No abstract available.
Texas

No abstract available.
Texas

BACKGROUND: In Korea, the Korean Laboratory Accreditation Program (KLAP) has set minimum standards for verification of clinical test performance. This verification process is time-consuming and labor-intensive when performed manually. We developed a free, statistical software program for KLAP, using the R language (R Foundation for Statistical Computing, Vienna, Austria). METHODS: We used CLSI guidelines for the algorithm. We built graphic user interfaces, including data input, with Embarcadero Delphi EX4 (Embarcadero Technologies, Inc., Texas, USA). The R Base Package and MCR Package for Method Comparison Regression were used to implement statistical and graphical procedures. RESULTS: Our program LaboStats has six modules: parallel test, linearity, method comparison, precision, reference interval, and cutoff. Data can be entered into the field either manually or by copying and pasting from an MS Excel worksheet. Users can print out precise reports. CONCLUSIONS: LaboStats can be useful for evaluating clinical test performance characteristics and preparing documents requested by KLAP.
Accreditation ; Korea ; Mathematical Computing ; Methods ; Texas

After publishing 2001 version of the Korean Medication Algorithm for Schizophrenia, the strategy of pharmacologic treatment for schizophrenia has been altered with the rapid advancement in the area of psychopharmacology. Currently, the feasibility of this algorithm has been evaluated. Guidelines require updating when significant new evidence appears. Recently, several guidelines of the treatment of schizophrenia including the APA practice guideline, the Expert Consensus Guideline Series and the Texas Medication Algorithm Project (TMAP) Antipsychotic Algorithm for Schizophrenia were revised. In this review, the authors briefly discussed the problems and limitations of the Korean Medication Algorithm for Schizophrenia and presented the direction of future revision on the model of above-mentioned guidelines.
Consensus ; Drug Therapy ; Methods* ; Practice Guidelines as Topic ; Psychopharmacology ; Schizophrenia* ; Texas

Since the behavior of malignant cells can be predicted by their histologic appearance, various attempts have been made to develop a uniform grading system for prostatic cancer. The system employed at the University of Texas M.D. Anderson Hospital(MDAH system) is based simply on assessment of percentage of gland formation in the tumor. Herein, using the modified MDAH system, histologic grading and prognosis were retrospectively reviewed in 35 patients with prostatic adenocarcinoma managed at Chonnam University Hospital between l997 and 1984. The following results were obtained. 1. The average age of all the patients was 70.1 years, with a range of 25 to 85 years. 2. In 35 patients, the modified MDAH system identified 6 patients (l7%) as Grade 1, 15(43%) as Grade 2-3, and 14 (40%) as Grade 4. There were a 83% 3-year survival for Grade 1 patients, a 69% 3-year survival for Grade 2-3 patients, and a 17% 3-year survival for Grade 4 patients. 3. Of 15 patients with clinical stage D, 2 had Grade 1, 6 had Grade 2-3, and 7 had Grade 4.There were a 100 % 3-year survival for Grade 1 patients, a 50% 3-year survival for Grade 2-3patients, and a 14% 3-year survival for Grade 4 patients.
Adenocarcinoma ; Humans ; Jeollanam-do ; Prognosis* ; Prostatic Neoplasms ; Retrospective Studies ; Texas

The augmentation of soft-tissue defects in the facial region is a challenging task for plastic and reconstructive surgeons. Numerous materials, both autologous and nonautologous materials including alloplastic implants, have been used for augmentation of soft-tissue defects of the face. Each has its limitations. There is no ideal material for soft-tissue augmentation. Acellular human dermal allograft (Alloderm, LifeCell Corporation, Woodlands, Texas, U.S.A.) combines the benefits of autografts and allografts. Alloderm does not appear to be resolved, it is a much more cost- effective treatment than fat injection, collagen injection, or other treatments that require multiple surgical operations or repeated application. Using Alloderm eliminates the need for creating a donor site. The authors report its use in 13 patients who have soft-tissue defects in the face. No serious complications such as rejection, absorption, dislocation, or extrusion were encountered. Alloderm appears to be an easily handled, safe material to use as an implant for permanent soft-tissue augmentation. Further long-term tudies are warranted to monitor the persistent volume maintenance of Alloderm.
Absorption ; Allografts* ; Autografts ; Collagen ; Dislocations ; Humans* ; Plastics ; Texas ; Tissue Donors

BACKGROUND: Mivacurium is a new, short acting, nondepolarizing muscle relaxant of the benzylisoquinolinium type. Enflurane produces relaxation and augments the neuromuscular blockade from muscle relaxation, but propofol does not produce muscle relaxation. We compared maintenance infusion rates, recovery index and correlations of recovery index to maintenance infusion rates and infusion duration after mivacurium during enflurane or propofol anesthesia in children. METHODS: Maintenance infusion rates, and the recovery index after mivacurium were studied in 30 pediatric patients in enflurane anesthesia (n = 15) and propofol anesthesia (n = 15). The ulnar nerve was stimulated at the wrist by repeated single twitch (1Hz) stimulus using the peripheral nerve stimulator (Model ST5 MaxiStimTM, Life-Tech , Inc, Texas, USA). We recorded the contraction of adductor pollicis longus via mechanomyography (MYOTRACE, Life-Tech, Inc, Texas, USA). RESULTS: The infusion rates of mivacurium for the maintenance of muscle relaxation (below 10% of control) were 9.6 0.80 microgram/kg/min in the enflurane anesthesia, and 11.04 1.22 microgram/kg/min in the propofol anesthesia. There was a significant difference between the groups. The recovery index was shorter in the propofol anesthesia, but regarding this index, there was no significant difference between both groups. The correlation between the recovery index and the infusion duration was significantly different in the enflurane anesthesia. CONCLUSIONS: We conclude that maintenance infusion rates are significantly lower in the enflurane anesthesia, the recovery index is insignificantly shorter in the propofol anesthesia, that there is a significant correlation between the maintenance infusion rates and recovery index in the enflurane anesthesia.
Anesthesia* ; Child* ; Enflurane* ; Humans ; Muscle Relaxation ; Neuromuscular Blockade ; Peripheral Nerves ; Propofol* ; Relaxation ; Texas ; Ulnar Nerve ; Wrist

There is limited literature on the frequency and distribution of pesticide exposures, specifically with respect to demographic and environmental factors in the United States. The purpose of this exploratory study was to investigate geographic trends and factors associated with unintentional pesticide exposures in children and adolescents in Texas. The study used an ecological design with secondary data. A spatial scan statistic, based on a Poisson regression model, was employed to identify spatial clusters of unintentional pesticide-related poison center exposures. Next, logistic regression models were constructed to identify potential demographic and environmental factors associated with unintentional pesticide-related poison center exposures. There were 59,477 unintentional pesticide-related poison center exposures from 2000 to 2013. The spatial scan statistic found a change in the number of counties in the identified clusters (e.g. , aggregation of counties with higher than expected exposures) for two time periods (2000-2006; 2007-2013). Based on the logistic regression models, factors associated with unintentional pesticide-related poison center exposures were percent black or African American population, year structure built, and percent moved in the past 12 months. In conclusion, this study found certain demographic and environmental factors may be associated with unintentional pesticide-related poison center exposures. Through understanding trends and associated factors, public health professionals can design interventions for populations at higher risk of pesticide exposures. This study also supports the use of spatial methods being utilized to expand upon current analysis of poison center data. Future research should confirm and build upon these findings.
Adolescent ; Child ; Humans ; Logistic Models ; Pesticides ; Poisoning ; Public Health ; Texas ; United States

There is limited literature on the frequency and distribution of pesticide exposures, specifically with respect to demographic and environmental factors in the United States. The purpose of this exploratory study was to investigate geographic trends and factors associated with unintentional pesticide exposures in children and adolescents in Texas. The study used an ecological design with secondary data. A spatial scan statistic, based on a Poisson regression model, was employed to identify spatial clusters of unintentional pesticide-related poison center exposures. Next, logistic regression models were constructed to identify potential demographic and environmental factors associated with unintentional pesticide-related poison center exposures. There were 59,477 unintentional pesticide-related poison center exposures from 2000 to 2013. The spatial scan statistic found a change in the number of counties in the identified clusters (e.g. , aggregation of counties with higher than expected exposures) for two time periods (2000-2006; 2007-2013). Based on the logistic regression models, factors associated with unintentional pesticide-related poison center exposures were percent black or African American population, year structure built, and percent moved in the past 12 months. In conclusion, this study found certain demographic and environmental factors may be associated with unintentional pesticide-related poison center exposures. Through understanding trends and associated factors, public health professionals can design interventions for populations at higher risk of pesticide exposures. This study also supports the use of spatial methods being utilized to expand upon current analysis of poison center data. Future research should confirm and build upon these findings.
Adolescent* ; Child* ; Humans ; Logistic Models ; Pesticides ; Poisoning* ; Public Health ; Texas* ; United States

OBJECTIVES: This study was conducted to develop a Korean algorithm of pharmacological and non-pharmacological treatment strategies in attention-deficit hyperactivity disorder (ADHD) and its specific comorbid disorders (e.g. tic disorder, depressive disorder, anxiety disorder, bipolar disorder, and oppositional defiant disorder/conduct disorder). METHODS: Based on a literature review and expert consensus, both paper- and web-based survey tools were developed with respect to a comprehensive range of questions. Most options were scored using a 9-point scale for rating the appropriateness of medical decisions. For the other options, the surveyed experts were asked to provide answers (e.g., duration of treatment, average dosage) or check boxes to indicate their preferred answers. The survey was performed on-line in a self-administered manner. Ultimately, 49 Korean child & adolescent psychiatrists, who had been considered experts in the treatment of ADHD, voluntarily completed the questionnaire. In analyzing the responses to items rated using the 9-point scale, consensus on each option was defined as a non-random distribution of scores as determined by a chi-square test. We assigned a categorical rank (first line/preferred choice, second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating score. RESULTS: Specific medication strategies for key clinical situations in ADHD and its comorbid disorders were indicated and described. We organized the suggested algorithms of ADHD treatment mainly on the basis of the opinions of the Korean experts. The suggested algorithm was constructed according to the templates of the Texas Child & Adolescent medication algorithm Project (CMAP). CONCLUSION: We have proposed a Korean treatment algorithm for ADHD, both with and without comorbid disorders through expert consensus and a broad literature review. As the tools available for ADHD treatment evolve, this algorithm could be reorganized and modified as required to suit updated scientific and clinical research findings.
Adolescent ; Anxiety Disorders ; Bipolar Disorder ; Child ; Comorbidity ; Consensus ; Depressive Disorder ; Humans ; Psychiatry ; Texas ; Tic Disorders ; Surveys and Questionnaires