• Title/Summary/Keyword: statistically sequential

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Sequential Changes of Plasma C-Reactive Protein, Erythrocyte Sedimentation Rate and White Blood Cell Count in Spine Surgery : Comparison between Lumbar Open Discectomy and Posterior Lumbar Interbody Fusion

  • Choi, Man Kyu;Kim, Sung Bum;Kim, Kee D.;Ament, Jared D.
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.218-223
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    • 2014
  • Objective : C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are often utilized to evaluate for postoperative infection. Abnormal values may be detected after surgery even in case of non-infection because of muscle injury, transfusion, which disturbed prompt perioperative management. The purpose of this study was to evaluate and compare the perioperative CRP, ESR, and white blood cell (WBC) counts after spine surgery, which was proved to be non-infection. Methods : Twenty patients of lumbar open discectomy (LOD) and 20 patients of posterior lumbar interbody fusion (PLIF) were enrolled in this study. Preoperative and postoperative prophylactic antibiotics were administered routinely for 7 days. Blood samples were obtained one day before surgery and postoperative day (POD) 1, POD3, and POD7. Using repeated measures ANOVA, changes in effect measures over time and between groups over time were assessed. All data analysis was conducted using SAS v.9.1. Results : Changes in CRP, within treatment groups over time and between treatment groups over time were both statistically significant F(3,120)=5.05, p=0.003 and F(1,39)=7.46, p=0.01, respectively. Most dramatic changes were decreases in the LOD group on POD3 and POD7. Changes in ESR, within treatment groups over time and between treatment groups over time were also found to be statistically significant, F(3,120)=6.67, p=0.0003 and F(1,39)=3.99, p=0.01, respectively. Changes in WBC values also were be statistically significant within groups over time, F(3,120)=40.52, p<0.001, however, no significant difference was found in between groups WBC levels over time, F(1,39)=0.02, p=0.89. Conclusion : We found that, dramatic decrease of CRP was detected on POD3 and POD7 in LOD group of non-infection and dramatic increase of ESR on POD3 and POD7 in PLIF group of non-infection. We also assumed that CRP would be more effective and sensitive parameter especially in LOD than PLIF for early detection of infectious complications. Awareness of the typical pattern of CRP, ESR, and WBC may help to evaluate the early postoperative course.

Factors predicting radiation pneumonitis in locally advanced non-small cell lung cancer

  • Kim, Myung-Soo;Lee, Ji-Hae;Ha, Bo-Ram;Lee, Re-Na;Lee, Kyung-Ja;Suh, Hyun-Suk
    • Radiation Oncology Journal
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    • v.29 no.3
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    • pp.181-190
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    • 2011
  • Purpose: Thoracic radiotherapy is a major treatment modality of stage III non-small cell lung cancer. The normal lung tissue is sensitive to radiation and radiation pneumonitis is the most important dose-limiting complication of thoracic radiation therapy. This study was performed to identify the clinical and dosimetric parameters related to the risk of radiation pneumonitis after definitive radiotherapy in stage III non-small cell cancer patients. Materials and Methods: The medical records were reviewed for 49 patients who completed definitive radiation therapy for locally advanced non-small cell lung cancer from August 2000 to February 2010. Radiation therapy was delivered with the daily dose of 1.8 Gy to 2.0 Gy and the total radiation dose ranged from 50.0 Gy to 70.2 Gy (median, 61.2 Gy). Elective nodal irradiation was delivered at a dose of 45.0 Gy to 50.0 Gy. Seven patients (14.3%) were treated with radiation therapy alone and forty two patients (85.7%) were treated with chemotherapy either sequentially or concurrently. Results: Twenty-five cases (51.0%) out of 49 cases experienced radiation pneumonitis. According to the radiation pneumonitis grade, 10 (20.4%) were grade 1, 9 (18.4%) were grade 2, 4 (8.2%) were grade 3, and 2 (4.1%) were grade 4. In the univariate analyses, no clinical factors including age, sex, performance status, smoking history, underlying lung disease, tumor location, total radiation dose and chemotherapy were associated with grade ${\geq}2$ radiation pneumonitis. In the subgroup analysis of the chemotherapy group, concurrent rather than sequential chemotherapy was significantly related to grade ${\geq}2$ radiation pneumonitis comparing sequential chemotherapy. In the univariate analysis with dosimetric factors, mean lung dose (MLD), $V_{20}$, $V_{30}$, $V_{40}$, MLDipsi, $V_{20}$ipsi, $V_{30}$ipsi, and $V_{40}$ipsi were associated with grade ${\geq}2$ radiation pneumonitis. In addition, multivariate analysis showed that MLD and V30 were independent predicting factors for grade ${\geq}2$ radiation pneumonitis. Conclusion: Concurrent chemotherapy, MLD and $V_{30}$ were statistically significant predictors of grade ${\geq}2$ radiation pneumonitis in patients with stage III non-small cell lung cancer undergoing definitive radiotherapy. The cutoff values for MLD and $V_{30}$ were 16 Gy and 18%, respectively.

Evaluation of a Sample-Pooling Technique in Estimating Bioavailability of a Compound for High-Throughput Lead Optimazation (혈장 시료 풀링을 통한 신약 후보물질의 흡수율 고효율 검색기법의 평가)

  • Yi, In-Kyong;Kuh, Hyo-Jeong;Chung, Suk-Jae;Lee, Min-Haw;Shim, Chang-Koo
    • Journal of Pharmaceutical Investigation
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    • v.30 no.3
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    • pp.191-199
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    • 2000
  • Genomics is providing targets faster than we can validate them and combinatorial chemistry is providing new chemical entities faster than we can screen them. Historically, the drug discovery cascade has been established as a sequential process initiated with a potency screening against a selected biological target. In this sequential process, pharmacokinetics was often regarded as a low-throughput activity. Typically, limited pharmacokinetics studies would be conducted prior to acceptance of a compound for safety evaluation and, as a result, compounds often failed to reach a clinical testing due to unfavorable pharmacokinetic characteristics. A new paradigm in drug discovery has emerged in which the entire sample collection is rapidly screened using robotized high-throughput assays at the outset of the program. Higher-throughput pharmacokinetics (HTPK) is being achieved through introduction of new techniques, including automation for sample preparation and new experimental approaches. A number of in vitro and in vivo methods are being developed for the HTPK. In vitro studies, in which many cell lines are used to screen absorption and metabolism, are generally faster than in vivo screening, and, in this sense, in vitro screening is often considered as a real HTPK. Despite the elegance of the in vitro models, however, in vivo screenings are always essential for the final confirmation. Among these in vivo methods, cassette dosing technique, is believed the methods that is applicable in the screening of pharmacokinetics of many compounds at a time. The widespread use of liquid chromatography (LC) interfaced to mass spectrometry (MS) or tandem mass spectrometry (MS/MS) allowed the feasibility of the cassette dosing technique. Another approach to increase the throughput of in vivo screening of pharmacokinetics is to reduce the number of sample analysis. Two common approaches are used for this purpose. First, samples from identical study designs but that contain different drug candidate can be pooled to produce single set of samples, thus, reducing sample to be analyzed. Second, for a single test compound, serial plasma samples can be pooled to produce a single composite sample for analysis. In this review, we validated the issue whether the second method can be applied to practical screening of in vivo pharmacokinetics using data from seven of our previous bioequivalence studies. For a given drug, equally spaced serial plasma samples were pooled to achieve a 'Pooled Concentration' for the drug. An area under the plasma drug concentration-time curve (AUC) was then calculated theoretically using the pooled concentration and the predicted AUC value was statistically compared with the traditionally calculated AUC value. The comparison revealed that the sample pooling method generated reasonably accurate AUC values when compared with those obtained by the traditional approach. It is especially noteworthy that the accuracy was obtained by the analysis of only one sample instead of analyses of a number of samples that necessitates a significant man-power and time. Thus, we propose the sample pooling method as an alternative to in vivo pharmacokinetic approach in the selection potential lead(s) from combinatorial libraries.

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Accessibility to digital information of middle-aged and elderly people, and its impact on life satisfaction level: Sequential Mediation Effects on online social engagement and online network activity (중고령자의 디지털 정보화 접근수준과 삶의 만족도 간의 관계에서 온라인 사회참여/네트워크 활동의 매개효과)

  • Kim, Su-Kyoung;Shin, Hye-Ri;Kim, Young-Sun
    • Journal of Digital Convergence
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    • v.17 no.12
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    • pp.23-34
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    • 2019
  • The purpose of this study was to examine the relationship between the access level of digital information service and life satisfaction level of the middle and high-aged people and to analyze the Sequential Mediation Effects on online social engagement and online network activities. To this end, we analyzed the effects of multiple mediations on 1,491 seniors who responded to the 2018 digital information gap survey. The results of the study are as follows: First, this study confirmed that there is a statistically significant relationship between the access levels of digital information service and the life satisfaction. Second, the results showed that impact of digital information access level on life satisfaction among high-aged people was higher when they were engaged in both online social activities and online networking, rather than only involved in online social activities. Overall, this study comprehensively examined the relationship among the level of digital information access, life satisfaction, online social engagement, and online networking, which is meaningful in that it can be used as data for reconsideration of the digital information services and life satisfaction of the high-aged people.

Treatment Result and Prognostic Factors in Pateints with Esophageal Cancer (식도암의 근치적 치료성적 및 예후인자)

  • Chung, Weon-Kuu;Kim, Soo-Kon;Kim, Min-Chul;Jang, Myoung;Moon, Sun-Rock
    • Radiation Oncology Journal
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    • v.13 no.3
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    • pp.233-241
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    • 1995
  • Purpose : To analyse clinical outcome and prognostic factors according to treatment modality, this paper report our experience of retrospective study of patients with esophageal cancer Materials and Methods : One hundred and ten patients with primary esophageal cancer who were treated in Presbyterian Medical Center from May 1985 to December 1992. We analysed these patients retrospectively with median follow up time of 28 months, one hundred and four patients($95{\%}$) were followed up from 15 to 69 months. In methods, twenty-eight patients were treated with median radiation dose irradiated 54.3Gy only. Fifty-six patients were treated with combined chemoradiotherapy. Sixteen cases of these patients were treated with concurrent chemoradiation and the other patients(forty cases) were treated sequential chemoradiotherapy. In concurrent chemoradiotherapy group, patients received 5-FU continuous IV infusion for 4 days. Cisplatin IV bolus. and concurrent esophageal irradiation to 30 Gy. After that patients received 5-FU continuous IV, Cisplatin bolus injection and Mitomycin-C bolus IV, Bleomycin continuous IV, and irradiation to 20 Gy. In sequential chemoradiotherapy group, the chemotherapy consisted of 5-FU 1,000mg/$m^2$ administered as a continuous 24 hour intravenous infusion during five days and Cisplatin 80-100mg/$m^2$ bolus injected, or Bleomycin, Vinblastine, Cisplatin, Methotrexate were used of 1 or 2 cycles. After preoperative concurrentm chemoradiation twenty-six patients underwent radical esophagectomy. Results : Ninety-three patients could be examined for response assessment, By treatment modality, response rates were $85.1{\%}$ for radiation alone group and $86.3{\%}$ for combined chemoradiation group. But in operation group, after one cycle of concurrent chemoradiation treatment, response rate was $61.9{\%}$. The pathologic complete response were $15.4{\%}$ in operation group. Overall median survival was II months and actuarial 5-year survival rate was $8{\%}$. The median survival interval was 6 months for radiation alone group, 11 months for combined chemoradiation group and 19 months for operation group. And also median survival was 19 months for complete responder group that 8 months for noncomplete responder group. In univariative analysis, statistically significant prognostic factors were tumor size, clinical stage, tumor response, and operation. In multivariative analysis, significantly better survival was associated with clinical stage, tumor response, radiation dose, and operation. Conclusion : Compared with radiotherapy alone, combined multimodality may improve the median survival in patients with localized carcinoma of the esophagus and toxicity is acceptable.

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Association Between GSTM1 Polymorphism and Nasopharyngeal Cancer Susceptibility: a Meta-analysis

  • Sun, Zhen-Feng;Zhang, Jia;Xu, Hong-Ming;Wang, Guo-Liang;Dong, Pin
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5817-5821
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    • 2012
  • Background/Aims: Glutathione S-transferase M1 (GSTM1) is a multifunctional enzyme that plays a critical role in the detoxification of varieties of carcinogenic metabolites. Many studies have been conducted to investigate the association between GSTM1 polymorphism and nasopharyngeal cancer (NPC) risk, but the findings among those studies are inconsistent. To assess this relationship more precisely, we performed a meta-analysis of all available studies on the subject. Methods: Case-control studies were identified by searching Pubmed, Embase, ISI Web of Science, and Wanfang databases through September 6, 2012. We used the pooled odds ratio (OR) with its corresponding 95% confidence interval (95%CI) to evaluate the association of GSTM1 polymorphism with NPC susceptibility. Subgroup analyses by pathological types, sex and smoking status were performed to further identify the association. Results: Overall, 11 published studies with 1,513 cases and 2,802 controls were finally included into this meta-analysis according to the inclusion criteria. Meta-analysis of total studies showed that the null genotype of GSTM1 was significantly associated with increased risk of NPC, when comparing with the non-null genotype (OR=1.51, 95%CI=1.33-1.72, POR<0.001). The association was still statistically significant in subgroup analysis of patients with nasopharyngeal squamous cell carcinoma (OR=1.73, 95%CI=1.24-2.42, POR=0.001). Males with the null genotype of GSTM1 were more likely to subject to NPC than females. In addition, the association between the null genotype of GSTM1 and NPC risk was strongest in individuals with exposure to smoking. Sensitivity analysis by sequential omission of any individual studies one at a time further demonstrated the significant association. Conclusions: The findings suggest that the null genotype of GSTM1 is a risk factor for NPC, and there is a gene-smoking interaction in this association.

Outcome of Intestinal Metaplasia in Gastric Biopsy of Patients with Dyspepsia in Guilan Province, North Iran

  • Mansour-Ghanaei, Fariborz;Joukar, Farahnaz;Soati, Fatemeh;Mansour-Ghanaei, Alireza;Atrkar-Roushan, Zahra
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3549-3554
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    • 2013
  • Background: It is generally accepted that gastric carcinomas are preceded by a sequential multistage process that includes chronic gastritis, gastric atrophy, usually with intestinal metaplasia (IM), and dysplasia. This series of changes in gastric carcinogenesis is often initiated by Helicobacter pylori (H pylori) infection. The aim of the present study was determination of gastric histopathologic changes in IM patients after at least one year in Guilan province, Iran. Materials and Methods: This case-series study was conducted in Guilan Gastrointestinal and Liver Disease Research Center (GLDRC) during 2010 to 2011. Gastric biopsy was performed for all 71 known cases of IM and precanceric lesions including gastric atrophy, IM, dysplasia and H pylori infection were determined after at least one year. Results: Of the total of 71 patients with established IM who were enrolled, 50 had complete-type IM and 21 had incomplete-type IM. Fifty two people had H pylori infection. H pylori eradication was achieved in 39 patients (75%). Secondary pathology findings of patients with IM were complete metaplasia (39.4%), incomplete metaplasia (32.4%), dysplasia (23.9%) and other precanceric lesions (4.2%). Dysplasia (20%vs 33%) occurred in patients who had complete and incomplete IM at baseline respectively (p>0.05). Age, gender, family history of gastric cancer(GC); smoking habits and NSAIDs use were not associated with gastric premalignant lesions in initial and secondary pathologies (p>0.05). The difference became statistically significant between H pylori infection in patients with more than 3 years diagnostic intervals (p<0.05). Statistical difference between eradicators and non-eradicators was not significant. Conclusions: We found that incomplete IM increased the risk of subsequent dysplasia in this study.

Effect of Aging on the Chemical Forms and Phytotoxicity of Arsenic in Soil (비소 오염기간이 토양 내 비소의 존재형태와 식물독성에 미치는 영향)

  • Yang, Woojin;Jho, Eun Hea;Im, Jinwoo;Jeong, Seulki;Nam, Kyoungphile
    • Journal of Soil and Groundwater Environment
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    • v.21 no.3
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    • pp.82-87
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    • 2016
  • This study investigates effects of an aging period on arsenic (As) chemical forms in soils and phytotoxicity using artificially As-contaminated soils with a range of As concentrations (0-300 mg/kg) and aging periods (0 and 3 months). A sequential extraction procedure showed that the increasing As concentration in soils increased the ratio of non-specifically and specifically bound As, which are known to be bioavailable. This resulted in increasing As uptake by tomatoes with increasing As concentration (R2=0.87 for exponential fitting); however, the seed germination was not sensitive to the As concentrations of the soil samples. The seed germination was also statistically similar in the soils with 75 and 150 mg-As/kg regardless of the aging period. The time taken until the seed germination (i.e., lag phase), on the other hand, decreased from 10 d to 3 d with aging for 3 months. This can be attributed to the decreased amount of bioavailable As with aging. Overall, this study shows that when the toxic effects of the As-contaminated soils are assessed using tomato plants, it is better to use more sensitive methods than seed germination such as the As accumulation or the lag phase for seed germination.

Effects of Respiration and Oral Motor Training based on Musical Elements and Singing on Voice of Healthy Elderly (음악요소와 노래 부르기를 활용한 호흡 및 구강훈련이 정상노인의 음성에 미치는 영향)

  • Jun, Hee-Un;Kim, Soo-Ji
    • The Journal of the Korea Contents Association
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    • v.11 no.10
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    • pp.380-387
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    • 2011
  • This study was to investigate the effects of music-combined respiration and oral motor training on the voice of healthy elderly. 27 women attending a senior center in Seoul participated and were randomly assigned to the experimental (n = 16) and the control group (n = 11). Subjects attended music program(25 minutes per session) once a week for 4 weeks. For both groups, Fundamental Frequency (F0), Maximum Phonation Time (MPT) and Sequential Motion Rates (SMR) were measured using the Praat speech analysis program before and after the training. The results showed statistical significance in scores of intensity, F0, MPT, and SMR in the experimental group while only intensity was statistically significant in the control group. Considering that, the increasing life expectancy and growing number of older adults, their quality of life has been important. So this study suggests that the respiration and oral motor training would be effectively incorporated into training and services for this population.

Causality between Spouse Attitude and Relapse of the Psychiatrically Disordered (정신장애인의 배우자 태도와 재발의 인과적 관계에 관한 탐색)

  • Shin, Sun-In
    • Korean Journal of Social Welfare
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    • v.60 no.3
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    • pp.59-82
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    • 2008
  • This study investigated the effect of spouse attitude of psychiatric patients on relapse. The research was based on the concept that spouses' attitudes toward mental illness influences relapse, mediated by marital relationship and social adaptation. Data were collected from 102 of the psychiatrically disordered who were married, and analyzed through Structural Equation Modelling to validate causal paths and mediator effects of the variables. The marital relationship was shown to act as a mediator between spouse attitude and social adaptation, while social adaptation showed a complete mediation effect between marital relationship and relapse. Thus, spouse attitude towards mental illness was shown to have a statistically meaningful effect on relapse indirectly and through sequential mediation effect of marital relationship and social adaptation. This study proposes the facilitation of counseling and training programs to improve the marital relationships of psychiatric patients. The emphasis is on the educational program for the spouses to improve their knowledge of mental illness.

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