Although medical insurance claims data provide an increasingly accessible and widely used source of data for health care research, there are few studies about their sensitivity. This study was conducted to investigate the sensitivity of diagnosed cancers in medical insurance claims data. Every case of Kwangju Cancer Registry registered during 1998-1999 was checked for its status in medical insurance claims. The sensitivity of medical insurance claims was expressed as the proportion of cases who were reported as having cancer among cancer registry cases. The sensitivities of Kwangju and nationwide medical insurance claims data for overall cancer were 87.2% and 92.8%, respectively. For cancer sites, the sensitivity of medical insurance claims data was the highest for breast, followed by thyroid, lymphoma and colorectum, and the lowest for pancreas and kidney. Medical insurance claims data would provide reasonably high sensitivity for the detection of cancer, especially if nationwide medical insurance claims are included. Further studies should examine false positive cases to measure other dimensions of accuracy, such as specificity and predictive value.
Breast ; Gwangju ; Health Services Research ; Insurance* ; Kidney ; Lymphoma ; Pancreas ; Sensitivity and Specificity ; Thyroid Gland

Although the incidence is not high in the general surgical population, pulmonary aspiration of gastric contents can result in serious long-term morbidity and mortality. We report a case of early use of extracorporeal membrane oxygenation (ECMO) to correct severe hypoxemia refractory to conventional mechanical ventilation in a patient with massive aspiration of gastric contents immediately followed by acute lung injury during general anesthesia induction. A 64-year-old woman diagnosed with stomach cancer was scheduled for elective diagnostic laparoscopy. Although there was no sign of gastrointestinal tract obstruction and midnight Nil per Os (NPO) was performed before the operation, pulmonary aspiration occurred during the induction of anesthesia. Despite the endotracheal intubation with mechanical ventilation, severe hypoxemia with hypercapnea persisted. Medical team agreed with applying veno-venous (VV) ECMO, and her blood gas analysis results became stable. ECMO was weaned successfully 9 days after the first aspiration event had occurred. Based on this case, early application of extracorporeal life support can have survival benefits.
Acute Lung Injury ; Anesthesia* ; Anesthesia, General ; Anoxia ; Blood Gas Analysis ; Extracorporeal Membrane Oxygenation* ; Female ; Gastrointestinal Tract ; Humans ; Incidence ; Intubation, Intratracheal ; Laparoscopy ; Middle Aged ; Mortality ; Pneumonia, Aspiration ; Respiration, Artificial ; Stomach Neoplasms

PURPOSE:This study was conducted to analyse the characteristics of the full-term neonates admitted in neonatal period and to evaluate the relationship between readmission and perinatal, maternal factors. METHODS:We studied retrospectively the neonatal readmissions who were born in Il Sin Christian Hospital during the 18-months period (January 1, 2007 to June 30, 2008). RESULTS:After discharge, 415 neonates were readmitted during the first month of life. The most common cause for readmission was jaundice (82.7%). Among them, 211 (61.5%) neonates were fully breast feeding and 119 (34.7%) were mixed feeding infants. The second cause was rota enteritis (6.3%). Others included dehydration (4.1%), suspected sepsis (3.1%), other enteritis (1.7%), pneumonia (0.7%), cardiac problem (0.5%), meningitis (0.5%), urinary tract infection (0.2%), and other urinary problem (0.2%). There were no significant relationships between readmission and neonatal, maternal factors. CONCLUSION:While newborns discharged from hospital are at risk for readmission, but relationship among neonatal, maternal, and other factors are not proven. Education of risk factors for jaundice to parents should be done and prevention of hospital acquired infection is important. Further research should include relationships between neonatal, maternal factors and the other factors influencing neonatal readmission.
Breast Feeding ; Dehydration ; Enteritis ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Meningitis ; Parents ; Pneumonia ; Retrospective Studies ; Risk Factors ; Sepsis ; Urinary Tract Infections

Purpose: This study aimed to identify the early sedation depth in the first 48 hours of mechanical ventilation and its relationship to clinical outcomes to promote the transition to light sedation. Methods: This retrospective single-center cohort study was conducted in two medical intensive care units (MICUs) at a general tertiary hospital, using a standardized sedation protocol. To investigate the early sedation depth, the Sedation Index was used, which can indicate changes over the first 48 hours. Patients were divided into three groups based on tertiles of Sedation Index. The primary outcome was mortality at 30, 90, and 180 days. The secondary outcomes included length of stay in the ICU and ventilator-free days. Kaplan-Meier analysis and multivariable Cox regression were conducted to compare factors influencing mortality. Results: This study included 394 patients. The deepest sedation group showed more severe illness, delirium, and deeper sedation at admission (p < .001). The survival curve decreased as sedation increased, even within the light sedation levels. In the deepest sedation group, 30-day mortality (hazard ratio [HR] 2.11, 95% confidence interval [CI] 1.33–3.34), 90-day mortality (HR 2.00, 95% CI 1.31–3.06), and 180-day mortality (HR 1.77, 95% CI 1.17–2.67) increased. The length of stay in the ICU and ventilator-free days did not show statistical differences. Conclusions These results indicate that early deep sedation is a modifiable factor that can potentially affect mortality. The protocol for inducing the transition into light sedation must comply with recommendations to improve clinical outcomes.

BACKGROUND/AIMS: Fecal calprotectin (FC) is a marker of intraluminal intestinal inflammation. Intestinal inflammation may contribute to the pathophysiology of irritable bowel syndrome (IBS). This study evaluated FC levels in children with IBS and differences in FC levels in children stratified by IBS subtype and healthy controls (HCs).METHODS: A total of 157 children with IBS and 56 HCs aged 4–16 years (119 boys, 94 girls, mean age of 9.48 years) were included in this prospective study. Children with IBS were diagnosed using the Rome III criteria and classified into 4 subtypes: IBS with constipation (IBS-C, n=37), IBS with diarrhea (IBS-D, n=54), IBS with alternating constipation and diarrhea (IBS-M, n=49), and IBS unsubtyped (IBS-U, n=17); postinfectious IBS (PI-IBS) was also considered. The FC concentration in stool samples was analyzed using an enzyme-linked immunosorbent assay. All participants answered a questionnaire regarding several demographic and clinical characteristics.RESULTS: Children with IBS had significantly higher levels of FC than the HCs (88.71 μg/g vs. 17.77 μg/g). Among the 4 IBS subtypes, the FC concentration was highest in children with IBS-D, followed by those with IBS-M, IBS-C, and IBS-U (169.94 μg/g vs. 45.04, 31.22, and 33.52 μg/g, respectively), and these differences were statistically significant. For PI-IBS, 90% of cases were in the IBS-D group.CONCLUSIONS: The FC level was significantly higher in children with IBS than in HCs and differed depending on the IBS subtype, supporting the notion that IBS is a type of low-grade bowel inflammation.
Child ; Constipation ; Diarrhea ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Inflammation ; Irritable Bowel Syndrome ; Leukocyte L1 Antigen Complex ; Prospective Studies

No abstract available.
Cystadenoma*

No abstract available.
Cystadenoma*

PURPOSE: There are few reports about the natural history of patients with pseudoprecocious puberty due to autonomous ovarian cyst. We reviewed the clinical course of 7 patients who had autonomous ovarian cysts and signs of precocious puberty. METHODS: We retrospectively evaluated 7 children, aged 2.8 to 7.9 years, who were diagnosed with pseudoprecocious puberty due to autonomous ovarian cysts from November 2005 to May 2011. The follow-up durations ranged from 0.5 to 6.3 years. RESULTS: Four out of 7 patients showed elevated serum estrogen levels and all revealed prepubertal response of gonadotropin to GnRH stimulation at diagnosis. The size of the cysts was from 1.7 to 4.6 cm on pelvic ultrasound examination. After 1 to 3 months, the ovarian cysts disappeared in all patients. Three of the girls developed relapsing signs of precocious puberty (vaginal bleeding and breast budding). Two of them showed an increase in growth velocity and bone age due to recurrent ovarian cysts, and one of them was converted to true precocious puberty. CONCLUSION: In our cases, all patients with autonomous ovarian cysts resolved spontaneously. However, some showed frequent recurrence of ovarian cysts, and needed a longer follow up because of the possibility of conversion to true precocious puberty and signs of McCune-Albright syndrome.
Aged ; Breast ; Child ; Estrogens ; Female ; Fibrous Dysplasia, Polyostotic ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Hemorrhage ; Humans ; Natural History ; Ovarian Cysts ; Puberty ; Puberty, Precocious ; Recurrence ; Retrospective Studies

OBJECTIVES: The purpose of this study was to evaluate the effects of emotional labor on burnout, turnover intention, and job satisfaction. METHODS: Dental hygienists were surveyed over a period of 13 days during March, 2013. Data from the completed questionnaires (N=202) were analyzed using the t-test, one-way ANOVA, Pearson's correlation, and hierarchical multiple regression. RESULTS: Higher levels of emotional labor resulted in higher levels of burnout and turnover intention, as well as lower levels of job satisfaction. The variable showing the largest mediating effect between emotional labor and burnout was emotional intelligence. Supervisor support had the largest mediating effect between emotional labor and turnover intention, as well as emotional labor and job satisfaction. CONCLUSIONS: To reduce the negative effects caused by emotional labor, it is necessary to foster the development of emotional intelligence and self-efficacy of employees. Employers' efforts to improve supervisor and colleague support for the employees should be made to reduce such negative effects.
Dental Hygienists* ; Emotional Intelligence ; Humans ; Intention* ; Job Satisfaction* ; Negotiating ; Surveys and Questionnaires

No abstract available.
Anemia, Aplastic* ; Bone Marrow Transplantation* ; Bone Marrow* ; Immunomodulation*