• Korean Journal of Clinical Pharmacy
• /
• v.27 no.2
• /
• pp.92-98
• /
• 2017

Background: Nebulized colistimethate is increasingly used, because there are problems such as renal dysfunction and low distribution within the lungs when colistimethate is administered intravenously. This study was designed to compare and analyze the changes in renal function by of nebulized colistimethate treatment for its safe administration. Methods: This study retrospectively reviewed the electronic medical records of adult patients above 19 years old, receiving only the nebulized colistimethate at least 4 days in Yonsei university health system from Nov 2014 to Aug 2015. Acute kidney injury (AKI) was determined by using the RIFLE criteria (Risk, Injury, Failure, Loss and End-stage renal disease) according to serum creatinine (SCr) levels before and after use of nebulized colistimethate. Results: 48 patients were included our study and their SCr increased significantly after nebulized colistimethate treatment ($SCr_0$ vs. $SCr_1$; $0.85{\pm}0.80$ vs. $1.00{\pm}0.82mg/dL$, n=48, p<0.001), but the changes were in normal range according to the standards at Yonsei university health $system^a$. Among 48 patients, 38 patients were in the non-AKI group (79.2%), and 10 patients developed AKI (20.8%). Within the AKI group, 2 patients were in the Injury group (20%) and the other 8 in the Risk group (80%). Conclusion: There was no significant difference in age, dosage and duration of treatment between AKI group and non-AKI group (p>0.05). The study has a significance in that it reviewed the safety of nebulized colistimethate only treatment to national patients, analyzing its nephrotoxicity. It has confirmed that nebulized colistimethate is a safer method than intravenous injection, and requires to establish a guideline for the use of nebulized colistimethate in further studies with broader patient groups. $^a$ : SCr Male 0.68-1.19 mg/dL, Female 0.49-0.91 mg/dL.

• Korean Journal of Adult Nursing
• /
• v.23 no.5
• /
• pp.503-513
• /
• 2011

Purpose: The purpose of this study was to identify a model based on f the learning objectives in adult health nursing curriculums. The model can be eventually reflected in Korean National Nurse's Licensing Examination (KNNLE). Methods: The model was developed through a series of practical analysis by the task force team from June to October, 2011. The research team conducted the data synthesis and analysis from the learning objectives of adult health nursing drawn from selected national and international universities, from the adult health nursing areas in KNNLE, and from the current disease prevalence from clinical data in the representative university hospitals in Korea. Results: The current disease prevalence and mortality rates are on the increase especially for malignant neoplasm, heart diseases, suicide and diabetes. The items on the KNNLE of adult nursing are categorized by body systems into digestive system (15%), introduction (13.8%), respiratory system (11.3%), and cardiac system (11.3%). While the current system-based learning objectives covers extensive areas of adult health nursing, the core items are required to be selected based on core competences and core learning objectives to restructure the items of KNNLE. The first revised model is to consolidate and restructure the items microscopically in the subjects of adult health nursing by system. The second proposed model from macroscopic perspective is to build a comprehensive scheme of nursing curriculum by encompassing 8 subjects under current KNNLE and adjust the number of items accordingly. Conclusion: The items of KNNLE need to be gradually redesigned by considering the intervention need at clinical practice and the modified learning objectives of adult health nursing. Based on the job analysis on core competences for newly employed nurses performed by the Korean Accreditation Board of Nursing, it is necessary to establish the core learning objectives of adult health nursing and set up standards for core items in KNNLE.

• Clinical and Experimental Pediatrics
• /
• v.50 no.3
• /
• pp.262-267
• /
• 2007

Purpose : The prevalence of hepatitis A virus (HAV) in a certain community reflects that community's living standards and hygienic conditions. And the pattern of HAV infection differs over time and geography. Recently, a shift in prevalence has been observed in cases from chilhood to adulthood. We studied the HAV antibody prevalence in the general population in Busan. Methods : From October 2004 to March 2005, total 472 subjects were tested for HAV antibodies. All samples were collected from patients in Maryknol Hospital. Results : The overall seropositive rate was 22.8% (108/472). The seropositive rates were 1.7% in subjects aged 2-5 years, 1.7% in 6-10 years, 0% in 11-20 years, 40.5% in 21-30 years, 82.1% in 31-40 years, 94.7% in 41-50 years, and 100% in subjects aged over 50 years. There was no significant gap between gender groups. Conclusion : As the socioeconomic conditions in Korea have improved, the HAV seropositive rate in school-aged children has dramatically decreased in the last 20 years. But, the seropositive rate of HAV didn't differ according to gender. The seropositive rate of HAV in the pediatric group was very low, which suggests the increasing possibility of clinical HAV infection in adults in the near future. Therefore, we should actively prevent the spread of hepatits A virus. In order to do that, we need to reorganize our lifestyle and personel hygiene and carry out active and passive immunization to high risk groups.

• Korean Journal of Clinical Laboratory Science
• /
• v.52 no.1
• /
• pp.28-35
• /
• 2020

This study aimed to investigate the differences in the upper and lower limits of the 95% distribution of fasting blood glucose (FBG) by age groups. We also analyzed the changes in the mean values and dispersion of the data using the Korean Blood Glucose Reference Standard raw data published by the National Health Insurance Service (NHIS). Furthermore, the trends among 16 administrative districts were analyzed and any gender differences were determined. We also assessed whether the study results correlated with the relative standard uncertainty, as published by the NHIS. On the dispersion analysis using the differences between the upper and lower limits of the 95% distribution of FBG by age group, there were significant differences across gender and administrative districts (P<0.05). The gender differences in FBG measurements, as published by the NHIS, were significant across different administrative districts and age groups (P<0.001). This confirmed the need to recalculate the blood glucose reference standards for men and women. No significant correlation was observed between the relative standard uncertainty, as published by NHIS, and the dispersion and number of measurements analyzed in this study. However, it showed a high correlation with the measured mean value (R²=0.95). Therefore, further research on the reference standard and uncertainty is needed.

• Journal of The Korean Society of Inherited Metabolic disease
• /
• v.3 no.1
• /
• pp.86-93
• /
• 2003

Background : The SCL began screening of newborns and high risk group blood spots with tandem mass spectrometry (MS/MS) in April 2001. Our goal was to determine approximate prevalence of metabolic disorders, optimization of decision criteria for estimation of preventive effect with early diagnosis. This report describes the ongoing effort to identify more than 30 metabolic disorders by MS/MS in South Korea. Methods : Blood spot was collected from day 2 to 30 (mostly from day 2 to 10) after birth for newborn. Blood spot of high risk group was from the pediatric patients in NICU, developmental delay, mental retardation, strong family history of metabolic disorders. One punch (3.2 mm ID) of dried blood spots was extracted with $150{\mu}L$ of methanol containing isotopically labelled amino acids (AA) and acylcarnitines (AC) internal standards. Butanolic HCl was added and incubated at $65^{\circ}C$ for 15 min. The butylated extract was introduced into the inlet of MS/MS. Neutral loss of m/z 102 and parent ion mode of m/z 85 were set for the analyses of AA and AC, respectively. Diagnosis was confirmed by repeating acylcarnitine profile, urine organic acid and plasma amino acid analysis, direct enzyme assay, or molecular testing. Results : Approximately 31,000 neonates and children were screened and the estimated prevalence (newborn/high risk group), sensitivity, specificity and recall rate amounted to 1:2384/1:2066, 96.55%, 99.98%, and 0.73%, respectively. Confirmed 28 (0.09%) multiple metabolic disorders (newborn/high risk) were as follows; 13 amino acid disorders [classical PKU (3/4), BH4 deficient-hyperphenylalaninemia (0/1), Citrullinemia (1/0), Homocystinuria (0/2), Hypermethioninemia (0/1), Tyrosinemia (1/0)], 8 organic acidurias [Propionic aciduria (2/1), Methylmalonic aciduria (0/1), Isovaleric aciduria (1/1), 3-methylcrotonylglycineuria (1/0), Glutaric aciduria type1 (1/0)], 7 fatty acid oxidation disorders [LCHAD def. (2/2), Mitochondrial TFP def. (0/1), VLCAD def. (1/0), LC3KT def. (0/1). Conclnsion : The relatively normal development of 10 patients with metabolic disorders among newborns (except for the expired) demonstrates the usefulness of newborn screening by MS/MS for early diagnosis and medical intervention. However, close coordination between the MS/MS screening laboratory and the metabolic clinic/biochmical geneticists is needed to determine proper decision of screening parameters, confirmation diagnosis, follow-up scheme and additional tests.

• Journal of Korean Medicine Rehabilitation
• /
• v.31 no.4
• /
• pp.49-63
• /
• 2021

Objectives This study aimed to investigate the trend in treating fracture with acupuncture and to evaluate the quality of case reports. Methods All case reports of fractures treated with acupuncture were extracted from four Korean web databases. We classified these studies by five fracture sites and investigated frequently used meridian and acupoint, outcome measurements, treatment period. And we assessed the quality of the case reports by the STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines. Results A total of 33 case reports were included. The outcome measurements were divided into six categories, and the outcome measurements used in more than three studies showed improvement in patient symptoms. The mainly used meridians for each fracture site were as follows: chest and abdomen (GB, LR, CV), back (BL, GB), upper limb (LI, TE), lower Limb (GB, ST, BL, SP). The most commonly used acupoints for each fracture site were as follows: chest and abdomen (Ashi points, GB24, GB25, GB26, LR13, LR14, CV16, CV17, CV18, CV19), back (BL23, BL24, BL25, BL26, BL40, BL51, BL52, BL60, GB34), upper limb (LI4, LI10, LI11, TE3), lower limb (GB34, GB40). According to the STRICTA guidelines, more than 54.54% of the reports were found to be 'not reported' or 'not sufficient' in the following categories: 'response sought', 'description of participating acupuncturist', and 'number of needle insertions per subject per session'. Conclusions The meridians and acupuncture points frequently used for acupuncture treatment of fractures were near the fracture site. Future clinical studies involving acupuncture must be reported in accordance with the STRICTA guidelines to improve transparency and uniformity.

• Journal of Radiation Industry
• /
• v.12 no.4
• /
• pp.311-316
• /
• 2018

Average life expectancy is getting longer due to medical developments and improvements in living standards. So much so that the elderly have an increased risk of developing osteoporosis. Therefore, it is important to prevent, diagnose, and treat the senile disease at an early stage through a bone density test. Bone density is measured by dual energy X-ray absorption (DXA). In this study, while using DXA, in cases when the measurements for both the lumbar and the femur could not be taken simultaneously, the correlation between both measurements were known, and the measurement of one area was used to make a clinical inference for the value of the other. Measurements were taken using Lunar Prodigy Advance (GE) for 43 participant with clinically significant fractures. Statistical calculations were produced and analysed regarding bone density. In case of T-score, lumbar spine produced a statistical result of $-2.112{\pm}1.836$ and femur neck was $-1.716{\pm}1.565$. In case of Z-score lumbar spine produced a statistical result of $-0.151{\pm}1.513$, and femur neck $-0.026{\pm}1.283$. It is indicated that the pearson correlation coefficient of T-score between lumbar spine and femur neck is high at 0.699, and the pearson correlation coefficient of Z-score is considered relatively high at 0.503. The correlation of bone density between lumbar spine and femur neck is shown to be statistically meaningful in T-score's p-value at 0.000 and Z-score's p-value at 0.001. In conclusion, it seems to have clinical usefulness that we can infer the result of one measurement through that of the other part tested, based on the knowledge of the correlation coefficients between lumbar spine and femur neck.

• Journal of the Korean Society of Radiology
• /
• v.12 no.6
• /
• pp.769-776
• /
• 2018

According IEC 60601-1 ed3.1 and IEC 60601-2-45 regulation, diagnostic X-ray equipment should be display to measured and calculated air kerma area product. On the clinical X ray equipment, air kerma area product dosimeter would like to have an evidence for dosimeter accuracy and energy dependency. This study was performed to indirect calibration and energy dependency test for attached type air kerma area product (KAP) dosimeter by RQR standards beam quality. On the RQR5 beam quality, attached KAP dosimeter error showed -7.5%, respectably. On the RQR9 beam quality, attached KAP dosimeter error showed -10.4%, respectably. All RQR beam quality, average absolute error was $8.30%{\pm}2.85%$, respectably. On this study, attached KAP dosimeter was satisfied to IEC 60580 and AAPM TG 190. This calibration method of KAP dosimeter will help to performance maintain for clinical KAP dosimeter.

• Journal of Gynecologic Oncology
• /
• v.29 no.6
• /
• pp.83.1-83.10
• /
• 2018

Objective: We aimed to propose a set of quality indicators (QIs) based on the clinical guidelines for cervical cancer treatment published by The Japan Society of Gynecologic Oncology, and to assess adherence to standard-of-care as an index of the quality of care for cervical cancer in Japan. Methods: A panel of clinical experts devised the QIs using a modified Delphi method. Adherence to each QI was evaluated using data from a hospital-based cancer registry of patients diagnosed in 2013, and linked with insurance claims data, between October 1, 2012, and December 31, 2014. All patients who received first-line treatment at the participating facility were included. The QI scores were communicated to participating hospitals, and additional data about the reasons for non-adherence were collected. Results: In total, 297 hospitals participated, and the care provided to 15,163 cervical cancer patients was examined using 10 measurable QIs. The adherence rate ranged from 50.0% for 'cystoscope or proctoscope for stage IVA' to 98.8% for 'chemotherapy using platinum for stage IVB'. Despite the variation in care, hospitals reported clinically valid reasons for more than half of the non-adherent cases. Clinically valid reasons accounted for 75%, 90.9%, 73.4%, 44.5%, and 88.1% of presented non-adherent cases respectively. Conclusion: Our study revealed variations in pattern of care as well as an adherence to standards-of-care across Japan. Further assessment of the causes of variation and non-adherence can help identify areas where improvements are needed in patient care.

• Journal of Veterinary Science
• /
• v.23 no.6
• /
• pp.12.01-12.10
• /
• 2022

Background: Staphylococcus aureus and Streptococcus agalactiae are the main cause of clinical mastitis in dairy cattle in Argentina, whereas coagulase-negative staphylococci (CNS) and environmental streptococci are the main cause of subclinical mastitis. Bacteria isolated from infected animals show increasing antimicrobial resistance. Objectives: This study aims to determine the antimicrobial resistance of staphylococci and streptococci isolated from milk with mastitis, and to genotypically characterize the methicillin-resistant (MR) staphylococci. Methods: Isolation was performed on blood agar and identification was based on biochemical reactions. Antimicrobial susceptibility was according to the Clinical and Laboratory Standards Institute guidelines. The antimicrobial resistance genes, SCCmec type and spa type were detected by the polymerase chain reaction method. Results: We isolated a total of 185 staphylococci and 28 streptococci from 148 milk samples. Among the staphylococcal isolates, 154 were identified as CNS and 31 as S. aureus. Among the 154 CNS, 24.6% (n = 38) were resistant to penicillin, 14.9% (n = 23) to erythromycin, 17.5% (n = 27) to clindamycin, 6.5% (n = 10) to cefoxitin and oxacillin. Among the S. aureus isolates, 16.1% (n = 5) were resistant to penicillin, 3.2% (n = 1) to cefoxitin and oxacillin (MRSA). Six MR isolates (5 CNS and 1 MRSA) were positive to the mecA gene, and presented the SCCmec IVa. The MRSA strain presented the sequence type 83 and the spa type 002. Among the 28 streptococcal isolates, 14.3% (n = 4) were resistant to penicillin, 10.7% (n = 3) to erythromycin and 14.3% (n = 4) to clindamycin. Conclusions: The present findings of this study indicate a development of antimicrobial resistance in main bacteria isolated from cows with mastitis in Argentina.