• Title/Summary/Keyword: Clinical Rounds

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Efficient Generation of BLCL Expressing Foreign Antigen as Antigen-presenting Cells with Recombinant Retroviruses

  • Hyun-Il Cho;Soon-Young Pail;Il-Hoan OH;Kyun-Jung Ahn;Dong-Wook Kim
    • Journal of Microbiology
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    • v.39 no.4
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    • pp.300-304
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    • 2001
  • Epstein-Barr Virus(EBV)-transformed lymphoblastoid B cell lines, BLCL which expresse antigens, are potential antigen-presenting cells(APCs) for the induction of CTL in vitro. However transfection of BLCLs with subsequent selection by antibiotics is notoriously difficult because plating efficiencies of BLCLsare reported to be 1% or less. To generated stable transfectants of BLCLs we produced high titers of retroviruess encoding pp 65 antigen of human cytomegalovirus of foreign antigens and trans-duced them of BLCLs. The pp 65 gene was cloned into the retroviral vector pLXSN. The recombinant retroviral vector was transfected to ecotropic packaging cell line, CP&E86, and this polyclonal recom-binant retrovirus was transduced to PA317 that is amphotropic pakaging cell line. The titers of colned PA317 amphotropic retroviruses ranged from 5 to $\times$10$^{6}$ colony forming units (CFU)per ml (CFU/ml) We performed three rounds of consecutive transductions to BLCLs in order to improve the clon-ing effieiencies. The expression of recombinant HCMV-pp65 antigen was more than 20% after the final transduction. THe third-transduced BLCLs were easily selected in optimal concentration of G418. BLCLs expressing foreign antigens could be used as target cells for CTL assay and/or as APCs for induction of in vitro CTL responses specific for viral and tumor antigens.

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Performance, Perception, and Influencing Contexts of Intentional Rounding (의도적 간호순회 인식과 배경요인이 이행에 미치는 영향)

  • Kim, Mi Young;Kim, Mi Soon;Kim, Ae Ran;Kim, Hee Sun
    • Journal of Korean Clinical Nursing Research
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    • v.27 no.1
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    • pp.66-76
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    • 2021
  • Purpose: This descriptive study aimed to explore the performance, nurses' perception, and influencing contexts of intentional rounding (IR), and to identify the factors influencing the performance of IR. Methods: 498 questionnaire responses were collected from clinical nurses with more than six months of work experiences in general wards performing IR in a general hospital. Results: The mean scores of the performance, nurses' perception, and influencing contexts of IR were 3.81(±0.68), 3.46(±0.42), and 3.79(±0.51) out of 5.00, respectively. There were significant differences in performance (F=20.51, p<.001) and nurses' perception (F=4.96, p=.001) based on the work department. There were significant differences in the influencing contexts based on age (F=6.02, p=.003) and the length of clinical experience in the ward (F=3.36, p=.010). Performance and nurses' perception(r=.42, p<.001), performance and influencing contexts (r=.46, p<.001), and nurses' perception and influencing contexts (r=.58, p<.001) showed a statistically positive correlation. Work unit (F=10.45, p<.001), nurses' perception of the benefits to patients (F=-2.46, p=.014) and to nurses (F=4.34, p<.001), and influencing contexts at the individual (F=7.77, p<.001) and department levels (F=2.99, p=.003) were found to be significant factors on the performance of IR. Conclusion: It is necessary to support the education programs and active participation of nurses in their role as leaders to raise their awareness regarding the benefits of IR. Furthermore, there is a need to adapt the IR protocol according to the unique characteristics of each unit and evaluate the effectiveness.

Effects of early clinical and basic laboratory exposure program on premedical students: a questionnaire survey

  • Cho, Kyu Hyang;Ko, Hyun Sook;Lee, Kyung Hee;Hwang, Tae-Yoon;Lee, Keun-Mi;Kim, Sae Yoon;Chang, Min Cheol
    • Journal of Yeungnam Medical Science
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    • v.39 no.4
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    • pp.309-313
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    • 2022
  • Background: Because premed students do not take courses related to medicine during their first 2 years, they cannot establish their identity as students at medical schools, making it difficult for them to set goals as future doctors. We conducted an early clinical and basic laboratory exposure program for premed students and studied the effects of the program and student satisfaction levels. Methods: We performed an early clinical and basic laboratory exposure program for premed students for 2 days and evaluated the effects of the program and student satisfaction with it. The program consisted of two types: type 1, where two to four students formed a group, which was assigned to a particular department to participate and make observations during ward rounds, outpatient clinics, examinations, procedures, and surgeries (in the case of basic laboratory work, the students partook in experimental observations); and type 2, where one student followed a medical school professor to observe the professor's day. After the program ended, an online survey was conducted to investigate the effects on students, their thoughts, and satisfaction levels. Results: In total, 114 students (91.2%) responded to the survey. Approximately 94% of them were satisfied with the program. They found that the program would be useful for deciding on future career paths, gaining knowledge about a department of interest, studying for a medical program after premedical studies, and befriending residents and professors in certain departments. Conclusion: Early clinical and basic laboratory exposure programs are recommended for premedical students.

Current status of interprofessional education learning activities in wards provided by tertiary hospitals and secondary general hospitals and barriers

  • Kang, Joonsung;Sin, Hye Yeon
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.2
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    • pp.106-115
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    • 2022
  • Background: The World Health Organization (WHO) has focused on the need for interprofessional education (IPE) to improve interprofessional collaboration competency and patient health outcomes. Accordingly, most European and North American medical colleges have established IPE for students. However, IPE learning activity in medical wards for the clinical experience of pharmacy students has not been fully reviewed in Korea. Therefore, this study aims to examine the current status of IPE learning activities in wards at tertiary and secondary hospitals in order to identify ways to improve the program. Methods: The official document of cooperation consists of six self-administered questions regarding IPE learning activities in wards. The preceptor's response in each hospital was evaluated. Results: Of the 22 hospitals, 9 tertiary hospitals and 12 secondary general hospitals responded. For the introductory pharmacy practice experience (IPPE), participating in intensive care (IC) was provided at one secondary general hospital (8.3%) and no tertiary hospital. Ward rounds with medical staff members were provided at two tertiary hospitals (22.2%) and one (8.3%) secondary general hospital. A major barrier to executing IPE was lack of rewards and incentives for the faculty and preceptors who participated in the program. Conclusion: In both tertiary hospitals and secondary general hospitals, pharmacy students have limited exposure to IPE learning activities in wards at hospital, and IPPE at most hospitals was carried out in pharmacy settings only. This study suggests that it is necessary for the hospitals to improve and support IPE learning activities in wards in order to improve learners' competency.

A Delphi Study of Korean Medicine for Anorexia in Children for Clinical Practice Guidelines (소아 식욕부진의 한의표준임상진료지침 개발을 위한 델파이 연구)

  • Bang Miran;Lee Sun Haeng;Chang Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.38 no.2
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    • pp.21-31
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    • 2024
  • Objectives This study aimed to develop consensus-based recommendations for establishing standard clinical practice guidelines for pediatric anorexia through the utilization of a Delphi study. Methods We analyzed existing randomized controlled trials for pediatric anorexia treatment using the Delphi method-a structured process for achieving consensus among a panel of experts. A questionnaire was distributed among a select panel of nine specialists in the field. Results The initial Delphi round led to consensus on 30 distinct recommendations; however, consensus was not reached for 19 other recommendations, prompting a second Delphi round. In the subsequent round, adjustments were made based on feedback from the initial round, and deliberations were held on recommendations that previously lacked consensus. Following these adjustments, consensus was achieved on all recommendations. Additionally, a third Delphi iteration was conducted to address three specific queries that required amendment due to a reevaluation of the evidence levels of certain recommendations. In total, three Delphi rounds were carried out to produce informed recommendations related to the diagnosis, treatment, and general management of anorexia. Conclusions This investigation successfully generated evidence-based recommendations for the diagnosis and treatment of pediatric anorexia. The recommendations encompassed various practices, including herbal medicine, acupuncture, moxibustion, cupping, and Chuna manual therapy, which can be integrated into clinical settings.

Development of validated Nursing Interventions for Home Health Care to Women who have had a Caesarian Delivery (조기퇴원 제왕절개 산욕부를 위한 가정간호 표준서 개발)

  • HwangBo, Su-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.1
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    • pp.135-146
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    • 2000
  • The purpose of this study was to develope, based on the Nursing Intervention Classification (NIC) system. a set of standardized nursing interventions which had been validated. and their associated activities. for use with nursing diagnoses related to home health care for women who have had a caesarian delivery and for their newborn babies. This descriptive study for instrument development had three phases: first. selection of nursing diagnoses. second, validation of the preliminary home health care interventions. and third, application of the home care interventions. In the first phases, diagnoses from 30 nursing records of clients of the home health care agency at P. medical center who were seen between April 21 and July 30. 1998. and from 5 textbooks were examined. Ten nursing diagnoses were selected through a comparison with the NANDA (North American Nursing Diagnosis Association) classification In the second phase. using the selected diagnoses. the nursing interventions were defined from the diagnoses-intervention linkage lists along with associated activities for each intervention list in NIC. To develope the preliminary interventions five-rounds of expertise tests were done. During the first four rounds. 5 experts in clinical nursing participated. and for the final content validity test of the preliminary interventions. 13 experts participated using the Fehring's Delphi technique. The expert group evaluated and defined the set of preliminary nursing interventions. In the third phases, clinical tests were held at in a home health care setting with two home health care nurses using the preliminary intervention list as a questionnaire. Thirty clients referred to the home health care agency at P. medical center between October 1998 and March 1999 were the subjects for this phase. Each of the activities were tested using dichotomous question method. The results of the study are as follows: 1. For the ten nursing diagnoses. 63 appropriate interventions were selected from 369 diagnoses interventions links in NlC., and from 1.465 associated nursing activities. From the 63 interventions. the nurses expert group developed 18 interventions and 258 activities as the preliminary intervention list through a five-round validity test 2. For the fifth content validity test using Fehring's model for determining lCV (Intervention Content Validity), a five point Likert scale was used with values converted to weights as follows: 1=0.0. 2=0.25. 3=0.50. 4=0.75. 5=1.0. Activities of less than O.50 were to be deleted. The range of ICV scores for the nursing diagnoses was 0.95-0.66. for the nursing interventions. 0.98-0.77 and for the nursing activities, 0.95-0.85. By Fehring's method. all of these were included in the preliminary intervention list. 3. Using a questionnaire format for the preliminary intervention list. clinical application tests were done. To define nursing diagnoses. home health care nurses applied each nursing diagnoses to every client. and it was found that 13 were most frequently used of 400 times diagnoses were used. Therefore. 13 nursing diagnoses were defined as validated nursing diagnoses. Ten were the same as from the nursing records and textbooks and three were new from the clinical application. The final list included 'Anxiety', 'Aspiration. risk for'. 'Infant behavior, potential for enhanced, organized'. 'Infant feeding pattern. ineffective'. 'Infection'. 'Knowledge deficit'. 'Nutrition, less than body requirements. altered', 'Pain'. 'Parenting'. 'Skin integrity. risk for. impared' and 'Risk for activity intolerance'. 'Self-esteem disturbance', 'Sleep pattern disturbance' 4. In all. there were 19 interventions. 18 preliminary nursing interventions and one more intervention added from the clinical setting. 'Body image enhancement'. For 265 associated nursing activities. clinical application tests were also done. The intervention rate of 19 interventions was from 81.6% to 100%, so all 19 interventions were in c1uded in the validated intervention set. From the 265 nursing activities. 261(98.5%) were accepted and four activities were deleted. those with an implimentation rate of less than 50%. 5. In conclusion. 13 diagnoses. 19 interventions and 261 activities were validated for the final validated nursing intervention set.

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Affinity Maturation of an Anti-Hepatitis B Virus PreS1 Humanized Antibody by Phage Display

  • Yang, Gi-Hyeok;Yoon, Sun-Ok;Jang, Myung-Hee;Hong, Hyo-Jeong
    • Journal of Microbiology
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    • v.45 no.6
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    • pp.528-533
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    • 2007
  • In a previous study we generated an anti-Hepatitis B Virus (HBV) preS1 humanized antibody (HzKR127) that showed in vivo HBV-neutralizing activity in chimpanzees. However, the antigen-binding affinity of the humanized antibody may not be sufficient for clinical use and thus affinity maturation is required for better therapeutic efficacy. In this study, phage display technique was employed to increase the affinity of HzKR127. All six amino acid residues (Glu95-Tyr96-Asp97-Glu98-Ala99-Tyr100) in the heavy (H) chain complementary-determining region 3 (HCDR3) of HzKR127 were randomized and phage-displayed single chain Fv (scFv) library was constructed. After three rounds of panning, 12 different clones exhibiting higher antigen-binding activity than the wild type ScFv were selected and their antigen-binding specificity for the preS1 confirmed. Subsequently, five ScFv clones were converted to whole IgG and subjected to affinity determination. The results showed that two clones (B3 and A19) exhibited an approximately 6 fold higher affinities than that of HzKR127. The affinity-matured humanized antibodies may be useful in anti-HBV immunotherapy.

Optimized Serological Isolation of Lung-Cancer-associated Antigens from a Yeast Surface-expressed cDNA Library

  • Kim, Min-Soo;Choi, Hye-Young;Choi, Yong-Soo;Kim, Jhin-Gook;Kim, Yong-Sung
    • Journal of Microbiology and Biotechnology
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    • v.17 no.6
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    • pp.993-1001
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    • 2007
  • The technique of serological analysis of antigens by recombinant cDNA expression library (SEREX) uses autologous patient sera as a screening probe to isolate tumor-associated antigens for various tumor types. Isolation of tumor-associated antigens that are specifically reactive with patient sera, but not with normal sera, is important to avoid false-positive and autoimmunogenic antigens for the cancer immunotherapy. Here, we describe a selection methodology to isolate patient sera-specific antigens from a yeast surface-expressed cDNA library constructed from 15 patient lung tissues with non-small cell lung cancer (NSCLC). Several rounds of positive selection using patient sera alone as a screening probe isolated clones exhibiting comparable reactivity with both patient and normal sera. However, the combination of negative selection with allogeneic normal sera to remove antigens reactive with normal sera and subsequent positive selection with patient sera efficiently enriched patient sera-specific antigens. Using the selection methodology described here, we isolated 3 known and 5 unknown proteins, which have not been isolated previously, but and potentially associated with NSCLC.

A Delphi Study on Plans to Revitalize Occupational Health Nursing at Industrial Worksites (직업건강간호 활성화 방안에 관한 델파이 연구)

  • Lee, Young Joo;Noh, Gyeongmin
    • Korean Journal of Occupational Health Nursing
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    • v.30 no.3
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    • pp.90-100
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    • 2021
  • Purpose: The study aimed to identify plans to revitalize occupational health nursing at industrial worksites. Methods: First, a literature review was conducted to derive the questions. Next, we used the Delphi method with two rounds to obtain experts' opinions. The 15 expert participants were seven occupational health nurses and eight professors from nursing colleges. Results: The analysis of opinions indicated that occupational health nurses should be competent in clinical nursing care to perform health management and health promotion activities of workers. It is necessary to develop high-quality occupational nursing services that can prevent and manage occupational diseases and work-related illnesses. Moreover, an improved system for stable employment of these nurses should be implemented. Conclusion: This study confirmed that occupational health nursing is an independent and important area for improving workers' disease prevention and health promotion. It will provide basic data for initiating occupational health nursing and expanding the role of the occupational health nurses.

Developing a Drug Information Leaflet of Antihypertensives for Senior Citizens; Employing Performance-based User-testing (수행능력 기반 사용자 평가를 활용한 노인용 고혈압치료제 안전사용설명서 개발)

  • Kim, Jin;Lee, Iyn-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.3
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    • pp.254-263
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    • 2016
  • Objective: Written information could be helpful for senior population to adhere to complex medication therapies, but must be well prepared and empirically assessed to achieve such end. We purposed to develop a drug information leaflet for senior citizens by applying 'performance-based user-testing.' Methods: We employed a user-testing, a mixed method to figure difficulties out with patients' leaflets from the user perspective. The cycle made of test and revision can be repeated as necessary. We recruited senior citizens with age of 65 or above who were taking antihypertensive medications at the point of participating and excluded the elderly who suffered illiteracy. We firstly rectified a drug information leaflet of antihypertensive medications for the general public distributed by the Korean authority based on focus group interviews (9 participants). The revised leaflets were tested four times with 8~12 participants in each round (40 seniors in total). We targeted to develop a leaflet which more than 80% of participants understood 10 key information. Main outcomes measures were to be able to find information and be able to understand information. This study was approved by the Yeungnam University Research Ethics Committee. Results: Focus group interviews identified difficulties with small font of words, professional language, long information, and a poor structure. The leaflet was revised and in the first round questionnaire found problems with 4/10 information points; interviews disclosed all but one (normal blood pressure range) were ill-understood. The second round questionnaire and interview found fewer problems but the comprehensiveness of participants was still poor in several points. For the third and fourth rounds we revised the leaflets in the individual-targeted manner. Finally, the fourth round showed all key information found and understood by at least 80% of participants except one question about drug name. Conclusion: The drug leaflets need to be developed in a personalized mode for the seniors. There was a limit for Korean seniors to understand nonproprietary name of their drugs because they used to producers' trade names which the Korean health system predominantly works with.