• Title/Summary/Keyword: health outcomes

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Effect of Beta Glucan on White Blood Cell Counts and Serum Levels of IL-4 and IL-12 in Women with Breast Cancer Undergoing Chemotherapy: A Randomized Double-Blind Placebo-Controlled Clinical Trial

  • Ostadrahimi, Alireza;Ziaei, Jamal Eivazi;Esfahani, Ali;Jafarabadi, Mohammad Asghari;Movassaghpourakbari, Aliakbar;Farrin, Nazila
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5733-5739
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    • 2014
  • Background: Breast cancer is the most common female malignancy in the world. Beta glucan can be a hematopoietic and an immune modulator agent in cancer patients. The aim of this trial was to determine the effect of beta glucan on white blood cell counts and serum levels of IL-4 and IL-12 in women with breast cancer undergoing chemotherapy. Materials and Methods: This randomized double-blind placebo-controlled clinical trial was conducted on 30 women with breast carcinoma aged 28-65 years. The eligible participants were randomly assigned to intervention (n=15) or placebo (n=15) groups using a block randomization procedure with matching based on age, course of chemotherapy and menopause status. Patients in the intervention group received two 10-mg capsules of soluble 1-3, 1-6, D-beta glucan daily and the control group receiving placebo during 21 days, the interval between two courses of chemotherapy. White blood cells, neuthrophil, lymphocyte and monocyte counts as well as serum levels of IL-4 and IL-12 were measured at baseline and at the end of the study as primary outcomes of the study. Results: In both groups white blood cell counts decreased after 21 days of the intervention, however in the beta glucan group, WBC was less decreased non significantly than the placebo group. At the end of the study, the change in the serum level of IL-4 in the beta glucan group in comparison with the placebo group was statistically significant (p=0.001). The serum level of IL-12 in the beta glucan group statistically increased (p=0.03) and comparison between two groups at the end of the study was significant after adjusting for baseline values and covariates (p=0.007). Conclusions: The findings suggest that beta glucan can be useful as a complementary or adjuvant therapy and immunomodulary agent in breast cancer patients in combination with cancer therapies, but further studies are needed for confirmation.

The Research of Pain and Functional Disability Assessment Scales for Knee Joint Disease (슬관절의 통증과 기능장애의 평가도구에 관한 연구)

  • Jung, Chan-Yung;Kim, Eun-Jung;Hwang, Min-Seop;Cho, Hyun-Seok;Kim, Kyung-Ho;Lee, Seung-Deok;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.27 no.2
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    • pp.123-142
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    • 2010
  • Objectives : The knee pain is the main reason of getting acupuncture treatment. In order to have confidence in the results of a study, it is necessary to establish that questionnaire is both valid and reliable in questionnaire related study. The aim of this study was to review the instruments that are currently in sue for assessing the knee joint. Methods : A literature study was performed to choose appropriate scales for assessment for pain and the function of the knee. Theoretically based scales were selected for review. Therefore, 18 scales for knee and 9 scale for pain were reviewed. the status of scales involved in knee treatment of acupuncture throughout several countries was evaluated. Results & Conclusion : Lysholm Knee Scoring Scale, Cincinnati knee rating system(CKRS) are adequate for ligament injury in knee. International Knee Documentation Committee scoring system(IKDC) may become a publication requirement for journals in view of the international standing of the committee. The available outcome measure for use in osteoarthritis are Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC), Lequesne Functional Severity Index(LFI) and Knee Injury and Osteoarthritis Outcome Score(KOOS), and in rheumatoid arthritis are McMaster-Toronto Arthritis patient function preference questionnaire(MACTAR), Quality of Life-Rheumatoid Arthritis Scale(QoL-RA Scale). Visual analog scale(VAS), verbal rating scale(VRS) are commonly used for the standard pain scale. For long term follow-up study The Medical Outcomes Study Short Form-36(SF-36), Arthritis Impact Measurement Scales(AIMS), Health Assessment Questionnaire(HAQ) should be included. Each measurement has its own composition and characteristics. Their validity, reliability, responsiveness and practical characteristics were already evaluated. We found 20 domestic and 28 overseas papers about knee treatment using acupuncture assessed with knee scales.

Vulnerability Assessment of the Air Pollution Using Entropy Weights : Focused on Ozone (엔트로피 가중치를 활용한 대기오염 취약성 평가 - 오존을 중심으로 -)

  • Lee, Sang-hyeok;Kang, Jung Eun;Bae, Hyun Joo;Yoon, Dong Keun
    • Journal of the Korean association of regional geographers
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    • v.21 no.4
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    • pp.751-763
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    • 2015
  • Both the selection of indicators and weights for them are critical issues in the vulnerability assessment. This study is to assess the air pollution vulnerability focused on ozone for 249 local jurisdictions using weights calculated by the entropy methodology and then examine the applicability of the methodology. We selected indicators for air pollution vulnerability assessment and standardized them. Subsequently, we calculated weights of each indicator using the entropy method and then integrated them into the vulnerability index. The exposure indicators consider meteorological and air pollution factors and the sensitivity of the local jurisdiction include variables on vulnerable areas and environments. The adaptive capacity contains socio-economic characteristics, health care capacities and air pollution managemental factors. The results show that Hwaseong-si, Gwangjin-gu, Gimpo-si, Gwangju-si, Gunpo-si are among the highest vulnerabilities based on the simple aggregation of indicators. And vulnerability-resilience (VRI) aggregation results indicates the similar spatial pattern with the simple aggregation outcomes. This article extends current climate change vulnerability assessment studies by adopting the entropy method to evaluate relative usefulness of data. In addition, the results can be used for developing customized adaptation policies for each jurisdiction reflecting vulnerable aspects.

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The metabolic syndrome and body composition in childhood cancer survivors

  • Sohn, Young-Bae;Kim, Su-Jin;Park, Sung-Won;Kim, Se-Hwa;Cho, Sung-Yoon;Lee, Soo-Hyun;Yoo, Keon-Hee;Sung, Ki-Woong;Chung, Jae-Hoon;Koo, Hong-Hoe;Jin, Dong-Kyu
    • Clinical and Experimental Pediatrics
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    • v.54 no.6
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    • pp.253-259
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    • 2011
  • Purpose: Long-term survivors of childhood cancer appear to have an increased risk for the metabolic syndrome, subsequent type 2 diabetes and cardiovascular disease in adulthood compared to healthy children. The purpose of this study was to investigate the frequency of the metabolic syndrome and associated factors in childhood cancer survivors at a single center in Korea. Methods: We performed a retrospective review of medical records of 98 childhood cancer survivors who were diagnosed and completed anticancer treatment at Samsung Medical Center, Seoul, Korea between Jan. 1996 and Dec. 2007. Parameters of metabolic syndrome were evaluated between Jan. 2008 and Dec. 2009. Clinical and biochemical findings including body fat percentage were analyzed. Results: A total of 19 (19.4%) patients had the metabolic syndrome. The median body fat percentage was 31.5%. The body mass index and waist circumference were positively correlated with the cranial irradiation dose (r=0.38, P<0.001 and r=0.44, P<0.00, respectively). Sixty-one (62.2%) patients had at least one abnormal lipid value. The triglyceride showed significant positive correlation with the body fat percentage (r=0.26, P=0.03). The high density lipoprotein cholesterol showed significant negative correlation with the percent body fat (r=- 0.26, P=0.03). Conclusion: Childhood cancer survivors should have thorough metabolic evaluation including measurement of body fat percentage even if they are not obese. A better understanding of the determinants of the metabolic syndrome during adolescence might provide preventive interventions for improving health outcomes in adulthood.

The Operative Treatment using Porous Hydroxyapatite for Intraarticular Calcaneal Fractures of Joint Depression Type (관절함몰형 종골 골절에 대한 다공성 하이드록시 아파타이트를 이용한 수술적 치료)

  • Choi, Eui-Sung;Kim, Yong-Min;Kim, Dong-Soo;Shon, Hyun-Chul;Park, Kyoung-Jin;Cho, Byung-Ki;Park, Ji-Kang;Yoo, Jun-Il
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.58-65
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    • 2010
  • Purpose: This study was performed to evaluate the clinical outcomes of operative treatment using porous hydroxyapatite for intraarticular calcaneal fracture of joint depression type. Materials and Methods: Twenty patients with intraarticular calcaneal fracture were followed up for more than 1 year. The period to union was calculated to evaluate the osteoconductivity of porous hydroxyapatite used as bone graft substitute. The measurement of Bohler angle, Gissane angle and the degree of articular surface depression was performed through preoperative and postoperative radiographs. The clinical evaluation was performed according to hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS) and scale of the Creighton-Nebraska health foundation (CNHF). Results: Bohler angle and Gissane angle had improved significantly from preoperative average $10.4^{\circ}$, $117.8^{\circ}$ to average $22.6^{\circ}$, $113.5^{\circ}$ immediate postoperatively, and had maintained to average $21.2^{\circ}$ and $114.4^{\circ}$ at the last follow-up. The degree of articular surface depression had improved significantly from preoperative average 4.8 mm to 1.5 mm at the last follow-up. All cases achieved bone union, and the interval to union was average 12.8 weeks. AOFAS score was average 85.2 points at last follow-up. There were 7 excellent, 10 good, and 3 fair results according to the CNHF scale. Therefore, 17 cases (85%) achieved satisfactory results. Conclusion: Plate fixation using porous hydroxyapatite seems to be one of effective treatment methods for intraarticular calcaneal fracture of joint depression type, because of supporting the reduction of subtalar articulation by augmenting bony defect and facilitating bone formation. Further evaluation about long-term radiological changes and histological analysis on hydroxyapatite implantation site should be required.

The Effect of Nutrition Education and Excercise Program on Body Composition and Dietary Intakes, Blood Lipid and Physical Fitness in Obese Women (2) - Relationship between Participation Rates and Effectiveness of Obesity Management Program - (영양교육과 운동중재 프로그램이 성인비만여성의 신체성분과 식이섭취, 혈중지질 및 기초체력에 미치는 효과 (2) - 비만관리 프로그램의 참여율과 프로그램 효과와의 상관성 -)

  • Lee, Hee-Seung;Lee, Ji-Won;Kim, Ji-Myung;Chang, Nam-Soo
    • Journal of Nutrition and Health
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    • v.43 no.3
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    • pp.260-272
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    • 2010
  • This study examined how the participation rates contribute to subjects' outcomes after a nutrition education (once/week) and exercise (3 times/week) intervention program for 12 weeks in 44 obese female subjects. The subjects were divided into two groups: high-participator (HP) or low-participator (LP) groups according to their participation levels based on the median visit value (30 visits out of a total of 48 visits). Daily nutrient intakes assessed by a 24-hour recall, body composition, blood lipid profiles and physical fitness were measured at baseline and after 12 weeks. After the intervention, weight, BMI, percent body fat, and the waist-hip ratio were significantly decreased in the HP group. In addition, the HP group had a greater rates of changes in weight (HP group: -6.6% and LP group: -3.1%, p < 0.01), BMI (-7.0% and -3.2%, p < 0.01), percent body fat (-7.8% and -4.2%, p < 0.05), and waist-hip ratio (-3.1% and -0.4%, p < 0.01) compared to the LP group. Energy-adjusted protein, fiber, potassium, vitamin $B_1$, vitamin $B_6$, and vitamin C were significantly increased in the HP group. The HP group showed a significant increase in HDLcholesterol and a decrease in blood pressure, total cholesterol, LDL-cholesterol, triglycerides, and atherogenic index (AI). While the muscle endurance, muscle strength, power, agility and flexibility were significantly increased in the HP group, agility and balance were improved in the LP group. In addition, dietary behavior score was significantly increased and stress score decreased in the HP group compared to the LP group. High participation rates were correlated with the improvement of the nutrient density (protein, fiber, potassium, Vitamin $B_1$, Vitamin $B_2$, Vitamin $B_6$ and folate), anthropometric parameters (body weight, BMI and percent body fat), serum lipid profiles (HDL-cholesterol, Triglyceride, and AI) and physical fitness (muscle endurance) adjusted for age, menopausal status, alcohol drinking, nutritional supplement use and baseline BMI. Our results suggest that high participation in nutrition education and exercise program was effective not only for weight reduction but also for the improvement of physical fitness in obese women.

Effect of Low Dose Administration of Aprotinin in Pump Priming Solution on Cardiac Surgery (심장수술시 심폐기 충전액에 첨가된 저용량 aprotinin의 효과)

  • Moon, Seong-Min;Choi, Seok-Cheol
    • Journal of Life Science
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    • v.17 no.4 s.84
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    • pp.515-521
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    • 2007
  • Aprotinin, a serine protease inhibitor, has been used to ameliorate the inevitable consequences, including blood component injury after cardiac surgery with cardiopulmonary bypass (CPB). However, there are many arguments on its dosage or usage. We assessed whether administration of low dose of aprotinin in only priming solution has any beneficial effect or reduces its side effects on cardiac surgery. Thirty patients scheduled for elective cardiac surgery were randomly assigned to aprotinin group (n=15) which received aprotinin in priming solution (two million kallikrein inhibitory unit, KIU) and added one million KIU at 1 hour after the beginning of CPB or control group (n=15) which did not receive it. Hematological and biochemical variables, cytokines and cardiac marker levels, and postoperative outcomes were compared between two groups at before, during or after operation. Platelet count in aprotinin group was higher than that of control group at postoperative 24 hr. Activated partial thromboplastin time in aprotinin group was longer than that of control group at intensive care unit (ICU). Troponin-I level and postoperative blood loss volumes in aprotinin group were lower than those of control group at ICU. There were no significant differences between the two groups on the others. These results showed that low dosage of only priming solution during cardiac surgery with CPB reduced platelet destruction and postoperative bleeding, and attenuates myocardial damage. However, further studies need to be carried out with more population or pediatric patients for evaluating various aprotinin usage.

A simulation model for evaluating serological monitoring program of Aujeszky's disease (확률모형을 이용한 오제스키병 혈청학적 모니터링 프로그램 평가)

  • Chang, Ki-Yoon;Pak, Son-Il;Park, Choi-Kyu;Lee, Kyoung-Ki;Joo, Yi-Seok
    • Korean Journal of Veterinary Research
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    • v.49 no.2
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    • pp.149-155
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    • 2009
  • The objective of this study was to analyze data from the planned national serological monitoring program for Aujeszky's disease (AD) using a simulation model to evaluate probable outcomes expected in the sample derived from the simulated herds at predefined within-herd prevalence and herd prevalence. Additionally, prevalence at animal- and herd-level estimated by the stochastic simulation model based on the distributions of the proportion of infected herds and test-positive animals was compared with those of data from a national serological survey in 2006, in which 106,762 fattening pigs from 5,325 herds were tested for AD using a commercial ELISA kit. A fixed value of 95% was used for test sensitivity, and the specificity was modeled with a minimum, most likely and maximum of 95, 97 and 99%, respectively. The within-herd prevalence and herd prevalence was modeled using Pert and Triang distributions, respectively with a minimum, most likely and maximum point values. In all calculations, population size of 1,000 was used due to lack of representative information. The mean number of infected herds and true test-positives was estimated to be 27 herds (median = 25; 95% percentile 44) and 214 pigs (median = 196; 95% percentile 423), respectively. When testing 20 pigs (mean of 2006 survey) in each herd, there was a 3.3% probability that the potential for false-positive reactions due to less than 100% specificity of the ELISA test would be detected. It was found that the model showed prevalence of 0.21% (99% percentile 0.50%) and 0.5% (99% percentile 0.99%) at animal- and herd-level, respectively. These rates were much similar to data from the 2006 survey (0.62% versus 0.83%). The overall mean herd-level sensitivity of the 2006 survey for fattening pigs was 99.9%, with only a 0.2% probability of failing to detect at least one infected herd.

Aesthetic outcomes after surgical repair of pectus excavatum in females: Differences between patients and professional evaluators

  • Wachter, Tanja;Frari, Barbara Del;Edlinger, Michael;Morandi, Evi Maria;Mayerl, Christina;Verstappen, Ralph;Celep, Emre;Djedovic, Gabriel;Kinzl, Johann;Schwabegger, Anton Herbert;Wolfram, Dolores
    • Archives of Plastic Surgery
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    • v.47 no.2
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    • pp.126-134
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    • 2020
  • Background Pectus excavatum is less common in females than in males, and it often aggravates a coexistent breast asymmetry. We conducted a study comparing female patients' versus medical professionals' evaluation of pectus excavatum repair to assess differences in aesthetic outcome ratings. Moreover, we evaluated the influence of surgical correction on patients' self-perception. Methods Of 30 female patients who were initially screened, 18 patients (mean age, 20 years) who underwent bar removal after surgical correction of pectus excavatum deformity participated in the survey (60%). They completed a questionnaire rating their appearance before and after surgery and responded to a psychological questionnaire about the changes that they had experienced. The mean interval between pectus bar removal and evaluation was 28 months. Standardized preoperative and postoperative patient photographs were evaluated using the same questionnaire by a panel of medical professionals and students (n=24) and the results were compared. Results Patients rated their preoperative deformity as more severe than the other evaluators, revealing the significant impact of the deformity on patients' self-perception. Postoperatively, patient and professional evaluations were much better than before and were very similar. The psychological evaluation showed a clear improvement in well-being. The ratings of the medical professionals were not influenced by their degree of medical education. Conclusions Surgical correction of pectus excavatum in female patients positively influences body perception and psychological well-being. It should therefore not be considered as a merely aesthetic correction, but as an important procedure to restore a patient's self-perception.

Convergence Research on Periodic Changes in the Quality Assessment of Surgical Prophylactic Antibiotics (수술 예방항생제 적정성 평가의 주기별 융합 변화 연구)

  • Yang, Sae-Yie;Kim, Kwang-Hwan
    • Journal of Digital Convergence
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    • v.14 no.6
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    • pp.325-333
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    • 2016
  • This study was conducted to provide the base line for the use of prophylactic antibiotics and the standard of antibiotic use and the evaluation based on analysis of current use, quality assessment and periodic changes of prophylactic antibiotics in a university hospital. We chose the year 2008, 2009, 2010, 2012, and 2014 as the study periods since the primary evaluation on the first year of implementation in 2007. For this study, healthcare benefit quality assessment data from the Health Insurance Review and Assessment Service was used. We analyzed the differences each year of treatment period; one category for initial treatment timing, three categories for selecting antibiotics, and two categories for the length of treatment from multiple evaluation indices of gastric surgeries, colorectal surgeries, and cholecystectomy. The analysis revealed the followings: Regarding length of antibiotics treatment, total days of treatment decreased down to 1.5, 1.5, and 0.6 days in the year 2014, from 13.5, 12.8, and 6.9 days in the year 2007, for gastric surgeries, colorectal surgeries, and cholecystectomy. Based on these outcomes, the efforts to devise efficient delivery and distribution of the recommendations or indices which medical staff could adhere for quality improvement of the prophylactic antibiotics would be necessary. Also implementing monitoring system to help the hospitals to acknowledge their own faults may be helpful.