• Title/Summary/Keyword: the Characteristics of Patients

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Expression and Clinical Significance of mTOR in Surgically Resected Non-small Cell Lung Cancer Tissues: a Case Control Study

  • Liu, Zhe;Wang, Liang;Zhang, Li-Na;Wang, Yue;Yue, Wen-Tao;Li, Qi
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6139-6144
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    • 2012
  • Aims: Mammalian target of rapamycin (mTOR) is master regulator of the PI3K/Akt/mTOR pathway and plays an important role in NSCLCs. Here we characterized mRNA and protein expression levels of mTOR and its functional associated molecules including PTEN, IGF-1R and 4EBP1 in surgically resected NSCLCs. Methods: Fifty-four patients with NSCLCs who underwent pulmonary resection were included in current study. mRNA levels of mTOR, PTEN, IGF-1R, and 4EBP1 were evaluated by RT-PCR and protein expression of mTOR, PTEN, and IGF-1R by immunohistochemistry (IHC). Association of expression of the relevant molecules with clinical characteristics, as well as correlations between mTOR and PTEN, 4EBP1 and IGF-1R were also assessed. Results: The results of RT-PCR showed that in NSCLCs, the expression level of mTOR increased, while PTEN, 4EBP1 and IGF-1R decreased. Statistical analysis indicated high IGF-1R expression was correlated with advanced clinical stage (stage III) and PTEN expression was reversely associated with tumor size (P=0.16). The results of IHC showed mTOR positive staining in 51.8% of cases, while IGF-1R positive staining was found in 83.3% and loss of PTEN in 46.3%. Protein expression of mTOR was correlated with its regulators, PTEN and IGF-1R, to some extent. Conclusions: Abnormal activation of mTOR signaling, high expression of IGF-1R, and loss of PTEN were observed in resected NSCLC specimens. The poor expression agreement of mTOR with its regulators, PTEN, and IGF-1R, implied that combination strategy of mTOR inhibitors with other targets hold significant potential for NSCLC treatment.

The Effects of Supplementary Education Awareness on Interpersonal Communication for Health Care Providers (종합병원 의료인의 교육훈련 인식이 의료인 상호간 커뮤니케이션에 미치는 영향)

  • Jung, Sang-Jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.411-420
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    • 2018
  • This study was conducted to identify the effects of interpersonal communication between health care providers after receiving supplementary education. The participants of this study were 433 health care providers who work at 29 general hospitals in Gwangju Metropolitan City and Jeollanamdo Province. Data were collected from June 8 to June 25, 2018 and evaluated by t-tests, dispersion analysis, correlation analysis and stepwise regression. The results were produced by investigating interpersonal communications according to socio-demographic and health-related characteristics including age, education level, bed size of the hospital at which the participant worked, job satisfaction, hospital location, personal health status, experience with health care management and experience with depression. There were significant differences in communication observed according to supplemental education awareness regarding age, bed size of hospital, occupation, wage, type of medical institution of employment, job satisfaction, work location, health status, health care education experience and chronic disease. There were positive correlations between supplemental education awareness in health workers and their interpersonal communication. The factors that had positive effects on interpersonal communication were level of education and health-related education experience, while age, hospital bed size and job dissatisfaction had negative effects. Finally, support environment, learning transfer and results were identified as sub-factors of supplemental education. Based on the results above, it was proposed that educational training to enhance results, provide a supportive environment and foster learning transfer be developed to increase communication between health workers and provide a safe health service for patients.

A simulation study for various propensity score weighting methods in clinical problematic situations (임상에서 발생할 수 있는 문제 상황에서의 성향 점수 가중치 방법에 대한 비교 모의실험 연구)

  • Siseong Jeong;Eun Jeong Min
    • The Korean Journal of Applied Statistics
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    • v.36 no.5
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    • pp.381-397
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    • 2023
  • The most representative design used in clinical trials is randomization, which is used to accurately estimate the treatment effect. However, comparison between the treatment group and the control group in an observational study without randomization is biased due to various unadjusted differences, such as characteristics between patients. Propensity score weighting is a widely used method to address these problems and to minimize bias by adjusting those confounding and assess treatment effects. Inverse probability weighting, the most popular method, assigns weights that are proportional to the inverse of the conditional probability of receiving a specific treatment assignment, given observed covariates. However, this method is often suffered by extreme propensity scores, resulting in biased estimates and excessive variance. Several alternative methods including trimming, overlap weights, and matching weights have been proposed to mitigate these issues. In this paper, we conduct a simulation study to compare performance of various propensity score weighting methods under diverse situation, such as limited overlap, misspecified propensity score, and treatment contrary to prediction. From the simulation results overlap weights and matching weights consistently outperform inverse probability weighting and trimming in terms of bias, root mean squared error and coverage probability.

Role of MRI in Diagnostic Evaluation of Papillary Lesions of the Breast (유방의 유두상 병변의 진단에서 자기공명영상의 역할)

  • Lee, So-Mi;Kim, Hye-Jung;Gwak, Yeon-Joo;Lee, Hui-Joong;Jang, Yun-Jin;Shin, Kyung-Min;Park, Ji-Young;Jung, Jin-Hyang
    • Investigative Magnetic Resonance Imaging
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    • v.14 no.1
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    • pp.41-46
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    • 2010
  • Purpose : To evaluate the role of magnetic resonance imaging (MRI) in the diagnosis of papillary lesions of the breast. Materials and methods : Among 45 papillary lesions diagnosed at ultrasonography-guided core biopsy (USCB), 27 benign papillary lesions in 22 patients who underwent breast MRI were reviewed. The excsional biopsy was performed in 1-10 days after MRI was done. In MRI findings, lesions were considered suspicious if they show irregular, rim enhancement, or linear enhancement in morphologic evaluation, or washout enhancement pattern of delayed phase in dynamic enhancement characteristics. Diffusionweighted images were analyzed according to visibility of lesions. MRI findings were correlated with pathologic results at excisional biopsy. Results : At excisional biopsy, two lesions (9%) were diagnosed malignant in 22 benign papillary lesions without atypia by USCB and 4 (80%) were malignant in 5 benign papillary lesions with atypia by USCB. Among 18 lesions detected on MRI, 16 lesions showed suspicious findings on MRI, 11 lesions (69%) were diagnosed as benign and 5 (31%) were malignant. Among 12 lesions detected on diffusion weighted imaging, 10 lesions were diagnosed as benign and 2 were malignant. MRI findings were not significantly correlated with pathologic results at excisional biopsy. Conclusion : MRI findings were not useful to predict malignancy in benign papillary lesions diagnosed at USCB, because MRI findings of these were mostly suspicious (88.9%, 16/18). The benign papillary lesion should be included in the false positive lesion on breast MRI.

A Case Report of ROSC for Out-of Hospital Cardiopulmonary Resuscitation: Based on one Area Heart Saver (병원 전 심폐소생술에 의한 자발순환 회복 8례: 일 지역 하트세이버 수여자를 기준으로)

  • Bang, Sung-Hwan;Kim, Jee-Hee;Kim, Gyoung-Youg;Roh, Sang-Gyun
    • Fire Science and Engineering
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    • v.27 no.4
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    • pp.61-67
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    • 2013
  • This study was to investigate the cardiopulmonary resuscitation (CPR) outcomes and the clinical characteristics of outof- hospital cardiac arrest (OHCA) by analyzing date in one region. A total 8 patients, survived over 72 hours after ROSC. The cardiac arrest were caused by unknown (5 cases), cardiac disease (3 cases). The most common place of cardiac arrest was in the home (6 cases), witnessed cardiac arrest (8 cases), cardiopulmonary resuscitation by bystander was performed (4 cases), agonal respiration (3 cases). The initial electrocardiogram (ECG) showed ventricular fibrillation (VF) in 7 cases, pulseless electrical activity (PEA) other rhythms in 1 cases. Average time from call to scene arrival 6.1 minutes, call to hospital arrival 23.0 minutes, duration of total CPR was 8.7 minutes. The certificate of them were level 1 emergency medical technician (EMT) 6 cases, level 2 EMT 3 cases, total 3 members 7 cases. To improve the rate of survival for out-ofhospital cardiac arrest victims, development of continuous CPR educational program for lay rescue.

Usefulness of X-ray Guided Biopsy and Ultrasound Guided Biopsy in Breast Microcalcification Biopsy (유방 미세석회화 조직검사에서 X선 유도 하 조직검사와 초음파 유도 하 조직검사의 유용성)

  • Choi, Miseon;Song, Jongnam
    • Journal of the Korean Society of Radiology
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    • v.10 no.3
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    • pp.201-206
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    • 2016
  • Social interest in breast cancer has increased. The most basic exams for diagnosis include breast X-ray and breast ultrasound. In particular, breast microcalcification requires histological diagnosis, and breast microcalcification biopsy is commonly performed. Therefore, this study aimed to analyze and assess X-ray guided biopsy (needle localized open biopsy) and ultrasound guided biopsy (sono guided core needle biopsy), which are basics in diagnosis of microcalcification. Targeting 241 cases in which magnification mammography was performed for patients who visited the hospital due to breast microcalcification, age distribution and the location of lesions were analyzed in X-ray guided biopsy and ultrasound guided biopsy. By classifying exams performed after magnification mammography, the frequencies of X-ray guided biopsy and ultrasound guided biopsy were analyzed, and malignant and benign results were confirmed. The results showed that 64 cases(26.6%) were X-ray guided biopsy, which was 5.4 times higher than 12 cases(4.9%) of ultrasound guided biopsy. Due to development of ultrasound equipments, stereotactic vacuum-assisted biopsy, etc. the methods of histological diagnosis of microcalcification have become diverse, but when considering characteristics and limitations of each exam, X-ray guided biopsy is thought to be most accurate and useful.

Factors Affecting Falls of Demented Inpatients (치매 입원환자의 낙상 영향 요인)

  • Kim, Sang-Mi;Lee, Seong-A
    • 한국노년학
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    • v.39 no.2
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    • pp.231-240
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    • 2019
  • The study aimed to identify risk factors for falls as well as hospitalization status according to disease and demographic characteristics of demented inpatients by investigating the in-depth Injury Patient Surveillance System data collected by Korea Centers for Disease Control and Prevention(KCDC). Older adults over 60 years old who were diagnosed with dementia were included(n=1,732). Their data were analyzed after being assigned to either a fall group or a non-fall group. STATA was used for statistical analyses, such as frequency analysis, chi-square (χ2) test, and logistics regression. It was found that 8.0% of the demented inpatients experienced falls. According to the analysis on category of fall and non-fall group were statistically significant difference in age and Charlson Comorbidity Index(CCI) and bone density deficiency. Based on the logistic regression analysis of factors affecting falls, older adults over 80 are 2.386 times more likely to fall and based on a target with a CCI of 0, the risk of falls is 0.421 times lower, finally based on those without bone density disorder, the fall risk for those with bone density disorder was 3.581 times higher. Therefore, we expect that the important about the factors relating to falls identified in this can not only be found valuable for educating inpatients with dementia and care-givers, but also be used as reference that supports clinical professionals to make decisions on falls management for patients with dementia.

Comparative Study of Risk Factors for Ischemic Stroke in Koreans : Multi-center Study (한국인의 허혈성 뇌졸중의 위험요인에 대한 비교고찰 - 다기관 연구)

  • Kim, Hye-Mi;Lee, In-Whan;Shin, Ae-Sook;Kim, Na-Hee;Shim, So-Ra;Kim, Min-Kyung;Na, Byung-Jo;Cho, Seung-Yeon;Park, Seong-Uk;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of Internal Korean Medicine
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    • v.31 no.4
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    • pp.870-879
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    • 2010
  • Objective : This study is about stroke risk factors which may differ between countries. Methods : We recruited 1725 ischemic stroke patients from multiple-centers. We analyzed stroke risk factors: hypertension, diabetes mellitus, dyslipidemia, depression, cardiac source, smoking, waist-to hip ratio, alcohol intake, physical activity, and psychosocial stress. We then compared risk factor results from other countries (the INTERSTROKE study) with this study. Results : 10 risk factors are related to stroke incidence. They were somewhat different between this study and the INTERSTROKE study. Conclusions : Hypertension is the most important risk factor of stroke, and other 9 risk factors also should be managed to prevent stroke incidence. Frequency of risk factors were different from the INTERSTROKE study. I think it could be partly due to differences of ethnicity and age. More studies are needed to describe characteristics of risk factors of Koreans.

A case of atypical hemolytic uremic syndrome as an early manifestation of acute lymphoblastic leukemia (비전형적 용혈성 요독 증후군으로 조기 발현한 급성 림프모구성 백혈병 1예)

  • Han, Dong Kyun;Baek, Hee Jo;Cho, Young Kuk;Kim, Chan Jong;Shin, Myung Geun;Kook, Hoon;Hwang, Tai Ju
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.253-257
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    • 2010
  • Hemolytic uremic syndrome (HUS) is the most common cause of acute renal failure in children younger than 4 years and is characterized by microangiopathic hemolytic anemia, acute renal failure, and thrombocytopenia. HUS associated with diarrheal prodrome is usually caused by Shiga toxin-producing Escherichia coli O157:H7 or by Shigella dysenteriae, which generally has a better outcome. However, atypical cases show a tendency to relapse with a poorer prognosis. HUS has been reported to be associated with acute lymphoblastic leukemia (ALL) in children. The characteristics and the mechanisms underlying this condition are largely unknown. In this study, we describe the case of an 11-year-old boy in whom the diagnosis of ALL was preceded by the diagnosis of atypical HUS. Thus, patients with atypical HUS should be diagnosed for the possibility of developing ALL.

Comparison of Clinical Manifestations of Rotaviral Gastroenteritis between Neonates and Infants (신생아와 영유아 로타바이러스 위장염의 임상 경과에 대한 비교)

  • Park, Min Kyoung;Park, Jae Ock;Kim, Chang Hwi
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.153-161
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    • 2006
  • Purpose: This study was designed to investigate rotavirus infection by comparing the clinical characteristics in neonates and infants. Methods: We enrolled 104 neonates and 250 infants wiht gastroenteritis and a rotazyme test positive reaction at the Soonchunhyang University Bucheon Hospital from February 2001 to January 2003. Results: The seasonal peaks of infection in infants occurred from February to June. However, in neonates, it occurred from October to December due to nursery outbreaks. Diarrhea, vomiting, fever and convulsions were significant symptoms in infants; however, metabolic acidosis with dehydration, jaundice, irritability, apnea, bloody stool, gastric residual, grunting, poor oral intake, lethargy as well as fever and diarrhea were more common in the neonates. Upper respiratory infection, pneumonia and bronchitis were present in the infants; however, necrotizing enterocolitis was more commonly observed in the in neonates. Among the patients with rotaviral infection, formula feeding was more popular than breast milk feeding in both the neonates and infants; however, this finding was not statistically significant. Conclusion: Rotavirus can be a significant pathogen in neonates as well as infants. Neonates suffering from fever, poor oral intake, lethargy and apnea should be investigated for rotaviral infection. A new vaccine, rotaviral specific immunoglobulin and treatment guidelines are needed for eradicating rotavirus infection. Further studies on isolation, infection pathway, immune response and treatment of rotavirus are needed.

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