ 7, MRI readers' experience, and endorectal coils were significant factors (p ≤ 0.01), whereas method to determine the LCC threshold, cutoff value, magnet strength, and publication year were not (p = 0.14-0.93). Diagnostic test accuracy estimates were comparable across all assessed MRI sequences. Conclusion: Greater LCC on MRI is associated with a higher probability of prostate cancer EPE. Due to heterogeneity among the studies, further investigation is needed to establish the optimal cutoff value for each clinical setting.

Consideration for Setting Reference Range for Adrenocorticotropic Hormone Test according to Blood Collection Time (채혈 시간에 따른 부신피질 자극 호르몬 검사의 참고치 설정에 관한 고찰)

  • Ji-Hye Park;Jin-Ju Choi;Soo-Yeon Lim;Seon-Hee Yoo;Sun-Ho Lee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.27 no.1
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    • pp.42-46
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    • 2023
  • Purpose The reference range described in Adrenocorticotropic Hormone reagent used in our laboratory is 10-60 pg/mL at 8 a.m. to 10 a.m., and 6-30 pg/mL at 8 p.m. to 10 p.m. However, in the case of outpatients, blood is mainly collected between 10 a.m. and 6 p.m., accounting for 57.8% of the total. Therefore, This study is intended to help make a more accurate diagnosis by reevaluating the reference range provided by the manufacturer of the Adrenocorticotropic Hormone reagent and setting split-timed reference range. Materials and Methods The patients collected blood before 10 a.m. were group A (68 people), and the patients collected blood after 10 a.m. were set to group B (80 people). A T-test was performed between groups to test their significance. And it was confirmed whether it was necessary to set the gender classification as a subgroup. The method of setting the reference range was calculated by the Bayesian's method and the Hoffmann's method. Results The reference range of Group A was 8.6 to 60.6 pg/mL by the Bayesian's method, and the Hoffmann's method was 3.6 to 61.3 pg/mL. The reference range of Group B was 6.9 to 50.5 pg/mL when applying the Bayesian's method, and the Hoffmann method's was 2.3 to 48.9 pg/mL. Conclusion This study was concluded that it was necessary to set the split-timed reference range. Through this study, the later the blood collection time, the lower the level of Adrenocorticotropic Hormone, indicating that blood collection time is important for patients with clinical significance. If a large number of subjects are selected and supplemented in the future, it is believed that systematic and accurate reference range can be set.

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MANDIBULAR DISTRACTION OSTEOGENESIS WITH COMPRESSION FORCE - BONE DENSITY, HISTOLOGICAL FINDINGS AND TMJ RESPONSE (압축력을 병용한 하악골 신장술)

  • Hwang, Young-Seob;Heo, June;Kim, Uk-Kyu;Park, Seong-Jin;Hwang, Dae-Seok;Kim, Yong-Deok;Chung, In-Kyo;Kim, Kyu-Cheon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.6
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    • pp.531-548
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    • 2006
  • The purpose of this study was to investigate the biomechanical, histologic findings of distracted regenerate and TMJ response in modified distraction osteogenesis (DO) technique combined with compression force as biomechanical stimulation method which has been suggested in 2002, and developed thereafter by authors. This study was performed with two experiments. First experiment was designed to explore the optimal ratio of compression force versus distraction force for the new DO technique. Second experiment was planned to evaluate the reaction of TMJ tissue, especially condyle, disc after application of the DO technique with compression force. Total 52 New Zealand adult male-rabbits with 3.0kg body weight were used for the study. For the first study, 30 adult male-rabbits underwent osteotomy at one side of mandibular body and a external distraction device was applied on each rabbit with same manner. In the control group of 10 rabbits, final 8 mm of distraction with 1 mm rate per day was done with conventional DO technique after 5 latency days. For the experimental group of 20 rabbits, a compression force with 1 mm rate per day was added to the distracted mandible on 3-latency day after over-distraction (over-lengthening). As the amount of the rate of compression versus distraction, experimental subgroup I (10 rabbits) was set up as 2 mm compression versus 10 mm distraction (1/5) and experimental subgroup II (10 rabbits) was set up as 3 mm compression versus 11 mm distraction (about 1/3). All 30 rabbits were set up to obtain final 8 mm distraction and sacrificed on postoperative 55 day to analysis on biomechanical, and histologic findings of the bone regenerates. For second study, 22 adult male-rabbits were used to evaluate TMJ response after the DO method application with compression force. In the control group, 10 rabbits was used to be performed with conventional DO method, on the other hand, in a experimental group of 10 rabbits, 10 mm distraction with 2 mm compression (1/5 ratio) was done. The remaining 2 rabbits served as the normal control group. Histomorphologic examinations on both condyle, histological studies on condyle, disc were done at 1, 2, 3, 4, 7 weeks after distraction force application. The results were as follows: 1. On the bone density findings, the experimental group II (force ratio - 1/3) showed higher bone density than the other experimental group (force ratio - 1/5) and control group (control group - $0,2906\;g/cm^2$, experimental group I - $0.2961\;g/cm^2$, experimental group II - $0.3328\;g/cm^2$). 2. In the histologic findings, more rapid bone maturation like as wide lamellar bone site, more trabeculae formation was observed in two experimental groups compared to the conventional DO control group. 3. In morphologic findings of condyle, there were no differences of size and architecture in the condyle in the control and experimental groups. 4. In histologic findings of condyles, there were thicker fiberous and proliferative layers in experimental group than those of control group until 2 weeks after distraction with compression force. But, no differences were seen between two groups on 3, 4, 7 weeks after compression. 5. In histologic findings of disc, more collagen contents in extracellular matrix, more regular fiber bundles, and less elastin fibers were seen in experimental group than control group until 2 weeks after distraction with compression. But, no differences were seen between two groups on 3, 4, 7 weeks after distraction with compression. From this study, we could identify that the new distraction osteogenesis technique with compression stimulation might improve the quality of bone regeneration. The no remarkable differences on TMJ response between control and experimental groups were seen and TMJ tissues were recovered similarly to normal TMJ condition after 3 weeks.

Evaluation of dietary quality of adolescents using Healthy Eating Index

  • Tek, Nilufer Acar;Yildiran, Hilal;Akbulut, Gamze;Bilici, Saniye;Koksal, Eda;Karadag, Makbule Gezmen;Sanher, Nevin
    • Nutrition Research and Practice
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    • v.5 no.4
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    • pp.322-328
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    • 2011
  • The aim of this study was to use the Healthy Eating Index-2005 (HEI-2005) to assess diet quality and determine the relationship between the HEI-2005 and the energy and nutrient intakes of adolescents. A cross-sectional study was conducted on 1,104 healthy adolescents, mean age of $15.8{\pm}1.24$ years. Dietary intake was measured with the 24-hour dietary recall method, and dietary quality was assessed by means of the HEI-2005. Diet quality scores ranged from 23.7 to 77.5. The mean score was found to be $51.5{\pm}9.07$ according to the HEI-2005. There were no differences according to gender, 42.8% had a poor diet and 57.2% had a diet that needs improvement. No subjects had a "good diet". Lower mean subgroup scores were found for whole grains, total vegetables, total fruits, dairy products, and meat and beans. Fruits and vegetables scores were significantly high in girls, whereas sodium, oil, and meat and beans scores were significantly high in boys. Total HEI-2005 scores were increasingly associated with parental education level when age and gender were adjusted. There was a negative correlation between HEI-2005 scores and age, total energy intake, and fat intake. Positive correlation was only observed in the HEI-2005 scores for protein and dietary fibre intakes. Consequently, the overall diet quality and nutritional habits of Turkish adolescents need modification and improvement. In the family, measures should be initiated by the government, including advertisements and campaigns.

The Effect of Economic Participatory Change on Unmet Needs of Health Care among Korean Adults (한국 성인의 경제활동 참여변화가 미충족 의료에 미치는 영향: 4·5차 한국의료패널자료를 이용하여)

  • Song, Hai-Yan;Choi, Jae-Woo;Park, Eun-Cheol
    • Health Policy and Management
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    • v.25 no.1
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    • pp.11-21
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    • 2015
  • Background: The objective of this research is to investigate and provide analysis of the economic participatory change affecting the unmet needs of health care in Korean adults. Methods: We used Korea health panel 4th and 5th data of 10,261 adults. The method of investigation is threefold. First, We identified the regional factors affecting unmet needs of health care. Second, we analyzed the effect of economic participatory change as it affects the unmet needs of health care. Third, we also investigated whether there were discernable differences between the age subgroups. Results: It was determined that influencing factors included sex, education, economic level, and health status. And after the subgroup analysis of age, we found that the economic participatory change was associated with the economical unmet needs of health care especially for those over 40 years of age. Also the population are facing unemployment enduring particular economic hardship in meeting their medical needs. Conclusion: This study finds that there are some policy recommendations for the sake of medical service equality. Medical welfare policy for those 40 years of age and older has been identified as an area that needs improvement. And considering that those 40 years of age and older are facing unemployment enduring particular economic hardship in meeting their medical needs, this study finds a need for government sponsored medical stipends or subsidizing of medical premiums, co-payment, and other fees.