• 제목/요약/키워드: multicenter

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Factors Associated with Gastric and Duodenal Neuroendocrine Tumor Development

  • Kwangwoo Nam;Su Youn Nam
    • Journal of Digestive Cancer Research
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    • 제12권1호
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    • pp.1-5
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    • 2024
  • The incidence and prevalence of upper gastrointestinal neuroendocrine tumors (NETs), including gastric NETs (GNETs) and duodenal NETs (DNETs), have been gradually increasing. These trends may be associated with the increased use of health checkups, which includes upper endoscopy, in conjunction with better disease recognition. However, the clinical factors associated with GNETs and DNETs remain unknown; previous studies revealed discrepancies. Recently, metabolic disorders have been indicated as potential factors that are associated with GNETs and DNETs. This review summarizes the results of previous studies and briefly introduces the results of a recent Korean multicenter study on the factors associated with GNETs and DNETs.

Big Data Research on Severe Asthma

  • Sang Hyuk Kim;Youlim Kim
    • Tuberculosis and Respiratory Diseases
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    • 제87권3호
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    • pp.213-220
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    • 2024
  • The continuously increasing prevalence of severe asthma has imposed an increasing burden worldwide. Despite the emergence of novel therapeutic agents, management of severe asthma remains challenging. Insights garnered from big data may be helpful in the effort to determine the complex nature of severe asthma. In the field of asthma research, a vast amount of big data from various sources, including electronic health records, national claims data, and international cohorts, is now available. However, understanding of the strengths and limitations is required for proper utilization of specific datasets. Use of big data, along with advancements in artificial intelligence techniques, could potentially facilitate the practice of precision medicine in management of severe asthma.

Flow diverter stenting for intracranial aneurysms in the pediatric population: Two case reports and literature review

  • Akram M Eraky;Christina Feller;Hatem Tolba;Mokshal Porwal;Raphael H. Sacho;Hirad Hedayat
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • 제26권1호
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    • pp.58-64
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    • 2024
  • The Pipeline Embolization Device (PED) is a flow-diverting intraluminal device that is approved for use in adults 18 years or older with internal carotid artery aneurysms. However, it can also be used off-label in pediatric patients with aneurysms that cannot be resolved with traditional endovascular treatments. Herein, we present two cases of flow diversion in the pediatric population with complete obliteration of the aneurysm and excellent outcomes. Flow diversion has been shown to be a safe endovascular option in treating complex aneurysms in children. Larger-sized, multicenter trials are encouraged to compare outcomes between flow diversion and other aneurysm treatment options given the rarity of pediatric aneurysms.

Long-Term Survival Outcomes of Elderly Patients Treated With S-1 or Capecitabine Plus Oxaliplatin for Stage II or III Gastric Cancer: A Multicenter Cohort Study

  • Choi, Seohee;Min, Jae-Seok;Jeong, Sang-Ho;Yoo, Moon-Won;Son, Young-Gil;Oh, Sung Jin;Kim, Jong-Han;Park, Joong-Min;Hur, Hoon;Jee, Ye Seob;Hwang, Sun-Hwi;Jin, Sung-Ho;Lee, Sang Eok;Lee, Young-Joon;Seo, Kyung Won;Park, Sungsoo;Lee, Chang Min;Kim, Chang Hyun;Jeong, In Ho;Lee, Han Hong;Choi, Sung Il;Lee, Sang-Il;Kim, Chan-Young;Chae, Hyundong;Son, Myoung-Won;Pak, Kyung Ho;Kim, Sungsoo;Lee, Moon-Soo;Kim, Hyoung-Il
    • Journal of Gastric Cancer
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    • 제22권1호
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    • pp.67-77
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    • 2022
  • Purpose: Tegafur/gimeracil/oteracil (S-1) and capecitabine plus oxaliplatin (CAPOX) are standard adjuvant chemotherapies (ACs) administered after gastrectomy to patients with stage II or III gastric cancer. However, the efficacy of AC in elderly patients remains unclear. The objective of this retrospective multicenter cohort study was to compare the efficacies of S-1 and CAPOX AC in patients aged ≥70 years. Materials and Methods: Nine hundred eighty-three patients who were treated with AC using S-1 (768 patients) or CAPOX (215 patients) were enrolled in this study. Each patient underwent AC after curative gastrectomy for stage II or III gastric cancer at one of 27 hospitals in the Republic of Korea between January 2012 and December 2013. Relapse-free survival (RFS) and overall survival (OS) were analyzed according to AC regimen and age group. Results: Of the 983 patients, 254 (25.8%) were elderly. This group had a similar RFS (P=0.099) but significantly poorer OS (p=0.003) compared with the non-elderly group. Subgroup analysis of the non-elderly group revealed no AC-associated differences in survival. Subgroup analysis of the elderly group revealed significantly better survival in the S-1 group than in the CAPOX group (RFS, P<0.001; OS, P<0.001). Multivariate analysis revealed that the CAPOX regimen was an independent poor prognostic factor for RFS (hazard ratio [HR], 1.891; 95% confidence interval [CI], 1.072-3.333; P=0.028) and OS (HR, 2.970; 95% CI, 1.550-5.692; P=0.001). Conclusions: This multicenter observational cohort study found significant differences in RFS and OS between S-1 and CAPOX AC among patients with gastric cancer aged ≥70 years.

한국인 다기관 암 코호트 시료의 DNA 생활성도 평가 (Assessment of DNA Viability in Long term-Stored Buffy Coat Species for the Korean Multicenter Cancer Cohort)

  • 양미희;유지현;김청식;신애선;강대희;장성훈;박수경;신해림;유근영
    • Journal of Preventive Medicine and Public Health
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    • 제36권4호
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    • pp.373-376
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    • 2003
  • Objectives : Peripheral blood-buffy coat fractions (N=14,956) have been stored at $-70^{\circ}C$ in the headquarter of the Korean Multicenter Cancer Cohort (KMCC), since 1993. To study the future molecular etiology of cancers using specimens of the cohort, properly stored specimens are necessary, Therefore, the DNA-viability of the bully coat samples was investigated. Methods : Buffy coat fraction samples were randomly selected from various collection areas and years (N=100). The DNA viability was evaluate from the UV-absorbent ratios at 260/280nm and the PCH for $\beta$-globin was performed with genomic DNA isolated from the buffy coat. Results : PCR products were obtained from 85 and 98% of the C and H area-samples, respectively, using 50 or $100{\mu}l$ of the buffy coat. There were significant differences in the yields of the PCR-amplifications from the C and H areas (p<0.05), which was due to differences in the homogenization of the buffy coat fractions available as aliquots. The PCR-products were obtained from all of the samples (N=7) stored at the C area-local confer, but the other aliquots stored at the headquarter were not PCR-amplified, Therefore, the PCR products in almost all the samples, even including the DNA-degraded samples, were obtained. In addition, an improvement in the DNA isolation, i,e. approx. 1.6 fold, was found after using extra RBC lysis buffer. Conclusions : PCR products for $\beta$-globin were obtained from nearly all of the samples. The regional differences in the PCR amplifications were thought to have originated from the different sample-preparation and homogenization performance. Therefore, the long term-stored buffy coat species at the KMCC can be used for future molecular studies.

외상후 스트레스장애 환자군의 알코올, 담배 및 약물 사용-다기관 병원 대상 연구 (Consumption of Alcohol, Cigarettes, and Drugs in Patients with Posttraumatic Stress Disorder-Korean Multicenter Hospital Samples)

  • 이주영;이하민;서호준;우영섭;김태석;채정호
    • 대한불안의학회지
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    • 제3권1호
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    • pp.41-45
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    • 2007
  • Objective : The present study investigates patterns of consumption of alcohol, cigarettes, and over the counter drugs (OTC) in Korean patients with PTSD and psychiatric patient controls and healthy controls from multicenter hospital samples. Method : Data were collected from 18 hospitals nationwide. Patients with PTSD were compared with nonpsychotic psychiatric disorders control and healthy control subjects on psychometric measures of consumption of alcohol, cigarettes, and OTC drugs. Result : Ninety-three patients with PTSD, 73 patients with psychiatric disorders control, and 88 healthy control subjects were enrolled. There were significant differences in the frequency of alcohol drinking among the three groups ($X^2$=12.93, df=6, p=0.044). Only 3.2% of healthy control subjects drank alcohol more than 4 times a week, but 43.9% of PTSD group and 46.5% of mental disorder controls drank alcohol more than 4 times a week, respectively. Regarding cigarette smoking, there were no differences among the three groups. There were significant differences in uses of OTC drugs among the three groups; 16.7 % in the PTSD group, 14.9% in the psychiatric control group and 1.3% in the heath control group, respectively ($X^2$=11.31, df=2, p=0.004). Conclusion : In this study, patients with PTSD showed significant differences in the frequency of consumption of alcohol and OTC drugs, as compared with healthy controls. However, there were no differences between the PTSD and psychiatric patient control groups. Since all subjects were enrolled from hospital based sample, results may differ in the community samples. Further studies will be needed for the evaluation of substance uses in these groups.

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An Early Experience of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in the Republic of Korea: A Retrospective Multicenter Study

  • Park, Joonhyeon;Jang, Sung Woo;Yu, Byungchul;Lee, Gil Jae;Chang, Sung Wook;Kim, Dong Hun;Chang, Ye Rim;Jung, Pil Young
    • Journal of Trauma and Injury
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    • 제33권3호
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    • pp.144-152
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    • 2020
  • Purpose: This retrospective multicenter study analyzed trauma patients who underwent resuscitative endovascular balloon occlusion of the aorta (REBOA) in the Republic of Korea. Methods: This study was conducted from February 2017 to May 2018 at three regional trauma centers in the Republic of Korea. The patients were divided into two groups (cardiopulmonary resuscitation [CPR] and No-CPR) for comparative analysis based on two criteria (complication and mortality) for logistic regression analysis (LRA). Results: There were significant differences between the CPR and No-CPR groups in mortality (p=0.003) and treatment administered (p=0.016). By LRA for complications, total occlusion has significantly lesser risk than intermittent or partial occlusion in both univariate (odds ratio [OR] 0.06, 95% confidence interval [CI] 0.00-0.36, p=0.01) and multivariate (OR 0.05, 95% CI 0.00-0.38, p=0.01) analyses. The Rescue had a higher risk than the Coda or Reliant in univariate analysis (OR 4.91, 95% CI 1.14-34.25, p=0.05); however, it was not statistically significant in multivariate analysis (OR 6.98, 95% CI 1.03-74.52, p=0.07). By LRA for mortality, the CPR group was the only variable that had a significantly higher risk of mortality than the No-CPR group in both univariate (OR 17.59, 95% CI 3.05-335.25, p=0.01), and multivariate (OR 24.92, 95% CI 3.77-520.51, p=0.01) analyses. Conclusions: This study was conducted in the early stages of REBOA implementation in the Republic of Korea and showed conflicting results from studies conducted by multiple institutions. Therefore, additional research with more accumulated data is needed.

Clinical Efficacy and Safety of Gyebutang Granules Combined with Acupuncture for the Treatment of Knee Osteoarthritis: Protocol for a Multicenter, Randomized, Assessor-blinded, 2-armed Parallel, Controlled Trial

  • Lee, Cham-Kyul;Kang, Ha-Ra;Lee, Yeon-Sun;Sung, Won-Suk;Lim, Chi-Yeon;Jung, Chan-Yung;Kim, Eun-Jung;Seo, Byung-Kwan;Baek, Yong-Hyeon;Kim, Kyung-Ho;Lee, Eun-Young
    • Journal of Acupuncture Research
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    • 제37권2호
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    • pp.102-109
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    • 2020
  • Background: Due to the aging population in Korea, knee osteoarthritis (KOA) has become an increasingly common condition. Many patients with KOA prefer analgesics, herbal medicines, acupuncture, or exercise, rather than arthroscopic surgery or a knee replacement. Gyebutang (GB) granules are a herbal extract widely used to treat KOA in traditional Korean medicine, but there is insufficient evidence of its efficacy and safety. Methods: A multicenter, randomized, assessor-blinded, 2-armed parallel, controlled clinical trial has been designed to investigate the efficacy and safety of GB combined with acupuncture for the treatment of KOA. There will be 100 patients with KOA enrolled in the study from 3 traditional Korean medicine hospitals. The participants will be randomly allocated to an experimental group (GB and acupuncture) or a control group (celecoxib and acupuncture) in a 1:1 ratio. Both groups will receive acupuncture treatment once a week for 6 weeks; one group will receive GB and the other will receive celecoxib for the same duration. Results: The primary outcome will be the change of knee osteoarthritic pain, based on scores on a 100 mm visual analog scale. The secondary outcomes will be scores on a numeric rating scale, the Western Ontario and McMaster Universities osteoarthritis index, patient global assessment, European quality of life 5-dimension 5-level scale, and adverse events. Conclusion: The results of this study will provide evidence of efficacy and safety of GB as a treatment for patients with KOA.

치과 치료를 위한 외래 정주진정 법에 대한 다기관 후향적 임상연구 (A MULTICENTER RETROSPECTIVE STUDY OF OUTPATIENT INTRAVENOUS SEDATION FOR DENTAL TREATMENTS)

  • 정세화;백상현;노현기;강나라;임재중;이병하;전재윤;황경균;심광섭;박창주
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제31권5호
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    • pp.394-400
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    • 2009
  • Purpose : On outpatient facilities, our sedation protocol focuses on the intermittent bolus injections of midazolam intravenously, according to patient's and operator's needs during the dental treatment. This multicenter retrospective study was aimed to prove the efficiency and safety of our sedation protocol. Patients and Methods : In three centers using the same outpatient sedation protocol for dental treatment (Division of Oral and Maxillofacial Surgery/Department of Dentistry in Hanyang University Medical Center, S-plant Dental Hospital. and Grand Oral and Maxillofacial Surgery), total 937 patients had various dental treatments under intravenous conscious sedations with independent patient monitoring from March 2006 to March 2009. By reviewing charts, we analyzed the results of sedation and dental treatment, retrospectively. Results : Our sedation protocol had no severe postoperative complications requiring admission. while showing good compatibility with almost all dental treatments, with acceptable satisfaction of both patients and operators. Conclusion : We assure that our sedation protocol can be used efficiently and safely on routine outpatient basis. We also hope that this study will provide the concrete concepts to common dental practitioners, who desire to perform sedation for dental treatment.

Characteristics of Upper Gastrointestinal Tract Involvement in Korean Pediatric Crohn's Disease: A Multicenter Study

  • Park, Ji Hyoung;Nam, Hye Na;Lee, Ji-Hyuk;Hong, Jeana;Yi, Dae Yong;Ryoo, Eell;Jeon, In Sang;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제20권4호
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    • pp.227-235
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    • 2017
  • Purpose: Crohn's disease (CD) can involve any site of the gastrointestinal tract (GIT). However, the characteristics of upper GIT involvement in CD are unclear, especially in the Eastern pediatric population. This study aimed to estimate the prevalence of upper GIT involvement and identify the clinical features of Korean children with CD. Methods: This was a retrospective multicenter cohort study that included 52 pediatric patients with CD who underwent esophagogastroduodenoscopy and biopsy. The clinical symptoms and endoscopic and histologic features of the upper GIT were identified according to the presence or absence of upper gastrointestinal symptoms. Results: Among the 52 patients, upper GIT involvement was noted in 50.0% (26/52). The mean age at CD diagnosis was $14.1{\pm}2.1$ years. Gastric ulcer was the most common lesion (19.2%) found on upper GIT endoscopy, followed by duodenal ulcers (15.4%). Chronic inflammation was the most common histopathologic feature (75.0%), followed by gastric erosion (17.3%). Granuloma was found in 9.6% of patients. Helicobacter pylori infection was identified in 5.8% of patients. Endoscopic and histologic findings were not significantly different, but the mean values of erythrocyte sedimentation rate ($60.7{\pm}27.1$ vs. $43.0{\pm}27.6mm/h$, p=0.037) and C-reactive protein ($16.5{\pm}28.2$ vs. $6.62{\pm}13.4mg/dL$, p=0.014) were significantly different between patients with and without upper gastrointestinal CD symptoms. Conclusion: Upper GIT involvement was relatively common in pediatric patients with CD irrespective of upper gastrointestinal symptoms, and H. pylori infection was relatively uncommon. The results of this study should aid the establishment of regional guidelines for upper GIT examination.