3.Serum β-hCG concentration is a predictive factor for successful early medical abortion with vaginal misoprostol within 24 hours.
Jung In KIM ; In Yang PARK ; Jung Mi YIM ; Ju Young CHEON ; Hang Goo YUN ; Ji Young KWON
Obstetrics & Gynecology Science 2017;60(5):427-432
OBJECTIVE: To evaluate the predictive factors associated with the success of medical abortion by misoprostol monotherapy within 24 hours in the first trimester of pregnancy. METHODS: The records of 228 women with miscarriage up to 11 weeks of gestational age who underwent medical abortion by intravaginal misoprostol monotherapy were reviewed. Success of abortion was defined as complete expulsion of the conceptus without the need for surgical intervention. Outcomes of interest were success of abortion within 24 hours following administration of misoprostol. RESULTS: Among 222 women who continued the process of medical abortion for 24 hours, 209 (94.1%) had a successfully completed abortion. Multivariate logistic regression showed that serum β-human chorionic gonadotropin (β-hCG) above 40,000 mIU/mL is significantly associated with failed medical abortion within 24 hours (odds ratio [OR], 7.13; 95% confidence interval [CI], 1.60–37.32; P=0.011). The area under the receiver operating characteristic curve of β-hCG level associated with successful abortion within 24 hours was 0.705 (95% CI, 0.63–0.77; P=0.007). Previous vaginal delivery seems to be significantly associated with successful abortion within 24 hours on univariate analysis (P=0.037), but the association was lost in multivariate analysis. CONCLUSION: Misoprostol monotherapy has a high success rate for first trimester abortion. Women with serum β-hCG less than 40,000 mIU/mL are likely to achieve a successful abortion within 24 hours after intravaginal administration of misoprostol.
Abortion, Spontaneous
;
Administration, Intravaginal
;
Chorionic Gonadotropin
;
Female
;
Gestational Age
;
Humans
;
Logistic Models
;
Misoprostol*
;
Multivariate Analysis
;
Pregnancy
;
Pregnancy Trimester, First
;
ROC Curve
4.Array-Based Comparative Genomic Hybridization in 190 Korean Patients with Developmental Delay and/or Intellectual Disability: A Single Tertiary Care University Center Study.
Cha Gon LEE ; Sang Jin PARK ; Jun No YUN ; Jung Min KO ; Hyon Ju KIM ; Shin Young YIM ; Young Bae SOHN
Yonsei Medical Journal 2013;54(6):1463-1470
PURPOSE: This study analyzed and evaluated the demographic, clinical, and cytogenetic data [G-banded karyotyping and array-based comparative genomic hybridization (array CGH)] of patients with unexplained developmental delay or intellectual disability at a single Korean institution. MATERIALS AND METHODS: We collected clinical and cytogenetic data based on retrospective charts at Ajou University Medical Center, Suwon, Korea from April 2008 to March 2012. RESULTS: A total of 190 patients were identified. Mean age was 5.1+/-1.87 years. Array CGH yielded abnormal results in 26 of 190 patients (13.7%). Copy number losses were about two-fold more frequent than gains. A total of 61.5% of all patients had copy number losses. The most common deletion disorders included 22q11.2 deletion syndrome, 15q11.2q12 deletion and 18q deletion syndrome. Copy number gains were identified in 34.6% of patients, and common diseases among these included Potocki-Lupski syndrome, 15q11-13 duplication syndrome and duplication 22q. Abnormal karyotype with normal array CGH results was exhibited in 2.6% of patients; theses included balanced translocation (n=2), inversion (n=2) and low-level mosaicism (n=1). Facial abnormalities (p<0.001) and failure to thrive were (p<0.001) also more frequent in the group of patients with abnormal CGH findings. CONCLUSION: Array CGH is a useful diagnostic tool in clinical settings in patients with developmental delay or intellectual disability combined with facial abnormalities or failure to thrive.
Adolescent
;
Adult
;
Child
;
Child, Preschool
;
Comparative Genomic Hybridization/*methods
;
Female
;
Gene Dosage/genetics
;
Humans
;
Infant
;
Intellectual Disability/*genetics
;
Karyotype
;
Male
;
Republic of Korea
;
Retrospective Studies
;
Tertiary Healthcare/statistics & numerical data
;
Young Adult
5.Symptom Prevalence of Work-Related Musculoskeletal Disorders and Related Factors among Bank Workers by Visual Dispaly Terminal Use .
Shang Hyuk YIM ; Yun Geun LEE ; Jung Jin CHO ; Jeong Il SON ; Jae Cheol SONG
Korean Journal of Occupational and Environmental Medicine 1997;9(1):85-98
The purpose of this study is to investigate the relationship between the self-reported musculoskeletal symptoms and related factors among VDT operators in bank. The subjects were 950 women workers. The characteristics of subjects were 26.6 years of average age, 5.7 years of average VDT use duration and 6.5 hours of daily VDT use time. The results were as follows. The prevalence of self-reported musculoskeletal symptoms more than severe in Likert scale were 51.4%, 43.9% at the shoulder, 38.3%, 31.8% at the lower back, 38.0%, 31.3% at the neck, 31.2%, 25.2% at the upper back, 21.7%, 16.5% at the wrist and 13.6%, 8.8% at the fingers (while on duty, after home-coming). General characteristic variables affecting the musculoskeletal symptoms were married, number of child and daily house-working time. Work-related factors affecting the musculoskeletal symptoms were VDT working career, daily working time, daily VDF use time, VDF use time without rest, daily work-load and regular rest. As the result of the multiple logistic regression analysis, daily working time, daily VDT use time and VDT working career were significant variables accounting for the musculoskeletal symptoms.
Child
;
Cumulative Trauma Disorders
;
Female
;
Fingers
;
Humans
;
Logistic Models
;
Neck
;
Prevalence*
;
Shoulder
;
Wrist
6.Tinea Capitis Caused by Trichophyton rubrum in a 81-Year-Old Woman.
Jun Gyu SONG ; Sang Youl YUN ; Moo Kyu SUH ; Gyoung Yim HA ; Tae Jung JANG
Korean Journal of Medical Mycology 2015;20(4):114-118
Trichophyton(T.) rubrum is an anthropophilic dermatophyte that is found all over the world. It has become one of the most important causative agents in tinea pedis and onychomycosis. But tinea capitis caused by T. rubrum is rare. Tinea capitis is uncommon in an adult. We report a case of tinea capitis caused by T. rubrum in an 81-year-old woman. She presented with localized asymptomatic well-demarcated thick scaly erythematous patches on the fronto-vertex scalp for 6 months. She was diagnosed as seborrheic dermatitis in local clinic and was treated with topical steroid. However, the lesion was not improved and spreading. Culture from scalp lesion of patient was grown on Sabouraud's dextrose agar and showed typical whitish cottony colonies of T. rubrum. She was treated with 200 mg of oral itraconazole daily for 8 weeks. The skin lesions improved 8 weeks after treatment, and recurrence has not been observed.
Adult
;
Agar
;
Aged, 80 and over*
;
Arthrodermataceae
;
Dermatitis, Seborrheic
;
Female
;
Glucose
;
Humans
;
Itraconazole
;
Onychomycosis
;
Recurrence
;
Scalp
;
Skin
;
Tinea Capitis*
;
Tinea Pedis
;
Tinea*
;
Trichophyton*
7.A Case with Multifocal Langerhans Cell Granulomatosis Involving the Thyroid Gland.
Kwan Woo LEE ; Chul Kwon CHUNG ; Sung Chul HWANG ; Hyun Hee YIM ; So Yun PARK ; Sung Kyu LEE ; Yun Suk CHUNG ; Hyun Man KIM ; Yoon Jung KIM ; Eun Kyung HONG ; Bong Nam CHAE
Journal of Korean Society of Endocrinology 1998;13(3):466-472
Langerhans cell granulomatosis(LCG), previously termed 'Histiocytosis-X', is one of the rare disease. LCG is characterized by proliferation of Langerhans cells in a unifocal or multifocal pattern. And LCG may be manifested in a variety of way, ranging from a spontaneously regressing solitary lesion to a multisystem life-threatening disorder. This disease usually involves the bone, lung, skin and lymph node. The most common endocrinologic abnormalities in LCG are diabetes insipidus and growth hormone deficiency. LCG involving the thyroid gland is extremely rare and only a small numbers of cases have been reported worldwide. A 41-year-old diabetic female visited the hospital due to the neck swelling for 3 months and she also complained of polyuria, polydipsia and easy fatigue. LCG involving multiple organs included thyroid gland was diagnosed by high-resolution CT of lung, by characteristic histological findings of the thyroid lesion and by the immunohistochemical staining for S-100 protein and OKT 6(CD la). She is followed at OPD without any medication.
Adult
;
Diabetes Insipidus
;
Fatigue
;
Female
;
Growth Hormone
;
Histiocytosis, Langerhans-Cell*
;
Humans
;
Langerhans Cells
;
Lung
;
Lymph Nodes
;
Neck
;
Polydipsia
;
Polyuria
;
Rare Diseases
;
S100 Proteins
;
Skin
;
Thyroid Gland*
8.Entecavir-induced Tubulointerstitial Nephritis.
Eun Jin HAN ; Sun Mi KIM ; Hong Sub LEE ; Sung Chan JEON ; Yun Jung JUNG ; Hyunee YIM ; Sung Won CHO ; Heungsoo KIM ; Gyu Tae SHIN
Korean Journal of Nephrology 2010;29(4):504-508
Acute interstitial nephritis is an important cause of acute kidney injury and most often induced by drug therapy. Entecavir is a potent antiviral agent approved for chronic hepatitis B. The antiviral therapy in chronic hepatitis B management is important because it reduces viral replication and liver injury, prevents development of complications, such as liver cirrhosis and hepatocellular carcinoma, and thus improves patient's survival. The advantage of entecavir is its safety profile, particularly in patients with renal dysfunction. Although doses of entecavir are needed to be adjusted for patients with renal dysfunction, there has been no known renal toxicity of the drug itself. Here we report a patient with chronic hepatitis B and normal renal function who developed acute kidney injury due to tubulointerstitial nephritis after 10 months of entecavir therapy. Renal biopsy showed not only acute changes of interstitial nephritis such as marked cortical infiltration with lymphoplasma cells and neutrophils, mesangial matrix expansion, eosinophilic granular casts and degenerative epithelial cells within tubular lumen but also chronic changes, minimal tubular atrophy and interstitial fibrosis. After immunosuppressant therapy with steroids and mycofenolate mofetil, the patient's renal function improved.
Acute Kidney Injury
;
Atrophy
;
Biopsy
;
Carcinoma, Hepatocellular
;
Eosinophils
;
Epithelial Cells
;
Fibrosis
;
Guanine
;
Hepatitis B, Chronic
;
Humans
;
Imidazoles
;
Liver
;
Liver Cirrhosis
;
Nephritis, Interstitial
;
Neutrophils
;
Nitro Compounds
;
Steroids
9.Subtyping of Performance Trajectory During Medical School, Medical Internship, and the First Year of Residency in Training Physicians:A Longitudinal Cohort Study
Je-Yeon YUN ; Hyunjin RYU ; Ju Whi KIM ; Hyun Bae YOON ; Seung CHOI ; Wan Beom PARK ; Eun Jung BAE ; Jae-Joon YIM ; Sun Jung MYUNG
Journal of Korean Medical Science 2024;39(33):e239-
Background:
Developmental trajectories of clinical skills in training physicians vary among tasks and show interindividual differences. This study examined the predictors of medical internship performance and residency entrance and found subtypes of performance trajectory in training physicians.
Methods:
This retrospective cohort study involved 888 training physicians who completed a medical internship between 2015 and 2019. After the internship, 627 physicians applied for residency training between 2016 and 2020. Finally, 160 of them completed their first-year residency in internal medicine, surgery, pediatrics, and psychiatry departments between 2016 and 2020. Pearson’s correlation coefficients of internship performance and first year-residency performance (n = 160) were calculated. Latent profile analysis identified performance trajectory subtypes according to medical school grade point average (GPA), internship performance, English proficiency, and residency selection procedures. Multivariate logistic regression models of residency acceptance (n = 627) and performance in the top 30%/lower 10% in the first year of residency were also constructed.
Results:
Medical internship performance showed a significant positive correlation with the medical school GPA (r = 0.194) and the written score for the medical licensing examination (r = 0.125). Higher scores in the interview (adjusted odds ratio [aOR], 2.57) and written examination (aOR, 1.45) of residency selection procedures and higher medical internship performance (aOR, 1.19) were associated with a higher chance of residency acceptance. The latent profile analyses identified three training physician subgroups: average performance, consistently high performance (top 30%), and adaptation to changes (lowest 10%). Higher scores in the interview for residency selection (aOR, 1.35) and lower scores for medical internship performance (aOR, 0.79) were associated with a higher chance of performing in the top 30% or lowest 10% in the first year of residency, respectively.
Conclusion
Performance in the interview and medical internship predicted being among the top 30% and lowest 10% of performers in the first year of residency training, respectively.Individualized educational programs to enhance the prospect of trainees becoming highfunctioning physicians are needed.
10.Subtyping of Performance Trajectory During Medical School, Medical Internship, and the First Year of Residency in Training Physicians:A Longitudinal Cohort Study
Je-Yeon YUN ; Hyunjin RYU ; Ju Whi KIM ; Hyun Bae YOON ; Seung CHOI ; Wan Beom PARK ; Eun Jung BAE ; Jae-Joon YIM ; Sun Jung MYUNG
Journal of Korean Medical Science 2024;39(33):e239-
Background:
Developmental trajectories of clinical skills in training physicians vary among tasks and show interindividual differences. This study examined the predictors of medical internship performance and residency entrance and found subtypes of performance trajectory in training physicians.
Methods:
This retrospective cohort study involved 888 training physicians who completed a medical internship between 2015 and 2019. After the internship, 627 physicians applied for residency training between 2016 and 2020. Finally, 160 of them completed their first-year residency in internal medicine, surgery, pediatrics, and psychiatry departments between 2016 and 2020. Pearson’s correlation coefficients of internship performance and first year-residency performance (n = 160) were calculated. Latent profile analysis identified performance trajectory subtypes according to medical school grade point average (GPA), internship performance, English proficiency, and residency selection procedures. Multivariate logistic regression models of residency acceptance (n = 627) and performance in the top 30%/lower 10% in the first year of residency were also constructed.
Results:
Medical internship performance showed a significant positive correlation with the medical school GPA (r = 0.194) and the written score for the medical licensing examination (r = 0.125). Higher scores in the interview (adjusted odds ratio [aOR], 2.57) and written examination (aOR, 1.45) of residency selection procedures and higher medical internship performance (aOR, 1.19) were associated with a higher chance of residency acceptance. The latent profile analyses identified three training physician subgroups: average performance, consistently high performance (top 30%), and adaptation to changes (lowest 10%). Higher scores in the interview for residency selection (aOR, 1.35) and lower scores for medical internship performance (aOR, 0.79) were associated with a higher chance of performing in the top 30% or lowest 10% in the first year of residency, respectively.
Conclusion
Performance in the interview and medical internship predicted being among the top 30% and lowest 10% of performers in the first year of residency training, respectively.Individualized educational programs to enhance the prospect of trainees becoming highfunctioning physicians are needed.