• Title/Summary/Keyword: Medical record

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Analysis of Immunogenicity after Hepatitis B Vaccination in Korea by Literature Review (문헌 분석에 의한 B형 간염 백신의 항체 양전률의 비교)

  • Roh, Hye Ok;Lee, Woo Gill;Sohn, Young Mo
    • Pediatric Infection and Vaccine
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    • v.5 no.2
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    • pp.245-257
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    • 1998
  • Purpose : Although hepatitis B vaccine has been available to general population in Korea since 1983, it was difficult to compare various types of hepatitis B virus(HBV) vaccines primarily due to the differences in vaccination schedule, dosage, test methods and seropositive antibody level. In this study we reviewed the results of previous studies published in Korea, which include antibody positive rates and antibody titers of various vaccines, and examined the immunogenicity of these HBV vaccines. Methods : Studies published in medical journals, university journals concerning antibody positive rates following hepatitis B vaccination were reviewed. Inclusion criteria were those studies in which seroprotective antibody rate of 10mIU/mL or the sample ratio unit of 10 RU were used as the cut-off value and in which the test methods were RIA or ELISA. Exclusion criteria were; 1) unclear or inconsistent vaccine dosage, 2) no record of antibody titers or seroconversion rate, 3) no defined antibody rate or ratio for positive rating and 4) the vaccination schedule other than 0-1-2 months or 0-1-6 months. Results : 23 out of 52 studies were subjected for the review for seroconversion rates. 1) As for the immunogenicity in each age group, the seroconversion rates of Hepaccine(Cheil Jedang) were 85.1% in infants, 83.3% in children and 62.7% in adults, indicating higher rates in infants and children compared to adults(P<0.01). The seroconversion rates of Hepavax(Korea Green Cross) were 84.7%, 81.1% and 90.8%, indicating higher rates in infants and adults compared to children(P<0.01). 2) The seroconversion rate of Hepavax was 85.6% with 0-1-6 mo. schedule, 78.5% with 0-1-2 mo. schedule with a statistically significant difference(P<0.01). 4) There was no difference of seroconversion rates between the two doses of Hepavax, $5{\mu}g$ and $10{\mu}g$ in infants and children. 5) In adults the seroconversion rates were 62.7% with Hepaccine, 90.8% with Hepavax, and 94.8% with Engerix-B(SmithKline Beecham). Conclusion : In Korea, the incidence of chronic hepatitis B is high and changing the schedule in vaccination cannot contribute to the increase of the serocoversion rate. And in order to maximize immunogenicity, more effective vaccines as well as more proper vaccination methods should be used.

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A Study on the Effects of the Institutional Pressure on the Process of Implementation and Appropriation of System: M-EMRS in Hospital Organization (시스템의 도입과 전유 과정에 영향을 미치는 제도적 압력에 관한 연구: 병원조직의 모바일 전자의무기록 시스템을 대상으로)

  • Lee, Zoon-Ky;Shin, Ho-Kyoung;Choi, Hee-Jae
    • Asia pacific journal of information systems
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    • v.19 no.2
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    • pp.95-116
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    • 2009
  • Increasingly the institutional theory has been an important theoretical view of decision making process and IT adoption in many academic researches. This study used the institutional theory as a lens through which we can understand the factors that enable the effective appropriation of advanced information technology. It posits that mimetic, coercive, and normative pressures existing in an institutionalized environment could influence the participation of top managers or decision makers and the involvement of users toward an effective use of IT in their tasks. Since the introduction of IT, organizational members have been using IT in their daily tasks, creating and recreating rules and resources according to their own methods and needs. That is to say, the adaptation process of the IT and outcomes are different among organizations. The previous studies on a diverse use of IT refer to the appropriation of technology from the social technology view. Users appropriate IT through not only technology itself, but also in terms of how they use it or how they make the social practice in their use of it. In this study, the concepts of institutional pressure, appropriation, participation of decision makers, and involvement of users toward the appropriation are explored in the context of the appropriation of the mobile electronic medical record system (M-EMRS) in particularly a hospital setting. Based on the conceptual definition of institutional pressure, participation and involvement, operational measures are reconstructed. Furthermore, the concept of appropriation is measured in the aspect of three sub-constructs-consensus on appropriation, faithful appropriation, and attitude of use. Grounded in the relevant theories to appropriation of IT, we developed a research framework in which the effects of institutional pressure, participation and involvement on the appropriation of IT are analyzed. Within this theoretical framework, we formulated several hypotheses. We developed a second order institutional pressure and appropriation construct. After establishing its validity and reliability, we tested the hypotheses with empirical data from 101 users in 3 hospitals which had adopted and used the M-EMRS. We examined the mediating effect of the participation of decision makers and the involvement of users on the appropriation and empirically validated their relationships. The results show that the mimetic, coercive, and normative institutional pressure has an effect on the participation of decision makers and the involvement of users in the appropriation of IT while the participation of decision makers and the involvement of users have an effect on the appropriation of IT. The results also suggest that the institutional pressure and the participation of decision makers influence the involvement of users toward an appropriation of IT. Our results emphasize the mediating effect of the institutional pressure on the appropriation of IT. Namely, the higher degree of the participation of decision makers and the involvement of users, the more effective appropriation users will represent. These results provide strong support for institutional-based variables as predictors of appropriation. These findings also indicate that organizations should focus on the role of participation of decision makers and the involvement of users for the purpose of effective appropriation, and these are the practical implications of our study. The theoretical contribution of this study is lies in the integrated model of the effect of institutional pressure on the appropriation of IT. The results are consistent with the institutional theory and support previous studies on adaptive structuration theory.

Characteristics and Clinical Correlations of Staphylococcus aureus Discovered in Stools from Children Hospitalized at a Secondary Hospital (일개 이차병원에 입원한 소아의 분변에서 발견된 황색포도알균의 특징과 임상적 연관성)

  • Shin, Eun Hye;Eun, Byung Wook;An, Young Min;Song, Mi Ok
    • Pediatric Infection and Vaccine
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    • v.25 no.2
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    • pp.61-71
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    • 2018
  • Purpose: Research on the clinical role of Staphylococcus aureus as a pathogen in acute gastroenteritis (AGE) in children has been scarce. This study aimed to clarify the prevalence and clinical correlation of S. aureus detection in children with AGE. Methods: Fecal samples were collected from children with symptoms of AGE who visited a secondary hospital between January 2012 and December 2015. The samples were sent to the Seoul Metropolitan Government Research Institute of Public Health and Environment to test for pathogenic organisms. Clinical patterns were analyzed through medical record review. Results: Among the 663 participants, the bacteria detection rate was 26.2% (n=174), the virus detection rate was 29.7% (n=197), and the non-detection rate was 43.1% (n=286). S. aureus was tested positive from 102 cases and was confirmed as a single pathogen in 53 cases. It was the third most common pathogen. The prevalence by age was highest (45.3%) in 0-2 year-olds. Most cases occurred in summer. Symptoms included diarrhea (71.7%), vomiting (67.9%), fever (49.1%), and abdominal pain (37.7%). Only vomiting showed a significant difference between the S. aureus group and the non-detection group (67.9% vs. 43.0%; P=0.001). Among enterotoxins, the higher incidence of vomiting was associated with classical staphylococcal enterotoxins (SEA, SEB, SEC, SED, and SEE) and SEH (P=0.027). Conclusions: S. aureus was the bacteria commonly isolated from children with AGE. Our study identified cases of staphylococcal AGE in children based on fecal samples and confirmed the characteristic symptoms, affected age groups, seasonal distribution, and correlation with enterotoxins.

Symptom Prevalence During Terminal Cancer Patients' Last 48 Hours of Life (말기 암 환자에서 임종 전 48시간 동안 나타나는 신체적 증상 빈도)

  • Jung, Soo-Jin;Lee, Bok-Ki;Choi, Kyung-Hi;Youn, Bang-Bu;Yeom, Chang-Hwan
    • Journal of Hospice and Palliative Care
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    • v.5 no.1
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    • pp.17-23
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    • 2002
  • Purpose : The prevalence of symptoms in patients with terminal cancer varies considerably and these symptoms are very difficult to control. However, patients can spend their last days or hours of life without suffering pain with appropriate care. One of the major concerns during last days of life is to predict the time of death. We would like to investigate symptom prevalence during terminal cancer patients' last 48 hours in Korea, and therefore contribute to predict the time of death and to help to determine appropriate treatments. Methods : The data for this study was recorded from 92 of 132 patients who died with terminal cancer at the hospital between February 1 and October 31, 2000. We investigated the symptom prevalence during the last 48 hours through medical obligation record and analyzed the changes of symptom prevalence at the admission, $48{\sim}24$ hours and $24{\sim}0$ hours before death. Results : The predominant symptom prevalence was pain (57.6%), followed by confusion (55.4%), dyspnea (48.9%), voiding difficulty (42.4%) in the last 48 hours before death. From the statistical analysis for the changes of symptom prevalence in time, pain, nausea and vomiting were decreased but noisy and moist breathing, sweating, groan, restlessness and agitation, and loss of consciousness were increased (P<0.05). Conclusion : The results from this study show the tendency to increase of prevalence of noisy and moist breathing, sweating, groan, restlessness and agitation as well as loss of consciousness in 48 hours before death. Therefore the symptoms above can be used for the important indicators to predict the imminent death.

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Effect of Knee Joint Stimulation on the Activity of Phrenic Nerve and Inspiratory Nuron in the Cat (슬관절 자극이 횡격신경 및 흡식중추신경에 미치는 영향)

  • Cho, Dong-Ill;Han, Hee-Chul;Nahm, Sook-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.683-693
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    • 1993
  • Background: During movement the major inputs to nervous system come from firstly the muscle and joint to maintain posture and motion and secondly the chemoreceptors and baroreceptors to adjust the cardiovascular and respiratory function. Their complex relationships are generally studied for many years but the direct relation between the joint and respiratory system is not studied thoroughly until now. So this experiment was performed to determine whether the natural movement of knee joint can cause the enhancement of respiratory function by observation of the changes of respiratory rate, phrenic nerve activity and inspiratory neuron activity during the stimulation of knee joint in cat anesthetized with $\alpha$-chloralose. Method: Twenty six male adult cats were used and the extracelluar recording using bipolar platinum electrode and carbon filament electrode was done to record the changes in the activities of phrenic nerve and inspiratory neuron movement of knee joint, injection of chemicals into the joint cavity and electrical stimulation of articular nerve were done. Results: The 60 Hz. could not but 120 Hz. flexion-extension movement of knee joint increased respiratory rate(R.R.), tidal neural activity(TNA) and minute neural activity(MNA). Intra-articular injection of lactate could not increase R.R. but significantly increase TNA and MNA which represented the enhanced respiratory function. Injection of potassium chloride showed similar effects with the case of lactate but the duration of effect was shorter. The electrical stimulation of medial articular nerve with IV strength which could activate only group I and II afferents showed increased TNA and MNA during stimulation but 20 V stimulation which could activate all the afferents increased all the respiratory parameters. The changes of inspiratory neuron activity by knee joint stimulation was similar to that of phrenic nerve. Conclusion: The respiratory center could be directly stimulated by the activation of group I and II articular afferents and it seemed that the magnitude of the respiratory center enhancement is proportional to the amount of sensory information from the knee joint. These facts might suggest that the respiratory function could be enhanced even by the normal movement of knee joint.

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Validation and Calibration of Semi-Quantitative Food Frequency Questionnaire - With Participants of the Korean Health and Genome Study - (반정량식품섭취빈도조사지의 타당성 검증 및 보정 - 지역사회 유전체 코호트 참여자를 대상으로 -)

  • Ahn, Youn-Jhin;Lee, Ji-Eun;Cho, Nam-Han;Shin, Chol;Park, Chan;Oh, Berm-Seok;Kimm, Ku-Chan
    • Korean Journal of Community Nutrition
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    • v.9 no.2
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    • pp.173-182
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    • 2004
  • We carried out a validation-calibration study of the food frequency questionnaire (FFQ) that we had previously developed for a community-based cohort of the Korean Genome and Health Study of the Korea National Genome Research Institute. We have collected a total of 254 3-day diet records (DRs) from 400 subjects, 200 each randomly selected from the two study cohorts of Ansung and Ansan. FFQ was administered at the time of cohort recruitment in 2001, and DRs were collected during a two month period from January through February of 2002. The mean age was 52.2 years. Farming for men and housewife for women were the most common occupations. The majority of the subjects had undergone 6∼12 years of education. The general characteristics including demographic and other data were not different from the total cohort subjects. Absolute levels of consumed nutrients including total energy (energy), protein, fat, carbohydrate, calcium, phosphorus, sodium, potassium, iron, retinol, carotene, vitamin A, thiamin, riboflavin, niacin and vitamin C were compared. The average of energy intake was not significantly different between the data collected by the 2 methods. However, consumptions of protein and fat were higher in data of DRs, whereas that of carbohydrate was higher in FFQ data. Significant correlation of each nutrient consumption between the data sets was observed (p < 0.05) except in the case of iron, while the average correlation coefficient between them was 0.22 ranging from 0.33 for energy to 0.11 for iron. The results of cross classification by quantile for exact classification ranged from 25.2% (carotene) to 35.0% (phosphorus), and from 64.6% (vitamin A) to 76.4% (retinol) for adjacent classification. The proportion of completely opposite classification was 8.1% in average. Calibration slope was estimated by regression and calibration parameters ranged from 0.025 for carotene to 0.423 for niacin. We conclude that the FFQ we have developed is an appropriate tool for assessing the nutrient intakes as ranking exposures in epidemiology studies in view that amounts of consumed nutrients obtained by FFQ were similar to those collected by DRs, that correlations between consumed nutrients collected by these methods were significant, and that classification results were relatively fair. The correlation coefficients, however, were lower than expected, which may be mainly due to the survey season. In fact, any short-term dietary survey cannot accurately reflect the overall dietary intakes that change heavily depending on seasons. Further studies including the analysis of chemical indices would be helpful for the studies of causal relationship between the diet and disease.

A Study on Ten Years Trend of Cancer Incidence and Evaluation of Quality of Cancer Registration in Daejeon Metropolitan City and Chungcheongnam-Do, Korea: 2000-2009 (대전·충남지역의 암 발생률 추이와 질적 평가에 대한 연구 -2000년부터 2009년까지 10년간 자료를 중심으로-)

  • Park, Un-Je;Nam, Hae-Seong;Kim, Kwang-Hwan;Park, Chang-Soo;Kwon, In-Sun;Kim, Jeong-A;Lee, Tae-Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.3
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    • pp.1234-1244
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    • 2013
  • This study aimed to analyze the ten years cancer incidence based on diagnosis years 2000-2009, and to evaluate the quality of cancer registry in Daejeon City and Chungcheongnam-Do, Korea. Crude incidence rate and age-standardized incidence rate (ASR) in these two regions were compared, and validity of incidence data was assessed by three indicators; age unknown (Age UNK%), histological verification (HV%), and death certificate only (DCO%). Mortality/incidence ratio (M/I ratio) was used to evaluate completeness of incidence data. Incidence rate differences were assessed using Poission distribution and calculated their 95% confidence interval of ASR, and those by sex, age, and region were compared by incidence rate curve. As a result, the highest cancer site during 2000-2009 was stomach in both regions, and incidence prpportion were 18.8% in Daejeon, 21.5% in Chungnam. The overall cancer incidence was higher in males than in females, and ASR of total cancer in Daejeon increased 0.6% (from 322.1 to 323.9 per 100,000) for men and 60.3% (from 203.9 to 326.8) for women, that in Chungnam increased 14.3% (from 294.7 to 336.9) for men and 70.7% (from 156.5 to 267.1) for women. The Age UNK% during 2000-2009 were 0.0% in both regions. MV% for men was increased from 71.8% to 88.5% and that for women was increased from 78.1% to 93.2%. DCO% for men was decreased from 6.4% to 0.7% and that for women was decreased from 5.4% to 0.8%. M/I ratio was ranged from 15.3% to 62.1% and can be evaluated fairy good registration.

Views of Public Dental Hygienist about Oral Health Hub Center - In the Area Not Implemented (구강보건센터 미설치 보건소 치과위생사의 구강보건센터 설치 및 운영에 관한 견해)

  • Kim, Kyung-Mi;Yoo, Eun-Mi;Heo, Sun-Soo;Hwang, Soo-Jeong
    • Journal of dental hygiene science
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    • v.12 no.6
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    • pp.675-681
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    • 2012
  • Korean Ministry of Health and Welfare started to implement oral health hub center to provide oral health preventive program and dental treatment to public, especially dental vulnerable class in 2006. But, there is no applicant area to implement it regardless of national budget arrangement in 2012. This study is aimed to investigate the reason not to be implemented and requirements of implementation. 293 among 1,000 public dental hygienists in the area where have not implemented oral health hub center were surveyed in Korea from April to July in 2012 through convenience sampling. The questionnaire consisted of the reason why oral health hub center have not been implemented, the requirement of implementation, duty area and duty position et al. After removal of insufficient responses, 217 questionnaires were analyzed by t-test and ANOVA using SPSS 20.0. The reason why oral health hub center have not been implemented were deficiency of the priority list as compared with other health program (72.4%), space insufficiency (71.4%), regional budget insufficiency (70.5%), will insufficiency of oral health promotion (70.5%) and manpower insufficiency (62.7%). The first requirement of implementation were space expansion and regional budget expansion, followed by reduction of record-originated and administrative tasks, understanding on oral health program of higher ranking public officials in health center, manpower expansion, reduction of other tasks than oral health program and volunteer source expansion. Budget insufficiency and manpower insufficiency in Metropolis were ranked higher than other area (p<0.05). The group not to discuss oral health hub center graded each reason not to be implemented significantly higher than the other group (p<0.05). We suggested that to promote the importance of public oral health program be needed to public and higher ranking public officials to implement oral health hub center. In addition, we insisted that more dental manpower and budget be needed for reduction of oral health inequity in metropolis.

Factors Influencing the Activation of Brown Adipose Tissue in 18F-FDG PET/CT in National Cancer Center (양전자방출단층촬영 시 갈색지방조직 활성화에 영향을 미치는 요인 분석)

  • You, Yeon Wook;Lee, Chung Wun;Jung, Jae Hoon;Kim, Yun Cheol;Lee, Dong Eun;Park, So Hyeon;Kim, Tae-Sung
    • The Korean Journal of Nuclear Medicine Technology
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    • v.25 no.1
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    • pp.21-28
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    • 2021
  • Purpose Brown fat, or brown adipose tissue (BAT), is involved in non-shivering thermogenesis and creates heat through glucose metabolism. BAT activation occurs stochastically by internal factors such as age, sex, and body mass index (BMI) and external factors such as temperature and environment. In this study, as a retrospective, electronic medical record (EMR) observation study, statistical analysis is conducted to confirm BAT activation and various factors. Materials and Methods From January 2018 to December 2019, EMR of patients who underwent PET/CT scan at the National Cancer Center for two years were collected, a total of 9155 patients were extracted, and 13442 case data including duplicate scan were targeted. After performing a univariable logistic regression analysis to determine whether BAT activation is affected by the environment (outdoor temperature) and the patient's condition (BMI, cancer type, sex, and age), A multivariable regression model that affects BAT activation was finally analyzed by selecting univariable factors with P<0.1. Results BAT activation occurred in 93 cases (0.7%). According to the results of univariable logistic regression analysis, the likelihood of BAT activation was increased in patients under 50 years old (P<0.001), in females (P<0.001), in lower outdoor temperature below 14.5℃ (P<0.001), in lower BMI (P<0.001) and in patients who had a injection before 12:30 PM (P<0.001). It decreased in higher BMI (P<0.001) and in patients diagnosed with lung cancer (P<0.05) In multivariable results, BAT activation was significantly increased in patients under 50 years (P<0.001), in females (P<0.001) and in lower outdoor temperature below 14.5℃ (P<0.001). It was significantly decreased in higher BMI (P<0.05). Conclusion A retrospective study of factors affecting BAT activation in patients who underwent PET/CT scan for 2 years at the National Cancer Center was conducted. The results confirmed that BAT was significantly activated in normal-weight women under 50 years old who underwent PET/CT scan in weather with an outdoor temperature of less than 14.5℃. Based on this result, the patient applied to the factor can be identified in advance, and it is thought that it will help to reduce BAT activation through several studies in the future.

Analysis of Factors Affecting the Length of Stay in Children(Aged 0 to 12) with Injuries: Centering Around the Data from the Korea National Hospital Discharge In-Depth Injury Surveys (어린이(0-12세) 손상환자의 재원일수에 미치는 요인분석: 퇴원손상심층자료를 중심으로)

  • Lee Chae Kyung
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.3
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    • pp.137-143
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    • 2023
  • This study was conducted to analyze factors affecting the length of stay in children with injuries by determining relationships between length of stay and characteristics of children(aged 0 to 12) with injuries. 7,804 patients aged 0 to 12 who participated in the Korea Nation Hospital Discharge In-Depth Injury Surveys, got a diagnosis of sequelae of injuries and of other consequences of external causes(S00-T98), and were discharged between 1 January 2016 and 31 December 2020 were investigated. A frequency analysis, independent samples t-test, and ANOVA were performed. Also, to identify factors affecting the length of stay, a regression analysis was performed. The average length of stay for the patients investigated in this study was 5.5 days. The length of stay for school-age children(aged 7 to 12) and children who had either public or private coverage was higher than that for preschoolers(aged 0 to 6) and children who didn't have public or private coverage, respectively. The length of stay for children admitted to a hospital in a rural area(Jeolla-do or Gyeongsang-do) was higher than that for children admitted to a hospital in a metropolitan area and the length of stay for children admitted to a hospital that had 100-299 hospital beds was relatively long. However, children who first visited a hospital for outpatient care stayed relatively short in hospital and children who had been burned or injured in traffic crashes stayed relatively long in hospital. Children who got a secondary diagnosis and had a principal procedure or who died after being discharged were in hospital for a long time. The findings of this study shall be useful, as they identified characteristics related to the length of stay for Korean children with injuries and factors that determine the length of stay for those children by analyzing the national dataset, or more specifically, the data from the Korea National Hospital Discharge In-Depth Injury Surveys. The risk of child injuries can be easily reduced by taking actions to prevent them and providing safety education programs. The present study has provided essential baseline data for the provision of aggressive care for child injuries and the establishment of a range of policies for child injury prevention.