• Title/Summary/Keyword: patient recruitment

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Effect of the pulmonary recruitment maneuver on pain after laparoscopic gynecological oncologic surgery: a prospective randomized trial

  • Gungorduk, Kemal;Asicioglu, Osman;Ozdemir, Isa Aykut
    • Journal of Gynecologic Oncology
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    • 제29권6호
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    • pp.92.1-92.9
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    • 2018
  • Objective: To evaluate the effectiveness of the pulmonary recruitment maneuver (PRM) at the end of the operation to decrease laparoscopy-induced abdominal or shoulder pain after gynecological oncologic surgery. Methods: In total, 113 women undergoing laparoscopic surgery for malignant or premalignant gynecological lesions were assigned randomly to two groups: the PRM group (the patient was placed in the Trendelenburg position ($30^{\circ}$) and the PRM, consisting of two manual pulmonary inflations to a maximum pressure of $40cmH_2O$) (n=54) and the control group (n=52). Postoperative shoulder and abdominal pain was assessed 12, 24, and 48 hours later using a visual analog scale (0-10). In addition, the incidence of post-discharge nausea and vomiting was recorded until 48 hours after discharge. Results: Postoperative shoulder pain at 12 and 24 hours was significantly less severe in the PRM group ($2.2{\pm}0.5$ and $2.0{\pm}0.4$) than in the control group ($4.0{\pm}0.5$ and $3.9{\pm}0.4$; both p<0.001). The PRM significantly reduced the severity of upper abdominal pain at 12 and 24 h compared with the control group ($3.1{\pm}0.4$ and $2.9{\pm}0.4$ vs. $2.9{\pm}0.5$ and $4.9{\pm}0.5$; both p<0.001). The analgesic requirement during the postoperative period was similar in the two groups (control group, 78.8%; PRM group, 75.9%; p=0.719). Conclusion: The PRM effectively and safely reduced postoperative shoulder and upper abdominal pain levels in patients undergoing laparoscopic gynecological oncologic surgery. Trial registry at ClinicalTrials.gov, NCT01940042.

The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD): A Korean Chronic Kidney Disease Cohort

  • Oh, Kook-Hwan;Park, Sue K.;Kim, Jayoun;Ahn, Curie
    • Journal of Preventive Medicine and Public Health
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    • 제55권4호
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    • pp.313-320
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    • 2022
  • The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) was launched in 2011 with the support of the Korea Disease Control and Prevention Agency. The study was designed with the aim of exploring the various clinical features and characteristics of chronic kidney disease (CKD) in Koreans, and elucidating the risk factors for CKD progression and adverse outcomes of CKD. For the cohort study, nephrologists at 9 tertiary university-affiliated hospitals participated in patient recruitment and follow-up. Biostatisticians and epidemiologists also participated in the basic design and structuring of the study. From 2011 until 2016, the KNOW-CKD Phase I recruited 2238 adult patients with CKD from stages G1 to G5, who were not receiving renal replacement therapy. The KNOW-CKD Phase II recruitment was started in 2019, with an enrollment target of 1500 subjects, focused on diabetic nephropathy and hypertensive kidney diseases in patients with reduced kidney function who are presumed to be at a higher risk of adverse outcomes. As of 2021, the KNOW-CKD investigators have published articles in the fields of socioeconomics, quality of life, nutrition, physical activity, renal progression, cardiovascular disease and outcomes, anemia, mineral bone disease, serum and urine biomarkers, and international and inter-ethnic comparisons. The KNOW-CKD researchers will elaborate a prediction model for various outcomes of CKD such as the development of end-stage kidney disease, major adverse cardiovascular events, and death.

IRB review points for studies utilizing paraffin blocks archived in the pathology laboratory

  • Kim, Yong-Jin;Jeong, Chang Rok;Park, Jeong Sik
    • Journal of Yeungnam Medical Science
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    • 제35권1호
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    • pp.36-39
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    • 2018
  • In the personalized medicine era, utilizing paraffin blocks in pathology archives for investigating human diseases has come into the limelight. This archived material with clinical data will reduce the research time and could prevent new patient recruitment to obtain tissue for research. However, the clause indicating the necessity of consent from human material providers in the Korean Bioethics and Safety Act has made the Institutional Review Board (IRB) deny permission to use paraffin blocks for research without consent, and alternatively to get the same before starting an experiment. Written consent may be waived off in studies using paraffin blocks with anonymous status or conditions not linked to personal information by applying the paragraph 3, article 16 of the current Bioethics and Safety Act. Also, the IRB should recommend researchers to preserve the blocks as medical records of patients in long-term archives.

Regulation of post-translational modification in breast cancer treatment

  • Heo, Kyung-Sun
    • BMB Reports
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    • 제52권2호
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    • pp.113-118
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    • 2019
  • The small ubiquitin-related modification molecule (SUMO), one of the post-translational modification molecules, is involved in a variety of cellular functions where it regulates protein activity and stability, transcription, and cell cycling. Modulation of protein SUMOylation or deSUMOylation modification has been associated with regulation of carcinogenesis in breast cancer. In the dynamic processes of SUMOylation and deSUMOylation in a variety of cancers, SUMO proteases (SENPs), reverse SUMOylation by isopeptidase activity and SENPs are mostly elevated, and are related to poor patient prognosis. Although underlying mechanisms have been suggested for how SENPs participate in breast cancer tumorigenesis, such as through regulation of target protein transactivation, cancer cell survival, cell cycle, or other post-translational modification-related machinery recruitment, the effect of SENP isoform-specific inhibitors on the progression of breast cancer have not been well evaluated. This review will introduce the functions of SENP1 and SENP2 and the underlying signaling pathways in breast cancer for use in discovery of new biomarkers for diagnosis or therapeutic targets for treatment.

Functional Reorganization Associated with Semantic Language Processing in Temporal Lobe Epilepsy Patients after Anterior Temporal Lobectomy: A Longitudinal Functional Magnetic Resonance Image Study

  • Kim, Jae-Hun;Lee, Jong-Min;Kang, Eun-Joo;Kim, June-Sic;Song, In-Chan;Chung, Chun-Kee
    • Journal of Korean Neurosurgical Society
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    • 제47권1호
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    • pp.17-25
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    • 2010
  • Objective: The focus of this study is brain plasticity associated with semantic aspects of language function in patients with medial temporal lobe epilepsy (mTLE) Methods: Using longitudinal functional magnetic resonance imaging (fMRI), patterns of brain activation were observed in twelve left and seven right unilateral mTLE patients during a word-generation task relative to a pseudo-word reading task before and after anterior temporal section surgery. Results: No differences were observed in precentral activations in patients relative to normal controls (n = 12), and surgery did not alter the phonological-associated activations. The two mTLE patient groups showed left inferior prefrontal activations associated with semantic processing (word-generation>pseudo-word reading), as did control subjects. The amount of semantic-associated activation in the left inferior prefrontal region was negatively correlated with epilepsy duration in both patient groups. Following temporal resection, semantic-specific activations in inferior prefrontal region became more bilateral in left mTLE patients, but more left-lateralized in right mTLE patients. The longer the duration of epilepsy in the patients, the larger the increase in the left inferior prefrontal semantic-associated activation after surgery in both patient groups. Semantic activation of the intact hippocampus, which had been negatively correlated with seizure frequency, normalized after the epileptic side was removed. Conclusion: These results indicate alternation of semantic language network related to recruitment of left inferior prefrontal cortex and functional recovery of the hippocampus contralateral to the epileptogenic side, suggesting an intra- and inter-hemispheric reorganization following surgery.

Age of Data in Contemporary Research Articles Published in Representative General Radiology Journals

  • Kang, Ji Hun;Kim, Dong Hwan;Park, Seong Ho;Baek, Jung Hwan
    • Korean Journal of Radiology
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    • 제19권6호
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    • pp.1172-1178
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    • 2018
  • Objective: To analyze and compare the age of data in contemporary research articles published in representative general radiology journals. Materials and Methods: We searched for articles reporting original research studies analyzing patient data that were published in the print issues of the Korean Journal of Radiology (KJR), European Radiology (ER), and Radiology in 2017. Eligible articles were reviewed to extract data collection period (time from first patient recruitment to last patient follow-up) and age of data (time between data collection end and publication). The journals were compared in terms of the proportion of articles reporting the data collection period to the level of calendar month and regarding the age of data. Results: There were 50, 492, and 254 eligible articles in KJR, ER, and Radiology, respectively. Of these, 44 (88%; 95% confidence interval [CI]: 75.8-94.8%), 359 (73%; 95% CI: 68.9-76.7%), and 211 (83.1%; 95% CI: 78-87.2%) articles, respectively, provided enough details of data collection period, revealing a significant difference between ER and Radiology (p = 0.002). The age of data was significantly greater in KJR (median age: 826 days; range: 299-2843 days) than in ER (median age: 570 days; range: 56-4742 days; p < 0.001) and Radiology (median age: 618; range: 75-4271 days; p < 0.001). Conclusion: Korean Journal of Radiology did not fall behind ER or Radiology in reporting of data collection period, but showed a significantly greater age of data than ER and Radiology, suggesting that KJR should take measures to improve the timeliness of its data.

도플러 초음파 기기를 이용한 편측 부전마비성 뇌졸중 환자와 정상인의 말초 혈류 비교 연구 (Comparison of Peripheral Blood Flow in Post-Stroke Hemiparetic Patients and Normal Person with Doppler Ultrasonography)

  • 한덕진;방창호;세르게이 김;배영민;신새론;양충용;이인
    • 동의생리병리학회지
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    • 제23권6호
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    • pp.1491-1496
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    • 2009
  • Stroke is usually associated with the cerebral blood flow of the central nervous system. However, studies concerning the effects of neurologic sysmptoms induced from stroke on the peripheral blood flow has not taken place sufficiently. To ascertain the feasibility of a blood flow meter adopting to use doppler ultrasonogrphy, under the prospect that hemiparesis induced from stroke may have effect on the peripheral blood flow, the peripheral blood flow velocity was observed. The control group made up of healthy people without any factors capable of effecting the peripheral blood flow velocity, and patient group which consist of hemiparetic people induced from stroke, were recruited. Volumes of recruitment are 21 persons in the patient group, and 29 persons in the control group, but the final numbers of people are 17 and 21 respectively because of the inconsistancy in the method of the test. The non-invasive method of Doppler effect of Ultrasound was used to measure the blood flow velocity. The blood flow velocity in the peripheral part of left and right fourth fingers:dorsal branches of proper palmar digital artery to dorsum of distal phalanges, was measured in the control group and patient group through Doppler Ultrasound. In comparison of the control group and the patient group, the systolic blood flow velocity from the peripheral part of the upper extremity was lower in the patient group than that of the control group. According to such results, it is concluded that hemiparesis induces the reduction of the peripheral blood flow velocity in the systolic phase.

간호사 및 간호조무사 활용에 관한 개업의사의 의견조사 (A survey of private physician's opinion on utilization of nursing manpower)

  • 김진순
    • 농촌의학ㆍ지역보건
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    • 제22권1호
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    • pp.75-83
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    • 1997
  • The medical insurance system has been adopted in 1989. Since then, the utilization of medical care services has increased rapidly. It appears that the medical institution needs more nursing manpower such as nurses and nurse aides to meet an increased demand for medical care for the residents. However, the medical care clinics run by a medical practitioners has a more shortage of nursing manpower than hospitals. The purpose of this survey was to analyze the current employment status and to obtain an opinion on the improvement of utilization such as recruitment and retention of nursing manpower. The questionnaire sent to the private physician and the response rate was 28.7% ; 87 out of 300 physicians. 82.6% of the respondents employed nurses aides rather than nurses and an average number of employees per clinic was 2.5 persons. Most physicians had difficulties in recruiting nursing manpower. It took more than one month for replacement on average, therefore, they were suffering from giving good continual care for the patient and also high resignation of nursing personnel. The low wage, long working hours, hard work and lack of incentives are the biggest reasons for the difficulty in recruiting and retaining of the nursing personnel obtained for the clinics survey. The above mentioned problems would be solved in the near future by changing those difficulties. In the meantime, the private physicians are marking an effort to retain the nursing personnel by keeping a relationship of the private physician's cooperatives.

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이압요법이 항암화학요법을 받는 유방암 환자의 불안 및 수면에 미치는 효과 (Effects of Auricular Acupressure on Anxiety and Sleep among Patients Undergoing Chemotherapy for Breast Cancer)

  • 강미애;여형남
    • 보건의료산업학회지
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    • 제13권3호
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    • pp.81-92
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    • 2019
  • Objectives: This study aimed to investigate the effects of auricular acupressure on anxiety and sleep among patients undergoing chemotherapy for breast cancer. Methods: A nonequivalent control group nonsynchronized design was employed. The experimental group received auricular acupressure on specific acupoints (shenmen, heart, kidney, subcortex), and the control group received auricular acupressure on helix 1, helix 2, helix 3, and helix 4 three times a day for three weeks. A total of 60 women were divided into an experimental (n=30) and control (n=30) group. Patient recruitment occurred between May and August 2019. The collected data were analyzed by a chi-square test, paired t-test, and independent t-tests using the SPSS 21.0 program. Results: There was a significant decrease in anxiety(t=4.61, p=<.001) and increase in sleep(t=3.81, p=<.001) in the experimental group compared to the control group. Conclusions: The findings confirm that auricular acupressure is an effective nursing intervention to decrease anxiety felt by patients undergoing chemotherapy and to increase the quality of their sleep.

일 종합전문병원에서의 전문간호사 역할 및 운영방안 개발 (Development of Roles and Organizational Policy of Advanced Practice Nurses in an Acute Hospital Setting)

  • 이태화;고일선;김인숙;김현옥;박영우;김인자;박정숙;최미옥;손미정;길윤경;김은현
    • 간호행정학회지
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    • 제13권3호
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    • pp.352-361
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    • 2007
  • Purpose: The purpose of this study was to develop roles and organizational policy of advanced practice nurses (APNs) in an acute hospital setting. Method: The design of the study was to descriptive-exploratory. Sample consisted of 43 participants who included 13 nurses, 18 nurse managers and 12 physicians. Survey, interview and focus group interview were performed to obtain the data. Results: The expected roles of APNs were education and counseling, direct management patient care with advanced skills, research, and collaboration and coordination among several departments. The expected outcomes were patient satisfaction, improved access to care, decreased the rate of complications, and speedy provision of services. Based on research, a proposal of APNs roles and organizational policy in a hospital setting was developed, which included definition of APNs, qualification, roles and specific roles, specialty areas, accountability, recruitment and affiliation, privileges, and expected outcomes. Conclusion: This study gives a guideline on how to introduce and use APNs in acute care tertiary settings.

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