• Title/Summary/Keyword: Gynecology department

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Standardization and Management of Interface Terminology regarding Chief Complaints, Diagnoses and Procedures for Electronic Medical Records: Experiences of a Four-hospital Consortium (전자의무기록 표준화 용어 관리 프로세스 정립)

  • Kang, Jae-Eun;Kim, Kidong;Lee, Young-Ae;Yoo, Sooyoung;Lee, Ho Young;Hong, Kyung Lan;Hwang, Woo Yeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.3
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    • pp.679-687
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    • 2021
  • The purpose of the present study was to document the standardization and management process of interface terminology regarding the chief complaints, diagnoses, and procedures, including surgery in a four-hospital consortium. The process was proposed, discussed, modified, and finalized in 2016 by the Terminology Standardization Committee (TSC), consisting of personnel from four hospitals. A request regarding interface terminology was classified into one of four categories: 1) registration of a new term, 2) revision, 3) deleting an old term and registering a new term, and 4) deletion. A request was processed in the following order: 1) collecting testimonies from related departments and 2) voting by the TSC. At least five out of the seven possible members of the voting pool need to approve of it. Mapping to the reference terminology was performed by three independent medical information managers. All processes were performed online, and the voting and mapping results were collected automatically. This process made the decision-making process clear and fast. In addition, this made users receptive to the decision of the TSC. In the 16 months after the process was adopted, there were 126 new terms registered, 131 revisions, 40 deletions of an old term and the registration of a new term, and 1235 deletions.

Prognostic Significance of Human Epidermal Receptor (HER)-3 Immunohistochemical Expression in Patients with Metastatic Breast Cancer

  • Olmez, Omer Fatih;Evrensel, Turkkan;Cubukcu, Erdem;Ugras, Nesrin;Avci, Nilufer;Canhoroz, Mustafa;Deligonul, Adem;Hartavi, Mustafa;Olmez, Fatma;Cubukcu, Sinem;Tolunay, Sahsine;Kurt, Ender;Kanat, Ozkan;Manavoglu, Osman
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4115-4119
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    • 2013
  • Background: Previous reports have shown that human epidermal receptor (HER)-3 overexpression may be associated with poor prognosis in patients with breast cancer, but results have been conflicting. In this study, we sought to investigate the prognostic significance of HER-3 immunohistochemical expression in patients with metastatic breast cancer. Methods: We retrospectively analyzed HER-3 immunohistochemical expression profiles in 45 paraffin-embedded specimens from patients who had been treated between 1996 and 2006 in the Department of Oncology of the Uludag University School of Medicine, Bursa, Turkey. Membranous or cytoplasmic dominant expression patterns of HER-3 were analyzed using the Rajkumar score and a cytoplasmic 4-point scoring system, respectively. Progression-free survival (PFS) and overall survival (OS) served as the main outcome measures. Results: The median PFS in the study participants was 9 months (interquartile range: 4.5-13 months), whereas the median OS was 20 months (interquartile range: 7.5-28 months). Categorization of the patient population according to HER-3 positive immunohistochemical expression did not reveal any statistically significant difference in terms of both PFS (p=0.70) and OS (p=0.81). The results of multivariable Cox regression analysis indicated that tumor size was the only independent predictor of PFS, whereas estrogen and progesterone receptor status was independently associated with OS. Conclusions: HER-3 immunohistochemical expression did not correlate with outcomes in Turkish patients with metastatic breast cancer. Although our results suggest that HER-3 expression in cancer specimens is not of prognostic significance, further prospective studies are warranted to confirm these results.

Study on the Current Situation and Issues for Clinical Research in Korean Medicine worldwide - Future Clinical Research Strategy I - (한의 임상 연구에 대한 국내외 현황 및 논쟁에 관한 고찰 - 미래 임상 연구 전략 I -)

  • Jung, Ki Yong;Go, Ho Yeon;Sun, Seung Ho;Jeong, Jong Jin;Park, Jeong Su;Song, Yun Kyung;Kim, Tae Hoon;Hong, Sung In;Choi, You Kyung;Go, Seong Gyu;Lim, Eun Mee;Lee, Choong Yeol;Park, Jong Hyeong;Jeon, Chan Yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.2
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    • pp.137-145
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    • 2014
  • The purpose of this paper is to explore the strategy of future Korean medicine(KM) clinical research through the study on the current situation and issues for KM clinical research worldwide. In this study, the papers published in English through Pubmed were investigated mainly. And we analyzed the methodological issues from the clinical research reports in the KM fields. As a result of examining the current situation of the RCTs(Randomized Controlled Trials) studies in KM, the sample size for most studies was small and the overall methodological quality appeared to be low. And there was a discussion about whether or not to apply RCTs method to the KM clinical research. The majority of studies have argued the use of RCTs method for KM clinical research. In addition, we could find some problems through the analysis of KM clinical studies. First, the majority of RCTs in KM were of low quality. Second, RCTs method was applied to the KM clinical studies according to the Western medicine methods only. Third, the actual KM diagnosis was not used in the KM studies and inadequate outcomes measurement methods were utilized without considering the characteristics of KM practice. The methodological issues in the KM clinical research were caused by the conflict between the characteristics of KM practice and clinical research method based on the western medicine.

Establishment and Application of Molecular Genetic Techniques for Preimplantation Genetic Diagnosis of Osteogenesis Imperfecta (골형성부전증의 착상전 유전진단을 위한 분자유전학적 방법의 조건 확립과 적용)

  • Kim, Min-Jee;Lee, Hyoung-Song;Choi, Hye-Won;Lim, Chun-Kyu;Cho, Jae-Won;Kim, Jin-Young;Song, In-Ok;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.35 no.2
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    • pp.99-110
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    • 2008
  • Objectives: Preimplantation genetic diagnosis (PGD) has become an assisted reproductive technique for couples carrying genetic conditions that may affect their offspring. Osteogenesis imperfecta (OI) is an autosomal dominant disorder of connective tissue characterized by bone fragility and low bone mass. At least 95% of cases are caused by dominant mutations in the COL1A1 or COL1A2. In this study, we report on our experience clinical outcomes with 5 PGD cycles for OI in two couples. Methods: Before clinical PGD, we assessed the amplification rate and allele drop-out (ADO) rate of alkaline lysis and nested PCR protocol using heterozygous patient's single lymphocytes in the pre-clinical diagnostic tests for OI. We performed 5 cycles of PGD for OI by nested PCR for the causative mutation loci, COL1A1 c.2452G>A and c.3226G>A, in case 1 and case 2, respectively. The PCR products were analyzed by agarose gel electrophoresis, restriction fragment length polymorphism (RFLP) analysis with HaeIII restriction enzyme in the case 1 and direct DNA sequencing. Results: We confirmed the causative mutation loci, COL1A1 c.2452G>A in case 1 and c.3226G>A in case 2. In the pre-clinical tests, the amplification rate was 94.2% and ADO rate was 22.5% in case 1, while 98.1% and 1.9% in case 2, respectively. In case 1, a total of 34 embryos were analyzed and 31 embryos (91.2%) were successfully diagnosed in 3 PGD cycles. Eight out of 19 embryos diagnosed as unaffected embryos were transferred in all 3 cycles, and in the third cycle, pregnancy was achieved and a healthy baby was delivered without any complications in July, 2005. In case 2, all 19 embryos (100.0%) were successfully diagnosed and 4 out of 11 unaffected embryos were transferred in 2 cycles. Pregnancy was achieved in the second cycle and the healthy baby was delivered in March, 2008. The causative locus was confirmed as a normal by amniocentesis and postnatal diagnosis. Conclusions: To our knowledge, these two cases are the first successful PGD for OI in Korea. Our experience provides a further demonstration that PGD is a reliable and effective clinical techniques and a useful option for many couples with a high risk of transmitting a genetic disease.

10-year Analysis of Inherited Metabolic Diseases Diagnosed with Tandem Mass Spectrometry (탠덤 매스 검사(Tandem Mass Spectrometry)를 이용한 선천성 대사이상 선별검사 10년간의 분석)

  • Lee, Bomi;Lee, Jiyun;Lee, Jeongho;Kim, Suk Young;Kim, Jong Won;Min, Won-Ki;Song, Woon Heung;Song, Jung Han;Woo, Hang Jae;Yoon, Hye Ran;Lee, Yong-Wha;Choi, Koue Young;Choi, Tae Youn;Lee, Dong Hwan
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.3
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    • pp.77-84
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    • 2017
  • Purpose: From the early 1990's, use of Tandem mass spectrometry in neonatal screening test, made early stage detection of disorders that was not detectable by the previous methods of inspection. This research aims to evaluate the frequency of positive results in national neonatal screening test by Tandem mass spectrometry and its usefulness. Methods: A designated organization for inherited metabolic disorder executed neonatal screening test on newborns using Tandem mass spectrometry from January 2006 to December 2015, followed by the investigation of these data by the Planned Population Federation of Korea (PPFK), and this research analyzed those inspected data from the PPFK. Results: Among total childbirth of 4,590,606, from January 2006 to December 2015, 3,445,238 were selected for MS/MS and conduction rate was 75.1%. 261 out of the selected 3,445,238 were confirmed patients and for last decade, detection rate of total metabolic disorder was 1/13,205. In 261 confirmed patients, 120 had an amino acid metabolic disorder and its detection rate was 1/28,710 and 110 had an organic acid metabolic disorder and detection rate was 1/31,320. Also, 31 had a fatty acid metabolic disorder and detection rate was 1/13,205. Conclusion: Inherited metabolic disorder is very rare. Until now, it was difficult to precisely grasp an understanding on the national incidence of inherited metabolic disorder, due to lack of overall data and inconsistent and incomplete long-term result analysis. However, this research attempted to comprehensively approach the domestic incidence, by analyzing previous 10 years of data.

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Study on the ${\ulcorner}$Medical Recoreds as a Guide to Diagnosis${\lrcorner}$ ("임증지남의안(臨證指南醫案)"에 관한 연구)

  • Shin, Soon-Shik;Hong, Won-Sik
    • Korean Journal of Oriental Medicine
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    • v.1 no.1
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    • pp.47-68
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    • 1995
  • A proper understanding of 'diagnosis and treatment based on overall analysis of symptoms and signs' can result in efficient clinical effect. Studies on the ${\lceil}$Medical Recoreds as a Guide to Diagnosis${\rfloor}$ can be expected to achieve a part of this purpose. In this study, the period, author, xylographica, contents and influence of next generation of ${\lceil}$Medical Records as a Guide to Diagnosis${\rfloor}$were investigated. Tian shi and his 12 followers completed thsis Medical recoreds with clinical experiences and data obtained throughout their lives. These books were first published in 1764. Since then these books have been published twenty times based on the first edition. These books are comprised of 10 volumes, from ${\lceil}$volume 1${\rfloor}$to ${\lceil}$volum 8${\rfloor}$are internal medicine, ${\lceil}$volum 9${\rfloor}$ is gynecology, ${\lceil}$volum 10${\rfloor}$ is pediatrics. The contents are as follows; 'method of regluating astenia-syndrome' , 'diagnosis and treatment based on overall analysis of symptoms and signs on eight extra meridians', 'theory of Yang forms endogenous wind-syndrome', 'theory of spleen-energy rise up and stomach-energy descend', 'theory of stmach-Yeum', 'diagnosis and treatment based on overall analysis of symptoms and signs on collaterals'. Tian shi completed his work by compling the previous medical theories and through clinical studies. It is expected that his theories are effectively applied to improve clinical medicine.

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Relationships among Malnutrition, Depression and Quality of Life in Patients with Gynecologic Cancer receiving Chemotherapy (항암화학요법을 받는 부인암 환자의 영양장애, 우울 정도와 삶의 질과의 관계)

  • Nho, Ju-Hee;Kim, Sung Reul;Kang, Gyeong Seon;Kwon, Yong Soon
    • Women's Health Nursing
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    • v.20 no.2
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    • pp.117-125
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    • 2014
  • Purpose: The purpose of this study was to identify nutritional status, and relationships among malnutrition, depression and quality of life in patients with gynecologic cancer who were receiving chemotherapy. Methods: For this study a descriptive cross-sectional design was used. Participants were 111 women who were enrolled and agreed to undergo a face-to-face interviews including administration of the structured questionnaires: Patient-Generated Subjective Global Assessment (PG-SGA), Beck Depression Inventory (BDI), Simplified Nutritional Appetite Questionnaire (SNAQ), and Functional Assessment of Cancer Therapy-General (FACT-G). Results: Mean body mass index was 23.3 and mean body weight was 56.5 kg. Sixty-three (57%) of the 111 patients were malnourished according to the PG-SGA. The malnourished patients showed higher levels of depression and lower quality of life compared to the non-malnourished patients. In addition, malnutrition was associated with BMI level, depression, appetite and quality of life. Conclusion: The findings indicate that the prevalence of malnutrition is high and malnutrition in patients with gynecologic cancer influences depression and adversely affects the quality of life of these women. To improve the patient's quality of life, nutritional assessment and appropriate management is important to decrease malnutrition in patients with gynecologic cancer.

Perspectives of Women during Reproductive Years for Cervical Cancer Scans and Influencing Factors

  • Acar, Gokce Banu;Pinar, Gul
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7171-7178
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    • 2015
  • Background: This descriptive study was performed in order to assess health perspectives of women, who applied to Yildirim Beyazit University Ataturk Education and Research Hospital, Outpatient Clinic of Obstetrics and Gynecology for cervical cancer scans and were in the reproductive years. Factors influencing their perspectives were also assessed. Materials and Methods: In this study, a simple random sampling formula was adopted to calculate the volume (300) of the targeted sample. Results of the research were obtained through individual diagnosis form and cervical cancer and the Pap smear test health belief model scale (HBMS). Results: It was found that 75.0% of the women heard of the Pap smear test before, and 48.7% had undertaken one. Some 51.4% of the women who had Pap smear test expressed that they had the test at irregular periods. Most of the women stated that they heard about the smear test from the health staff (51.7%). Lack of any health complaints (28.3%) and not having adequate information about the test (21.0%) were among the reasons for not undergoing a Pap smear test. It was found that lower dimension average scores of the women obtained from the cervical cancer and Pap smear test HBMS varied from $7.7{\pm}2.3$ to $33.5{\pm}9.3$. When the lower dimension average scores of women from the HBMS were examined, the perception of usefulness was high but the susceptibility and health motivations were low. Conclusions: In this study, it was determined that the awareness of women about cervical cancer and the Pap smear test was insufficient, and susceptibility and motivation perception towards having a Pap smear test were low.

Perceptions and Opinions about Male Breast Cancer and Male Breast Self-Examination: A Qualitative Study

  • Al-Naggar, Redhwan Ahmed;Al-Naggar, Dhekra Hamoud
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.243-246
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    • 2012
  • Objective: While the relatively common nature of female breast cancer has resulted in a high level of general awareness, male breast cancer is still comparatively unknown to the general public and to healthcare professionals. The objective of this study is to explore the perceptions and opinions about male breast cancer and male breast self-examination among male university students. Methodology: In-depth interviews were conducted among 36 male university students from the Management and Science University, Malaysia, selected by simple random sampling. The themes of the interview were: knowledge of male breast cancer and male breast self-examination, sources of knowledge and attitudes towards male BSE. The data obtained were classified into various categories and analyzed manually. Results: The majority of participants mentioned that there is a low possibility for males to get breast cancer. They also believed that the cause of breast cancer among men is due to the carcinogens from cigarettes. The majority of participants mentioned that they know about breast self-examination from the mass media and that the presence of a lump in the breast is the main symptom of breast cancer in men. The majority of participants mentioned that they encourage their family members to practice breast self-examination but considered that BSE is not important for men because they have a low probability of getting breast cancer. Conclusions: Misconceptions regarding male breast cancer and breast self-examination among men still exist among male university students. Therefore especial attention should be given to educate men about male breast cancer and male BSE.

Age and Survival of Cervical Cancer Patients with Bone Metastasis

  • Nartthanarung, Adisak;Thanapprapasr, Kamolrat;Udomsubpayakul, Umaporn;Thanapprapasr, Duangmani
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8401-8404
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    • 2014
  • Background: To determine survival times of cervical cancer patients with bone metastasis related to the effect of age at the time of cervical cancer diagnosis, we performed the retrospectively analytical study. Methods: A total of 68 cervical cancer patients with bone metastasis were treated at a single hospital, during January 1998 to December 2010. Fifty-two medical records were identified and collected, the remaining sixteen medical records were not found. Main outcome measures were patient characteristics, clinical information, duration from cervical cancer diagnosis to bone metastasis diagnosis, survival time after bone metastasis and overall survival time. Results: Among fifty-two cervical cancer patients with bone metastasis, there were 13 patients who were less than 45 years old, and 39 patients were 45 years old or more at the time of cervical cancer diagnosis. The younger group had less median overall survival than the older group, with a statistically significant difference (21 months, 95% CI 19.93-22.06; 34 months, 95% CI 23.27-44.72, p = 0.021). However, they were comparable in the duration from cervical cancer diagnosis to bone metastasis diagnosis and the survival time after bone metastasis. Conclusion: Young patients with bone metastasis aged less than 45 years old at the time of cervical cancer diagnosis have a poorer prognosis than the elderly patients. Impact: To improve survival and quality of life, more intensive and novel multimodal treatments at the time of cervical cancer diagnosis should be considered in patients less than forty-five years, who can tolerate the side effects better.