• Title/Summary/Keyword: Retrospective Control Chart

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Diagnosis and constitutional and laboratory features of Korean girls referred for precocious puberty

  • Kim, Doosoo;Cho, Sung-Yoon;Maeng, Se-Hyun;Yi, Eun Sang;Jung, Yu Jin;Park, Sung Won;Sohn, Young Bae;Jin, Dong-Kyu
    • 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.

Pain and Pain Management in Hospitalized Cancer Patients (입원 암환자의 통증 실태와 통증관리 실태)

  • Kim, Mi-Jung;Park, Jin-A;Shin, Su-Jin
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.15 no.2
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    • pp.161-170
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    • 2008
  • Purpose: The purpose of this study was to provide basic data for proper pain management. Method: Data were collected from 85 hospitalized patients with cancer pain. A retrospective chart review of level of pain, source of pain, verbal expression of pain, and pain management was done. The data were analyzed with the SPSS program. Results: The level of pain measured by NRS at the three time points was as follows Time 1 ($4.40{\pm}2.25$), Time 2 ($0.61{\pm}1.30$), Time 3 ($2.47{\pm}2.75$). The kinds of pain were somatic pain (51.8%), visceral pain (37.6%), neuropathic pain (12.9%). The analgesic amount measured by OME (oral morphine equivalent) was as follows: Time 1 ($70.85{\pm}69.65$), Time 2 ($91.61{\pm}89.20$), Time 3 ($96.71{\pm}94.25$). Degree of pain had significant differences according to type of cancer (F=-3.286, p= .002), cancer origin (F=2.906, p= .018), and metastasis (F=2.906, p= .018) at Time 2. Best control period had significant difference according to type of cancer (F=2.373, p= .023), and origin of cancer (F=2.466, p= .040) at Time 2 Conclusion: These finding will enable the application of nursing interventions for pain control in cancer patients, identification of kinds of nursing compared to priorities, and increased levels of comfort in cancer patients in clinical settings.

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Validation of Administrative Big Database for Colorectal Cancer Searched by International Classification of Disease 10th Codes in Korean: A Retrospective Big-cohort Study

  • Hwang, Young-Jae;Kim, Nayoung;Yun, Chang Yong;Yoon, Hyuk;Shin, Cheol Min;Park, Young Soo;Son, Il Tae;Oh, Heung-Kwon;Kim, Duck-Woo;Kang, Sung-Bum;Lee, Hye Seung;Park, Seon Mee;Lee, Dong Ho
    • Journal of Cancer Prevention
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    • v.23 no.4
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    • pp.183-190
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    • 2018
  • Background: As the number of big-cohort studies increases, validation becomes increasingly more important. We aimed to validate administrative database categorized as colorectal cancer (CRC) by the International Classification of Disease (ICD) 10th code. Methods: Big-cohort was collected from Clinical Data Warehouse using ICD 10th codes from May 1, 2003 to November 30, 2016 at Seoul National University Bundang Hospital. The patients in the study group had been diagnosed with cancer and were recorded in the ICD 10th code of CRC by the National Health Insurance Service. Subjects with codes of inflammatory bowel disease or tuberculosis colitis were selected for the control group. For the accuracy of registered CRC codes (C18-21), the chart, imaging results, and pathologic findings were examined by two reviewers. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for CRC were calculated. Results: A total of 6,780 subjects with CRC and 1,899 control subjects were enrolled. Of these patients, 22 subjects did not have evidence of CRC by colonoscopy, computed tomography, magnetic resonance imaging, or positron emission tomography. The sensitivity and specificity of hospitalization data for identifying CRC were 100.00% and 98.86%, respectively. PPV and NPV were 99.68% and 100.00%, respectively. Conclusions: The big-cohort database using the ICD 10th code for CRC appears to be accurate.

Factors associated with effectiveness of and rash occurrence by Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors in patients with non-small cell lung cancer (비소세포폐암 환자에 있어서 Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors의 약효 및 rash 발생과 관련한 인자에 대한 연구)

  • Bae, Na-Rae;Choi, Hye-Jin;Lee, Byung-Koo;Gwak, Hye-Sun
    • Korean Journal of Clinical Pharmacy
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    • v.18 no.2
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    • pp.75-83
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    • 2008
  • Purpose: Currently lung cancer ranks second in cancer for incidence rate and is a disease that ranks first for a death rate by cancerous growth because it is already advanced at the time of diagnosis. The purpose of this paper was to analyze the factors that affect the effectiveness of and rash occurrence by Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor (EGFR TKI) in patients with non-small cell lung cancer. Methods: A retrospective chart review of 100 patients, who took EGFR TKI (erlotinib, gefitinib) among patients who were diagnosed with non-small cell lung cancer in a Hospital in Korea between May 2005 and February 2008, was conducted. The drug effectiveness was evaluated by Response Evaluation Criteria In Solid Tumor. Results: EGFR mutation was the only factor associated with drug response (complete response and partial response). When stable disease was added to drug response as the evaluation parameter, ECOG and rash as well as EGFR mutation were found to be important factors. Survival, however, was not affected by EGFR mutation. The factors influenced on survival were older age (${\geq}65$), low ECOG ($1{\sim}2$), adenocarcinoma and rash. In the case of rash, group with EGFR mutation or low ECOG showed significantly higher chance of occurrence. There was no significant difference in rash occurrence between gefitinib and erlotinib groups. Conclusions: Based on the results, EGFR mutation positive and low ECOG ($1{\sim}2$) were significantly important factors for both effectiveness of EGFR TKI and rash occurrence. Also, rash itself was found to be an independently significant factor for the disease control and survival. Therefore, while administering EGFR TKI, patients who have the factors associated with rash occurrence should be closely monitored for effective and safe drug therapy.

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The Situational, Clinical and Psychosocial Factors Related to Treatment-Seeking Behavior Among Those with Acute Myocardial Infarction (심근경색증 환자의 상황적, 임상적 요인 및 사회심리적 요인과 치료추구행위에 관한 연구)

  • Kim, Cho Ja;Kim, Gi Yon;Jang, Yeon Soo
    • Korean Journal of Adult Nursing
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    • v.12 no.3
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    • pp.323-333
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    • 2000
  • The purpose of this study was to determine the impact of situational, clinical and psychsoical factors on treatment-seeking behavior among those with acute myocardial infarction(AMI). This study used a retrospective, descriptive design. The sample consisted of 72 patients aged over 30 and who were diagnosed with an acute myocardial infarction at two large university-affiliated medical centers from July 1, 1998 to March 30, 2000. But of 72, patients 5 who were an outlier in treatment-seeking time were deleted. Data were collected by using questionnaires, which included demographic data, situational, clinical and psychosocial data. Also patient interviews and chart review were used to obtain information related to treatment-seeking time. The results of this study were summarized as follows ; 1. Mean time from the onset of AMI symptoms to arrival at the hospital was $12.09{\pm}11.44$ hours; 2. Treatment-seeking time was not significantly different by age, gender, or education; 3. Most(44 or 65.78%) patients were at home when they began having AMI symptoms. The remaining patients were either in a public area, workplace or in a car. Patients at home delayed longer than those who had their first symptoms elsewhere, but not significantly different. Also, most patients were with another person when they began to experience AMI symptoms: a spouse(25 or 37.3%), other family member(31 or 46.3%); the remaining 11 were alone. There were no significant differences in treatment-seeking time based on whether alone or with others. Most patients(46 or 68.7%) used an ambulance rather than taking private transportation, and patients who used an ambulance were delayed longer than those who used private transportation, but there were no significant differences; 4. Time to treatment-seeking was not significantly different by blood pressure, heart rate on admission and the peak CK-MB, CPK and Cholesterol level, Killips class; 5. There were no significant statistical differences in treament-seeking times by anxiety level, mood status or control ability.

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Blood culture contamination in hospitalized pediatric patients: a single institution experience

  • Min, Hyewon;Park, Cheong Soo;Kim, Dong Soo;Kim, Ki Hwan
    • Clinical and Experimental Pediatrics
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    • v.57 no.4
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    • pp.178-185
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    • 2014
  • Purpose: Blood culture is the most important tool for detecting bacteremia in children with fever. However, blood culture contamination rates range from 0.6% to 6.0% in adults; rates for young children have been considered higher than these, although data are limited, especially in Korea. This study determined the contamination rate and risk factors in pediatric patients visiting the emergency room (ER) or being admitted to the ward. Methods: We conducted a retrospective chart review of blood cultures obtained from children who visited Yonsei Severance Hospital, Korea between 2006 and 2010. Positive blood cultures were labeled as true bacteremia or contamination according to Centers for Disease Control and Prevention/National Healthcare Safety Network definitions for laboratory-confirmed bloodstream infection, after exclusion of cultures drawn from preexisting central lines only. Results: Among 40,542 blood cultures, 610 were positive, of which 479 were contaminations and 131 were true bacteremia (overall contamination rate, 1.18%). The contamination rate in the ER was significantly higher than in the ward (1.32% vs. 0.66%, P<0.001). The rate was higher in younger children (2.07%, 0.94%, and 0.61% in children aged <1 year, 1-6 years, and >6 years, respectively). Conclusion: Overall, contamination rates were higher in younger children than in older children, given the difficulty of performing blood sampling in younger children. The contamination rates from the ER were higher than those from the ward, not accounted for only by overcrowding and lack of experience among personnel collecting samples. Further study to investigate other factors affecting contamination should be required.

Palliative Care Provided for Older Patients with Terminal Stage of Cardiopulmonary Disease Before and After Life-Sustaining Treatment Decisions (만성 심폐질환을 가진 말기 노인환자의 연명의료결정 전후 완화간호의 제공)

  • Choi, Jung-Ja;Kim, Su Hyun
    • Journal of Convergence for Information Technology
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    • v.11 no.1
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    • pp.45-53
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    • 2021
  • This study was a retrospective descriptive study to identify frequency and change of palliative care provided for older patients with terminal stage of cardiopulmonary disease before and after life-sustaining treatment (LST) decision making. As a result of chart review of 124 older patients in a university hospital, oral analgesics medication, cold and hot therapy for pain management, antibiotics medication and urine culture for urinary infection, oral care, hair wash, and partial bath were provided significantly less after LST decision making. Provision of praying and relaxation therapy for pain control, oral and nasal care, and emotional care were not changed before and after LST decision making. Spiritual care was the least provided care. Therefore, non-pharmacological pain management, emotional care, and spiritual care need to be improved for older patients with terminal cardiopulmonary disease at the end of life.

Young Women with Breast Cancer in the United States and South Korea: Comparison of Demographics, Pathology and Management

  • Son, Byung Ho;Dominici, Laura S;Aydogan, Fatih;Shulman, Lawrence N;Ahn, Sei Hyn;Cho, Ja Young;Coopey, Suzanne B;Kim, Sung Bae;Min, H Elise;Valero, Monica;Wang, Jiping;Caragacianu, Diana;Gong, Gyung-yub;Hevelone, Nathanael D;Baek, Seunghee;Golshan, Mehra
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2531-2535
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    • 2015
  • Background: Breast cancer diagnosed in young women may be more aggressive, with higher rates of local and distant recurrence compared to the disease in older women. Epidemiologic evidence suggests that Korean women have a lower incidence of breast cancer than women in the United States, but that they present at a younger age than their American counterparts. We sought to compare risk factors and management of young women with breast cancer in Boston, Massachusetts (US) with those in Seoul, South Korea (KR). Materials and Methods: A retrospective review was performed of consecutive patients less than 35 years old with a diagnosis of breast cancer at academic cancer centers in the US and KR from 2000-2005. Patient data were obtained by chart review. Demographic, tumor and treatment characteristics were compared utilizing Pearson's chisquare or Wilcoxon rank-sum tests where appropriate. All differences were assessed as significant at the 0.05 level. Results: 205 patients from the US and 309 from KR were analyzed. Patients in US were more likely to have hormone receptor positive breast cancer, while patients in KR had a higher rate of triple negative lesions. Patients in US had a higher mean body mass index and more often reported use of birth control pills, while those in the KR were less likely to have a sentinel node procedure performed or to receive post mastectomy radiation. Conclusions: Patients under 35 diagnosed with breast cancer in the US and KR differ with respect to demographics, tumor characteristics and management. Although rates of breast conservation and mastectomy were similar, US patients were more likely to receive post mastectomy radiation. The lower use of sentinel node biopsy is explained by the later adoption of the technique in KR. Further evaluation is necessary to evaluate recurrence rates and survival in the setting of differing disease subtypes in these patients.

Clinical Manifestations of Norovirus Infection in Korean Pediatric Cancer Patients (한국 소아 암환자에서 노로바이러스 감염증의 임상 양상)

  • Choi, Hyunshin;Choi, Young Bae;Hwang, Ji-Young;Cheon, Doo-Sung;Jeong, Hye Sook;Choe, Yon Ho;Yoo, Keon Hee;Sung, Ki Woong;Koo, Hong Hoe;Kim, Yae-Jean
    • Pediatric Infection and Vaccine
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    • v.18 no.1
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    • pp.40-47
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    • 2011
  • Purpose : Norovirus infection, a common cause of community-acquired gastroenteritis, can also lead to severe illness in immunocompromised patients. We investigated clinical manifestations of norovirus infection in pediatric cancer patients. Methods : Stool specimens were collected from pediatric patients with gastrointestinal symptoms between November 2008 and September 2009 at Samsung Medical Center, Seoul, Korea. Norovirus infection was identified by reverse-transcription polymerase chain reaction (RT-PCR). A retrospective chart review was performed in pediatric cancer patients who were diagnosed with norovirus infection. Results : Ten patients were diagnosed with norovirus infection by RT-PCR in stool samples. The median age was 0.83 years (range 0.25-5.5 years) and the male to female ratio was 1.5:1 (6 males and 4 females). Underlying diseases were hematologic malignancies (4/10, 40%), neuroblastoma (4/10, 40%), and brain tumors (2/10, 20%). Three patients were infected before hematopoietic cell transplantation (HCT) and four patients after HCT. All patients had diarrhea (10/10, 100%), with a median frequency of diarrhea of 8.5 times/day (range 4-22 times/day). Median virus shedding duration was 72.5 days (range 19-299 days). Four patients with pneumatosis intestinalis were conservatively treated with bowel rest and total parenteral nutrition. One patient with severe diarrhea and bloody stool had concomitant chronic gut graft-versus-host disease (GVHD). Norovirus infection-related mortality was not observed. Conclusion : Norovirus infection can cause significant clinical manifestations with prolonged viral shedding in immunocompromised patients. Norovirus should be considered in pediatric cancer patients with severe gastrointestinal symptoms.

Safety and Efficacy of Early Treatment with Intravenous Immunoglobulin in Patients with Kawasaki Disease (가와사끼병에서 면역글로불린 조기치료의 안전성과 효과)

  • Kim, Hyun Jin;Yom, Hae Won;Kim, Hae Soon;Sohn, Sejung
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.1019-1023
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    • 2003
  • Purpose : To determine the differences in clinical characteristics, blood chemistry and coronary artery complications between patients with Kawasaki disease who received intravenous immunoglobulin (IVIG) within the fourth day of illness and after the fifth day of illness. Methods : A retrospective chart review was conducted of all children with Kawasaki disease who were admitted to Ewha Mokdong Hospital between January 2001 and June 2002. The early treatment group received IVIG within the fourth day of illness(n=34) and the control group received IVIG after the fifth day of illness(n=53). Clinical manifestations, fever duration, hospitalization days, CBC, blood chemistry and coronary artery complications were compared between two groups. Results : No demographic differences were noted between the two groups(P>0.05). Total duration of fever was significantly shorter in the early treatment group than the control group($4.8{\pm}2.5days$ vs $7.4{\pm}3.0days$, P<0.05), but there were no differences in fever duration after IVIG treatment and hospitalization days between two groups(P>0.05). No significant differences were noted in the level of hemoglobin, WBC, ESR, CRP, AST, ALT and albumin between two groups(P>0.05). No significant differences in the incidence of IVIG retreatment were noted between the two groups(11.8% vs 5.7%, P>0.05). No significant differences in the incidence of coronary artery complications were noted between the two groups(11.7% vs 18.9%, P>0.05). No significant differences in the recurrence rate were noted between the two groups(3% vs 2%, P>0.05). Conclusion : Early IVIG treatment in patients with Kawasaki disease reduces the total fever duration. Coronary artery complications were not increased in patients with early IVIG treatment.