• Title/Summary/Keyword: e-clinical data

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The Principle of Acupoint Selection Based on Branch and Root Treatment (표치와 본치의 측면에서 경혈 선혈의 원리)

  • Lee, In-Seon;Ryu, Yeonhee;Chae, Younbyoung
    • Korean Journal of Acupuncture
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    • v.37 no.3
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    • pp.203-208
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    • 2020
  • Objectives : Since there are complex associations between diseases/symptoms and acupoints, one-to-one correspondence may not be the proper approach. Pattern identification has been being used as a clinical framework to make treatment decisions by extracting and synthesizing clinical data including patients' signs and symptoms. In this article, we propose two different models explaining the relationships between diseases and acupoints based on the branch treatment [Zhibiaofa] and the root treatment [Zhibenfa]. Methods : We explained the relationships between diseases/symptoms and acupoints from the example data from our previous study on traditional acupuncture point selection patterns for pain control. Diseases include low back pain, migraine, irritable bowel syndrome, osteoarthritis, ankle sprain, carpal tunnel syndrome, and dysmenorrhea, and acupoints included LI4, BL23, BL25, SP6, BL60, TE5, and CV4. Results : The relationships between diseases/symptoms and acupoints can be explained directly based on the branch treatment, and also can be explained indirectly through pattern identification based on the root treatment. Pattern identifications included both meridian-based pattern identification based on the spatial information of diseases and visceral organ-based pattern identification based on the characteristics of diseases. Conclusions : In the East Asian traditional medicine, Korean medicine doctors choose the most appropriate acupoints based either on the diseases/symptoms (i.e., branch treatment) or on the results of pattern identifications (i.e., root treatment). It is necessary to understand the two different approaches to choose specific acupoints for the targeted diseases.

Altered Distribution and Expression Pattern of E-cadherin in Hepatocellular Carcinomas: Correlations with Prognosis and Clinical Features

  • Jiang, Xue-Mei;Zhang, Ju-Bo;Xiong, Ju;Huang, Xiao-Xi;Ren, Zheng-Gang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6455-6461
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    • 2012
  • Objective: E-cadherin has been identified as a tumor suppressor in many types of carcinoma. However, some studies recently suggested that the role and expression of E-cadherin might be more complex and diverse. In the present study, we evaluated the prognostic value of E-cadherin expression with reference to levels in membranes and cytoplasm, and the membrane/cytoplasm ratio, in hepatocellular carcinomas (HCCs) after curative hepatectomy. Methods: The expression of E-cadherin was assessed by immunohistochemistry in HCC tissue microarrays from 125 patients, and its prognostic values and other clinicopathlogical data were retrospectively analyzed. Patients were followed for a median period of 43.7 months (range 1 to 126 months). Results: Univariate analysis demonstrated that a high membrane/cytoplasm (M/C) ratio of E-cadherin expression was associated with poor overall survival (OS) (P =0.001) and shorter time to recurrence (TTR) (P=0.038), as well as tumor size, intrahepatic metastasis, and TNM stage. In contrast, neither membrane nor cytoplasmic expression of E-cadherin was related with OS and TTR. Furthermore, multivariate analysis confirmed the M/C ratio to be an independent predictor of OS (P=0.031). ${\chi}^2$ tests additionally showed that the M/C ratio of E-cadherin expression was related with early stage recurrence (P=0.012), rather than later stage recurrence. Conclusion: The M/C ratio of E-cadherin expression is a strong predictor of postoperative survival and is associated with early stage recurrence in patients with HCC.

Qualitative and Quantitative Analysis for Microbiome Data Matching between Objects (마이크로바이옴 데이터 일치를 위한 물체들 사이의 정량 및 정성적 분석)

  • You, Hee Sang;Ok, Yeon Jeong;Lee, Song Hee;Lee, So Lip;Lee, Young Ju;Lee, Min Ho;Hyun, Sung Hee
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.3
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    • pp.202-213
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    • 2020
  • Although technological advances have allowed the efficient collection of large amounts of microbiome data for microbiological studies, proper analysis tools for such big data are still lacking. Additionally, analyses of microbial communities using poor databases can lead to misleading results. Hence, this study aimed to design an appropriate method for the analysis of big microbial databases. Bacteria were collected from the fingertips and personal belongings (mobile phones and laptop keyboards) of individuals. The genomic DNA was extracted from these bacteria and subjected to next-generation sequencing by targeting the 16S rRNA gene. The accuracy of the bacterial matching percentage between the fingertips and personal belongings was verified using a formula and an environment-related and human-related database. To design appropriate analysis, the bacterial matching accuracy was calculated based on the following three categories: comparison between qualitative and quantitative analysis, comparisons within same-gender participants as well as all participants regardless of gender, and comparison between the use of a human-related bacterial database (hDB) and environment-related bacterial database (eDB). The results showed that qualitative analysis, comparisons within same-gender participants, and the use of hDB provided relatively accurate results. This study provides an analytical method to obtain accurate results when conducting studies involving big microbiological data using human-derived microorganisms.

Mesial Angulation of Upper Anterior Teeth Crown : Positional Relationship between Pupil and Mesial Inclination Line of Upper Canine (상악 전치 치관의 근심경사도: 견치 근심경사선과 동공의 위치적 관계)

  • Oh, Sang-Chun;Um, Sang-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.20 no.2
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    • pp.135-141
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    • 2004
  • Statement of problem: Arrangement and angulation of clinical crown is very important for esthetic restoration in the upper anterior dentition. However, there was no clinical criteria to mesial angulation of the crown for Korean. Purpose: This study was undertaken to estimate the mesial angulation of the crown of the anterior teeth and the Oh's E-triangle made of the inter-pupillary line and the mesial inclination lines of the canines. Material and Method: 270 portraits of Korean were used for this study. The mesial angulation of the upper anterior teeth and the relationship of the inter-pupillary line and the mesial inclination lines of the canines were measured with the tools of PhotoShop software on the scanned images. Results: The angulation between the clinical crowns having a same name in the upper anterior dentition were $3.6^{\circ}$ between the central incisors, $8.6^{\circ}$ between the lateral incisors, and $13.6^{\circ}$ between the canines. There was no significance according to occupation and gender( P > 0.05). The ratio of height to base line of Oh's E-triangle was 4.47. 81.6% of the subjects showed the mesial inclination line of the canine passed by mesial border area of pupil. Conclusion: These data for Korean would be useful clinically to give the esthetic arrangement and to make the contour of upper anterior teeth.

Survey on Pharmacist's Awareness of E-commerce for Non-prescription Medicine (일반의약품의 전자상거래에 대한 약사의 인식도 고찰)

  • Park, Young-Dal;Bang, Joon Seok;Min, Young Sil;Sohn, Uy Dong
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.2
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    • pp.137-149
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    • 2016
  • Objective: Online pharmacies were introduced in some countries such as United States of America or Canada. They can provide benefits to consumer because they can buy and take conveniently drugs without limitation of location or time. In Korea, online pharmacies are illegal and only pharmacists can sell drugs to consumers or patients. Therefore, we investigated the knowledge of online pharmacy and the possible problem in Korea to survey pharmacists. Methods: We developed questionnaire based on previous articles about online pharmacy and surveyed nation-wide pharmacists by mail or e-mail. The data was analyzed by SPSS and Microsoft Excel. P-values less than 0.05 were statistically significant. Results: 175 pharmacists involved in this study. About introduction of online pharmacies, 53.1% were opposition while 10.3% were approval and 36.6% were conditional. Although online pharmacies were introduced, 46.3% pharmacists do not have a plan to start online pharmacy. However, the approval and tends about starting online pharmacies were higher in younger pharmacists (20s, 30s) (p < 0.05). The criteria of permission about opening online pharmacies were 100% pharmacist license regardless of holding off-line pharmacy. 53.7% pharmacists responded education about taking medication is impossible. When online pharmacies are introduced, 65.1% pharmacists responded traditional pharmacies are affected negatively. Pharmacists concerned that the competition with large-sized distribution corporations, reduced reliance between pharmacists and patients, illegal transaction of counterfeit drugs, increased misuse of drugs. Conclusion: These results showed that Korea pharmacists have negative standard on online pharmacies. Therefore it is required to be more cautious before introducing online pharmacy and it need strict watching system and continuous education and study for safety after introducing online pharmacy.

Acquired noncaustic esophageal strictures in children

  • Sag, Elif;Bahadir, Aysenur;Imamoglu, Mustafa;Sag, Sefa;Reis, Gokce Pinar;Erduran, Erol;Cakir, Murat
    • Clinical and Experimental Pediatrics
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    • v.63 no.11
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    • pp.447-450
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    • 2020
  • Background: Esophageal stricture (ES) is an uncommon clinic entity in pediatrics that may be congenital or acquired in childhood. Acquired noncaustic ES is very rare, and clinical features of affected patients are unknown. Purpose: We aimed to evaluate the clinical findings, and outcomes of patients with acquired noncaustic ES to aid physicians in the early referral of patients to gastroenterologists. Methods: The medical data of patients with acquired noncaustic ES who were followed in our gastroenterology clinic between January 2009 and December 2019 were reviewed. Results: Acquired noncaustic ES was found in 12 of the 4,950 patients (0.24%) who underwent endoscopy during the study period. The main symptoms were dysphagia (58.3%), vomiting (33.3%), and chronic anemia (8.3%). Chronic malnutrition and underweight were found in 66.6% of the patients. The most common etiological factors were radiotherapy, peptic reflux, and achalasia (16.6%, each), while chemotherapy, squamous-cell carcinoma (SC) of the esophagus, eosinophilic esophagitis (EoE), esophageal web, epidermolysis bullosa, and esophageal diverticulum (8.2%, each) were the other etiological factors. Patients with EoE underwent endoscopic bougie dilation in addition to steroid use and elimination diet. Patients with epidermolysis bullosa and esophageal web underwent bougie dilation. Patients with peptic reflux-related ES were initially put on antireflux therapy, but during follow-up, one patient required esophageal replacement with colonic interposition. Patients with radiotherapy-related ES recovered with medical therapy. The patient with initially underwent surgical gastrostomy and tumoral mass excision. The patient then received chemotherapy and radiotherapy and underwent jejunal interposition. Patients with achalasia underwent surgical esophagomyotomy. Conclusion: The presence of solid dysphagia, malnutrition, and an associated disease may alert physicians to the presence of ES.

Design and Development of Middleware for Clinical Trial System based on Brain MR Image (뇌 MR 영상기반 임상연구 시스템을 위한 미들웨어 설계 및 개발)

  • Jeon, Woong-Gi;Park, Kyoung-Jong;Lee, Young-Seung;Choi, Hyun-Ju;Jeong, Sang-Wook;Kim, Dong-Eog;Choi, Heung-Kook
    • Journal of Korea Multimedia Society
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    • v.15 no.6
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    • pp.805-813
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    • 2012
  • In this paper, we have designed and developed a middleware for an effectively approaching database to the existed brain disease clinical research system. The brain disease clinical research system was consisted of two parts i.e., a register and an analyzer. Since the register collects the registration data the analyzer yields a statistical data which based on the diverse variables. The middleware has designed to database management and a large data query processing of clients. By separating the function of each feature as a module, the module which was weakened connectivity between functionalities has been implemented the re-use module. And image data module used a new compression method from image to text for an effective management and storage in database. We tested the middleware system using 700 actual clinical medical data. As a result, the total data transmission time was improved maximum 115 times faster than the existing one. Through the improved module structures, it is possible to provide a robust and reliable system operation and enhanced security functionality. In the future, these middleware importances should be increased to the large medical database constructions.

Diagnostic Performance of HPV E6/E7 mRNA and HPV DNA Assays for the Detection and Screening of Oncogenic Human Papillomavirus Infection among Woman with Cervical Lesions in China

  • Wang, Hye-young;Lee, Dongsup;Park, Sunyoung;Kim, Geehyuk;Kim, Sunghyun;Han, Lin;Yubo, Ren;Li, Yingxue;Park, Kwang Hwa;Lee, Hyeyoung
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7633-7640
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    • 2015
  • Background: Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide and it is responsible for most cases of cervical uterine cancer. Although HPV infections of the cervix do not always progress to cancer, 90% of cervical cancer cases have been found to be associated with high risk HPV (HR-HPV) infection. HPV DNA testing is widely used, along with Papanicolaou (Pap) testing, to screen for cervical abnormalities. However, there are no data on the prevalence of genotype-specific HPV infections assessed by measuring HPV E6/E7 mRNA in women representative of the Chinese population across a broad age range. Materials and Methods: In the present study, we compared the results with the CervicGen HPV RT-qDx assay, which detects 16 HR-HPV genotypes (Alpha-9: HPV 16, 31, 33, 35, 52, and 58; Alpha-7: HPV 18, 39, 45, 51, 59, and 68; and Alpha-5, 6: HPV 53, 56, 66, and 69), and the REBA HPV-ID assay, which detects 32 HPV genotypes based on the reverse blot hybridization assay (REBA) for the detection of oncogenic HPV infection according to cytological diagnosis. We also investigated the prevalence and genotype distribution of HPV infection with a total of 324 liquid-based cytology samples collected in western Shandong province, East China. Results: The overall HPV prevalences determined by HPV DNA and HPV E6/E7 mRNA assays in this study were 79.9% (259/324) and 55.6% (180/324), respectively. Although the positivity of HPV E6/E7 mRNA expression was significantly lower than HPV DNA positivity, the HPV E6/E7 mRNA assay showed greater specificity than the HPV DNA assay (88.6% vs. 48.1%) in normal cytology samples. The prevalence of Alpha-9 (HPV 16, 31, 33, 35, 52, and 58) HPV infection among these women accounted for up to 80.3% and 76.1% of the high-grade lesions detected in the HPV mRNA and DNA tests, respectively. The HR-HPV genotype distribution, based on HPV DNA and E6/E7 mRNA expression by age group in patients with cytologically confirmed lesions, was highest in women aged 40 to 49 years (35.9% for cytologically confirmed cases, Pearson correlation r value=0.993, p<0.001) for high-grade lesions. Among the oncogenic HR-HPV genotypes for all age groups, there was little difference in the distribution of HPV genotypes between the HPV DNA (HPV -16, 53, 18, 58, and 33) and HPV E6/E7 mRNA (HPV -16, 53, 33, 58, and 18) assays. HPV 16 was the most common HPV genotype among women with high-grade lesions. Conclusions: Our results suggest that the HPV E6/E7 mRNA assay can be a sensitive and specific tool for the screening and investigation of cervical cancer. Furthermore, it may provide useful information regarding the necessity for early cervical cancer screenings and the development of additional effective HPV vaccines, such as one for HPV 53 and 58. Additionally, gaining knowledge of HPV distribution may also inform us about ecological changes in HPV after the vaccination.

The Relationships among Self-Efficacy, Spiritual Well-Being, and Job Stress in Clinical Nurses (임상간호사의 자기효능감, 영적안녕 및 직무스트레스와의 관계)

  • Han, Mi Young;Sohn, Sue Kyung;Kwon, Su-Hye;Choi, Jeong Hwa;Choi, Kum Hee
    • Journal of East-West Nursing Research
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    • v.20 no.1
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    • pp.21-28
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    • 2014
  • Purpose: This study was to identify the extent of and the relationships among self-efficacy, spiritual well-being, and job stress in clinical nurses. Methods: The subjects were 201 clinical nurses from three different general hospitals in B city. Data were collected from May 26 to August 9, 2012 and analyzed by using descriptive statistics, independent t-test, One-way ANOVA, Sheff$\acute{e}$ test, and Partial correlation coefficients. Results: The mean scores of self-efficacy, spiritual well-being, and job stress were moderate, 3.50, 3.58, and 3.44 respectively. There were statistically significant relationships between marital status, influence of religion, the number of night shifts per month, motives for choosing nursing as a career, job satisfaction and self-efficacy. Spiritual well-being was found to be significantly related to all participants' general characteristics, and job stress was significantly related to marital status and type of religion. There was a significantly weak positive correlation between self-efficacy and spiritual well-being, and a weak negative correlation between self-efficacy and job stress. There was no significant correlation between job stress and spiritual well-being. Conclusion: This study suggests that effective strategies to foster spiritual well-being is needed to enhance clinical nurses' self-efficacy, which should equip clinical nurses to better deal with job stress in their work places.

DESIGN AND ANALYSIS OF RANDOMIZED CLINICAL TRIALS REQUIRING PROLONGED OBSERVATION OF EACH PATIENT I. INTRODUCTION AND DESIGN

  • Peto R.;Pike M.C.;Armitage P.;Breslow N.E.;Cox D.R.;Howard S.V.;Mantel N.;Mcpherson K.;Peto J.;Smith P.G.
    • 대한예방의학회:학술대회논문집
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    • 1994.02b
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    • pp.206-233
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    • 1994
  • The Medical Research Council has for some years encouraged collaborative clinical trials in leukaemia and other cancers, reporting the results in the medical literature. One unreported result which deserves such publication is the development of the expertise to design and analyse such trials. This report was prepared by a group of British and American statisticians, but it is intended for people without any statistical expertise. Part!, which appears in this issue, discusses the design of such trials; Part II, which will appear separately in the January 1977 issue of the Journal, gives full instructions for the statistical analysis of such trials by means of life tables and the logrank test, including a worked example, and discusses the interpretation of trial results, including brief reports of particular trials. Both parts of this report are relevant to all clinical trials which study time to death, and would be equally relevant to clinical trials which study time to other particular classes of untoward event: first stroke, perhaps, or first relapse, metastasis, disease recurrence, thrombosis, transplant rejection, or death from a particular cause. Part I, in this issue, collects together ideas that have mostly already appeared in the medical literature, but Part II, next month, is the first simple account yet published for non-statistical physicians of how to analyse efficiently data from clinical trials of survival duration. Such trials include the majority of all clinical trials of cancer therapy; in cancer trials, however, it may be preferable to use these statistical methods to study time to local recurrence of tumour, or to study time to detectable metastatic spread, in addition to studying total survival. Solid tumours can be staged at diagnosis; if this, or any other available information in some other disease is an important determinant of outcome, it can be used to make the overall logrank test for the whole heterogeneous trial population more sensitive, and more intuitively satisfactory, for it will then only be necessary to compare like with like, and not, by chance, Stage I with Stage III.

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