• Title/Summary/Keyword: e-clinical data

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Clinical Observations of Gastrointestinal Cow Milk Allergy in Children According to a New Classification (새로운 분류법에 따른 소아 위장관 우유 알레르기 질환에 관한 임상적 고찰)

  • Hwang, Jin Bok;Choi, Seon Yun;Kwon, Tae Chan;Oh, Hoon Kyu;Kam, Sin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.40-47
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    • 2004
  • Purpose: A new classification of gastrointestinal food allergy was published, but the changes of terminology between previously reported terms and the new ones were in a state of disorder. This has resulted in confusion between medical communication and diagnostic and therapeutic approaches. The clinical observations of infants presenting with gastrointestinal cow milk allergy (GI-CMA) were performed, and the changes in the terminology reviewed through the published Korean literature. Methods: Between March 2003 and July 2003, data from 37 consecutive infants with GI-CMA, aged 2 weeks to 15 months, were reviewed. The challenge and elimination test of cow milk, and the endoscopic and histologic findings, were used for the seven subdivisions of GI-CMA according to a new classification on the basis of patients' ages, clinical manifestations and location of gastrointestinal lesions. Results: The 37 patients had a mean age of $5.4{\pm}4.8$ months, with those observed in 26 (70.3%) of patients being below 6 months of age. The seven final diagnoses were; cow milk protein-induced enterocolitis (CMPIE) in 12 (32.4%), cow milk protein proctitis (PROC) in 12 (32.4%), IgE-mediated (IGE) in 6 (16.2%), gastroesophageal reflux-associated cow milk allergy (GERA) in 5 (13.5%) and eosinophilic gastroenterocolitis in 2 (5.4%). CMPIE was revealed as the typical type in 7 (18.9%) and the atypical type in 5 (13.5%), and all of typical CMPIE revealed cow milk protein-induced enteropathy. The mean age at symptom onset was $4.3{\pm}0.8$ months, and for those with typical and atypical CMPIE, and PROC and GERA were $3.8{\pm}4.6$, $10.4{\pm}3.8$, $3.4{\pm}3.9$ and $7.8{\pm}5.7$ months, respectively (p<0.05). The period from onset of symptom to diagnosis was $2.4{\pm}3.3$ (0.5~12) months, with those observed in atypical CMPIE and GERA being over 3months. Although the birth weights in all patients were within the 10~90 percentile range, the body weights on diagnoses were below the 3 percentile in 48.6%; IGE 16.7%, EOS 0%, typical CMPIE 85.7%, atypical CMPIE 60.0%, PROC 25.0% and GERA 100% (p<0.05). Through the review of the Korean literature, 8 case reports and 14 original articles for GI-CMA were found. Conclusion: GI-CMA is not a rare clinical disorder and is subdivided into seven categories on the basis of the patient's age, clinical manifestations and location of the gastrointestinal lesions. The terms for GI-CMA are changing with new classifications, and careful approaches are necessary for medical communications.

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Nationwide Analysis of Treatment Patterns for Korean Breast Cancer Survivors Using National Health Insurance Service Data

  • Chung, Il Yong;Lee, Jihyoun;Park, Suyeon;Lee, Jong Won;Youn, Hyun Jo;Hong, Jung Hwa;Hur, Ho
    • Journal of Korean Medical Science
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    • v.33 no.44
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    • pp.276.1-276.10
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    • 2018
  • Background: The National Health Insurance Service (NHIS) established a healthcare claim database for all Korean citizens. This study aimed to analyze the NHIS data and investigate the patterns of breast cancer treatments. Methods: We constructed a retrospective female breast cancer cohort by analyzing annual incident cases. The annual number of newly diagnosed female breast cancer was compared between the NHIS data and Korea National Cancer Incidence Database (KNCIDB). The annual treatment patterns including surgery, chemotherapy, radiation therapy, endocrine therapy and targeted therapy were analyzed. Results: A total of 148,322 women with newly diagnosed invasive breast cancer during 2006-2014 was identified. The numbers of newly diagnosed invasive breast cancer cases were similar between the NHIS data and KNCIDB, which demonstrated a strong correlation (r = 0.995; P < 0.001). The age distribution of the breast cancer cases in the NHIS data and KNCIDB also showed a strong correlation (r = 1.000; P < 0.001). About 85% of newly diagnosed breast cancer patients underwent operations. Although the proportions of chemotherapy use have not changed during 2006-2014, the total number of chemotherapy prescriptions sharply increased during this period. The proportions of radiotherapy and anti-hormonal therapy increased. Among the anti-hormonal agents, tamoxifen was the most frequently prescribed medication, and letrozole was the most preferred endocrine treatment in patients aged ${\geq}50$ years. Conclusion: Along with the increased breast cancer incidence in Korea, the frequencies of breast cancer treatments have increased. The NHIS data can be a feasible data source for future research.

The Study of Safety of Herbal Medicine Including Fuzi(附子) on High Range of LFT, RFT Patients (간, 신장수치 이상 환자에 부자(附子) 배합 처방 투여가 미치는 영향)

  • Lee, Young-Jun;Hwang, Won-Duk;Lee, Jae-Wook;Jeong, Hui-Jin;Bae, Su-Hyun;Kim, Kyu-Gon
    • Herbal Formula Science
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    • v.19 no.2
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    • pp.179-189
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    • 2011
  • Objectives : Aconiti Lateralis Preparata Radix(fuzi, 附子) and its class herbs(chaunwu, caowu etc.) are necessary for some clinical conditions, such as cold pain, chilling etc,. But, they has some poison component. And, they have been known to cause liver and kidney injury, and dangerous in the patients who has abnormal range of LFT and RFT. This study shows the consequences for aspartate aminotransferase(AST), alanine aminotransferase(ALT), blood urea nitrate(BUN), and Creatinine were analyzed using samples from patients who took the decoction containing fuzi. Methods : Blood samples for Experiment Group(E) were collected from 63 patients, who took the decoction containing fuzi, admitted into the 6th internal medicine department of Dong Eui Oriental Medical Hospital between from January 2007 to March 2011. In compared to those of experiment group, blood samples as Control Group(C) were collected from 64 patients, who took the decoction not containing fuzi, admitted into the same hospital from January 2009 to April 2011. Results and Conclusions : 1. AST No changed : E 4.17%, C 2.63%, Increased : E 12.5%, C 28.95%, Decreased : E 80.33%, C 68.42% 2. ALT No changed : E2.94%, C5.13%, Increased : E 8.82%, C 20.51%, Decreased : E 88.24%, C 74.36% 3. BUN No changed : E 0%, CG 7.14%, Increased : E 32.25%, CG 14.29% Decreased : EG 67.65%, CG 78.57% 4. Creatinine No changed : EG 5.00%, CG 0%, Increased : EG 35.00%, CG 54.55% Decreased : EG 60.00%, CG 45.45% 5. The results suggest that the decoction containing fuzi isn't harmful AST, ALT, BUN, Cr of the patients who has high range of them.

HISTOLOGICAL AND CLINICAL STUDY OF ARTIFICIAL DERMIS IMPLANTATION FOR RESTORATION OF SOFT TISSUE DEFECTS (연조직 결손부 회복을 위한 인공진피 이식의 조직학적 및 임상적 연구)

  • Ryu, Sun-Youl;Kim, Sun-Kook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.5
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    • pp.410-417
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    • 2006
  • The present study was aimed to compare the resorption rate and the histological change of the autogenous dermis and the artificial dermis (Terudermis$^{(R)}$) after the transplantation, and to report the clinical results of the use of Terudermis$^{(R)}$ in order to restore the soft tissue defect. Twenty mature rabbits, weighing about 2 kg, were used for the experimental study. The autogenous dermis and the Terudermis$^{(R)}$ size 1${\times}$1 cm were transplanted to the space between the external abdominal oblique muscle and the external abdominal oblique fascia of the each rabbits. They were divided into 4 groups (n=5 each) and gathered at 1, 2, 4, and 8 weeks after the transplantation. The resorption rate was calculated, and H-E stain was preformed to observe the histological changes. The chart review of the 17 patients who received Terudermis$^{(R)}$ graft to the facial soft tissue defects was conducted for the clinical study. The resorption rate at 8 weeks after the transplantation was 21.5% for the autogenous dermis, and 36.4% Terudermis$^{(R)}$. In microscopic examinations, the infiltration of the inflammatory cells and the epidermal inclusion cyst were observed in the autogenous dermis graft. The neovascularization and the progressive growth of the new fibroblast were shown in the Terudermis$^{(R)}$ graft. In clinical data of 17 patients, the size of the grafted Terudermis$^{(R)}$ was from 1.5$cm^2$ to 7.5$cm^2$ (average 3.5$cm^2$). Follow-up ranged from 5 to 25 months. Fourteen patients with cleft palate demonstrated stability of the graft and unremarkable complications. But unstability of the graft and the partial relapse were observed in three patients received the vestibuloplasty. These results indicate that Terudermis$^{(R)}$ can be available substitute of autogenous dermis because of the stability about resorption, the histocompatibility, and the unremarkable clinical complications.

Investigating Organ Toxicity Profile of Tenofovir and Tenofovir Nanoparticle on the Liver and Kidney: Experimental Animal Study

  • Peter, Aniekan Imo;Naidu, Edwin CS;Akang, Edidiong;Ogedengbe, Oluwatosin O;Offor, Ugochukwu;Rambharose, Sanjeev;Kalhapure, Rahul;Chuturgoon, Anil;Govender, Thirumala;Azu, Onyemaechi O
    • Toxicological Research
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    • v.34 no.3
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    • pp.221-229
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    • 2018
  • Tenofovir nanoparticles are novel therapeutic intervention in human immunodeficiency virus (HIV) infection reaching the virus in their sanctuary sites. However, there has been no systemic toxicity testing of this formulation despite global concerns on the safety of nano drugs. Therefore, this study was designed to investigate the toxicity of Tenofovir nanoparticle (NTDF) on the liver and kidney using an animal model. Fifteen adult male Sprague-Dawley (SD) rats maintained at the animal house of the biomedical resources unit of the University of KwaZulu-Natal were weighed and divided into three groups. Control animals (A) were administered with normal saline (NS). The therapeutic doses of Tenofovir (TDF) and nanoparticles of Tenofovir (NTDF) were administered to group B and C and observed for signs of stress for four weeks after which animals were weighed and sacrificed. Liver and kidney were removed and fixed in formal saline, processed and stained using H/E, PAS and MT stains for light microscopy. Serum was obtained for renal function test (RFT) and liver function test (LFT). Cellular measurements and capturing were done using ImageJ and Leica software 2.0. Data were analysed using graph pad 6, p values < 0.05 were significant. We observed no signs of behavioural toxicity and no mortality during this study, however, in the kidneys, we reported mild morphological perturbations widening of Bowman's space, and vacuolations in glomerulus and tubules of TDF and NTDF animals. Also, there was a significant elevation of glycogen deposition in NTDF and TDF animals when compared with control. In the liver, there were mild histological changes with widening of sinusoidal spaces, vacuolations in hepatocytes and elevation of glycogen deposition in TDF and NTDF administered animals. In addition to this, there were no significant differences in stereological measurements and cell count, LFT, RFT, weight changes and organo-somatic index between treatment groups and control. In conclusion, NTDF and TDF in therapeutic doses can lead to mild hepatic and renal histological damage. Further studies are needed to understand the precise genetic mechanism.

Clinical Differences in Triple-Positive Operable Breast Cancer Subtypes in Korean Patients: An Analysis of Korean Breast Cancer Registry Data

  • You, Sun Hyong;Chae, Byung Joo;Eom, Yong Hwa;Yoo, Tae-Kyung;Kim, Yong-seok;Kim, Jeong Soo;Park, Woo-Chan
    • Journal of Breast Cancer
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    • v.21 no.4
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    • pp.415-424
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    • 2018
  • Purpose: Triple-positive breast cancer is defined by estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2) positivity. Several systemic breast cancer therapies target hormonal and HER2 responsiveness. We compared clinical outcomes of triple-positive disease with those of HER2-enriched and luminal HER2-negative disease and investigated the clinical efficacy of anti-HER2 therapy for triple-positive disease. Methods: We retrospectively compared overall and recurrence-free survival among cases included in the Korean Breast Cancer Society (KBCS) and Seoul St. Mary's Hospital breast cancer registries and the therapeutic efficacy of trastuzumab for triple-positive and HER2-enriched cases. Results: KBCS registry data (2006-2010; median follow-up, 76 months) indicated that patients with triple-positive breast cancer had intermediate survival between those with luminal A and HER2-enriched subtypes (p<0.001). Trastuzumab did not improve overall survival among patients with triple-positive breast cancer (p=0.899) in contrast to the HER2-enriched subtype (p=0.018). Seoul St. Mary's Hospital registry data indicated similar recurrence-free survival outcomes (p<0.001) and a lack of improvement with trastuzumab among patients with triple-positive breast cancer (median follow-up, 33 months; p=0.800). Multivariate analysis revealed that patients with triple-positive breast cancer had better overall survival than those with HER2-enriched disease and similar survival as those with the luminal A subtype (triple-positive: hazard ratio, 1.258, p=0.118; HER2-enriched: hazard ratio, 2.377, p<0.001). Conclusion: Our findings showed that anti-HER2 therapy was less beneficial for treatment of triple-positive breast cancer than for HER2-enriched subtypes of breast cancer, and the triple-positive subtype had a distinct prognosis.

Metastasis Risk Reduction Related with Beta-Blocker Treatment in Mexican Women with Breast Cancer

  • Parada-Huerta, E;Alvarez-Dominguez, TP;Uribe-Escamilla, R;Rodriguez-Joya, JF;Ponce-Medrano, JA Diaz;Padron-Lucio, S;Alfaro-Rodriguez, A;Bandala, C
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2953-2957
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    • 2016
  • Background: Breast Cancer (BCa) is the most common malignant tumour in Mexican women. In BCa, several studies have linked ${\beta}2-adrenergic$ receptor activation with increased tumour growth and progression as related with Epinephrine-NorEpinephrine (E-NE) stimulation. The aim of this study was to describe Beta-Blocker (BB) treatment related with reduction of the risk of metastasis in Mexican patients with BCa. Materials and Methods: We collected data of 120 patients seen at the High-Specialty Naval General Hospital in Mexico City (HOSGENAES), all of these with a histopathological diagnosis of BCa. Four groups of patients were divided as follows: without Systemic Arterial Hypertension (SAH); with SAH treatment with non-selective BB; with SAH treatment with selective BB, and with SAH treatment with other antihypertensive drugs. Chi-square, Mantel-Haenszel, Student t, and ANOVA tests were performed for data analysis. Results: On average, patients were $54.8{\pm}11.8$ years of age. Risk factors such as smoking and consuming alcohol exhibited a frequency of 33 and 36.5% respectively. Clinical stages III- IV were found in 50% of patients, while, 30% of patients had arterial hypertension (n=29 and N=96, respectively) and 17.5% used BB. One hundred percent of patients with arterial hypertension treated with BB for ${\beta}1$ - and ${\beta}2$ -adrenergic-receptors did not present metastasis globally, but patients treated with ${\beta}1$ BB presented 30% of metastasis while patients treated with no BB or without SAH had around 70% of metastasis. Conclusions: In Mexican patients with BCa and SAH treated with non-selective (${\beta}1$- and ${\beta}2-adrenergic$ receptors) BB, a decrease in the risk for metastasis was observed at the time of diagnosis.

Patient Safety Nursing Experiences of Nurses in Integrated Nursing Service Wards (간호·간병통합서비스 병동 간호사의 환자안전 간호 경험)

  • Eun Hye Kim;Hyunjin Lee;Sookbin Im
    • Journal of Industrial Convergence
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    • v.22 no.9
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    • pp.103-112
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    • 2024
  • The purpose of this study is to understand the experiences of nurses working in integrated nursing service wards regarding patient safety nursing. To achieve the purpose of this study, data were collected through one-on-one in-depth interviews with nine clinical nurses working in the integrated nursing service ward at E University Hospital from October 1, 2019 to December 22, 2019. A pre-prepared semi-structured questionnaire was used for the interview, and the recordings were transcribed after the interview. Data were analyzed by applying the phenomenological method of Colaizzi. The results of this study reflected the patient safety nursing experience of the study participants, and 123 meaning units were discovered, which were derived into 9 themes and 4 theme clusters. : 'ambivalence of patient safety nursing,' 'pressure related to patient safety incidents,' 'advancement in patient safety through practical experience complementing adherence to principles,' and 'achieving safety nursing together with patients'. In conclusion, Integrated Nursing Service ward have a duality of patient safety, and it is necessary to recognize the need for a patient safety system suitable for integrated nursing service ward.

The use of gonadotropin-releasing hormone antagonist post-ovulation trigger in ovarian hyperstimulation syndrome

  • Chappell, Neil;Gibbons, William E.
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.2
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    • pp.57-62
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    • 2017
  • The purpose of this paper is to assimilate all data pertaining to the use of gonadotropin-releasing hormone (GnRH) antagonists in in vitro fertilization cycles after ovulation trigger to reduce the symptoms of ovarian hyperstimulation syndrome (OHSS). A systematic review of the literature was performed to identify all studies performed on the use of a GnRH antagonist in IVF cycle post-ovulation trigger with patients at high risk for OHSS. Ten studies were identified and reviewed. Descriptions of the studies and their individual results are presented in the following manuscript. Due to significant heterogeneity among the studies, it was not possible to perform a group analysis. The use of GnRH antagonists post-ovulation trigger for treatment of OHSS has been considered for almost 20 years, though research into its use is sparse. Definitive conclusions and recommendations cannot be made at this time, though preliminary data from these trials demonstrate the potential for GnRH antagonists to play a role in the treatment of OHSS in certain patient populations.

The Relationship among Nurse-Doctor Collaboration, Job Autonomy and Organizational Commitment (간호사-의사 협력, 직무자율성과 조직몰입의 관계)

  • Hong, Ji-Yeon;Kim, Ok-Hyun;Lee, Eun-Kyung
    • Journal of Korean Academy of Nursing Administration
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    • v.15 no.4
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    • pp.601-609
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    • 2009
  • Purpose: This study aimed to investigate and analyze the state of the relationship among nurse-doctor collaboration, job autonomy and organizational commitment. Method: The 304 participants were obtained who were working at a General ward, Intensive care unit and Operation room in three university hospitals located in Seoul and Kyunggi-do. The data were collected using a structured questionnaire from March 2d to April 10th, 2009. The collected data were analyzed with t-test, ANOVA, Scheff$\acute{e}$ test and Pearson's correlation on SPSS Win 16.0. Result: There was a significant relationship among nurse-doctor collaboration, job autonomy and organizational commitment. The level of appointment, clinical experience and current hospital experience of nurses affected significantly nurse-doctor collaboration, job autonomy and organizational commitment. The age of nurse had the relation nurse-doctor collaboration and organizational commitment. The relationship between the nurse's working area and job autonomy had positive correlation. Conclusions: The findings of study suggest that the program enhancing the collaborated relationship between nurses and doctors is important to improve nurse's job autonomy and organizational commitment under the situation of citizen's demanding more advanced medical service.

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