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Sang Min Youn,Jin Seok Heo,Dong Wook Choi,Seong Hyeon Yun,Ho Kyung Chun,Woo Yong Lee,Seong Ho Choi,Hee Cheol Kim,Yong Bum Cho 한국간담췌외과학회 2010 한국간담췌외과학회지 Vol.14 No.3
Purpose: This study was designed to compare outcomes in patients who underwent hepatectomy or radiofrequency thermal ablation (RFA) for synchronous or metachronous colorectal liver metastases (CLM). Methods: One hundred twenty-two patients who underwent hepatectomy or RFA for their first CLM between 2001 and 2004 were enrolled in this study. The patients were divided into two groups (synchronous [N=77] and metachronous [N=45] CLM). Patient characteristics, clinicopathologic features, long-term outcomes, and prognostic factors were analyzed retrospectively. Results: There were no significant differences in the 5-year disease-free and overall survival rates between the synchronous and metachronous CLM groups (36.2% vs. 37.2%, p=0.78; and 53.0% vs. 54.4%, p=0.82, respectively). Patients in the synchronous CLM group underwent more bilobar hepatic resections, intra-operative RFA, or co-modality treatments than the metachronous CLM group (p=0.035). The surgical resection group had a longer disease-free survival, but not overall survival than the RFA group. Greater N stage and female gender were associated with a worse prognosis in overall survival; N0 stage and surgical resection were good prognostic factors for disease-free survival. N stage and surgical resection were also statistically significant prognostic factors based on multivariate analysis. Conclusion: The synchronicity of CLM is not a significant prognostic factor, but the clinicopathologic characteristics that reflect more disseminated disease than metachronous metastasis are significant prognostic factors. Tumor characteristics and aggressiveness may be more important for prognosis than chronology.
Performance of patient-reported index in outcome assessment of rheumatoid arthritis
( Hyeon Su Kim ),( Sung-hoon Park ),( Jung-yoon Choe ),( Seong-kyu Kim ),( Hwajeong Lee ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
Background/Objective: The objective of this study is, the first, to evaluate a feasibility in assessing the rheumatoid arthritis (RA) disease activity with these four RA disease activity indices and to assess the correlation with routine assessment of patient index data 3 (RAPID3), and the second, to evaluate an interrater agreement with Boolean-criteria proposed by American college of rheumatology (ACR) and European league against rheumatology (EULAR) in categorizing remission group. Methods: A total of 503 RA patients who visited usual rheumatology outpatient clinic were investigated cross-sectionally. Medical records of patients were reviewed and data regarding demographics, disease duration, and laboratory parameters were collected. Shapiro-Wilk W test was used to identify normality of distribution in the study population. Wilcoxon rank sum test was used to compare the age, RAPID3 in RA patients group. Stratification of the patients group by disease activity with different measure was done and Cohen’s kappa (κ) was analyzed to evaluate interrater agreement. In general, kappa value >0.8 corresponds to almost perfect, 0.61-0.8 to substantial, 0.41-0.6 to moderate and 0.2-0.4 to fair agreement. Results: The proportion of remisson patients was highest in RAPID3≤3 category as 20.1% and the lowest in clinical disease activity index (CDAI) category. Comparably, high disease activity group was highest in RAPID3 category as 38.5%. Categorization of study population by Boolean-definition remission criteria was done and 8.3% of patients were shown to satisfied with remission criteria (patients with tender joint count≤ 1, swollen joint count≤1, C-reactive protein ≤ 1 mg/dl and patient’s global≤1). Inter-criteriaagreement in disease activity categorization was compared between composite measures. A substantial level of agreement was shown by RAPID3 and Boolean definition with 0.67 of kappa value and a modest agreement with DAS28, simplified disease activity indexand CDAI. Conclusions: On the basis of these results, Korean version of RAPID3 has an substantial efficacy and validity in assessment of disease activity in RA patents on the setting of usual clinical practice.
Effect of Formal Education Level on Measurement of Rheumatoid Arthritis Disease Activity
( Hyeon Su Kim ),( Ui Hong Jung ),( Hyesun Lee ),( Seong Kyu Kim ),( Hwajeong Lee ),( Jung Yoon Choe ),( Sang Gyu Kwak ),( Theodore Pincus ),( Sung Hoon Park ) 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.4
Objective. The aim of this study is to analyze the capacity of three demographic variables - age, sex, and formal education level - as well as disease duration to explain variation in 7 Core Data Set variables and 4 indices used to assess rheumatoid arthritis (RA), in a cohort of Korean patients seen in usual care. Methods. All RA Core Data Set measures were collected in usual care of 397 RA patients, including tender/swollen joint counts (TJC, SJC) 28, physician global estimate of status, erythrocyte sedimentation rate, C-reactive protein, and a multidimensional health assessment questionnaire to assess physical function, pain, and patient global estimate of status (PATGL). Four indices were computed: disease activity score with 28 joint count (DAS28), simplified disease activity index (SDAI), clinical disease activity index (CDAI), and routine assessment of patient index data 3 (RAPID3). Descriptive statistics and multivariate generalized linear models were used in data analysis. Results. Patients with lower education had higher scores, indicating greater severity, for all 7 Core Data Set measures and 4 indices (significant for TJC, function, pain, PATGL, DAS28, SDAI, CDAI, RAPID3). In a series of regressions that included age, sex, disease duration, and education, formal education level was the only significant variable to explain variation in TJC, pain, PATGL, physician global estimate of status (DOCGL), DAS28, SDAI, CDAI, and RAPID3. Conclusion. Significant associations with education were found in Korean RA patients according to most RA Core Data Set measures and 4 indices. Education was more likely than age, sex, or disease duration to explain variation in most measures and indices. (J Rheum Dis 2015;22:231-237)