• Quality Improvement in Health Care
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• v.11 no.1
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• pp.4-14
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• 2004

Background : To examine the problems involved in writing practice of death certificates, we compared the determination of underlying cause of death for vital statistics using recorded underlying cause of death in issued death statistics. Methods : We collected 688 mortality certificates issue in year of 2,000 from 3 university hospitals. And we also collected vital statistics from ministry of statistics. The causes of death were coded by experienced medical record specialists. And causes of death determined at ministry of statistics for national vital statistics were mapped to causes of death recorded at each death certificates. The rate that underlying causes of death for vital statistics were derived from underlying causes of death recorded at issued death certificates were analysed. Results : 64.5% of underlying cause of death for could be derived from underlying cause of death recorded at issued death certificates, 8.6% derived from intermediate cause of death, and 3.9% derived from direct cause of death. In 23% of cases, underlying cause of death could not be derived using issued death certificates. The rate that underlying cause of death for vital statistics could be derived from underlying cause of death recorded at death certificates was different between 3 university hospitals. And the rate was also different between death certificates and postmortem certificates. We classified the causes of death using 21 major categories. The rate was different between diseases or conditions that caused death too. Conclusion : When we examined the correctness of death certificate writing practice using above methods, correctness of writing could not be told as satisfactory. There was difference in correctness of writing between hospitals, between death certificates and postmortem certificates, and between diseases and conditions that caused death. With this results, we suggested some strategy to improve the correctness of death certificate writing practice.

• Journal of the Korea Safety Management & Science
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• v.2 no.4
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• pp.19-32
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• 2000

Assignable causes producing temporary deviation from the underlying system can influence on process adjustment and process monitoring in dynamic feedback control system. In this paper, the impact of assignable causes on EWMA forecasts and process adjustment which is based on the EWMA forecasts are derived for optimum control methods.

• Childhood Kidney Diseases
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• v.26 no.1
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• pp.40-45
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• 2022

Purpose: Chronic kidney disease (CKD) has various underlying causes in children. Identification of the underlying causes of CKD is important. Genetic causes comprise a significant proportion of pediatric CKD cases. Methods: In this study, we performed whole-exome sequencing (WES) to identify genetic causes of pediatric CKD. From January to June 2021, WES was performed using samples from pediatric patients with CKD of unclear etiology. Results: Genetic causes were investigated using WES in 37 patients (17 males) with pediatric CKD stages 1 (n=5), 2 (n=7), 3 (n=2), 4 (n=2), and 5 (n=21). The underlying diseases were focal segmental glomerulosclerosis (n=9), congenital anomalies of the kidney and urinary tract including reflux nephropathy (n=8), other glomerulopathies (n=7), unknown etiology (n=6), and others (n=7). WES identified genetic causes of CKD in 12 of the 37 patients (32.4%). Genetic defects were discovered in the COL4A4 (n=2), WT1 (n=2), ACTN4, CEP290, COL4A3, CUBN, GATA3, LAMA5, NUP107, and PAX2 genes. WT1 defects were found in patients whose pathologic diagnosis was membranoproliferative glomerulonephritis, and identification of CUBN defects led to discontinuation of immunosuppressive agents. Genetic diagnosis confirmed the clinical diagnosis of hypoparathyroidism, sensorineural deafness, and renal disease; Alport syndrome; and Joubert syndrome in three of the patients with CKD of unknown etiology (COL4A4 [n=2], CUBN [n=1]). Extrarenal symptoms were considered phenotypic presentations of WT1, PAX2, and CEP290 defects. Conclusions: WES provided a genetic diagnosis that confirmed the clinical diagnosis in a significant proportion (32.4%) of patients with pediatric CKD.

• Childhood Kidney Diseases
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• v.21 no.2
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• pp.53-60
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• 2017

Proteinuria is common in pediatric and adolescent patients. Proteinuria is defined as urinary protein excretion at levels higher than $100-150mg/m^2/day$ in children. It can be indicative of normal or benign conditions as well as numerous types of severe underlying renal or systemic disease. The school urine screening program has been conducted in Korea since 1998. Since then, numerous patients with normal or benign proteinuria as well as early stage renal diseases have been referred to the hospital. Benign proteinuria includes orthostatic proteinuria and transient proteinuria. Most causes of proteinuria can be categorized into 3 types: 1) overflow, 2) tubular, and 3) glomerular. Although treatment should be directed at the underlying cause of the proteinuria, prompt evaluation, diagnosis, and long-term monitoring of these pediatric patients can prevent potential progression of the underlying disease process. This article provides an overview of proteinuria: its causes, methods of assessment, and algorithmic suggestions to differentiate benign from pathologic renal disease.

• Journal of Genetic Medicine
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• v.18 no.2
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• pp.75-82
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• 2021

Speech and language functions are highly cognitive and human-specific features. The underlying causes of normal speech and language function are believed to reside in the human brain. Developmental persistent stuttering, a speech and language disorder, has been regarded as the most challenging disorder in determining genetic causes because of the high percentage of spontaneous recovery in stutters. This mysterious characteristic hinders speech pathologists from discriminating recovered stutters from completely normal individuals. Over the last several decades, several genetic approaches have been used to identify the genetic causes of stuttering, and remarkable progress has been made in genome-wide linkage analysis followed by gene sequencing. So far, four genes, namely GNPTAB, GNPTG, NAGPA, and AP4E1, are known to cause stuttering. Furthermore, thegeneration of mouse models of stuttering and morphometry analysis has created new ways for researchers to identify brain regions that participate in human speech function and to understand the neuropathology of stuttering. In this review, we aimed to investigate previous progress, challenges, and future perspectives in understanding the genetics and neuropathology underlying persistent developmental stuttering.

• Journal of Korean Society for Quality Management
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• v.31 no.2
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• pp.183-193
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• 2003

A special cause producing temporary deviation in the underlying process can influence on process adjustment in responsive feedback control system. In this paper, the impact of special causes on the EWMA(Exponentially Weighted Moving Average) forecasts and the process adjustment that is based on the EWMA forecasts are derived. For some special causes with patterned type of contamination, the influence of the causes on the output process are explicitly investigated. A data set, contaminated by a special cause of level shift, is analyzed to evaluate the impact numerically.

• Journal of the Korea Safety Management & Science
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• v.7 no.5
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• pp.213-231
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• 2005

Assignable causes producing temporary deviation from the underlying system can influence on process adjustment and process monitoring in dynamic feedback control system. In this paper, the influence of assignable causes on EWMA forecasts and compensatory variables are derived for a dynamic feedback control system. An example is presented to confirm the impact numerically through the analysis of a data.

• Journal of Korean Society for Quality Management
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• v.32 no.2
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• pp.201-211
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• 2004

Process adjustment is a complimentary tool to process monitoring in process control. Process adjustment directs on maintaining a process output close to a target value by manipulating another controllable variable, by which significant process improvement can be achieved. Therefore, this approach can be applied to the 'Improve' stage of Six Sigma strategy. Though the optimal control rule minimizes process variability in general, it may not properly function when special causes occur in underlying process, resulting in off-target bias and increased variability in the adjusted output process, possibly for long periods. In this paper, we consider a responsive feedback control system and the minimum mean square error control rule. The bias in the adjusted output process is investigated in a general framework, especially focussing on stationary underlying process and the special cause of level shift type. Illustrative examples are employed to illustrate the issues discussed.

• Proceedings of the Korean Society for Quality Management Conference
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• 2004.04a
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• pp.425-429
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• 2004

Process adjustment Is a complimentary tool to process monitoring in process control. Process adjustment directs on maintaining a process output close to a target value by manipulating another controllable variable, by which significant process improvement can be achieved. Therefore, this approach can be applied to the 'Improve' stage of Six Sigma strategy. Though the optimal control rule minimizes process variability in general, it may not properly function when special causes occur in underlying process, resulting in off-target bias and increased variability in the adjusted output process, possibly for long periods. In this paper, we consider a responsive feedback control system and the minimum mean square error control rule. The bias in the adjusted output process is investigated in a general framework, especially focussing on stationary underlying process and the special cause of level shift type. Illustrative examples are employed to illustrate the issues discussed.

• Clinical and Experimental Pediatrics
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• v.57 no.4
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• pp.164-170
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• 2014

Influenza causes acute respiratory infections and various complications. Children in the high-risk group have higher complication and hospitalization rates than high-risk elderly individuals. Influenza prevention in children is important, as they can be a source infection spread in their communities. Influenza vaccination is strongly recommended for high-risk children with chronic underlying circulatory and respiratory disease, immature infants, and children receiving long-term immunosuppressant treatment or aspirin. However, vaccination rates in these children are low because of concerns regarding the exacerbation of underlying diseases and vaccine efficacy. To address these concerns, many clinical studies on children with underlying respiratory diseases have been conducted since the 1970s. Most of these reported no differences in immunogenicity or adverse reactions between healthy children and those with underlying respiratory diseases and no adverse effects of the influenza vaccine on the disease course. Further to these studies, the inactivated split-virus influenza vaccine is recommended for children with underlying respiratory disease, in many countries. However, the live-attenuated influenza vaccine (LAIV) is not recommended for children younger than 5 years with asthma or recurrent wheezing. Influenza vaccination is contraindicated in patients with severe allergies to egg, chicken, or feathers, because egg-cultivated influenza vaccines may contain ovalbumin. There has been no recent report of serious adverse events after influenza vaccination in children with egg allergy. However, many experts recommend the trivalent influenza vaccine for patients with severe egg allergy, with close observation for 30 minutes after vaccination. LAIV is still not recommended for patients with asthma or egg allergy.