• Title/Summary/Keyword: Re-diagnosis

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Impact of Intraoperative Macroscopic Diagnosis of Serosal Invasion in Pathological Subserosal (pT3) Gastric Cancer

  • Kim, Dong Jin;Lee, Jun Hyun;Kim, Wook
    • Journal of Gastric Cancer
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    • v.14 no.4
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    • pp.252-258
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    • 2014
  • Purpose: The macroscopic diagnosis of tumor invasion through the serosa during surgery is not always distinct in patients with gastric cancer. The prognostic impact of the difference between macroscopic findings and pathological diagnosis of serosal invasion is not fully elucidated and needs to be re-evaluated. Materials and Methods: A total of 370 patients with locally advanced pT2 to pT4a gastric cancer who underwent curative surgery were enrolled in this study. Among them, 155 patients with pT3 were divided into three groups according to the intraoperative macroscopic diagnosis of serosal invasion, as follows: serosa exposure (SE)(-) (no invasion, 72 patients), SE(${\pm}$) (ambiguous, 47 patients), and SE(+) (definite invasion, 36 patients), and the clinicopathological features, surgical outcomes, and disease-free survival (DFS) were analyzed. Results: A comparison of the 5-year DFS between pT3_SE(-) and pT2 groups and between pT3_SE(+) and pT4a groups revealed that the differences were not statistically significant. In addition, in a subgroup analysis of pT3 patients, the 5-year DFS was 75.1% in SE(-), 68.5% in SE(${\pm}$), and 39.4% in SE(+) patients (P<0.05). In a multivariate analysis to evaluate risk factors for tumor recurrence, macroscopic diagnosis (hazard ratio [HR], SE(-) : SE(${\pm}$) : SE(+)=1 : 1.01 : 2.45, P=0.019) and lymph node metastasis (HR, N0 : N1 : N2 : N3=1 : 1.45 : 2.20 : 9.82, P<0.001) were independent risk factors for recurrence. Conclusions: Gross inspection of serosal invasion by the surgeon had a strong impact on tumor recurrence in gastric cancer patients. Consequently, the gross appearance of serosal invasion should be considered as a factor for predicting patients' prognosis.

A study for the factors on choosing hospitals and patients satisfaction between Geriatric Hospitals and General Hospitals (노인병원과 종합병원의 선택요인 및 환자만족도 분석)

  • Yoon, Seo-Jung;Yu, Seung-Hum;Kim, Young-Hoon;Lee, Ji-Jeon
    • Korea Journal of Hospital Management
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    • v.9 no.2
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    • pp.46-75
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    • 2004
  • This research anticipated on acknowledging the inpatients factors in choosing which hospital for the geriatric hospital and general hospital they would prefer to go to the analization of different factors in patients satisfaction, and the relation between satisfactory standards and the patients intentions on recommendation or re-visiting the hospital. The statistical data was based upon the 359 question and answer papers that were done by inpatients that were hospitalized in two geriatric hospitals and two general hospitals, and the methods used for analyzing were frequency, t-test, factor analysis, and hierarchical multiple regression. The results are as follows. 1. The factors on choosing hospitals between geriatric hospital and general hospitals were different. The priority for the geriatrics was kindness, and then considerate nursing, and the reliance of treatment. The patients of general hospitals looked first for reliance of treatment, reputation and history of the hospital, and the kindness of the staff. The kindness of the staff, good nursing, and easy procedures were the primary factors of choosing geriatric hospital. 2. The four primary factors in choosing which hospital patients would go to were the predominance of the facilities, kindness and convenience, the reliance and proximity of medical treatment, and recommendation. The patients in the geriatric hospital first looked for kindness and convenience, second the reliance and proximity of medical treatment, third predominance of facilities, and last recommendation. The general hospitals main priority was the reliance and proximity of medical care, second predominance of facilities, kindness and hospitality, and last recommendation. 3. The satisfaction rate was higher in the geriatric hospital compared to general hospitals, but the satisfactory of factors were very similar. Patients in the geriatric hospital were pleased with the hospital staffs kindness, quick nursing and the improvement of inconvenient matters, and clear diagnosis of the doctors. The general hospital patients were satisfied with the hospital staffs clear explanation and accurate diagnosis 4. The analysis in the satisfactory factors turned out to be the environment of the hospital, kindness of the staff, and convenience. Both the patients of the geriatric hospital and general hospitals were very pleased with the kindness of the hospital staff. Ranking second and third was convenience and service for the geriatric hospital, and environment of the hospital and convenience for the general hospital. 5. According to a rank of multiple recurrent analysis of the patients satisfaction and the intention of re-visiting in addition to intention of solicitation, in the case of a geriatric hospital, when the intention of re-visiting is the dependent variable, the first stage shows that the less insurance the patient has, the higher was the intention of re-visiting. In the second stage, the more satisfied the patient is of the staffs kindness, the higher was the intention of re-visiting. Further more, when the intention of solicitation is the dependent variable, the first stage shows that not all the independent variables were significant, but the second stage shows that the more satisfied the patient is of the staffs kindness and the hospital along with the medical treatment expenses, the higher was the intention of solicitation. 6. In the first stage of a rank of multiple recurrent analysis of the satisfaction of the general hospital and the intention of re-visiting, not all the variables were significant, but in the second stage, all the satisfaction by factors were significant. Moreover, when the intention of solicitation was the dependent variable, the first stage shows not all the variables were significant, but in the second stage, all the satisfaction by factors were significant. That is to say, in the case of a general hospital, the satisfaction of the hospital and the medical treatment expenses were high, and the more satisfied the patient is of the hospitals environment and the staffs kindness, the intention of re-visiting and the intention of solicitation was higher.

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A Life Cycle-Based Performance-Centric Business Process Management Framework For Continuous Process Improvement (지속적 프로세스 개선을 위한 성과 중심의 생애 주기 기반 비즈니스 프로세스 관리 프레임워크)

  • Han, Kwan Hee
    • The Journal of the Korea Contents Association
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    • v.17 no.7
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    • pp.44-55
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    • 2017
  • Many enterprises have recently been pursuing process innovation or improvement to attain their performance goal. To comprehensively support business process execution, the concept of business process management (BPM) has been widely adopted. A life cycle of BPM is composed of process diagnosis, (re)design, and enactment. For aligning with enterprise strategies, all BPM activities must be closely related to performance metrics because the metrics are the drivers and evaluators of business process operations. The objective of this paper is to propose a life cycle-based BPM framework integrated with the process-based performance measurement model, in which business processes are systematically interrelated with key performance indicators (KPIs) during an entire BPM life cycle. By using the proposed BPM framework, company practitioners involved in process innovation projects can easily and efficiently find the most influencing processes upon enterprise performance in the process diagnosis phase, evaluate the performance of newly designed process in the process (re)design phase, monitor the KPIs of new business process, and adjust business process activities in the process execution phase through the BPM life cycle.

Operative Management of Complicated Meckel's Diverticulum Laparotomy and versus Laparoscopic Assisted Surgery (소아 멕켈씨 게실 합병증에서 시행한 개복 수술과 복강경 보조 수술의 비교)

  • Lee, Yu-Ra;Cho, Min-Jeng;Kim, Tae-Hoon;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.17 no.1
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    • pp.45-50
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    • 2011
  • Meckel's diverticulum (MD) has various clinical presentations and due to the limitation of imaging studies, pre-operative diagnosis is a challenge in pediatric patients. Recently, laparoscopic exploration has been suggested as a favorable method for the diagnosis and treatment of complicated MD. We investigated the results of laparoscopic-assisted surgery compared with open technique. We retrospectively studied patients who underwent resection of complicated MD at our institute from 1997 to 2010 and compared 11 treated by laparoscopic-assisted diverticulectomy (LD) with 11 treated by open diverticulectomy (OD) for complicated MD. Operation time was not significantly different in the two groups. Hospital stay and time to diet were not significantly different. Two patients were re-admitted due to mechanical ileus in the LD group. None of patients in either group needed re-operation. Considering the possibility of false-positive results with imaging studies and the cosmetic benefit, laparoscopic-assisted surgery is a safe and effective treatment modality to diagnose and treat complicated Meckel's diverticulum.

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Comparison of Quality Control for Chest Radiography between Special Examination and Medical Institution for Pneumoconiosis (진폐 정밀/요양기관과 요양기관의 흉부 방사선분야 정도관리 비교)

  • Lee, Won-Jeong
    • The Journal of the Korea Contents Association
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    • v.11 no.2
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    • pp.322-330
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    • 2011
  • To compare of quality control for chest radiography between special examination (SEP) and medical institution for pneumoconiosis (MIP). For the first time, we had visited at 33 institutions (SEP; 17 institutions, MIP; 16 institutions) to evaluate the quality control of chest radiography which is used in diagnosis of patients with pneumoconiotic complications. Image quality was rated by two experienced chest radiologists, and evaluated for radiological technique (RT), reading environment (RE) and image quality (IQ) between SEP and MIP according to the guideline published by OSHRI. Generator capacity, used duration and modality of chest radiography equipment were not signigicant difference between SEP and MIP, but there were signigicant difference in tube voltage and grid ratio used for chest radiography except to tube current and exposure time. SEP was statistically significant higher in RT (71.2 vs. 54.5, p=0.015), RE (78.8 vs. 51.5, p=0.007) to MIP, but not significant difference in IQ (64.8 vs. 59.3, p=0.180). For reliable and precisional diagnosis of patients with pneumoconiotic complications, the MIP requires the evaluation and education of quality control for improving chest radiography.

The Difference of Quality of Life on Blood Stasis Using SF-36 (SF-36을 이용한 어혈군과 비어혈군의 삶의 질 연구)

  • Lee, Yoon-Jae;Sohn, Sung-Se
    • The Journal of Korean Obstetrics and Gynecology
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    • v.27 no.4
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    • pp.15-24
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    • 2014
  • Objectives: There were only small studies about the difference of the quality of life depending on blood stasis. We investigated that the blood stasis made the differences of quality of life. Methods: We recruited the participants stratified according to age and gender. The participants were assessed independently by two Korean medicine doctors more than 7 years of clinical experiences whether or not with blood stasis. And they responded at the questionnaire associated with blood stasis and SF-36. The analysis was done with IBM SPSS Statistics (ver. 21). Results: Total 101 participants were checked for with/without blood stasis. 40 participants were accord in the diagnosis with blood stasis by two doctors. Two researchers coincided in diagnosis with non-blood stasis in 42 participants. 19 participants showed the discrepancy between the assessment of blood stasis and they were classified as non-blood stasis. The mean age in group of blood stasis was $44.07{\pm}11.65$, it was not shown the significant difference comparing non-blood stasis group. The subscale of physical function (PF), role-physical (RP), bodily pain (BP), general health (GH), vitality (VT), mental health (MH) and role emotional (RE) in SF-36 were significantly low in the group of blood stasis. Blood test including biochemistry, fibrinogen, prothrombin time and D-dimer was not in abnormal range according to blood stasis without CRP. Conclusions: The patients that diagnosed of blood stasis showed the bad physical health status, and partially bad mental health. It is necessary to investigate whether Korean traditional treatment for blood stasis would be made improvement for quality of life. Moreover, the standardization of diagnosis on blood stasis would be needed.

The Principle and Trends of CRISPR/Cas Diagnosis (CRISPR/Cas 진단의 원리와 현황)

  • Park, Jeewoong;Kang, Bong Keun;Shin, Hwa Hui;Shin, Jun Geun
    • Journal of Biomedical Engineering Research
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    • v.42 no.3
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    • pp.125-142
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    • 2021
  • The POCT (point-of-care test) sensing that has been a fast-developing field is expected to be a next generation technology in health care. The POCT sensors for the detection of proteins, small molecules and especially nucleic acids have lately attracted considerable attention. According to the World Health Organization (WHO), the POCT methods are required to follow the ASSURED guidelines (Affordable, Sensitive, Specific, User- friendly, Robust and rapid, Equipment-free, Deliverable to all people who need the test). Recently, several CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) based diagnostic techniques using the sensitive gene recognition function of CRISPR have been reported. CRISPR/Cas (Cas, CRISPR associated protein) systems based detection technology is the most innovative gene analysis technology that is following the ASSURED guidelines. It is being re-emerged as a powerful diagnostic tool that can detect nucleic acids due to its characteristics that enable rapid, sensitive and specific analyses of nucleic acid. The first CRISPR-based diagnosis begins with the discovery of the additional function of Cas13a. The enzymatic cleavage occurs when the conjugate of Cas protein and CRISPR RNA (crRNA) detect a specific complementary sequence of the target sequence. Enzymatic cleavage occurs on not only the target sequence, but also all surrounding non-target single-stranded RNAs. This discovery was immediately utilized as a biosensor, and numerous sensor studies using CRISPR have been reported since then. In this review, the concept of CRISPR, the characteristics of the Cas protein required for CRISPR diagnosis, the current research trends of CRISPR diagnostic technology, and some aspects to be improved in the future are covered.

A protein interactions map of multiple organ systems associated with COVID-19 disease

  • Bharne, Dhammapal
    • Genomics & Informatics
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    • v.19 no.2
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    • pp.14.1-14.6
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    • 2021
  • Coronavirus disease 2019 (COVID-19) is an on-going pandemic disease infecting millions of people across the globe. Recent reports of reduction in antibody levels and the re-emergence of the disease in recovered patients necessitated the understanding of the pandemic at the core level. The cases of multiple organ failures emphasized the consideration of different organ systems while managing the disease. The present study employed RNA sequencing data to determine the disease associated differentially regulated genes and their related protein interactions in several organ systems. It signified the importance of early diagnosis and treatment of the disease. A map of protein interactions of multiple organ systems was built and uncovered CAV1 and CTNNB1 as the top degree nodes. A core interactions sub-network was analyzed to identify different modules of functional significance. AR, CTNNB1, CAV1, and PIK3R1 proteins were unfolded as bridging nodes interconnecting different modules for the information flow across several pathways. The present study also highlighted some of the druggable targets to analyze in drug re-purposing strategies against the COVID-19 pandemic. Therefore, the protein interactions map and the modular interactions of the differentially regulated genes in the multiple organ systems would incline the scientists and researchers to investigate in novel therapeutics for the COVID-19 pandemic expeditiously.

Genetic Diversity of Plasmodium vivax Causing Epidemic Malaria in the Republic of Korea

  • Bahk, Young Yil;Kim, Jeonga;Ahn, Seong Kyu;Na, Byoung-Kuk;Chai, Jong-Yil;Kim, Tong-Soo
    • Parasites, Hosts and Diseases
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    • v.56 no.6
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    • pp.545-552
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    • 2018
  • Plasmodium vivax is more challenging to control and eliminate than P. falciparum due to its more asymptomatic infections with low parasite densities making diagnosis more difficult, in addition to its unique biological characteristics. The potential re-introduction of incidence cases, either through borders or via human migrations, is another major hurdle to sustained control and elimination. The Republic of Korea has experienced re-emergence of vivax malaria in 1993 but is one of the 32 malaria-eliminating countries to-date. Despite achieving successful nationwide control and elimination of vivax malaria, the evolutionary characteristics of vivax malaria isolates in the Republic of Korea have not been fully understood. In this review, we present an overview of the genetic variability of such isolates to increase understanding of the epidemiology, diversity, and dynamics of vivax populations in the Republic of Korea.

A Study on the Length of Stay In Hospital Before and After Operation (수술전.후 재원일수에 관한 조사연구)

  • Kim Mi-Young;Park Kyung-Sook;Kim Kyung-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.4 no.2
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    • pp.245-265
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    • 1997
  • The purpose of this study was to promote the effectiveness in managing disease or injury, by examining the length of stay in hospital according to characteristics concerned before and after operation, and by serving as a basis for reducing that length. As a result of investigating the length of stay in hospital according to inpatient's personal characteristics, clinical features and other characteristics concerned, the following characteristics appeared significant. The characteristics that showed a significant difference about the length of stay in hospital before and after operation were the age and the fact whether one was married or not among inpatient's personal characteristics. The significant ones among clinical features were the route to be taken to hospital, the form of insurance, the experience of re-hospitalization, whether another disease coexisted, the experiment of changing department, whether a diagnosis was determined by consultation, whether an intensive care unit was used, whether re-operation was performed, the total number of case of the experience of re-hospitalization, inpatient who were again sent to hospital under the same diagnosis was not included in the investigation, which was pointed out as a limit in this study. The significant ones among other characteristics concerned were the date and season when the patients were taken to hospital and the doctor in attendance. The doctor in attendance appeared to give a significant impact on the length of stay in hospital before operation, but no significant difference was noted in the mean among the doctors in attendance. And those characteristics were not found regularly among the selected departments. As stated above, one way to reduce the length of stay In hospital was to diminish the length of stay in hospital before operation. The term of hospitalization before operation shall be reduced by grasping the factors that affected that length before operation and by conducting examination as many as possible in the out-patient department. Also, the efforts should be put on that length after operation. The management of hospital seemed to be successfully carried out if those factors affected that length were effectively controlled.

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