• Clinical and Experimental Pediatrics
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• v.55 no.12
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• pp.481-486
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• 2012

Purpose: Precocious puberty is defined as breast development before the age of 8 years in girls. The present study aimed to reveal the diagnosis of Korean girls referred for precocious puberty and to compare the constitutional and endocrinological features among diagnosis groups. Methods: The present study used a retrospective chart review of 988 Korean girls who had visited a pediatric endocrinology clinic from 2006 to 2010 for the evaluation of precocious puberty. Study groups comprised fast puberty, true precocious puberty (PP), pseudo PP, premature thelarche, and control. We determined the height standard deviation score (HSDS), weight standard deviation score (WSDS), and body mass index standard deviation score (BMISDS) of each group using the published 2007 Korean growth charts. Hormone tests were performed at our outpatient clinic. Results: The PP groups comprised fast puberty (67%), premature thelarche (17%), true PP (15%), and pseudo PP (1%). Advanced bone age and levels of estradiol, basal luteinizing hormone (LH), and peak LH after gonadotropin-releasing hormone stimulation testing were significantly high in the fast puberty and true PP groups compared with the control group. HSDS, WSDS, and BMISDS were significantly higher in the true PP group than in the control group (P<0.05). Conclusion: The frequent causes of PP were found to be fast puberty, true PP, and premature thelarche. Furthermore, BMISDS were significantly elevated in the true PP group. Therefore, we emphasize the need for regular follow-up of girls who are heavier or taller than others in the same age group.

• Journal of Genetic Medicine
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• v.20 no.2
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• pp.60-69
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• 2023

Purpose: Despite enzyme replacement therapy (ERT) and/or allogeneic hematopoietic stem cell transplantation, individuals with mucopolysaccharidosis (MPS) I or II often experience significant growth deficiencies. This study aimed to assess the safety and efficacy of recombinant human growth hormone (hGH) treatment in children diagnosed with MPS I or II. Materials and Methods: A total of nine pediatric patients-four with MPS I and five with MPS II-underwent treatment with ERT and hGH at Samsung Medical Center. Results: The mean hGH dose administered was 0.26±0.03 mg/kg/week. In the MPS I group, three patients showed an increase in height Z-score from -4.09±0.83 to -3.68±0.43 after 1 year of hGH treatment, and to -3.10±0.72 by the end of the hGH regimen. In the MPS II group, while the height Z-score of four patients decreased according to standard growth charts, it improved from 1.61±1.79 to 2.71±1.68 based on the disease-specific growth chart through hGH treatment. Two patients discontinued hGH treatment due to lack of efficacy after 22 and 6 months each of treatment, respectively. No new-onset neurological symptoms or necessity for prosthetic or orthopedic surgery were reported during hGH treatment. Conclusion: This study provides insights into the impact of hGH on MPS patients, demonstrating its potential to reverse growth deceleration in some cases. Further research is needed to explore the long-term effects of hGH on changes in body composition, muscle strength, and bone health in this population.

• Clinical and Experimental Pediatrics
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• v.55 no.11
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• pp.430-437
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• 2012

Purpose: Mucopolysaccharidosis IVA (MPS IVA; Morquio A syndrome) is rare lysosomal storage disorder caused by N-acetylgalactosamine-6-sulfatase (GALNS) deficiency. Only a few MPS IVA cases have been reported in the Korean literature; there is a paucity of research about clinical or radiologic findings for this disorder. Therefore, we studied clinical findings, radiological features, and genetic data of Korean MPS IVA patients for determining factors that may allow early diagnosis and that may thus improve the patients' quality of life. Method: MPS IVA was confirmed via assay for enzymatic activity of leukocytes in 10 patients. The GALNS gene was analyzed. Patients' charts were retrospectively reviewed for obtaining clinical features and evaluated for radiological skeletal surveys, echocardiography, pulmonary function test, and ophthalmologic test results. Result: Nine patients had severe clinical phenotype, and 1 had an intermediate phenotype, on the basis of clinical phenotype criteria. Radiologic findings indicated skeletal abnormalities in all patients, especially in the hips and extremities. Eight patients had an odontoid hypoplasia, and 1 showed mild atlantoaxial subluxation and cord myelopathy. Genetic analysis indicated 10 different GALNS mutations. Two mutations, c.451C>A and c.1000C>T, account for 37.5% (6/16) and 25% (4/16) of all mutations in this samples, respectively. Conclusion: An understanding of the clinical and radiological features involved in MPS IVA may allow early diagnosis of MPS IVA. Adequate evaluations and therapy in the early stages may improve the quality of life of patients suffering from skeletal abnormalities and may reduce life-threatening effects of atlantoaxial subluxation.

• Korean Journal of Digital Imaging in Medicine
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• v.13 no.3
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• pp.139-144
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• 2011

The purpose of this report is recommending a standard indicator which reflects the radiation exposure that is incident on a detector after every exposure event and that reflects the noise levels present in the image data. The experiment was performed with mobile digital X-ray unit and used a acrylic phantom for exposure index measurement. Exposure modality was kVp, mAs, SID. After every exposure, make a data sheet for characteristic curve of detector response. The equipment performed Mobile digital X-ray unit provide the user with values ralated to the incident exposure(air kerma)to the digital detector. They are showed as a logarithmic function shaped. As a result, DEI means a relative measure of exposure to the detector, as compared to the expected exposure for a particular anatomical view. Radiographic technique is the combination of factors used to exposure an anatomical part to produce a high quality radiography and technique charts used most commonly by radiographers to produce consistently exposure level which patient dose can be kept acceptably low.

• Journal of Preventive Medicine and Public Health
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• v.56 no.2
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• pp.190-195
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• 2023

Objectives: Pregnancy complications, including pre-eclampsia, gestational diabetes (GDM), and perinatal mood and anxiety disorders (PMADs), impact long-term health. We compared the frequency of screening documentation for pregnancy complications versus a general medical history at well woman visits between providers in primary care and obstetrics and gynecology. Methods: We conducted a retrospective cohort study of subjects with at least 1 prior birth who presented for a well woman visit in 2019-2020. Charts were reviewed for documentation of a general medical history (hypertension, diabetes, and mood disorders) versus screening for comparable obstetric complications (pre-eclampsia, GDM, and PMADs). The results were compared using the McNemar and chi-square tests as appropriate. Results: In total, 472 encounters were identified, and 137 met the inclusion criteria. Across specialties, clinicians were significantly more likely to document general medical conditions than pregnancy complications, including hypertensive disorders (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.18 to 5.48), diabetes (OR, 7.67; 95% CI, 3.27 to 22.0), and mood disorders (OR, 10.5; 95% CI, 3.81 to 40.3). Obstetrics and gynecology providers were more likely to document any pregnancy history (OR, 4.50; 95% CI, 1.24 to 16.27); however, they were not significantly more likely to screen for relevant obstetric complications (OR, 2.49; 95% CI, 0.90 to 6.89). Overall, the rate of pregnancy complication documentation was low in primary care and obstetrics and gynecology clinics (8.8 and 19.0%, respectively). Conclusions: Obstetrics and gynecology providers more frequently documented a pregnancy history than those in primary care; however, the rate was low across specialties, and providers reported screening for clinically relevant complications less frequently than for general medical conditions.

• Archives of Craniofacial Surgery
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• v.17 no.1
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• pp.20-24
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• 2016

Background: Midface concavity is a relatively common facial feature in East Asian populations. Paranasal augmentation is becoming an increasingly popular procedure for patients with mild concavity and normal occlusion. In this study, we evaluate clinical outcomes following a series of paranasal augmentation. Methods: A retrospective review was performed for patients with Class I occlusion who had undergone bilateral paranasal augmentation using custom-made silicone implants, between October 2005 and September 2013. Patient charts were reviewed for demographic information, concomitant operations, and postoperative complications. Preoperative and postoperative (1-month) photographs were used to evaluate operative outcome. Results: The review identified a total of 93 patients meeting study criteria. Overall, aesthetic outcomes were satisfactory. Five-millimeter thick silicone implant was used in 81 cases, and the mean augmentation was 4.26 mm for this thickness. Among the 93 patients, 2 patients required immediate implant removal due to discomfort. An additional 3 patients experienced implant migration without any extrusion. Nine patients complained of transient paresthesia, which had resolved by 2 weeks. There were no cases of hematoma or infection. All patients reported improvement in their lateral profile and were pleased at follow-up. Complications that arose postoperatively included 9 cases of numbness in the upper lip and 3 cases of implant migration. All cases yielded satisfactory results without persisting complications. Sensations were fully restored postoperatively after 1 to 2 weeks. Conclusion: Paranasal augmentation with custom-made silicone implants is a simple, safe, and inexpensive method that can readily improve the lateral profile of a patient with normal occlusion. When combined with other aesthetic procedures, paranasal augmentation can synergistically improve outcome and lead to greater patient satisfaction.

• Journal of Korean Neurosurgical Society
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• v.59 no.2
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• pp.117-121
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• 2016

Objective : Hemorrhagic moyamoya disease (hMMD) is associated with a poor clinical course. Furthermore, poorer clinical outcomes occur in cases of recurrent bleeding. However, the effect of hemodynamic insufficiency on rebleeding risk has not been investigated yet. This study evaluated the prognostic implications of the perfusion status during the clinical course of adult hMMD. Methods : This retrospective study enrolled 52 adult hMMD patients between April 1995 and October 2010 from a single institute. Demographic data, clinical and radiologic characteristics, including hemodynamic status using single photon emission computed tomography (SPECT), and follow up data were obtained via a retrospective review of medical charts and imaging. Statistical analyses were performed to explore potential prognostic factors. Results : Hemodynamic abnormality was identified in 44 (84.6%) patients. Subsequent revascularization surgery was performed in 22 (42.3%) patients. During a 58-month (median, range 3-160) follow-up assessment period, 17 showed subsequent stroke (hemorrhagic n=12, ischemic n=5, Actuarial stroke rate $5.8{\pm}1.4%/year$). Recurrent hemorrhage was associated with decreased basal perfusion (HR 19.872; 95% CI=1.196-294.117) and omission of revascularization (10.218; 95%; CI=1.532-68.136). Conclusion : Decreased basal perfusion seems to be associated with recurrent bleeding. Revascularization might prevent recurrent stroke in hMMD by rectifying the perfusion abnormality. A larger-sized, controlled study is required to address this issue.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2611-2617
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• 2016

Background: Medication errors are common but most often preventable events in any health care setup. Studies on medication errors involving chemotherapeutic drugs are limited. Objective: We studied three aspects of medication errors - prescription, transcription and administration errors in 500 cancer patients who received ambulatory cancer chemotherapy at a resource limited setting government hospital attached cancer centre in South India. The frequency of medication errors, their types and the possible reasons for their occurrence were analysed. Design and Methods: Cross-sectional study using direct observation and chart review in anmbulatory day care unit of a Regional Cancer Centre in South India. Prescription charts of 500 patients during a three month time period were studied and errors analysed. Transcription errors were estimated from the nurses records for these 500 patients who were prescribed anticancer medications or premedication to be administered in the day care centre, direct observations were made during drug administration and administration errors analysed. Medical oncologists prescribing anticancer medications and nurses administering medications also participated. Results: A total of 500 patient observations were made and 41.6% medication errors were detected. Among the total observed errors, 114 (54.8%) were prescription errors, 51(24.5%) were transcribing errors and 43 (20.7%) were administration errors. The majority of the prescription errors were due to missing information (45.5%) and administration errors were mainly due to errors in drug reconstitution (55.8%). There were no life threatening events during the observation period since most of the errors were either intercepted before reaching the patient or were trivial. Conclusions: A high rate of potentially harmful medication errors were intercepted at the ambulatory day care unit of our regional cancer centre. Suggestions have been made to reduce errors in the future by adoption of computerised prescriptions and periodic sensitisation of the responsible health personnel.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4797-4802
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• 2016

Background: Breast cancer (BC) is the top cancer among women worldwide and has been the most frequent malignancy among Kazakhstan women over the past few decades. Information on clinical and histopathological features of metastatic breast cancer (MBC), as well as the distribution of molecular subtypes is limited for Kazakh people. Materials and Methods: The present observational retrospective study was carried out at Regional Oncologic Dispensaries in the North-East Region of Kazakhstan (in Semey and Pavlodar cities). Сlinical and histopathological data were obtained for a total of 570 MBC patients in the 10 year period from 2004-2013, for whom data on molecular subtype were available for 253. Data from hospital charts were entered into SPSS 20 for analysis by one-way ANOVA analysis of associations of different variables with 1-5 year survival. Pearson correlation and linear regression models were used to examine the relation between parameters with a p-value < 0.05 considered statistically significant. Results: No significant relationships were evident between molecular subtype and survival, site of metastases, stage or ethnicity. Young females below the age of 44 were slightly more likely to have triple negative lesions. While the ductal type greatly predomonated, luminal A and B cases had a higher percentage with lobular morphology. Conclusions: In this select group of metastatice brease cancer, no links were noted for survival with molecular subtype, in contrast to much of the literature.

• The Korean Nurse
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• v.32 no.5
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• pp.78-92
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• 1994

The purposes of this study were to evaluate the results of the hospital self inspection with the medical insurance and to offer basic materials to the medical insurance inspection and the education of medical insurance. The study was undertaken with 4,730 cases among the total 13,810 medical insurance in patients from Jan. 1990 to Dec. 1990 at one university hospital in Pusan. The major contents of the inspection were the omission of diagnosis and medical fee, curtailment, application mistake, the rates of inclusion, subtraction and total accumulation. The data were collected using patients charts and bills. The results of the paper analysis were as follows. 1. From the pre-discharge hospital self inspection, major omission were treatment and material fee but medication fee were moderately high and high curtailment was operation fee. 2. Decreasing order of operation fee adjustment were digestive(22.4%) muscular(22%) and neuro system operation(21.4%). Majority of the medication fee adjustments were injection form of medication(95.7%). 50% of the treatment fee adjustments were composed of injection fee(27.9%) and dressing or post-operative dressing fee(22.3%). 74.7% of material costs were composed of oxygen(30.6%), blood and the blood composed materials(44.1%). 3. Pre-discharge inspection showed 6% adjustment rate, 4.3% addition and 2.1% curtailment rate. Most of the adjustment were omission(66.1%). 4. Omission were divided by event omission(92.6%)and application mistake(7.4%). The decreasing order of omission fee were operation(21.84%), treatment(18.71 %) diagnosis(18.68%), medication (14.53%) and material costs(10.84%). So operation and treatment part were the major part of the total omission fee(40.55%). 5. The average omission of diagnosis were 1,800 per month.