• 제목/요약/키워드: Clinical coding

검색결과 142건 처리시간 0.022초

Improving Accuracy and Completeness in the Collaborative Staging System for Stomach Cancer in South Korea

  • Lim, Hyun-Sook;Won, Young-Joo;Boo, Yoo-Kyung
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권21호
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    • pp.9529-9534
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    • 2014
  • Background: Cancer staging enables planning for the best treatments, evaluation of prognosis, and predictions for survival. The Collaborative Stage (CS) system makes it possible to significantly reduce the proportion of patients labeled at an "unknown" stage as well as discrepancies among different staging systems. This study aims to analyze the factors that influence the accuracy and validity of CS data. Materials and Methods: Data were randomly selected (233 cases) from stomach cancer cases enrolled for CS survey at the Korea Central Cancer Registry. Two questionnaires were used to assess CS values for each case and to review the cancer registration environment for each hospital. Data were analyzed in terms of the relationships between the time spent for acquisition and registration of CS information, environments relating to cancer registration in the hospitals, and document sources of CS information for each item. Results: The time for extracting and registering data was found to be shorter when the hospitals had prior experience gained from participating in a CS pilot study and when they were equipped with full-time cancer registrars. Evaluation of the CS information according to medical record sources found that the percentage of items missing for Site Specific Factor (SSF) was 30% higher than for other CS variables. Errors in CS coding were found in variables such as "CS Extension," "CS Lymph Nodes," "CS Metastasis at Diagnosis," and "SSF25 Involvement of Cardia and Distance from Esophagogastric Junction (EGJ)." Conclusions: To build CS system data that are reliable for cancer registration and clinical research, the following components are required: 1) training programs for medical records administrators; 2) supporting materials to promote active participation; and 3) format development to improve registration validity.

Massive Parallel Sequencing for Diagnostic Genetic Testing of BRCA Genes - a Single Center Experience

  • Ermolenko, Natalya A;Boyarskikh, Uljana A;Kechin, Andrey A;Mazitova, Alexandra M;Khrapov, Evgeny A;Petrova, Valentina D;Lazarev, Alexandr F;Kushlinskii, Nikolay E;Filipenko, Maxim L
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7935-7941
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    • 2015
  • The aim of this study was to implement massive parallel sequencing (MPS) technology in clinical genetics testing. We developed and tested an amplicon-based method for resequencing the BRCA1 and BRCA2 genes on an Illumina MiSeq to identify disease-causing mutations in patients with hereditary breast or ovarian cancer (HBOC). The coding regions of BRCA1 and BRCA2 were resequenced in 96 HBOC patient DNA samples obtained from different sample types: peripheral blood leukocytes, whole blood drops dried on paper, and buccal wash epithelia. A total of 16 random DNA samples were characterized using standard Sanger sequencing and applied to optimize the variant calling process and evaluate the accuracy of the MPS-method. The best bioinformatics workflow included the filtration of variants using GATK with the following cut-offs: variant frequency >14%, coverage ($>25{\times}$) and presence in both the forward and reverse reads. The MPS method had 100% sensitivity and 94.4% specificity. Similar accuracy levels were achieved for DNA obtained from the different sample types. The workflow presented herein requires low amounts of DNA samples (170 ng) and is cost-effective due to the elimination of DNA and PCR product normalization steps.

콘택트렌즈 보존 용기 유래 Acnnthamoebc lugdunensis을 KA/LS주의 내공생세균 (Bacterial endosymbiosis within the cytoplasm of Acanthamoeba Lwnunensis isolated from a contact lens storage case)

  • 정동일;공현희
    • Parasites, Hosts and Diseases
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    • 제35권2호
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    • pp.127-134
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    • 1997
  • 콘택트렌즈 보존 용기 유래 가시아메바 KA/LS주의 세포질 내에 존재하는 bacterial endosymbiont(내공생세균)를 투과전자현미경으로 관찰하여 확인하였다. 숙주인 가시아메바 KA/LS주는 형태학적으로 제2군에 속하였고 rDNA PCR-RFLP 결과 A. lugdunensis로 동정되었다. 미토콘드리아 DNA RFLP와 동위효소 분석상 이 충주는 국내 콘택트렌즈 보존용기에서 가장 흔히 분리되는 type인 KA/L1주, 국내 임상 분리주 중 하나인 KA/E2주, 내공생세균을 가지는 것으로 보고된 병원 냉각수 유래 KA/W4주 및 L3a주와 동일하거나 매우 유사한 성적을 보였다. 내 공생세균은 약 $1.38{\;}{\times}{\;}0.50{\;}{\mu\textrm{m}}$의 크기였고, 아메바 세포질 내에 불규칙하게 분포하고 있었으며 그 표면에 아메바의 ribosome이 부착되어 있었다. 내공생세균을 둘러싼 lacunae나 막과 같은 구조는 관찰되지 않았다. Legionoun 특이 primer를 이용한 효소중합반응(PCR)에서 내공생세균의 염색체 DNA는 증폭되지 않았다 A. lugdunensis의 우리말 이름을 담수가시아메바로 제안한다.

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유방암 환자의 보완대체요법 추구 과정: 치유를 향한 끝없는 심신 다스리기 (Endless Management of Mind and Body for Healing: The Process of Pursuing Complementary and Alternative Medicine in Patients with Breast Cancer)

  • 태영숙;권수혜;이영숙;배주영
    • 성인간호학회지
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    • 제27권6호
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    • pp.728-741
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    • 2015
  • Purpose: The purpose of the study was to explore and describe the experience of pursuing complementary and alternative medicine (CAM) in breast cancer patients. Methods: Ten women with breast cancer participated in the study. Data were collected through individual in-depth unstructured and individualized interviews with each participant from February to July, 2015. Theoretical sampling was used upto the point of theoretical saturation. Data were analyzed using Corbin & Strauss's grounded theory methodology. Results: Through open coding, 22 sub-categories, and 13 categories were identified. Analysis revealed that the core category was 'endless management of mind and body for healing', which consisted of four phases; exploring, applying, grasping, and integrating. Through this process, the participants utilized various action/interactional strategies such as 'dealing with information', 'trying out blindly', 'enduring volitionally', 'experiencing effects on mind and body,' and 'grasping one's own way.' The consequences of these strategies were integrating the habit of health remedy into one's life, becoming a main agent for change, and tolerating one's weak body. Conclusion: In-depth understanding of the CAM pursuing experiences of patients with breast cancer would guide clinical nurses and policy makers to develop effective interventions and policies for better supporting them with regard to the usage of CAM.

Observational Study on Patient's Satisfactions and Quality of Life (QoL) Among Cancer Patients Receiving Treatment with Palliative Care Intent in a Tertiary Hospital in Malaysia

  • Sharifa Ezat, Wan Puteh;Fuad, Ismail;Hayati, Yaakub;Zafar, Ahmed;Wanda Kiyah, George Albert
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권2호
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    • pp.695-701
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    • 2014
  • The main objective of palliative treatment for cancer patients has been to maintain, if not improve, the quality of life (QoL). There is a lack of local data on satisfaction and QoL among cancer patients receiving palliative treatment in Malaysia. This study covers patients with incurable, progressive cancer disease receiving palliative treatment in a teaching hospital in Kuala Lumpur, comparing the different components of QoL and correlations with patient satisfaction. A cross-sectional survey using Malay validated SF36 QoL and PSQ-18 (Short Form) tools was carried out between July 2012 -January 2013 with 120 cancer patients receiving palliative treatment, recruited into the study after informed consent using convenient sampling. Results showed that highest satisfaction were observed in Communication Aspect ($50.6{\pm}9.07$) and the least in General Satisfaction ($26.4{\pm}5.90$). The Mental Component Summary ($44.9{\pm}6.84$) scored higher when compared with the Physical Component Summary ($42.2{\pm}7.91$). In this study, we found that patient satisfaction was strongly associated with good quality of life among cancer patients from a general satisfaction aspect (r=0.232). A poor significant negative correlation was found in Physical Component (technical quality, r=-0.312). The Mental Component showed there was a poor negative correlation between time spent with doctor (r=-0.192) and accessibility, (r=-0.279). We found that feeling at peace and having a sense of meaning in life were more important to patients than being active or achieving good physical comfort. More studyis needed to investigate patients who score poorly on physical and mental component aspects to understand their needs in order to achieve better cancer care.

Combined Genotype Analyses of Precursor miRNA-196a2 and -499a Variants with Hepatic and Renal Cancer Susceptibility- a Preliminary Study

  • Toraih, Eman A;Fawzy, Manal S;Elgazzaz, Mona G;Hussein, Mohammad H;Shehata, Rasha H;Daoud, Hisham G
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3369-3375
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    • 2016
  • MicroRNAs, a novel class of small non-coding RNAs, are key players in many cellular processes, including cell proliferation, differentiation, invasion and regeneration. Tissue and circulatory microRNAs could serve as useful clinical biomarkers and deregulated expression levels have been observed in various cancers. Gene variants may alter microRNA processing and maturation. Thus, we aimed to investigate the association of MIR-196a2 rs11614913 (C/T), MIR-499a rs3746444 (A/G) polymorphisms and their combination with cancer susceptibility in an Egyptian population. Sixty five renal cell carcinoma (RCC) and 60 hepatocellular carcinoma (HCC) patients and 150 controls were enrolled in the study. They were genotyped using real-time polymerase chain reaction technology. Both $miR-196a2^*T$ and $miR-499a*G$ were associated with RCC risk, but only $miR-196a^*T$ was associated with HCC development. Carriage of the homozygote combinations ($MIR196a2^*TT+MIR499a^*AA$) and ($MIR196a2^*CC+MIR499a^*GG$) was associated with 25 and 48 fold elevation of likelhood to develop RCC, respectively. The miR-196a2 SNP was also linked with larger tumor size in RCC and advanced tumor stage in HCC. miR-196a2 and miR-499a combined genotypes were associated with RCC and HCC. Further functional analysis of SNPs is required to confirm relationships between genotypes and phenotypes.

Compound heterozygous mutations of ACADS gene in newborn with short chain acyl-CoA dehydrogenase deficiency: case report and literatures review

  • An, Se Jin;Kim, Sook Za;Kim, Gu Hwan;Yoo, Han Wook;Lim, Han Hyuk
    • Clinical and Experimental Pediatrics
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    • 제59권sup1호
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    • pp.45-48
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    • 2016
  • Short-chain acyl-CoA dehydrogenase deficiency (SCADD) is a rare autosomal recessive mitochondrial disorder of fatty acid ${\beta}$-oxidation, and is associated with mutations in the acyl-CoA dehydrogenase (ACADS) gene. Recent advances in spectrometric screening for inborn errors of metabolism have helped detect several metabolic disorders, including SCADD, without symptoms in the neonate period. This allows immediate initiation of treatment and monitoring, so they remain largely symptomless metabolic disease. Here, we report a 15-month-old asymptomatic male, who was diagnosed with SCADD by newborn screening. Spectrometric screening for inborn errors of metabolism 72 hours after birth revealed an elevated butyrylcarnitine (C4) concentration of $2.25{\mu}mol/L$ (normal, < $0.99{\mu}mol/L$). Urinary excretion of ethylmalonic acid was also elevated, as detected by urine organic acid analysis. To confirm the diagnosis of SCADD, direct sequencing analysis of 10 coding exons and the exon-intron boundaries of the ACADS gene were performed. Subsequent sequence analysis revealed compound heterozygous missense mutations c.164C>T (p.Pro55Leu) and c.1031A>G (p.Glu344Gly) on exons 2 and 9, respectively. The patient is now growing up, unretarded by symptoms such as seizure and developmental delay.

경력이 단절된 치과위생사의 직무 복귀에 대한 치과의사의 의견 (Dentists' opinions on return to work of career interrupted dental hygienists)

  • 박귀옥;장영은;김선일;박지은;이선미;김남희
    • 한국치위생학회지
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    • 제16권5호
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    • pp.741-750
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    • 2016
  • Objectives: This study aims to identify dentists' opinions about the return to work of the dental hygienists with career interrupted. Convenience sampling was made of 22 dentists with the clinical experience (about 0.25%) of the 4,944 members of Gyeonggi-do Dental Association. Data were collected through an electronic survey using e-mails and telephone interviews and analyzed using the constant comparison method. Methods: Open coding was assigned to the initial data from the survey in an explicit language, and focusing on the types of their employment, working conditions, etc. Summarization and conceptualization were made of the second data in an implicit language. Results: Most of the dentists were found to have positive attitudes toward the return to work of career interrupted dental hygienists and hope to adjust their wages based on their job performance or after their probational period expires. Most of the dentists were found to have positive attitudes towards the hygienists' flexible working although their concerns about work efficiency and hospital atmosphere. This study is a qualitative study that describes dentists' opinions and presents the need for the career interrupted dental hygienists to return to work. Conclusions: The study proposed that the educational institutions should take into account the hygienists' opinions when implementing the programs for promoting their return to work and their evaluative studies.

북한이탈 어머니의 영유아 자녀 양육 경험 (The Early Childhood Caring Experience of North Korean Refugee Mothers)

  • 김예영
    • Child Health Nursing Research
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    • 제19권2호
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    • pp.102-110
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    • 2013
  • 목적 본 연구의 목적은 북한이탈 어머니의 영유아 자녀 양육 경험이 무엇인지 그 경험 과정을 확인하고, 양육과정을 통해 심리사회적 문제를 어떻게 해결하는가에 대한 실체이론을 개발하는 것이다. 방법 연구참여자는 이론적 표본추출을 통하여 선정하였고 연구 자료는 심층면담과 참여관찰 및 참여자의 의무기록 등을 사용하여 수집한 후 Strauss와 Corbin (1998)의 근거이론방법을 적용하여 분석하였다. 결과 연구 결과 개방코딩 과정에서 62개의 개념과 23개의 하위범주, 11개의 범주가 도출되었으며 북한이탈 어머니의 영유아 자녀 양육 과정의 핵심범주는 '희망을 가지고 키워가기'로 밝혀졌다. 시간 흐름에 따른 양육 과정은 '양육 환경 변화 인식기', '양육 방법 조정기', '자신감 형성기'의 3단계로 나타났으며 양육 과정의 유형은 기대하기형, 지켜보기형, 걱정하기형의 세 가지 유형으로 구분되었다. 결론 본 연구의 결과는 영유아 자녀를 돌보는 북한이탈 어머니들의 양육경험을 이해하고 개별적인 간호를 제공하는데 기초가 될 이론적 기틀로 활용할 수 있을 것이며 북한이탈주민이 급증하고 이에 따라 동반 입국하는 아동의 수도 함께 증가하고 있는 현 시점에서 이 아동들의 건강 유지 및 증진을 위한 간호 실무에 매우 중요한 초석이 될 것이다.

실시간 심전도 모니터링을 위한 HL7 메시지 간소화 전략 (A Lightweight HL7 Message Strategy for Real-Time ECG Monitoring)

  • 이구연;강경태;이재면;박주영
    • 정보과학회 컴퓨팅의 실제 논문지
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    • 제21권3호
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    • pp.183-191
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    • 2015
  • 최근 IT 기술이 발전함에 따라 실시간 심전도 모니터링이 가능해 졌으며, 이는 의료정보교환을 위한 HL7 표준의 전도 유망한 응용 중 하나로 인식되고 있다. 하지만 HL7 메시지 내 데이터 중복으로 인한 메시지의 크기 및 생성시간의 증가로 인해 HL7 표준을 실시간 심전도 모니터링에 바로 적용하기에는 무리가 있다. 이에 본 논문에서는 실시간 심전도 모니터링에 적합한 HL7 메시지의 간소화 전략을 제안한다. 다양한 형식의 심전도 데이터를 Feature Scaling을 거쳐 정형화된 포맷으로 조정하고 HL7 규약에 순응하는 메시지를 생성한다. 또한 HL7 ORU 메시지 내의 중복되는 OBX 필드를 제거하기 위해 De-Duplication 알고리즘을 수행한다. 이를 통해 기존의 HL7 표준 적용 대비 메시지의 생성시간은 최대 51%, 크기는 최대 1/8로 줄일 수 있음을 실험적으로 확인하였다.