• Title/Summary/Keyword: Korean clinic

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Carriage Rates of Methicillin-resistant Staphylococcus aureus in Neonates with Neonatal Jaundice (신생아황달 환아에서의 메티실린내성 황색포도알균 보균율에 관한 연구)

  • Na, Dong Cheon;Seo, Jae Min;Lee, Jung Hyun;Lee, Won Uk;Kim, Eun Ryoung
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.143-153
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    • 2011
  • Purpose : It is known that carriage rates of Staphylococcus aureus (S. aureus) are highest in newborns and that the asymptomatic carriage of methicillin-resistant Staphylococcus aureus (MRSA) is associated with invasive MRSA infection with the colonizing strain. This study was carried out to investigate the carriage rates of MRSA in neonates with neonatal jaundice. Methods : We reviewed the medical records of 545 neonates admitted with neonatal jaundice to neonatal intensive care units between January 2006 and December 2010. Nasal and inguinal swab specimens had been taken from them and cultured for the isolation of S. aureus. Antimicrobial susceptibility tests had been done for such isolates to determine methicillinresistance. Results : Out of 545 neonates, 318 (58.3%) were colonized with S. aureus and 214 (39.3%) were colonized with MRSA. Results of the antibiogram analysis showed that 65.7% of MRSA isolates were likely to be community-associated (CA) MRSA. Conclusion : Based on the MRSA carriage rate of 39.3%, a surveillance program for MRSA colonization is considered necessary in neonates transferred from other clinics or hospitals. Out of MRSA isolates, 65.7% were likely to be CA-MRSA. This suggests that CA-MRSA strains were already present in obstetric clinic environments where the neonates were born. It is thought that MRSA surveillance programs in these environments are also necessary.

Annual Visit Days, Prescription Days and Medical Expenses of Hypertensive Patients (고혈압 환자의 연간 내원일수, 처방일수 그리고 진료비)

  • Chun, Byung-Yeol;Kam, Sin;Im, Jeong-Soo;Park, Soon-Woo;Park, Jung-Han;Lim, Bu-Dol
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.4
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    • pp.340-350
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    • 2002
  • Objectives : To evaluate the annual visit days, the annual prescription days and the medical costs of hypertensive patients. Methods : The medical insurance records of 40,267 incident patients with the diagnostic code of hypertension from September 1998 through August 1999 in Daegu city were reviewed. Results : The proportion of the most proper medical care pattern group (Group VIII) who visited for 6-15 days with 240 prescription days or more a year was only 6.2%. The proper care group (Group IX) who visited for more than 16 days with 240 prescription days or more a year was 9.3%. The overall proper care group (Group VIII+IX) was therefore 15.5%. The proportion of the insufficient care group (Group I, IV) in both the number of visiting days and prescription days was 57.4%. The mean prescription day of the most proper group (Group VIII) was 29 days; the mean annual medical expenses,453,587won; the mean annual amount paid by patients, 218,013won; and mean medical expenses per prescription day, 1,483won. The proportion of the overall proper care group (Group VIII+IX) was significantly higher in adults aged 50-59, those who were enrolled in industrial workers health insurance as well as government employees and private school teachers health insurance, and those who made a higher contribution per month (p<0.01). According to the type of medical facilities, the proportion of the most proper medical care pattern group was highest in the general hospitals (9.3%) but the overall proper care group was higher in the public health centers (22.1%) and private clinics (17.1%). Conclusions : The management system of hypertension should be reinforced urgently. Therefore, it is necessary to develop guidelines including the number of visiting days per year and prescription days per visit day, and make the system provide medical facilities to more properly care for hypertensive patients.

Tandem Mass Spectrometric Analysis for Disorders in Amino, Organic and Fatty Acid Metabolism : 2 Years of SCL Experience in Korea

  • Yoon, Hye-Ran;Lee, Kyung Ryul
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.3 no.1
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    • pp.86-93
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    • 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.

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Effectiveness of $Myprodol^{(R)}$ in ram Management (통증 조절에 있어서 $Myprodol^{(R)}$의 효과)

  • Shin, Sang-Wook;Lee, Hyun-Sub;Kim, Inn-Se;Baik, Seong-Wan
    • Journal of Hospice and Palliative Care
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    • v.4 no.1
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    • pp.41-46
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    • 2001
  • Background : Many analgesics are used to relieve the pain of various causes. Among these, $Myprodol^{(R)}$, a combination analgesic with codeine, ibuprofen and paracetamol, was recently used as a new analgesics. This study was performed to survey the kinds of diseases, side effects and pain relief effect of $Myprodol^{(R)}$ in clincal practice. Methods : This retrograde study surveyed the medical records of 183 patients treated with $Myprodol^{(R)}$ at Pain Clinic, Pusan National University Hospital. From medical records, the disease entities, the pain characteristics, duration of $Myprodol^{(R)}$ medication, the analgesic effect and side effects were evaluated. Results : $Myprodol^{(R)}$ is used in the treatment of cancer pain (64.3%) and non-cancer pain (35.7%). Among side effects of $Myprodol^{(R)}$ medication, nausea with vomiting, constipation and generalized edema were common in cancer pain, but epigatric pain was common in non cancer pain. $Myprodol^{(R)}$ was more effective in non cancer pain than cancer pain. Conclusions: $Myprodol^{(R)}$ was used in cancer and non-cancer pain patients. In cancer pain patients, $Myprodol^{(R)}$ was effective in early cancer pain but, not effective in advanced cancer. $Myprodol^{(R)}$ was also used and effective in non-malignant benign chest pain, lumbago, post-operative pain.

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The Development of 63nm Diode Laser System for Photodynamic Therapy of Cancer (광역학적 암치료를 위한 635nm 다이오드 레이저 시스템 개발)

  • 임현수
    • Journal of Biomedical Engineering Research
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    • v.24 no.4
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    • pp.319-328
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    • 2003
  • The purpose of this paper is to develop a medical laser system using the semiconductor diode laser in order to photodynamic cancel therapy as a light source. The ideal light source for photodynamic therapy would be a homogeneous nondiverging light with variable spot size and specific wavelength with stability. After due consideration in this point, in this paper, we used a diode laser resonator of 635nm wavelength. The development laser system have a statistical laser out beam with accuracy control using the constant current control of method and clinic-friendly with compact. In order to protect the diode resonator from the over-current, the rush-current and electrical fault, we specially designed. The most importance therapeutic factor are the radiation mode for cancer therapy. So we developed the radiation mode of CW(Continuous Wave), long pulse, short pulse, and burst pulse and can adjust the exposure time from several milli-second to several minute. The experimental result shows that laser beam power was increased linear from 10mW to 300mW according to the increasing input current and the increasing exposure time. The developed new compact diode laser system have a stability of output power and specific wavelength with easy control and transportable for many applications of PDT.

Fixation of Nasal Bone Fracture with Carved Merocel® (Carved Merocel®을 이용한 비골골절의 고정)

  • Kong, Jung Sik;Jung, Jae A;Kang, So Ra;Kim, Yang Woo;Jeon, Young Woo
    • Archives of Craniofacial Surgery
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    • v.12 no.2
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    • pp.93-96
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    • 2011
  • Purpose: In most cases of nasal bone fracture, closed reduction with internal or external splint fixation approach is selected. However, because of indiscriminate insertion of the internal splint without considering of anatomical difference or deformity, insufficient fixation happens frequently that need additional fixation. Therefore, we suggest a new method for providing adequate support in reduced nasal bone by carving $Merocel^{(R)}$ that is fixed for the anatomical structure. Method: Closed reduction and internal fixation with carved $Merocel^{(R)}$ was performed in 15 nasal bone fracture patients from March, 2010 to July, 2010. Each patient was evaluated by physical examination, facial photographic check, simple X-ray, and computerized tomography. On the first day post-operation, location of packing and amount of reduction were checked by follow up X-ray and computerized tomography. In addition, patients' symptoms were evaluated. During the 3-month post-op follow up at out-patient clinic, operator, 2 doctors in training and one assistant performed the objective evaluations by physical examination on nasal dorsal hump, nasal deviation, nasal depression, nasal breath difficulty, and nasal airway obstruction. A survey of subjective patients' satisfaction in 4-stages was also performed. Results: The results of follow-up computerized tomography of the 15 patients revealed that 11 patients had good reduced state. Three patients with combined maxillary frontal process fracture had over reductions. A survey performed on the first day post-operation showed that 14 of 15 patients answered that their current symptoms were more than tolerable. At the 3-month follow-up physical exam, one case had a dorsal hump. However, there were no nasal deviations, nasal depressions, nasal breath difficulties, or nasal airway obstructions. Twelve of the 15 patients answered more than moderate on the 3-month survey. Conclusion: Intranasal packing after carving the $Merocel^{(R)}$ considering anatomical structure is a new effective method to promote proper-reduction, maintain stability, and minimize patients' symptoms by addition of a simple procedure.

A Study on the Effects of the Economic Stress and State-Trait Anxiety on the Periodontal Disease (경제적 스트레스와 상태.특성불안이 치주질환에 미치는 영향)

  • Ryu, Hae-Gyum
    • Journal of dental hygiene science
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    • v.12 no.6
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    • pp.583-590
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    • 2012
  • The purpose of this study was to investigate effect of the economic stress and state-trait anxiety on the periodontal disease in order to prevent the occurrence and progression of periodontal disease. Date were collected from total of 326 subjects in their forties and fifties by using questionnaire and examination of periodontal states during the period from February to November 2011. Results were analyzed by using frequency, t-test, ANOVA and Multiple regression of SPSS ver. 19.0. 1. The economic stress were significant statistically to the higher, medium and low of gingival index (p<0.01). 2. The state-trait anxiety were significant statistically to the higher, medium and low of gingival index (p<0.001), of the pocket depth (p<0.05), of the clinical attachment loss (p<0.05). 3. The gingival index were investigate effect of the higher the economic stress ($\beta$=0.052, p<0.01), the higher the state-trait anxiety ($\beta$=0.052, p<0.01). As a result, this study suggests that the dental clinic institute needs to let the patients with the periodontal disease know about the effects of economic stress and state-trait anxiety. They also necessarily need to implement education program including stress management, economic stress, and state-trait anxiety improvement in order to prevent periodontal disease and to take charge.

The Effect of Following Oral Health Care on Implant Patients (임플란트 환자의 계속구강건강관리 효과)

  • Kim, Young-Sun;Oh, Mi-Jung
    • Journal of dental hygiene science
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    • v.9 no.5
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    • pp.491-496
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    • 2009
  • This research is conducted for 152 implant patients at the H dental clinic during the 2 years(from the January, 2007 to the December, 2008). After adjusting the following oral health care and analyzing the effects of plaque control scores(PCS), following results are obtained. The average PCS is higher at the 4th visit(65.37), which is the termination of education, than the 1st visit(32.89), which is before education(p = .000). Although following PCS decreases after 3 months(56.27) from the termination of education, it increase again after 6 months(60.44), 9 months(64.72) by following oral health care(p = .000). The female got a higher average PCS than the male, and also got a higher following PCS at 3 month(p = .000). According to the average PCS, patients are divided to group A who got lower grade than 69 and B who got higher grade than 70. Comparing with that results and the following PCS, group B get a higher grade than group A in the every period(p = .000). We can observe that the average PCS is improved as doing repeated education and constant management, and we think these results are occurred because people change their minds by following oral health care and obtain proper oral management habit.

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Selective blockade of spinal D2DR by levo-corydalmine attenuates morphine tolerance via suppressing PI3K/Akt-MAPK signaling in a MOR-dependent manner

  • Dai, Wen-Ling;Liu, Xin-Tong;Bao, Yi-Ni;Yan, Bing;Jiang, Nan;Yu, Bo-Yang;Liu, Ji-Hua
    • Experimental and Molecular Medicine
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    • v.50 no.11
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    • pp.6.1-6.12
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    • 2018
  • Morphine tolerance remains a challenge in the management of chronic pain in the clinic. As shown in our previous study, the dopamine D2 receptor (D2DR) expressed in spinal cord neurons might be involved in morphine tolerance, but the underlying mechanisms remain to be elucidated. In the present study, selective spinal D2DR blockade attenuated morphine tolerance in mice by inhibiting phosphatidylinositol 3 kinase (PI3K)/serine-threonine kinase (Akt)-mitogen activated protein kinase (MAPK) signaling in a ${\mu}$ opioid receptor (MOR)-dependent manner. Levo-corydalmine (l-CDL), which exhibited micromolar affinity for D2DR in D2/CHO-K1 cell lines in this report and effectively alleviated bone cancer pain in our previous study, attenuated morphine tolerance in rats with chronic bone cancer pain at nonanalgesic doses. Furthermore, the intrathecal administration of l-CDL obviously attenuated morphine tolerance, and the effect was reversed by a D2DR agonist in mice. Spinal D2DR inhibition and l-CDL also inhibited tolerance induced by the MOR agonist DAMGO. l-CDL and a D2DR small interfering RNA (siRNA) decreased the increase in levels of phosphorylated Akt and MAPK in the spinal cord; these changes were abolished by a PI3K inhibitor. In addition, the activated Akt and MAPK proteins in mice exhibiting morphine tolerance were inhibited by a MOR antagonist. Intrathecal administration of a PI3K inhibitor also attenuated DAMGO-induced tolerance. Based on these results, l-CDL antagonized spinal D2DR to attenuate morphine tolerance by inhibiting PI3K/Akt-dependent MAPK phosphorylation through MOR. These findings provide insights into a more versatile treatment for morphine tolerance.

A Music Technology-Based Interactive Music-Making for Improving the Social Communication Skills of Children With Autism Spectrum Disorder (자폐스펙트럼장애 아동의 사회적 의사소통 향상을 위한 음악제작 앱 기반 상호적 음악만들기 사례)

  • Yoon, Sol
    • Journal of Music and Human Behavior
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    • v.18 no.2
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    • pp.19-43
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    • 2021
  • The purpose of this case study was to examine whether an interactive music-making intervention using GarageBand was applicable to improve the social communication skills of school-age children with autism spectrum disorder (ASD). Two children with ASD (both male, ages = 8 and 11 yrs.) participated in this study. The interactive music-making intervention included three stages: 1) musical imitation, 2) musical expression and coordination, and 3) musical interaction. Each session lasted 40 minutes, and sessions took place twice a week over 4 weeks. The participants' social communication behaviors were observed and analyzed in terms of exchanging ideas with each other. Engagement in interactive behaviors (e.g., turn-taking, imitating or reflecting the investigator's music, and creating one's own music using the motive from the investigator) during music making was also analyzed. During the sessions, increases in the attempts to express their opinions on music making processes and requests for help for the process were observed. Engagement in turn-taking form of interactive playing and reflecting the musical motive from a partner (i.e., investigator) were also improved. The Social Responsiveness Scale-2 (SRS-2) ratings indicated negative social behaviors decreased after intervention in both participants. The findings of this study suggest that interactive music-making activities using GarageBand can be an effective method in clinical practice to improve social communication skills for school-aged children with ASD.