• Title/Summary/Keyword: e-clinical data

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Introduction of Medical Simulation and the Experience of Computerized Simulation Program Used by $MicroSim^{(R)}$

  • Lee, Sam-Beom;Bang, Jae-Beum;SaKong, Joon
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.148-153
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    • 2007
  • Background : Computer- and web-based simulation methods help students develop problem solving and decision making skills. In addition, they provide reality based learning to the student clinical experience with immediate medical feedback as well as repetitive training, on-site reviews and case closure. Materials and Methods : Seventy-five third-year medical students participated in a two-week simulation program. The students selected four modules from eight modules as follows: airway and breathing 1, cardiac arrest 1, cardiac arrhythmia 1, and chest pain 1, and then selected the first case within each of the modules. After 2 weeks, a pass score was obtained and the data analyzed. The average pass score of over 70% was considered a passing grade for each module. If the student did not pass each module, there was no score (i.e., pass score was zero). In addition, when at least one of the four modules was zero, the student was not included in this study. Results : Seventy-five students participated in the simulation program. Nineteen students were excluded based on their performance. The final number of students studied was 56 students (74.7%). The average scores for each module 1 to 4 were 86.7%, 85.3%, 84.0%, and 84.0%, and the average obtained pass score was 88.6 for the four modules in all 56 students. Conclusion : Medical simulation enabled students to experience realistic patient situations as part of medical learning. However, it has not been incorporated into traditional educational methodology. Here we describe the introduction and the development of various simulation modules and technologies for medical education.

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EGFR Mutation Genotype Impact on the Efficacy of Pemetrexed in Patients with Non-squamous Non-small Cell Lung Cancer

  • Igawa, Satoshi;Sato, Yuichi;Ishihara, Mikiko;Kasajima, Masashi;Kusuhara, Seiichiro;Nakahara, Yoshiro;Otani, Sakiko;Fukui, Tomoya;Katagiri, Masato;Sasaki, Jiichiro;Masuda, Noriyuki
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3249-3253
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    • 2016
  • Background: Pemetrexed monotherapy has come to be recognized as one of the standard second-line therapies for advanced non-squamous non-small cell lung cancer (NSCLC). However, there have been no reports of studies that have evaluated the efficacy of pemetrexed according to type of active EGFR mutation, i.e., an exon 19 deletion or an L858R point mutation. Materials and Methods: The records of non-squamous NSCLC patients harboring an EGFR mutation who received pemetrexed monotherapy as a second or later line of chemotherapy at Kitasato University Hospital between March 2010 and October 2015 were retrospectively reviewed, and the treatment outcomes were evaluated. Results: The overall response rate and progression-free survival time (PFS) of the 53 patients with non-squamous NSCLC were 15.1% and 2.3 months, respectively. There were significant differences between the disease control rate (37.5% vs. 76.2%) and PFS time (1.8 months vs. 3.3 months) of the exon 19 deletion group and the L858R point mutation group, and a multivariate analysis identified type of EGFR mutation as well as performance status (PS) as independent predictors of PFS. Conclusions: The clinical data obtained in this study provided a valuable rationale for considering type of EGFR mutation as well as non-squamous histology as predictors of the efficacy of pemetrexed monotherapy.

Correlation of Preoperative Ki67 and Serum CA15.3 Levels with Outcome in Early Breast Cancers - a Multi Institutional Study

  • Rasmy, A;Abozeed, W;Elsamany, S;El Baiomy, M;Nashwa, A;Amrallah, A;Hasaan, E;Alzahrani, A;Faris, M;Alsaleh, K;AlFaraj, A
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3595-3600
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    • 2016
  • Background: To investigate the association between preoperative pathological Ki-67 labeling index and serum tumor marker cancer antigen 15-3 (CA 15-3) with clinic-pathological parameters and treatment outcomes in early breast cancer. Materials and Methods: A retrospective study at 4 cancer centers in Saudi Arabia and Egypt was performed. Data were collected for female patients diagnosed with unilateral early breast cancer between March 2010 and October 2013. Cases treated with neoadjuvant chemotherapy (NACT) followed by surgery and radiotherapy were included. NACT included 6-8 cycles of anthracycline and taxane based regimens. Trastuzumab and hormonal treatments were added according to HER2 and hormone receptor status. Baseline serum CA15.3 and pathological Ki67 levels were evaluated and correlated with disease free survival (DFS) and overall survival (OS). Results: A total of 280 pts was included. The median age was 49 years (38-66 y) and median overall survival was 35 (20-38) months (mo). Estrogen receptors (ER), progesterone receptors (PR) and HER 2 receptors were positive in 233 (83.2%), 198 (70%) and 65 cases (23.2%), respectively. High preoperative Ki67 and CA15.3 were noted in 177 (63.2%) and 131 (46.8%). A total of 45 (16%) patients had distal or local recurrence and 24 (8.6%) died of their disease. Most of the relapsed cases had high preoperative Ki-67 (n=41, 91%) and CA15.3 (n=28, 62%) values. All of the patients who died had a high Ki-67 but CA15.3 was high in 9 (37%) only. Mean DFS/OS in patients with high preoperative Ki-67 was 32 months /32 months as compared to 37 months/35 months in those with normal Ki-67 (p<0.001). Correlation of preoperative CA15.3 and survival was statistically not significant. Conclusions:Preoperative Ki-67 can be a predictive and prognostic marker. Higher levels are associated with poor DFS and OS in patients with early BC.

Nrf2 Overexpression Predicts Prognosis and 5-FU Resistance in Gastric Cancer

  • Hu, Xiu-Feng;Yao, Jun;Gao, She-Gan;Wang, Xin-Shuai;Peng, Xiu-Qing;Yang, Yan-Tong;Feng, Xiao-Shan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5231-5235
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    • 2013
  • Objective: NF-E2-related factor 2 (Nrf2) is activated in several human malignancies. However, the role of Nrf2 in gastric cancer (GC) remains incompletely understood. In this study, we therefore analyzed associations of Nrf2 expression status with clinical features and chemotherapeutic resistance in GC. Materials and Methods: A total of 186 samples from GC patients who underwent gastrectomy were used for prognostic assessment. A further 142 samples from GC cases who received first-line combination chemotherapy were applied for investigation of chemoresistance. The Nrf2 expression was evaluated by immunohistochemistry in GC samples, and its relationship with clinicopathological parameters and chemotherapy sensitivity was analyzed. The effect of Nrf2 gene silencing on chemotherapy resistance was also examined by cell viability assay in vivo. Results: Of the 186 patients with GC, 104/186 (55.9%) showed high expression for Nrf2. The overexpression of Nrf2 was an independent predictor of overall survival [OS, hazard ratio (HR) 3.9; P=0.011] and disease-free survival (DFS, HR 4.3; P=0.002). The gene silencing of Nrf2 reduced resistance to cell death induced by 5-FU in GC cell lines. Conclusion: Our data show that Nrf2 is an independent prognostic factor in GC. Furthermore, Nrf2 confers resistance to chemotherapeutic drug 5-FU in GC cells. Taken together, Nrf2 is a potential prognostic marker and predictive for 5-FU resistance in GC.

Measurement of Respiratory Motion Signals for Respiratory Gating Radiation Therapy (호흡동조 방사선치료를 위한 호흡 움직임 신호 측정)

  • Chung, Jin-Beom;Chung, Won-Kyun;Kim, Yon-Lae;Lee, Jeong-Woo;Suh, Tae-Suk
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2005.04a
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    • pp.59-63
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    • 2005
  • Respiration motion causes movement of internal structures in the thorax and abdomen, making accurate delivery of radiation therapy to tumors in those areas a challenge. Accounting for such motion during treatment, therefore, has the potential to reduce margins drawn around the clinical target volume (CTV), resulting in a lower dose to normal tissues (e.g., lung and liver) and thus a lower risk of treatment induced complications. Among the techniques that explicitly account for intrafraction motion are breath-hold, respiration gating, and 4D or tumor-tracking techniques. Respiration gating methods periodically turn the beam on when the patient's respiration signal is in a certain part of the respiratory cycle (generally end-inhale or end-exhale). These techniques require acquisition of some form of respiration motion signal (infrared reflective markers, spirometry, strain gauge, thermistor, video tracking of chest outlines and fluoroscopic tracking of implanted markers are some of the techniques employed to date), which is assumed to be correlated with internal anatomy motion. In preliminary study for the respiratory gating radiation therapy, we performed to measurement of this respiration motion signal. In order to measure the respiratory motion signals of patient, respiration measurement system (RMS) was composed with three sensor (spirometer, thermistor, and belt transducer), 4 channel data acquisition system and mobile computer. For two patients, we performed to evaluation of respiratory cycle and shape with RMS. We observed under this system that respiratory cycle is generally periodic but asymmetric, with the majority of time spent. As expected, RMS traced patient's respiration each other well and be easily handled for application.

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Characterization and Comparative Evaluation of Milk Protein Variants from Pakistani Dairy Breeds

  • Yasmin, Iqra;Iqbal, Rabia;Liaqat, Atif;Khan, Wahab Ali;Nadeem, Muhamad;Iqbal, Aamir;Chughtai, Muhammad Farhan Jahangir;Rehman, Syed Junaid Ur;Tehseen, Saima;Mehmood, Tariq;Ahsan, Samreen;Tanweer, Saira;Naz, Saima;Khaliq, Adnan
    • Food Science of Animal Resources
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    • v.40 no.5
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    • pp.689-698
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    • 2020
  • The aim of study was to scrutinize the physicochemical and protein profile of milk obtained from local Pakistani breeds of milch animals such as Nilli-Ravi buffalo, Sahiwal cow, Kajli sheep, Beetal goat and Brela camel. Physicochemical analysis unveiled maximum number of total solids and protein found in sheep and minimum in camel. Buffalo milk contains the highest level of fat (7.45%) while camel milk contains minimum (1.94%). Ash was found maximum in buffalo (0.81%) and sheep (0.80%) while minimum in cow's milk (0.71%). Casein and whey proteins were separated by subjecting milk to isoelectric pH and then analyzed through sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). The results showed heterogeneity among these species. Different fractions including αS1, αS2, κ-casein, β-casein and β-lactoglobulen (β-Lg) were identified and quantitatively compared in all milk samples. Additionally, this electrophoretic method after examining the number and strength of different protein bands (αS1, αS2, β-CN, α-LAC, BSA, and β-Lg, etc.), was helpful to understand the properties of milk for different processing purposes and could be successfully applied in dairy industry. Results revealed that camel milk was best suitable for producing allergen free milk protein products. Furthermore, based on the variability of milk proteins, it is suggested to clarify the phylogenetic relationships between different cattle breeds and to gather the necessary data to preserve the genetic fund and biodiversity of the local breeds. Thus, the study of milk protein from different breed and species has a wide range of scope in producing diverse protein based dairy products like cheese.

The Effects of the Combined Patterns of Proprioceptive Neuromuscular Facilitation on Static Balance (고유수용성 신경근 촉진법의 통합 패턴이 정적 균형에 미치는 영향)

  • Choi, Won-Jye;Kim, Yoon-Hwan;Lee, Seung-Yub
    • PNF and Movement
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    • v.6 no.1
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    • pp.1-12
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    • 2008
  • Purpose : The purpose of this study was to investigate the effects of the combined patterns of PNF(proprioceptive neuromuscular facilitation) on the static balance ability. Methods : The measurements of the static balance ability were completed by 10 subjects for 6 weeks, from October to November 2007. The combined patterns of PNF were carried out by means of self-exercising suggested by Dietz, which were designed as four cases: two positions (standing and quadruped) for both patterns(sprinter and skater), respectively. The exercises were practiced once a day, 3 times a week in same condition. By using the GOOD BALANCE system, assessment of the static balance ability was taken at before and after exercise from 6 positions: normal standing, one leg left and one leg right standing when eye open and close, respectively. For each case, the experimental data was obtained in 3 items: mean X speed, mean Y speed and velocity moment. Results : The results of this study were as follows : 1. There were statistically significant differences of Mean X speed, Mean Y speed and Velocity moment between the before and the after exercise in the case of normal standing when eye open and close(NSEO and NSEC), respectively. 2. There was statistically significant difference of Mean X speed between the before and the after exercise in the case of one leg left standing when eye open(OLLEO). In this case, however, the statistically significant differences were not found in both terms of Mean Y speed and Velocity moment. 3. There were statistically significant differences of Mean X speed and Mean Y speed between the before and the after exercise in the case of one leg left standing when eye close(OLLEC). In this case, however, the statistically significant difference was not found in term of Velocity moment. 4. There were statistically significant differences of Mean X speed, Mean Y speed and Velocity moment between the before and the after exercise in the case of one leg right standing when eye close(OLREC). 5. There was statistically significant difference of Mean X speed between the before and the after exercise in the case of one leg right standing when eye open(OLREO). In this case, however, the statistically significant differences were not found in both terms of Mean Y speed and Velocity moment. 6. There were statistically significant differences of total Mean X speed, total Mean Y speed and total Velocity moment between the before and the after exercise. Conclusions : The above results from this study indicated that the combined patterns of PNF have improved the static balance ability. However the used self-exercise can be applied to normal people, i.e., the exercise is difficult to apply into clinical patients. The further study should be focused at development of various modified forms of the combined patterns of PNF in keeping up the improvement effect of this exercise.

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MMPI PROFILE TYPES OF MOTHERS WITH PSYCHIATRIC DISORDERED CHILDREN (정신 장애 아동들의 어머니의 MMPI 유형 분석)

  • Shin, Min-Sup;Oh, Kyung-Ja;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.3 no.1
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    • pp.97-105
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    • 1992
  • Present study investigated the relationship between children's psychiatric disorders and their mothers' psychological problems. Ninety-one psychiatric outpatients from a children's hospital were classified into three diagnostic groups - internalizing symptom group(n=35), externalizing symptom group(n=35), and developmental disorder group(n=21) - based on their psychiatric problems. A normal control group was formed by matching on the age and education of mothers. Mothers' MMPI profiles which were classified into five types - normal, depression, anxiety disorder, somatization disorder, and personality disorder - were examined in relation with children's diagnoses. The profiles of the mothers in the normal control group were mostly normal, while depressive profiles were dominant among those of the clinical groups regardless of the children's diagnoses. Therefore, the data implied association between children's psychiatric problems and their mothers' psychological problems. A possibility of negative reciprocal interactions between children and their mothers was discussed. It was also suggested that further research need to examine the specific effects of children's psychiatric problems on the psychological adjustment of their mothers, as well as the effects of parental psychiatric problems on the adjustment of their offsprings.

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The Protective Effects of IGF-1 on Different Subpopulations of DRG Neurons with Neurotoxicity Induced by gp120 and Dideoxycytidine In Vitro

  • Lu, Lin;Dong, Haixia;Liu, Guixiang;Yuan, Bin;Li, Yizhao;Liu, Huaxiang
    • Biomolecules & Therapeutics
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    • v.22 no.6
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    • pp.532-539
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    • 2014
  • Peripheral neuropathy induced by human immunodeficiency virus (HIV) infection and antiretroviral therapy is not only difficult to distinguish in clinical practice, but also difficult to relieve the pain symptoms by analgesics because of the severity of the disease at the later stage. Hence, to explore the mechanisms of HIV-related neuropathy and find new therapeutic options are particularly important for relieving neuropathic pain symptoms of the patients. In the present study, primary cultured embryonic rat dorsal root ganglion (DRG) neurons were used to determine the neurotoxic effects of HIV-gp120 protein and/or antiretroviral drug dideoxycytidine (ddC) and the therapeutic actions of insulin-like growth factor-1 (IGF-1) on gp120- or ddC-induced neurotoxicity. DRG neurons were exposed to gp120 (500 pmol/L), ddC ($50{\mu}mol/L$), gp120 (500 pmol/L) plus ddC ($50{\mu}mol/L$), gp120 (500 pmol/L) plus IGF-1 (20 nmol/L), ddC ($50{\mu}mol/L$) plus IGF-1 (20 nmol/L), gp120 (500 pmol/L) plus ddC ($50{\mu}mol/L$) plus IGF-1 (20 nmol/L), respectively, for 72 hours. The results showed that gp120 and/or ddC caused neurotoxicity of primary cultured DRG neurons. Interestingly, the severity of neurotoxicity induced by gp120 and ddC was different in different subpopulation of DRG neurons. gp120 mainly affected large diameter DRG neurons (> $25{\mu}m$), whereas ddC mainly affected small diameter DRG neurons (${\leq}25{\mu}m$). IGF-1 could reverse the neurotoxicity induced by gp120 and/or ddC on small, but not large, DRG neurons. These data provide new insights in elucidating the pathogenesis of HIV infection- or antiretroviral therapy-related peripheral neuropathy and facilitating the development of novel treatment strategies.

Extracting Minimized Feature Input And Fuzzy Rules Using A Fuzzy Neural Network And Non-Overlap Area Distribution Measurement Method (퍼지신경망과 비중복면적 분산 측정법을 이용한 최소의 특징입력 및 퍼지규칙의 추출)

  • Lim Joon-Shik
    • Journal of the Korean Institute of Intelligent Systems
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    • v.15 no.5
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    • pp.599-604
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    • 2005
  • This paper presents fuzzy rules to predict diagnosis of Wisconsin breast cancer with minimized number of feature in put using the neural network with weighted fuzzy membership functions (NEWFM) and the non-overlap area distribution measurement method. NEWFM is capable of self-adapting weighted membership functions from the given the Wisconsin breast cancer clinical training data. n set of small, medium, and large weighted triangular membership functions in a hyperbox are used for representing n set of featured input. The membership functions are randomly distributed and weighted initially, and then their positions and weights are adjusted during learning. After learning, prediction rules are extracted directly from n set of enhanced bounded sums of n set of small, medium, and large weighted fuzzy membership functions. Then, the non-overlap area distribution measurement method is applied to select important features by deleting less important features. Two sets of prediction rules extracted from NEWFM using the selected 4 input features out of 9 features outperform to the current published results in number of set of rules, number of input features, and accuracy with 99.71%.