• Title/Summary/Keyword: multi-institutional study

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Impact of positive/close margins in oropharyngeal cancer according to the HPV status (HPV 관련성에 따른 구인두암에서의 positive/close 절제연의 의미)

  • Jung, Yuh-Seog
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.2
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    • pp.1-9
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    • 2018
  • With the emerging knowledge about tumor biology specific for human papillomavirus (HPV)-related head and neck cancers, the classical understanding about the curative surgery in head and neck cancers are starting to progress, customized for their HPV-associations and ultimately specific for tumor biologic characteristics. The common rule for surgery should reflect the biologic characteristics of target tumors, but still, multi-institutional large-scale data could be scarce, due to the subjective feature of surgical treatment itself. However, the impact of HPV for margin determination is now being questioned by multiple groups, and typical example is European Cooperative Oncology Group (ECOG)-3311 study. Here, we review the impact of viral association for surgical decision and its biological background and implications.

Directions for Muti-institutional Cooperation in Follow-up Management of Prostatic Disease Screening for the Low-income Group in Gangwon-do (강원도 저소득층의 전립선질환 검진사업과 사후관리를 위한 유관기관 협력방안)

  • Jang, Sungok;Lee, Jongseok
    • Korean Journal of Health Education and Promotion
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    • v.30 no.4
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    • pp.99-110
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    • 2013
  • Objectives: This study aimed to investigate factors related to prostate disease and follow-up procedure on health examination program in Gangwon-do. Methods: The studied population was 16,501 male aged 40 or more, who underwent screening tests for prostatic disease in 2011 health examination program designed for the low income residents in Gangwon-do. The screening tests included prostate specific antigen (PSA), international symptom score (IPSS), and maximal flow rate (Qmax). We conducted chi-square test for trend, two independent samples t-test, and binary logistic regression to find out the relationship between prostate cancer or benign prostatic hyperplasia and risk factors such as age, PSA level, and IPSS. Results: The number of subjects who turned out positive for PSA level (> 3.8ng/ml) was 971 men accounting for 5.9%. The result of post survey on them showed that 511 subjects (52.6%) got the urology check-up: 156 (30.5%) were diagnosed as normal, 286 (56.0%) as benign prostatic hyperplasia, and 69 (13.5%) as prostate cancer. The detection rate for prostate cancer was 8.8% when PSA level was between 3.81 and 9.99g/ml, and was 30.6% when PSA level was more than 10.00ng/ml. The rates of further testing varied depending on the communities from 26.7% to 68.2%, which was mainly affected by the role of local health center. Conclusions: Our findings indicate that enhanced quality control of local health center and empowerment of screening agency would increase the effort of coupled institutions between public and private sectors.

Diagnostic Accuracy of Percutaneous Transthoracic Needle Lung Biopsies: A Multicenter Study

  • Kyung Hee Lee;Kun Young Lim;Young Joo Suh;Jin Hur;Dae Hee Han;Mi-Jin Kang;Ji Yung Choo;Cherry Kim;Jung Im Kim;Soon Ho Yoon;Woojoo Lee;Chang Min Park
    • Korean Journal of Radiology
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    • v.20 no.8
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    • pp.1300-1310
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    • 2019
  • Objective: To measure the diagnostic accuracy of percutaneous transthoracic needle lung biopsies (PTNBs) on the basis of the intention-to-diagnose principle and identify risk factors for diagnostic failure of PTNBs in a multi-institutional setting. Materials and Methods: A total of 9384 initial PTNBs performed in 9239 patients (mean patient age, 65 years [range, 20-99 years]) from January 2010 to December 2014 were included. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PTNBs for diagnosis of malignancy were measured. The proportion of diagnostic failures was measured, and their risk factors were identified. Results: The overall accuracy, sensitivity, specificity, PPV, and NPV were 91.1% (95% confidence interval [CI], 90.6-91.7%), 92.5% (95% CI, 91.9-93.1%), 86.5% (95% CI, 85.0-87.9%), 99.2% (95% CI, 99.0-99.4%), and 84.3% (95% CI, 82.7-85.8%), respectively. The proportion of diagnostic failures was 8.9% (831 of 9384; 95% CI, 8.3-9.4%). The independent risk factors for diagnostic failures were lesions ≤ 1 cm in size (adjusted odds ratio [AOR], 1.86; 95% CI, 1.23-2.81), lesion size 1.1-2 cm (1.75; 1.45-2.11), subsolid lesions (1.81; 1.32-2.49), use of fine needle aspiration only (2.43; 1.80-3.28), final diagnosis of benign lesions (2.18; 1.84-2.58), and final diagnosis of lymphomas (10.66; 6.21-18.30). Use of cone-beam CT (AOR, 0.31; 95% CI, 0.13-0.75) and conventional CT-guidance (0.55; 0.32-0.94) reduced diagnostic failures. Conclusion: The accuracy of PTNB for diagnosis of malignancy was fairly high in our large-scale multi-institutional cohort. The identified risk factors for diagnostic failure may help reduce diagnostic failure and interpret the biopsy results.

Coordinators' Experiences in Collaborative Practices between Korean Medicine and Western Medicine : A Qualitative Study (한.양방 협진 코디네이터의 실무경험 : 질적 연구)

  • Yu, Min-Hee;Son, Haeng-Mi;Lim, Byung-Mook
    • Journal of Society of Preventive Korean Medicine
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    • v.15 no.3
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    • pp.83-99
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    • 2011
  • Objective : To explore and describe coordinators' experiences in collaborative practices between the traditional Korean medicine doctors and the western medicine doctors. Methods : Five coordinators who agreed and completed the informed consent to take part in this qualitative study were interviewed thoroughly and tape-recorded. Transcribed data were analysed thematically with ground theory. Results : Most participants started their coordinating work without sufficient knowledge and systemic support. They, however, could find their identity as coordinators for collaborative practices through preparing manuals and protocols, providing comprehensive patients care, and experiencing the partnership with doctors. To coordinate Korean medicine and western medicine practices efficiently, participants have tried to enhance their professional knowledge and skills, and establish favorable networks. On the other hand, they were in dilemmas of being a multi-player and imbalance of responsibilities and powers in their jobs. Conclusions : It is recommended to clarify job description of coordinator for collaborative practices, develop training programme, and provide the institutional support for wider recognition of coordinator. Findings from this study should be considered in both Korean medicine-western medicine collaborative research and practice.

AHP Model and a Case Study for Determinants of Overseas Factory Location for Sewing and Apparel Products Industry (AHP를 이용한 봉제·의류제조업의 해외입지선정 모형 및 적용 사례)

  • Kim, Joo-In;Baek, Nakki;Lee, Jae Kwang
    • Journal of the Korea Safety Management & Science
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    • v.16 no.3
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    • pp.377-388
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    • 2014
  • There have been a lot of studies about overseas factory location in order to meet various needs of industries according to the international economic developments. However, most of the studies were written about generic theory for general industries or mainly concerned to high capital industries. This study is focusing on the sewing and apparel industries which represent labor intensive and small-medium type of enterprises. For this study, AHP(Analytic Hierarchy Process) methods were applied to make proper analysis after wide range of survey to clarify determinants which provide a guidance for overseas factory location. As a result of the analytical researches done in the thesis the most important which should be taken consideration while determining of overseas factory location for sewing and apparel products industry are as follows - economic factors(0.569), geographic factors(0.171), social and cultural factors(0.157), regulations and institutional factors(0.103). In the last, S company is examined for example to show how this determinants have practically been applied.

Determinants of Business Education on Student Satisfaction in Higher Education: A Case Study in Cambodia

  • LONG, Sovang;DUANG-EK-ANONG, Somsit;VONGURAI, Rawin
    • The Journal of Asian Finance, Economics and Business
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    • v.8 no.3
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    • pp.1405-1416
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    • 2021
  • The study uses an innovative management perspective to investigate the environment of higher education institutions to ensure the survival of universities in Cambodia. This has led Cambodian universities to expand their educational offerings to students in Years 2, 3 and 4. The data was collected through a Google Forms survey to facilitate and accelerate data collection. The sample of 500 students come from three higher education institution by employing multi-stage sampling technique of probability and non-probability sampling methods to ensure representation of the research population. The data were analyzed by using Confirmatory Factor Analysis (CFA) and Structural Equation Model (SEM) to investigate the impact of these determinants on students' satisfaction and loyalty, via answering 54 questions. The results showed that the three Cambodian universities perform well in terms of satisfactory conditions such as transformative quality and university image. There are four issues to which universities need to pay attention, namely, teaching methods, infrastructure facilities, learning material, and academic environment that are yet to meet the needs of students. This study contributes to the principle of innovative management in the context of Cambodian academic environment. The results help to fathom the depth of enhancing quality and institutional survival.

Survival in Head and Neck Cancers - Results of A Multi-Institution Study

  • Nandakumar, Ambakumar
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1745-1754
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    • 2016
  • Background: The prime output of Hospital Based Cancer Registries is stage and treatment based survival to evaluate patient care, but because of challenges of obtaining follow-up details a separate study on Patterns of Care and Survival for selected sites was initiated under the National Cancer Registry Programme of India. The results of stage and treatment based survival for head and neck cancers by individual organ sites are presented. Materials and Methods: A standardized Patient Information Form recorded the details and entered on-line at www.hbccrindia.org to a central repository - National Centre for Disease Informatics and Research. Cases from 12 institutions diagnosed between 1 January 2006 and 31 December 2008 comprised the study subjects. The patterns of treatment were examined for 14053 and survival for 4773 patients from five institutions who reported at least 70% follow-up as of 31 December 2012. Results: Surgical treatment with radiation for cancer tongue and mouth showed five year cumulative survival (FCS) of 67.5% and 60.4% respectively for locally advanced stage. Chemo-radiation compared to radiation alone showed better survival benefit of around 15% in both oro and hypo-pharyngeal cancers and their FCS was 40.0%; Hazard Ratio (HR):1.5;CI=1.2-1.9) and 38.7%; (HR):1.7; CI=1.3-2.2). Conclusions: The awareness about the requirement of concurrent chemo-radiation in specifically cancers of the oro and hypopharynx has to be promoted in developing countries. The annual (2014) estimate number of new Head and Neck cancers with locally advanced disease in India is around 140,000 and 91,000 (65%) patients do not receive the benefit of optimal treatment with ensuing poorer survival.

A Study on the Improvement of Multi-Agency R&D Program for Strategic Budget Allocation and Enhance Effectiveness (전략적 예산배분 및 실효성 강화를 위한 다부처R&D사업의 개선방안에 관한 연구)

  • Moon, Kwansik;Kim, Eun Jeong
    • Journal of Digital Convergence
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    • v.14 no.6
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    • pp.9-19
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    • 2016
  • Since continuous expand in governmental R&D investments and growth number of research institutions, model of multi-agency program has been planned and pushed ahead to settle the inefficiency of investment by the scattered and competitive R&D Programs. However, it was often pointed out that new model's effect has been fall because the institutional inertia of cooperative system between agencies. In this study, we analyze the current state of multi-agency program and suggest the optimal R&D governance model to improve a better direction. Afterward, several problems were turned up and that allocation and execution of the R&D budget separately, less coordination and cooperation among agencies, and absence of typical evaluation system of multi-agency program. Therefore, we suggest some of improvements by analyzing each steps.

Association between Lymphovascular Invasion and Recurrence in Patients with pT1N+ or pT2-3N0 Gastric Cancer: a Multi-institutional Dataset Analysis

  • Fujita, Keizo;Kanda, Mitsuro;Ito, Seiji;Mochizuki, Yoshinari;Teramoto, Hitoshi;Ishigure, Kiyoshi;Murai, Toshifumi;Asada, Takahiro;Ishiyama, Akiharu;Matsushita, Hidenobu;Tanaka, Chie;Kobayashi, Daisuke;Fujiwara, Michitaka;Murotani, Kenta;Kodera, Yasuhiro
    • Journal of Gastric Cancer
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    • v.20 no.1
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    • pp.41-49
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    • 2020
  • Purpose: Patients with pathological stage T1N+ or T2-3N0 gastric cancer may experience disease recurrence following curative gastrectomy. However, the current Japanese Gastric Cancer Treatment Guidelines do not recommend postoperative adjuvant chemotherapy for such patients. This study aimed to identify the prognostic factors for patients with pT1N+ or pT2-3N0 gastric cancer using a multi-institutional dataset. Materials and Methods: We retrospectively analyzed the data obtained from 401 patients with pT1N+ or pT2-3N0 gastric cancer who underwent curative gastrectomy at 9 institutions between 2010 and 2014. Results: Of the 401 patients assessed, 24 (6.0%) experienced postoperative disease recurrence. Multivariate analysis revealed that age ≥70 years (hazard ratio [HR], 2.62; 95% confidence interval [CI], 1.09-7.23; P=0.030) and lymphatic and/or venous invasion (lymphovascular invasion (LVI): HR, 7.88; 95% CI, 1.66-140.9; P=0.005) were independent prognostic factors for poor recurrence-free survival. There was no significant association between LVI and the site of initial recurrence. Conclusions: LVI is an indicator of poor prognosis in patients with pT1N+ or pT2-3N0 gastric cancer.

Low-Tube-Voltage CT Urography Using Low-Concentration-Iodine Contrast Media and Iterative Reconstruction: A Multi-Institutional Randomized Controlled Trial for Comparison with Conventional CT Urography

  • Kim, Sang Youn;Cho, Jeong Yeon;Lee, Joongyub;Hwang, Sung Il;Moon, Min Hoan;Lee, Eun Ju;Hong, Seong Sook;Kim, Chan Kyo;Kim, Kyeong Ah;Park, Sung Bin;Sung, Deuk Jae;Kim, Yongsoo;Kim, You Me;Jung, Sung Il;Rha, Sung Eun;Kim, Dong Won;Lee, Hyun;Shim, Youngsup;Hwang, Inpyeong;Woo, Sungmin;Choi, Hyuck Jae
    • Korean Journal of Radiology
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    • v.19 no.6
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    • pp.1119-1129
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    • 2018
  • Objective: To compare the image quality of low-tube-voltage and low-iodine-concentration-contrast-medium (LVLC) computed tomography urography (CTU) with iterative reconstruction (IR) with that of conventional CTU. Materials and Methods: This prospective, multi-institutional, randomized controlled trial was performed at 16 hospitals using CT scanners from various vendors. Patients were randomly assigned to the following groups: 1) the LVLC-CTU (80 kVp and 240 mgI/mL) with IR group and 2) the conventional CTU (120 kVp and 350 mgI/mL) with filtered-back projection group. The overall diagnostic acceptability, sharpness, and noise were assessed. Additionally, the mean attenuation, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM) in the urinary tract were evaluated. Results: The study included 299 patients (LVLC-CTU group: 150 patients; conventional CTU group: 149 patients). The LVLC-CTU group had a significantly lower effective radiation dose ($5.73{\pm}4.04$ vs. $8.43{\pm}4.38mSv$) compared to the conventional CTU group. LVLC-CTU showed at least standard diagnostic acceptability (score ${\geq}3$), but it was non-inferior when compared to conventional CTU. The mean attenuation value, mean SNR, CNR, and FOM in all pre-defined segments of the urinary tract were significantly higher in the LVLC-CTU group than in the conventional CTU group. Conclusion: The diagnostic acceptability and quantitative image quality of LVLC-CTU with IR are not inferior to those of conventional CTU. Additionally, LVLC-CTU with IR is beneficial because both radiation exposure and total iodine load are reduced.