• Title/Summary/Keyword: Choi-cha

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The Effect of Six Sigma Activity in Major Trauma Patients on the Time Spent in the Emergency Department (Six Sigma 활동을 통한 중증외상환자의 응급실 체류시간 개선 활동)

  • Kim, Hyun-Soo;Kim, Ok-Jun;Choi, Sung-Wook;Kim, Eui-Chung;Park, Young-Tae;Ko, Tae-I;Cho, Yun-Kyung
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.119-127
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    • 2010
  • Purpose: This study was conducted to shorten the time spent at each stage of treatment and to reduce the total amount of time patients spend in the emergency department (ED) by applying Six Sigma in the treatment of major trauma patients. Methods: This is a comparative study encompassing 60 patients presenting to the ED of Bundang CHA Hospital from January 2008 to December 2008 and from July 2009 to March 2010. The stages of treatment for major trauma patients were divided into six categories (T1: total emergency department staying time, T2: duration of visit-radiologic evaluation time, T3: duration of visit-consult to department of admission, T4: duration of consultation-issue of hospital admissions time, T5: duration of visit-issue of hospital admissions time, T6: duration of issue of hospital admission-emergency department discharge time) and the total time patients spent in the ED was compared and analyzed for periods; before and after the application of Six Sigma. Results: After the application of Six Sigma, the numerical values in four of the six categories were significantly reduced; T2, T3, T4, and T5. However, the average of the total time patients spent in the ED did not show any remarkable change because the T6 increased highly. The level of Six Sigma increased $0.17{\sigma}$. Conclusion: The application of Six Sigma for major trauma patients in the ED resulted in a significant improvement in the error rate for the total time patients spent in the ED. The Six Sigma activity has shown great potential. Therefore, the project is expected to bring better results in every stage of treatment if the levels of the hospital facilities are improved.

Endometrial profilin 1: A key player in embryo-endometrial crosstalk

  • Lee, Chang-Jin;Hong, Seon-Hwa;Yoon, Min-Ji;Lee, Kyung-Ah;Ko, Jung-Jae;Koo, Hwa Seon;Kim, Jee Hyun;Choi, Dong Hee;Kwon, Hwang;Kang, Youn-Jung
    • Clinical and Experimental Reproductive Medicine
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    • v.47 no.2
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    • pp.114-121
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    • 2020
  • Objective: Despite extensive research on implantation failure, little is known about the molecular mechanisms underlying the crosstalk between the embryo and the maternal endometrium, which is critical for successful pregnancy. Profilin 1 (PFN1), which is expressed both in the embryo and in the endometrial epithelium, acts as a potent regulator of actin polymerization and the cytoskeletal network. In this study, we identified the specific role of endometrial PFN1 during embryo implantation. Methods: Morphological alterations depending on the status of PFN1 expression were assessed in PFN1-depleted or control cells grown on Matrigel-coated cover glass. Day-5 mouse embryos were cocultured with Ishikawa cells. Comparisons of the rates of F-actin formation and embryo attachment were performed by measuring the stability of the attached embryo onto PFN1-depleted or control cells. Results: Depletion of PFN1 in endometrial epithelial cells induced a significant reduction in cell-cell adhesion displaying less formation of colonies and a more circular cell shape. Mouse embryos co-cultured with PFN1-depleted cells failed to form actin cytoskeletal networks, whereas more F-actin formation in the direction of surrounding PFN1-intact endometrial epithelial cells was detected. Furthermore, significantly lower embryo attachment stability was observed in PFN1-depleted cells than in control cells. This may have been due to reduced endometrial receptivity caused by impaired actin cytoskeletal networks associated with PFN1 deficiency. Conclusion: These observations definitively demonstrate an important role of PFN1 in mediating cell-cell adhesion during the initial stage of embryo implantation and suggest a potential therapeutic target or novel biomarker for patients suffering from implantation failure.

Clinical risk factors associated with the development of wheezing in children less than 2 years of age who required hospitalization for viral lower respiratory tract infections

  • Kim, Joon Hwan;Choi, Ji-Yeon;Kim, Na Yeon;Kim, Jin Woo;Baek, Ji Hyeon;Baek, Hye Sung;Yoon, Jung Won;Jee, Hye Mi;Choi, Sun Hee;Kim, Hyeung Yoon;Kim, Ki Eun;Shin, Youn Ho;Han, Man Yong
    • Clinical and Experimental Pediatrics
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    • v.58 no.7
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    • pp.245-250
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    • 2015
  • Purpose: Wheezing following viral lower respiratory tract infections (LRTIs) in children <2 years of age is an important risk factor for the development of asthma later in life; however, not all children with viral LRTIs develop wheezing. This study investigated risk factors for the development of wheezing during viral LRTIs requiring hospitalization. Methods: The study included 142 children <2 years of age hospitalized for LRTIs with at least one virus identified as the cause and classified them into children diagnosed with LRTIs with wheezing (n=70) and those diagnosed with LRTIs without wheezing (n=72). Results: There were no significant differences in the viruses detected between the two groups. Multivariate logistic regression analysis showed that, after adjusting for potentially confounding variables including sex and age, the development of wheezing was strongly associated with parental history of allergic diseases (adjusted odds ratio [aOR], 20.19; 95% confidence interval [CI], 3.22-126.48), past history of allergic diseases (aOR, 13.95; 95% CI, 1.34-145.06), past history of hospitalization for respiratory illnesses (aOR, 21.36; 95% CI, 3.77-120.88), exposure to secondhand smoke at home (aOR, 14.45; 95% CI, 4.74-44.07), and total eosinophil count (aOR, 1.01; 95% CI, 1.01-1.02). Conclusion: Past and parental history of allergic diseases, past history of hospitalization for respiratory illnesses, exposure to secondhand smoke at home, and total eosinophil count were closely associated with the development of wheezing in children <2 years of age who required hospitalization for viral LRTIs. Clinicians should take these factors into consideration when treating, counseling, and monitoring young children admitted for viral LRTIs.

Efficacy of Assisted Hatching by Laser in Human IVF-ET Program (체외수정 및 배아이식술에서 레이저를 이용한 보조부화술의 효용성에 대한 연구)

  • Lee, Jung-Hyun;Han, Ji-Eun;Kim, You-Shin;Won, Hyung-Jae;Cho, Chung-Hyun;Kwak, In-Pyung;Eum, Jin-Hee;Park, Eun-A;Choi, Yoon-Jung;Lee, Dong-Ryul;Yoon, Tae-Ki
    • Clinical and Experimental Reproductive Medicine
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    • v.35 no.3
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    • pp.193-202
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    • 2008
  • Objective: To evaluate efficacy of assisted hatching by laser (AHL) and acidified Tyrode solution (AHA) in selected groups of IVF-ET patients who have a poor prognosis. Methods: From February 2006 to September 2006, total of 328 IVF-ET cycles with advanced female age (${\geq}38$ years), recurrent implantation failure (${\geq}3$ cycles), thick zona (${\geq}17{\mu}m$), and/or poor quality of embryo were randomly divided into assisted hatching by acidified Tyrode solution (AHA, n=180) and the assisted hatching using the ZILOS-tk laser (AHL, n=148) groups. Clinical outcomes were analyzed and compared between AHA and AHL group based on the patient characteristics. Results: In all AHL and AHA group, there were no significant differences in pregnancy (42.6%, 63/148 vs. 33.3%, 60/180) and implantation rates (17.4%, 82/470 vs. 16.0%, 89/556) However, in advanced female age group (Group 1), pregnancy (37.0%, 20/54 vs. 18.7%, 14/75) and implantation rates (14.4%, 23/160 vs. 7.1%, 15/210) in AHL group were significantly (p<0.05) higher than those of AHA, although there was no difference in patient parameters of both groups. And, the clinical outcome of groups with recurrent implantation failure (Group 2), thick zona pellucida (Group 3) and poor quality embryo (Group 4) were improved in AHL compared to those of AHA: 43.8% (21/48) and 31.6% (25/79) in Group 2, 43.8% (32/73) and 34.1% (28/82) in Group 3, 25.0% (7/28) and 14.6% (6/41) in Group 4, but no significance. Conclusion: The AHL improved the pregnancy and implantation rates in patients with advanced female age and recurrent implantation failure when compared to outcomes achieved from AHA. Therefore, this AHL technique may be a efficient and safe method for patients with poor prognosis.

Analysis of Follicle Stimulating Hormone Receptor Gene Mutation in Korean (한국인의 난포자극호르몬수용체 유전자변이에 대한 분석)

  • Nam, Y.S.;Kim, N.K.;Choi, M.J.;Park, S.H.;Chung, K.W.;Lee, S.H.;Yoon, T.K.;Cha, K.Y.
    • Clinical and Experimental Reproductive Medicine
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    • v.25 no.3
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    • pp.281-286
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    • 1998
  • Premature ovarian failure is a condition causing amenorrhea, hypoestrogenism, and elevated gonadotropins in women younger than 40 years. Many causes of premature ovarian failure were reported, including genetic abnormalities, enzymatic defects, defects in gonadotropin secretion or action, autoimmune disorders, physical and idiopathic causes. Recently, Finnish group reported a point mutation in the follicle stimulating hormone (FSH) receptor gene in premature ovarian failure patients. But it was reported that the group from United States could not find any mutation in FSH receptor gene. So we analysed C566T point mutation of FSH receptor gene using restriction fragment length polymorphism (RFLP) and compared the result between premature ovarian failure patient with idiopathic and known causes. But we did not find 556C${\rightarrow}$T mutation in the FSH receptor gene in both groups. These findings suggest that the missense mutation in the human FSH receptor gene reported in Finnish women with premature ovarian failure is uncommon in Korean women with premature ovarian failure.

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Incarcerated Flap Tear of the Medial Meniscus into the Inferior Joint Capsule - A Report of Two Cases - (하방 관절낭 내로 감돈된 내측 반월상 연골의 판상파열 - 2예 보고 -)

  • Kim, Byung-Kuk;Lee, Yoon-Seok;Lee, Dong-Hoon;Choi, Won Chul
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.66-70
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    • 2013
  • Flap tear is a type of displaced meniscal fragments that is often clinically significant lesions requiring surgical intervention. If the displaced tear is located inferomedial to the tibial plateau and incarcerated into the articular capsule, it can be overlooked from preoperative magnetic resonance imaging evaluation and escape detection during arthroscopic examination. In addition, the clinical feature and treatment result of incarcerated flap tear has not been reported. We present 2 cases of medial meniscus flap tear incarcerated into the articular capsule that showed specific clinical features, in order to emphasize the importance of clinical suspicion of such a lesion for accurate preoperative diagnosis.

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Effect of Pentoxifylline on the ICSI Program Undergone in Severe Asthenozoospermia (심한 무력정자증 환자의 ICSI 시행시 Pentoxifylline을 사용한 정자처리법이 임상결과에 미치는 영향)

  • Sohn, Jie-Ohn;Shin, Ji-Su;Jeong, Chang-Jin;Cho, Yong-Seon;Oum, Ki-Boong;Choi, Dong-Hee;Kim, Hyun-Joo
    • Clinical and Experimental Reproductive Medicine
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    • v.29 no.2
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    • pp.97-103
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    • 2002
  • Objective: The aim of this study was to evaluate the effect of pentoxifylline (PF) on the conventional ICSI program undergone in severe asthenozoospermia. Method: Total 348 cycles of ICSI programs undertaken at CHA General Hospital from January, 1996 to September, 2000, were divided into two groups - injected with pentoxifylline-treated sperm (PFT, 204 cycles) or non-treated sperm (NPFT, 144 cycles) and the clinical results of PFT group were compared with those of NPFT. Results: PF-treatment on sperm increased their motility of normozoospermia and severe asthenozoospermia. Fertilization rate of PFT group was higher than those of ICSI programs undertaken using sperm of NPFT (70.6% vs. 62.9%, p<0.01). And, ET and clinical pregnancy rates of PFT were slightly higher than those of NPFT (93.1%, 44.2% vs. 90.3%, 36.2%). Conclusion: These results showed that treatment of pentoxifylline has a beneficial role on selection of viable sperm in severe asthenozoospermia.