{"title":"=?UTF-8?B?UmlzayBmYWN0b3JzIGZvciBjZW50cmFsIGFuZCBsYXRlcmFsIGx5bXBoIG5vZGUgbWV0YXN0YXNpcyBpbiBwYXBpbGxhcnkgdGh5cm9pZCBjYXJjaW5vbWE=?=","authors":"Jiho Ahn, H. Chang","doi":"10.7180/kmj.22.136","DOIUrl":"https://doi.org/10.7180/kmj.22.136","url":null,"abstract":"","PeriodicalId":53015,"journal":{"name":"Kosin Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48255010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Soeun Jeon, Eunsoo Kim, Sun Hack Lee, S. I. Paek, Hyun-Su Ri, Dowon Lee
{"title":"=?UTF-8?B?RGV2ZWxvcG1lbnQgb2Ygc2V2ZXJlIGp1bmN0aW9uYWwgYnJhZHljYXJkaWEgYWZ0ZXIgZGV4bWVkZXRvbWlkaW5lIGluZnVzaW9uIGluIGEgcG9seXBoYXJtYWN5IHBhdGllbnQ6IGEgY2FzZSByZXBvcnQgYW5kIGxpdGVyYXR1cmUgcmV2aWV3?=","authors":"Soeun Jeon, Eunsoo Kim, Sun Hack Lee, S. I. Paek, Hyun-Su Ri, Dowon Lee","doi":"10.7180/kmj.22.113","DOIUrl":"https://doi.org/10.7180/kmj.22.113","url":null,"abstract":"","PeriodicalId":53015,"journal":{"name":"Kosin Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48615819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eun Jeong Choi, S. Jee, Sang Heon Lee, Ji Hyun Kim, J. Yoon, J. Heo, S. Yu, Hee Won Baek, Hong Sub Lee
Background: Benign esophageal strictures are treated endoscopically, often with balloon dilatation (BD) or bougie dilators. However, recurrent esophageal strictures have been reported after BD, and severe complications sometimes occur. The aim of this study was to compare the efficacy and complications of endoscopic incisional therapy (EIT) and BD for benign esophageal strictures. Methods: We retrospectively reviewed patients who underwent BD or EIT as primary treatment for benign esophageal strictures between July 2014 and June 2021. Technical success was defined as restoration of the lumen diameter with <30% residual stenosis. Clinical success was defined as no recurrence of dysphagia within 1 month after BD or EIT and an increase of 1 grade or more on the Functional Oral Intake Scale. Results: Thirty patients with benign esophageal stricture were enrolled. There were 16 patients in the BD group and 14 patients in the EIT group. No significant differences in technical and clinical success rates were found between the two groups. Furthermore, no significant differences in the re-stricture rate were observed between the groups. There was one complication in the EIT group and three complications in the BD group. Three patients who underwent BD had re-stricture and underwent EIT thereafter, and we regrouped patients who underwent EIT at least once. The clinical success rate was significantly higher in patients regrouped to the EIT group than in patients who underwent BD only. Conclusions: EIT is not inferior to BD as the primary treatment for benign esophageal strictures, especially for recurrent cases.
{"title":"Comparison of the efficacy and complications of endoscopic incisional therapy and balloon dilatation for benign esophageal strictures","authors":"Eun Jeong Choi, S. Jee, Sang Heon Lee, Ji Hyun Kim, J. Yoon, J. Heo, S. Yu, Hee Won Baek, Hong Sub Lee","doi":"10.7180/kmj.22.128","DOIUrl":"https://doi.org/10.7180/kmj.22.128","url":null,"abstract":"Background: Benign esophageal strictures are treated endoscopically, often with balloon dilatation (BD) or bougie dilators. However, recurrent esophageal strictures have been reported after BD, and severe complications sometimes occur. The aim of this study was to compare the efficacy and complications of endoscopic incisional therapy (EIT) and BD for benign esophageal strictures. Methods: We retrospectively reviewed patients who underwent BD or EIT as primary treatment for benign esophageal strictures between July 2014 and June 2021. Technical success was defined as restoration of the lumen diameter with <30% residual stenosis. Clinical success was defined as no recurrence of dysphagia within 1 month after BD or EIT and an increase of 1 grade or more on the Functional Oral Intake Scale. Results: Thirty patients with benign esophageal stricture were enrolled. There were 16 patients in the BD group and 14 patients in the EIT group. No significant differences in technical and clinical success rates were found between the two groups. Furthermore, no significant differences in the re-stricture rate were observed between the groups. There was one complication in the EIT group and three complications in the BD group. Three patients who underwent BD had re-stricture and underwent EIT thereafter, and we regrouped patients who underwent EIT at least once. The clinical success rate was significantly higher in patients regrouped to the EIT group than in patients who underwent BD only. Conclusions: EIT is not inferior to BD as the primary treatment for benign esophageal strictures, especially for recurrent cases.","PeriodicalId":53015,"journal":{"name":"Kosin Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44163158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Urinary microRNA-21 (miR-21) has been reported to correlate with the histologic lesions of IgA nephropathy (IgAN). We investigated whether urinary or circulating miR-21 could serve as a biomarker for detecting the renal progression of IgAN. Methods: Forty patients with biopsy-proven IgAN were enrolled in this study. Serum and urinary sediment miRs were extracted, and the expression of miR-21 was quantified by real-time quantitative polymerase chain reaction. Renal progression was defined as end-stage renal disease, a sustained doubling of serum creatinine, or a 50% decrease in estimated glomerular filtration rate (eGFR) from baseline. Results: Six patients experienced renal progression during the follow-up period. The baseline eGFR was lower in the progression group (49±11 mL/min/1.73 m 2 vs. 90±23 mL/min/1.73 m 2 , p <0.05) than in the non-progression group. The level of circulating miR-21 on kidney biopsy was higher in the progression group than in the non-progression group (40.0±0.6 vs. 38.2±1.1 ΔCt value of miR-21, p <0.01), whereas there was no significant difference in urinary miR-21 (38.1±2.1 vs. 37.8±1.4 ΔCt value of miR-21, p =0.687) between the two groups. Receiver operating characteristic curve analysis demonstrated that circulating miR-21 had good discrimina-tive power for diagnosing renal progression of IgAN, with an area under the curve of 0.975. Conclusions: The level of circulating miR-21 was higher in the progression group than in the non-progression group at the time of kidney biopsy. Therefore, circulating miR-21 could be a surrogate marker of renal progression in patients with IgAN.
{"title":"The clinical significance of circulating microRNA-21 in patients with IgA nephropathy","authors":"A. Y. Cho, Ju Hwan Oh, K. Lee, I. Sun","doi":"10.7180/kmj.22.116","DOIUrl":"https://doi.org/10.7180/kmj.22.116","url":null,"abstract":"Background: Urinary microRNA-21 (miR-21) has been reported to correlate with the histologic lesions of IgA nephropathy (IgAN). We investigated whether urinary or circulating miR-21 could serve as a biomarker for detecting the renal progression of IgAN. Methods: Forty patients with biopsy-proven IgAN were enrolled in this study. Serum and urinary sediment miRs were extracted, and the expression of miR-21 was quantified by real-time quantitative polymerase chain reaction. Renal progression was defined as end-stage renal disease, a sustained doubling of serum creatinine, or a 50% decrease in estimated glomerular filtration rate (eGFR) from baseline. Results: Six patients experienced renal progression during the follow-up period. The baseline eGFR was lower in the progression group (49±11 mL/min/1.73 m 2 vs. 90±23 mL/min/1.73 m 2 , p <0.05) than in the non-progression group. The level of circulating miR-21 on kidney biopsy was higher in the progression group than in the non-progression group (40.0±0.6 vs. 38.2±1.1 ΔCt value of miR-21, p <0.01), whereas there was no significant difference in urinary miR-21 (38.1±2.1 vs. 37.8±1.4 ΔCt value of miR-21, p =0.687) between the two groups. Receiver operating characteristic curve analysis demonstrated that circulating miR-21 had good discrimina-tive power for diagnosing renal progression of IgAN, with an area under the curve of 0.975. Conclusions: The level of circulating miR-21 was higher in the progression group than in the non-progression group at the time of kidney biopsy. Therefore, circulating miR-21 could be a surrogate marker of renal progression in patients with IgAN.","PeriodicalId":53015,"journal":{"name":"Kosin Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47846665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dignity therapy for terminally ill patients in end-of-life care helps improve their psychological and spiritual well-being. In this study, the effectiveness and feasibility of dignity therapy in terminally ill patients were analyzed by reviewing previous studies. The review’s findings show that dignity therapy alleviates psychological distress and improves patients' spiritual well-being and dignity. In addition, many patients and their families found emotional support in generativity documents created through dignity therapy. Finally, the possibility of applying dignity therapy to palliative care in Korea in the future was explored. The findings indicate the influence of Eastern culture on recognizing death in patients who receive dignity therapy. Thus, dignity therapy shows promise as a contribution to improving palliative care; however, additional studies are needed to implement effective dignity therapy in the Korean context.
{"title":"Dignity therapy for effective palliative care: a literature review","authors":"Se-Ryun Park, Y. Cha","doi":"10.7180/kmj.22.127","DOIUrl":"https://doi.org/10.7180/kmj.22.127","url":null,"abstract":"Dignity therapy for terminally ill patients in end-of-life care helps improve their psychological and spiritual well-being. In this study, the effectiveness and feasibility of dignity therapy in terminally ill patients were analyzed by reviewing previous studies. The review’s findings show that dignity therapy alleviates psychological distress and improves patients' spiritual well-being and dignity. In addition, many patients and their families found emotional support in generativity documents created through dignity therapy. Finally, the possibility of applying dignity therapy to palliative care in Korea in the future was explored. The findings indicate the influence of Eastern culture on recognizing death in patients who receive dignity therapy. Thus, dignity therapy shows promise as a contribution to improving palliative care; however, additional studies are needed to implement effective dignity therapy in the Korean context.","PeriodicalId":53015,"journal":{"name":"Kosin Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42124909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The principle of treatment for a vesicovaginal fistula (VVF) tract is complete removal of the fistula tract and surrounding scar tissue, followed by anastomosis without tension from surrounding healthy tissue. We present our novel two-step procedure for VVF repair. Methods: We retrospectively analyzed 12 women, aged 14 to 67 years, who were treated between 2011 and December 2018. Conservative treatments failed, as these patients had complex VVFs. This technique consisted of two steps: first, transurethral resection of the fistula tract and surrounding scar tissue; second, transvaginal repair of the bladder mucosa, bladder muscle, and vaginal mucosa with tensionless anastomosis. If an interposition flap was needed, we used a Martius flap. Results: The mean operation time was 186.3 minutes (range, 145–320 minutes), and the mean urethral catheter indwelling time was 10 days. Ten patients successfully underwent surgery through a transvaginal approach with no intraoperative or postoperative complications. However, one patient developed peritoneal perforation during transurethral resection of the fistula due to severe granulation tissue formation around the fistula, which prompted conversion to an abdominal approach. In two cases, we used a Martius flap because of the poor tissue condition due to previous radiation therapy and an inflammatory reaction. At a mean follow-up of 37 months (range, 16–51 months), no recurrence of VVF was observed in any patients. Conclusions: This novel technique for transurethral VVF tract resection followed by transvaginal fistula repair was very safe and effective technique, and this straightforward technique is expected to reduce surgeons’ burden.
{"title":"A novel technique for transurethral vesicovaginal fistula tract resection followed by transvaginal fistula repair: a two-step procedure","authors":"S. Kim, Hee-Ok Jeong, W. Cho","doi":"10.7180/kmj.22.124","DOIUrl":"https://doi.org/10.7180/kmj.22.124","url":null,"abstract":"Background: The principle of treatment for a vesicovaginal fistula (VVF) tract is complete removal of the fistula tract and surrounding scar tissue, followed by anastomosis without tension from surrounding healthy tissue. We present our novel two-step procedure for VVF repair. Methods: We retrospectively analyzed 12 women, aged 14 to 67 years, who were treated between 2011 and December 2018. Conservative treatments failed, as these patients had complex VVFs. This technique consisted of two steps: first, transurethral resection of the fistula tract and surrounding scar tissue; second, transvaginal repair of the bladder mucosa, bladder muscle, and vaginal mucosa with tensionless anastomosis. If an interposition flap was needed, we used a Martius flap. Results: The mean operation time was 186.3 minutes (range, 145–320 minutes), and the mean urethral catheter indwelling time was 10 days. Ten patients successfully underwent surgery through a transvaginal approach with no intraoperative or postoperative complications. However, one patient developed peritoneal perforation during transurethral resection of the fistula due to severe granulation tissue formation around the fistula, which prompted conversion to an abdominal approach. In two cases, we used a Martius flap because of the poor tissue condition due to previous radiation therapy and an inflammatory reaction. At a mean follow-up of 37 months (range, 16–51 months), no recurrence of VVF was observed in any patients. Conclusions: This novel technique for transurethral VVF tract resection followed by transvaginal fistula repair was very safe and effective technique, and this straightforward technique is expected to reduce surgeons’ burden.","PeriodicalId":53015,"journal":{"name":"Kosin Medical Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41428380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinicians and healthcare decision-makers conduct their clinical practice based on the results of clinical trials. However, some health problems remain unresolved; in such cases, further research is required. To ensure reliable research results, it is important to under-stand the study design and conduct well-designed clinical trials. Many study designs can be chosen within the two broad categories of observational and interventional. Clinical studies have a variety of designs, including case series, case-control, cross-sectional, and prospective and retrospective cohort studies. Well-designed clinical studies can clarify important differences between treatment op-tions and provide data on long-term drug efficacy and safety. Interpreting the results of clinical trials can be difficult because weak-nesses in research design, data collection methods, analytic methods, and reporting can compromise their value and usefulness. However, although randomized controlled trials are limited owing to ethical and practical issues, they are optimal for investigating the effects of therapy and establishing causality. Here we present an overview of different clinical research designs and review their ad-vantages and limitations.
{"title":"How to conduct well-designed clinical research","authors":"Da Jung Kim, Song Yi Kil, Jongwon Son, Ho Sup Lee","doi":"10.7180/kmj.22.122","DOIUrl":"https://doi.org/10.7180/kmj.22.122","url":null,"abstract":"Clinicians and healthcare decision-makers conduct their clinical practice based on the results of clinical trials. However, some health problems remain unresolved; in such cases, further research is required. To ensure reliable research results, it is important to under-stand the study design and conduct well-designed clinical trials. Many study designs can be chosen within the two broad categories of observational and interventional. Clinical studies have a variety of designs, including case series, case-control, cross-sectional, and prospective and retrospective cohort studies. Well-designed clinical studies can clarify important differences between treatment op-tions and provide data on long-term drug efficacy and safety. Interpreting the results of clinical trials can be difficult because weak-nesses in research design, data collection methods, analytic methods, and reporting can compromise their value and usefulness. However, although randomized controlled trials are limited owing to ethical and practical issues, they are optimal for investigating the effects of therapy and establishing causality. Here we present an overview of different clinical research designs and review their ad-vantages and limitations.","PeriodicalId":53015,"journal":{"name":"Kosin Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43675968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: We investigated how quiz activities can improve summative assessment outcomes by analyzing the relationship between them. Methods: We used 217 first-year medical students’ medical informatics data from 3 consecutive years. We analyzed summative assessment outcomes between quiz completion and incompletion groups, one-time and multiple-time quiz learning groups, and three combined comparisons between subgroups of quiz learning activity frequencies: 1 versus 2, 3, 4, and 6 (group 1), 1 and 2 versus 3, 4, and 6 (group 2), and 1, 2, and 3 versus 4 and 6 (group 3). We then analyzed correlations between the final quiz scores and summative assessment outcomes. Results: The summative assessment means for students who completed quizzes and those who did not were 87.16±8.73 and 83.22±8.31, respectively ( p =0.001). The means for the one-time and multiple-time quiz learning groups were 86.54±8.94 and 88.71±8.10, respectively ( p =0.223). The means for combined subgroups were not significantly different between groups ( p >0.05), although a statistically significant increasing trend was found from groups 1 to 3 (0.223>0.203>0.075 using the t -test and 0.225>0.150>0.067 using the Mann-Whitney test, respectively). Summative assessment scores were not significantly correlated with quiz scores ( r =0.115, p =0.213). Conclusions: Quizzes helped students who used self-directed learning obtain better summative assessment outcomes. Formative quizzes presumably did not provide students with direct knowledge, but showed them their weak points and motivated them to work on areas where their knowledge was insufficient.
{"title":"How does quiz activity affect summative assessment outcomes? An analysis of three consecutive years’ data on self-directed learning","authors":"C. E. Oh, Hyun-Sook Hwang","doi":"10.7180/kmj.22.118","DOIUrl":"https://doi.org/10.7180/kmj.22.118","url":null,"abstract":"Background: We investigated how quiz activities can improve summative assessment outcomes by analyzing the relationship between them. Methods: We used 217 first-year medical students’ medical informatics data from 3 consecutive years. We analyzed summative assessment outcomes between quiz completion and incompletion groups, one-time and multiple-time quiz learning groups, and three combined comparisons between subgroups of quiz learning activity frequencies: 1 versus 2, 3, 4, and 6 (group 1), 1 and 2 versus 3, 4, and 6 (group 2), and 1, 2, and 3 versus 4 and 6 (group 3). We then analyzed correlations between the final quiz scores and summative assessment outcomes. Results: The summative assessment means for students who completed quizzes and those who did not were 87.16±8.73 and 83.22±8.31, respectively ( p =0.001). The means for the one-time and multiple-time quiz learning groups were 86.54±8.94 and 88.71±8.10, respectively ( p =0.223). The means for combined subgroups were not significantly different between groups ( p >0.05), although a statistically significant increasing trend was found from groups 1 to 3 (0.223>0.203>0.075 using the t -test and 0.225>0.150>0.067 using the Mann-Whitney test, respectively). Summative assessment scores were not significantly correlated with quiz scores ( r =0.115, p =0.213). Conclusions: Quizzes helped students who used self-directed learning obtain better summative assessment outcomes. Formative quizzes presumably did not provide students with direct knowledge, but showed them their weak points and motivated them to work on areas where their knowledge was insufficient.","PeriodicalId":53015,"journal":{"name":"Kosin Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48102323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：