• Title/Summary/Keyword: Diagnosis-related group

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Bilateral retinoblastoma: Long-term follow-up results from a single institution (단일기관의 장기추적 결과)

  • Choi, Sang Yul;Kim, Dong Hwan;Lee, Kang Min;Lee, Hyun Jae;Kim, Mi-Sook;Lee, Tai-Won;Choi, Sang Wook;Kim, Dong Ho;Park, Kyung Duk;Lee, Jun Ah
    • Clinical and Experimental Pediatrics
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    • v.52 no.6
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    • pp.674-679
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    • 2009
  • Purpose : The authors aimed to analyze the long-term effects of treatments, especially external beam radiotherapy (EBRT), in bilateral retinoblastoma patients. Methods : This retrospective study analyzed the medical records of 22 bilateral retinoblastoma patients who were registered between October, 1987 and October, 1998 and followed-up for more than 10 years. They were treated by enucleation, EBRT, and systemic chemotherapy. Age at diagnosis, sex, delay prior to treatment, Reese-Ellsworth (RE) classification, and the local treatment modalities were analyzed in relation to recurrence-free survival (RFS) and complications. Results : Median age at diagnosis was 7.0 months (range 1.7-31.6 months). Leukocoria was the most common presenting feature. Two patients had a familial history. The RE classifications of the 44 eyes were group II in 4, III in 14, IV in 4, and V in 22. At the end of a median follow-up period of 141 months (range 55-218 months), 20 patients were alive. The 10-year ocular survival rate of the 44 eyes was $56.8{\pm}7.5%$. The 10-year RFS and ocular survival rate of the 29 eyes treated by combined EBRT and chemotherapy were 75.9% and 86.2%, respectively. Treatment delay (>3 months) was found to be related to higher risk of recurrence. Complications after EBRT were cataract, retinal detachment, phthisis bulbi, and facial asymmetry. No patient developed a second malignancy during the follow-up period. Conclusion : Early detection and prompt treatment can increase ocular survival rates. In addition, careful attention should be paid to possible long-term sequelae in these patients.

The Diagnosis for Educational Behavioral Strategies of Community Health Nurse-Community Health Worker for Control of Hypertensive Urban Young Black Men in America (간호사-지역사회건강상담자팀의 미국 도시지역 젊은 흑인 남자 집단의 고혈압 관리를 위한 전략 활동의 교육-행위진단)

  • Park, Kyung-Min
    • Research in Community and Public Health Nursing
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    • v.7 no.1
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    • pp.80-99
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    • 1996
  • Young black men(YBM) have the most severs levels of high blood pressure(HBP) and, in all reports but one, the lowest of HBP control of any age /sex /race group. To increase entry into care, remaining in care, and BP control for young(18-49 years) Black men, It is needed to review socio-demographic, medical characteristics, and behaviors(importance of and difficulty with HBP control behaviors, or worry about mdication) for experimental intervention study(educational- behavior strategies) of hypertensive urban young black men. The 204 participants had an average age of 38.8+7.0 years and an average educational level of $11.0{\pm}2.4$ years; only 23.1% were employed full- or part-time while 26% were on disability ; and 6% were married. Only 35.3% had an MD for HBP care and 37.3% had some form of health insurance. The average BP of those men currently being in care on medication(35.3%) was $148.2/95.1{\pm}19.5/11.3$ compared to those men not taking HBP care $153.7/99.1{\pm}14.0/9.8(p<.05)$. The average creatinine level was 1.3(excluding 3 marked elevations of 15.9, 9.6, and 7.7) for the 163 men consenting to have their blood drawn. Self-reported co-morbidity induded heart disease 7.8%, diabetes 8.9%, high cholesterol 18.2%, CVA 3.4%, alcohol and drug related problems 27.9% and 22.5% respectively. The kidney disease of those men currently being in care & on medication was 9.7 compared to those men not taking HBP care 0.8(p<.05). The problems of with sex life, physicl activity and dearly thinking of those men currently being in care & on medication was higher compared to those men not taking HBP care(p<.05). Questions of 'during the past month, on how many days did you have 5 or more drinks (bottles) of any alcoholic beverag?' and smoking of those men currently being in care & on medication was 18.1% and 72.2% compared to those men not taking HBP care 27.3 and 82.6%, respectively. HBP control behaviors was assessed with 1-5 point Likert subscales(5=extreme, 1-none at all), In general, th men reportd low levels of perceived psychological barrier to HBP care and control behaviors; importance of and difficulty with HBP control behaviors, or worry about mdication. For example, on a five point scale(1=none at all, 5=extreme), average ratings for perceived important and difficulty with BP care and behaviors were 2.8(SD=1.2) and 2.5(SD=1.1). Average ratings for perceived benefit with BP care and behaviors worry about medication of those men currently being in care on medication was 4.0(SD=0.9) and 2.2(SD=1.1) compared to those men not taking HBP care 3.6(SD=0.8), 2.8 (SD=1.6) respectively(p<.05). These data support the need for educational-behavioral strategies of community health nurse to improve high blood pressure control in this high risk group through perceived barriers to treatment, health care skills and use of resources, and social support.

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Analysis of the perception degree on dental medical accident and dispute experience, psychological status and preventive education according to clinical career of dental hygienist (일부지역 치과위생사의 임상경력에 따른 치과 의료사고 및 분쟁 경험, 심리상태, 예방교육에 대한 인식정도 분석)

  • Yoon, Na-Na;Lee, Myung-Ju;Seong, Mi-Gyung
    • Journal of Korean Academy of Dental Administration
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    • v.5 no.1
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    • pp.13-21
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    • 2017
  • Objective: To understand the experience of medical accidents and disputes according to clinical career of dental hygienists. Methods: A self-administrated questionnaire survey was conducted from May 2012 to June 2012 targeting 313 dental hygienists in Gyeongsangnam-do, Republic of Korea. Data were analyzed by descriptive analysis, χ2-test, and one-way analysis of variance (ANOVA). Collected data were analyzed using SPSS 18.0. Results: 1) The group who had more than 6 years of clinical experience experienced complaints from patients (70.3%) and dental hygienists duty (30.7%); 2) Complaints were related to diagnosis, dental treatment instruments and materials, scaling, impression preparation, and prosthodontics. Pediatric patients had significantly more complaints compared to other patients. Overall, there were more frequent cases in the group with over 6 years of clinical career; 3) For the psychological state after experiencing patients' complaints, 'the process is difficult, but I forget after thinking it could be happen' had 160 respondents. Among them, 38.1% had clinical experience of more than 6 years, 37.5% had less than 3 years, and 24.4% had clinical career of 3~6 years; 4) About 73.6% of those had 3~6 years of clinical career answered that 'sometimes it is doubtful' on the issue of medical accidents and conflicts on prevention education of dental hygienists that 'there is a doubt about the issue of medical treatment or the occurrence of disputes'. About 60.0% of those who had less than 3 years of clinical experience answered that it was highly 'necessary but not urgent' on the necessity of preventive education, while 87.1% of those who had more than 6 years of clinical career answered that it was highly 'necessary but not urgent' on the necessity of preventive education. The difference between the two was not statistically significant. Conclusions: It is necessary and urgent to provide education related to prevention and countermeasures against malpractice disputes for dental hygienists.

Effects of skin temperature change, cold pain and muscle activity by Cold Air Application type on the induced delayed onset muscle soreness (지연성 근육통 유발 후 냉기 적용 방법이 피부온도의 변화, 냉각 통과 근육 기능에 미치는 효과)

  • Choi, Yoorim;Jung, Bongjae;Hwang, Byeongjun
    • Journal of the Korean Society of Radiology
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    • v.7 no.1
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    • pp.99-106
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    • 2013
  • The purpose of this study was to after induced delayed onset muscle soreness, the purpose of this study is to present the effective way on skin temperature changes and cold pain for 14 subjects during to applied with only Cold-jet stream and Cold-jet stream with infra red. 14 healthy men and women who delayed onset muscle soreness eccentric contractions induced by exercise and then the biceps alone was applied to the Cold-jet stream. We measured the time that skin temperature fall from room temperature to $10^{\circ}C$(first period), the time rewarmed from $10^{\circ}C$ to $20^{\circ}C$(second period), the time fall again to $10^{\circ}C$(third period) and the time rewarmed again to $20^{\circ}C$(fourth period). Cold-jet stream with infrared combination therapy was performed with the same method. Results of this study were 1st and 2nd experimental cooling experiments in the to fall to $10^{\circ}C$ Cold-jet stream with infrared combination therapy than in the Cold-jet stream was longer(p<.05). At second period, It took longer in Cold-jet stream with infrared rewarmed than Cold-jet stream to rewarm skin(p<.05). Cold-jet stream with infrared combination therapy than Cold-jet stream had less incidence of cold pain(p<.05). Thickness of biceps brachii were found significant difference related measurment each group was consistent. In this study, Cold-jet stream with infrared combination therapy more effective than Cold-jet stream in reduced cold pain and lowering skin temperature. This work was supported by education capacity building project fund of Taegu Science University, 2012.

Overview of Transforming Growth Factor β Superfamily Involvement in Glioblastoma Initiation and Progression

  • Nana, Andre Wendindonde;Yang, Pei-Ming;Lin, Hung-Yun
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.6813-6823
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    • 2015
  • Glioblastoma, also known as glioblastoma multiforme (GBM), is the most aggressive of human brain tumors and has a stunning progression with a mean survival of one year from the date of diagnosis. High cell proliferation, angiogenesis and/or necrosis are histopathological features of this cancer, which has no efficient curative therapy. This aggressiveness is associated with particular heterogeneity of the tumor featuring multiple genetic and epigenetic alterations, but also with implications of aberrant signaling driven by growth factors. The transforming growth factor ${\beta}$ ($TGF{\beta}$) superfamily is a large group of structurally related proteins including $TGF{\beta}$ subfamily members Nodal, Activin, Lefty, bone morphogenetic proteins (BMPs) and growth and differentiation factor (GDF). It is involved in important biological functions including morphogenesis, embryonic development, adult stem cell differentiation, immune regulation, wound healing and inflammation. This superfamily is also considered to impact on cancer biology including that of GBM, with various effects depending on the member. The $TGF{\beta}$ subfamily, in particular, is overexpressed in some GBM types which exhibit aggressive phenotypes. This subfamily impairs anti-cancer immune responses in several ways, including immune cells inhibition and major histocompatibility (MHC) class I and II abolishment. It promotes GBM angiogenesis by inducing angiogenic factors such as vascular endothelial growth factor (VEGF), plasminogen activator inhibitor (PAI-I) and insulinlike growth factor-binding protein 7 (IGFBP7), contributes to GBM progression by inducing metalloproteinases (MMPs), "pro-neoplastic" integrins (${\alpha}v{\beta}3$, ${\alpha}5{\beta}1$) and GBM initiating cells (GICs) as well as inducing a GBM mesenchymal phenotype. Equally, Nodal promotes GICs, induces cancer metabolic switch and supports GBM cell proliferation, but is negatively regulated by Lefty. Activin promotes GBM cell proliferation while GDF yields immune-escape function. On the other hand, BMPs target GICS and induce differentiation and sensitivity to chemotherapy. This multifaceted involvement of this superfamily in GBM necessitates different strategies in anti-cancer therapy. While suppressing the $TGF{\beta}$ subfamily yields advantageous results, enhancing BMPs production is also beneficial.

Korean Clinical Practice Guidelines for Aneurysmal Subarachnoid Hemorrhage

  • Cho, Won-Sang;Kim, Jeong Eun;Park, Sukh Que;Ko, Jun Kyeung;Kim, Dae-Won;Park, Jung Cheol;Yeon, Je Young;Chung, Seung Young;Chung, Joonho;Joo, Sung-Pil;Hwang, Gyojun;Kim, Deog Young;Chang, Won Hyuk;Choi, Kyu-Sun;Lee, Sung Ho;Sheen, Seung Hun;Kang, Hyun-Seung;Kim, Byung Moon;Bae, Hee-Joon;Wan, Chang;Park, Hyeon Seon
    • Journal of Korean Neurosurgical Society
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    • v.61 no.2
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    • pp.127-166
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    • 2018
  • Despite advancements in treating ruptured cerebral aneurysms, an aneurysmal subarachnoid hemorrhage (aSAH) is still a grave cerebrovascular disease associated with a high rate of morbidity and mortality. Based on the literature published to date, world-wide academic and governmental committees have developed clinical practice guidelines (CPGs) to propose standards for disease management in order to achieve the best treatment outcomes for aSAHs. In 2013, the Korean Society of Cerebrovascular Surgeons issued a Korean version of the CPGs for aSAHs. The group researched all articles and major foreign CPGs published in English until December 2015 using several search engines. Based on these articles, levels of evidence and grades of recommendations were determined by our society as well as by other related Quality Control Committees from neurointervention, neurology and rehabilitation medicine. The Korean version of the CPGs for aSAHs includes risk factors, diagnosis, initial management, medical and surgical management to prevent rebleeding, management of delayed cerebral ischemia and vasospasm, treatment of hydrocephalus, treatment of medical complications and early rehabilitation. The CPGs are not the absolute standard but are the present reference as the evidence is still incomplete, each environment of clinical practice is different, and there is a high probability of variation in the current recommendations. The CPGs will be useful in the fields of clinical practice and research.

Patterns of Unintentional Domestic Injuries in Korea (우리나라 주택 내에서 발생하는 비의도적 손상의 양상)

  • Lee, Eun-Jung;Lee, Jin-Seok;Kim, Yoon;Park, Kun-Hee;Eun, Sang-Jun;Suh, Soo-Kyung;Kim, Yong-Ik
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.1
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    • pp.84-92
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    • 2010
  • Objectives: To investigate the patterns of unintentional home injuries in Korea. Methods: The study population was 12,382,088 people who utilized National Health Insurance services due to injuries (main diagnosis codes S00 to T28) during 2006. Stratified samples(n=459,501) were randomly selected by sex, age group and severity of injury. A questionnaire was developed based on the International Classification of External Causes of Injury and 18,000 cases surveyed by telephone were analyzed after being projected into population proportionately according to the response rates of their strata. Domestic injury cases were finally included. Results: Domestic injuries (n=3,804) comprised 21.1% of total daily life injuries during 2006. Women were vulnerable to home injuries, with the elderly and those of lower income (medical-aid users) tending to suffer more severe injuries. Injury occurred most often due to a slipping fall (33.9%), overexertion (15.3%), falling (9.5%) and stumbling (9.4%), with severe injury most often resulting from slipping falls, falls and stumbles. Increasing age correlated with domestic injury-related disability. Conclusions: The present findings provide basic information for development of home injury prevention strategies, with focus on the elderly.

CLINICAL STUDY OF CYST IN THE JAW (악골 낭종에 대한 임상적 연구)

  • Cha, Sang-Kweon;Kim, Il-Kyu;Oh, Seong-Seob;Choi, Jin-Ho;Oh, Nam-Sik;Lim, Young-Il;Kim, Wang-Sik;Heo, Ji-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.2
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    • pp.167-173
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    • 2001
  • Cystic lesion of the jaw are frequently encountered clinically. Although they rarely lead to development of tumors, they can result in resorption of the jaw bone or asymmetry of the face may occur. The purpose of this study is to find the clinical and histopathological pattern of cysts and to help better understanding for the diagnosis and treatment of jaw cysts. The hospital chart, out-patient chart, panorama X-ray, histopathological report and operation report of 246 patients were reviewed who had been diagnosed as cyst. Sex distribution, age distribution, classification, anatomic distribution, clinical sign & symptoms, treatment, post-operation complications, recurrence rate were studied. Then significant difference between the diameter of cyst with bone graft and none-bone graft was calculated with SAS program. The results were as follows. 1. Among the total patient of 246 cases, male were 163 case(67.0%), and female were 83 case(37.0%), male predominated by the ratio of 1.98. 2. By age group, the 20's accounted for the largest proportion of the cases(27.2%) and the 30' accounted for the 2nd largest proportion of the case(19.5%). 3. Radicular cyst and dentigerous cyst were most common cysts, irrespective of 166 case(67.5%) and 62 case(25.2%). 4. Clinical sign & symptoms were swelling(167case), pain(85case), pus discharge(53case), teeth discoloration(28case), indicating that most complaints were related to inflammation and facial asymmetry. 4.9% of the total cases were discovered accidentally. 5. The primary site of cysts were maxillary anterior area(43.9%), the others were, in descending order, mandibular posterior area(25.6%), maxillary posterior area(14.6%). 6. Enucleation with endodontic treatment was a main treatment method(133 case, 54.1%) and 38 cases(15.4%) were enucleation with extraction, and 37 cases(15.0%) were only enucleation, and 21 cases(8.5%) were enucleation with bone graft. 7. The average diameter of cysts with bone graft was significally greater than with non-bone graft(p<0.05). 8. Post-operation complications occurred in 10 case(4.1%), all of this were due to secondary infection.

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Clinical Outcome of Turkish Metastatic Breast Cancer Patients with Currently Available Treatment Modalities - Single Center Experience

  • Cabuk, Devrim;Basaran, Gul;Teomete, Mehmet;Dane, Faysal;Korkmaz, Taner;Seber, Selcuk;Telli, Ferhat;Yumuk, Perran Fulden;Turhal, Serdar
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.117-122
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    • 2014
  • Background: Breast cancer is the most common malignancy and the second leading cause of cancer-related death among women in the developed countries. Despite advances in screening, improved local therapies and adjuvant systemic treatments, median survival of metastatic breast cancer patients (MBC) is in the range of 2-3 years at most. We aimed to investigate whether the prognostic factors and therapeutic responses of our Turkish patients are similar to those in the literature. Materials and Methods: We reviewed the medical records of MBC patients who had been treated in our institution between 1999-2009 and analyzed their clinicopathological features and survival outcomes retrospectively Results: A hundred and sixty patients were included. Median age was 47 (23-82), median follow up was 24 (2-186) months. At the time of diagnosis 59% of patients were under the age of 50 and 46% were postmenopausal. The majority (37%) had multiple sites of metastases. Forty percent received endocrine therapy and 40% chemotherapy as first line metastatic treatment. Thirty (20%) patients were treated with molecular targeting agents like trastuzumab, lapatinib and sunitinib, frequently combined with a chemotherapy agent. Five-year overall survival (OS) was 32% and median OS was 38 months for the whole group. Five year progression free survival (PFS) was 10% and median PFS was 10 months. Menopausal status, hormone receptor expression and disease free status had a significant impact on overall survival in the multivariate analysis (p 0.018, p 0.018 and p:0.003, respectively). Conclusions: All our patients were treated with the modern oncologic therapies recommended by the international guidelines. From our data, MBC patients live up to 3-4 years, indicating that further improvement beyond that requires development of new treatment modalities. The survival outcomes of our patients were consistent with the data reported in the literature.

Appetite and Related Factors among Community Elders in Korea (국내 일부 재가 노인의 식욕부진 실태와 관련 인자 분석)

  • Park, Soojin
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.9
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    • pp.1431-1438
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    • 2014
  • This study assessed the risk and prevalence of anorexia as well as associated factors among home-dwelling elderly adults. The subjects were 419 elderly men (116) and women (303) aged 65 years and older ($76{\pm}5.6yr$) living in Korea. Data were collected by personal interviews using questionnaires. The collected data were analyzed by descriptive statistics and Pearson's correlation. The prevalence of anorexia was 35.1% among participants. Male elders (74.1%) had higher proportions of anorexia than female elders (20.1%) (P<0.001). Significant differences in the appetite were observed according to type of disease, depression, and activities of daily living (ADL) index. In the poor appetite group, central nervous system diseases were the primary illness in male elders (P<0.01), whereas endocrine diseases were the primary illness in female elders (P<0.01). Elders with good appetites had less symptoms of depression (P<0.001) and greater independence in ADL (P<0.001). These results explored the high prevalence of anorexia in geriatric populations in Korea and its impact on elderly nutritional status and health. Further research should be performed to identify the causes of anorexia and establish an intervention protocol allowing the early diagnosis of anorexia.