• Title/Summary/Keyword: Medicine Material Cost

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Postoperative Atrial Fibrillation after Isolated Coronary Artery Bypass Graft Surgery (단독관상동맥우회로술 후 발생한 심방세동)

  • Suh, Jong-Hui;Park, Chan Beom;Moon, Mi-Hyoung;Kweon, Jong Bum;Kim, Young-Du;Jin, Ung;Moon, Seok-Whan;Kim, Chi-Kyung
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.14-21
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    • 2009
  • Background: Postoperative atrial fibrillation (AF) is a common complication after coronary artery bypass graft (CABG) surgery. Although postoperative AF is regarded as benign, transient and self-limited, it has been associated with increased morbidity, thromboembolic events and an increased duration and cost of hospitalization. Material and Method: From January 1994 to December 2007, 190 patients that had isolated CABG surgery were divided into two groups. Group 1 (n=139) involved those who had postoperative atrial fibrillation, and group 2 (n=51) did not have any such events. We reviewed the medical records retrospectively including the incidence of postoperative AF, patient characteristics, surgery related factors and the outcome of the patients with postoperative AF. Result: The frequency of postoperative AF was 26.8%, the conversion rate to regular sinus rhythm before discharge was 82.4%; 82.4% of the AF developed within the first three postoperative days. Although the postoperative AF group was significantly older and had a prolonged postoperative Intensive care unit (ICU) stay, there was no difference in the aortic crossclamp time or duration of hospitalization. No spontaneous defibrillation at declamping, and longer duration of cardiopulmonary bypass were significantly related to the development of postoperative AF. However, postoperative treatment with a beta blocker was associated with a decreased incidence of postoperative AF. The multivariate analysis showed that age and ICU stay were significantly associated with the development of POAF. Spontaneous defibrillation and postoperative beta blocker treatment were significantly associated with a decreased frequency of POAF. Conclusion: AF after CABG surgery is a common complication associated with increased morbidity and a longer ICU stay. Therefore, various strategies aimed at reducing AF, and its complications, such as postoperative treatment with a beta blocker should be considered.

Validation of QF-PCR for Rapid Prenatal Diagnosis of Common Chromosomal Aneuploidies in Korea

  • Han, Sung-Hee;Ryu, Jae-Song;An, Jeong-Wook;Park, Ok-Kyoung;Yoon, Hye-Ryoung;Yang, Young-Ho;Lee, Kyoung-Ryul
    • Journal of Genetic Medicine
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    • v.7 no.1
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    • pp.59-66
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    • 2010
  • Purpose: Quantitative fluorescent polymerase chain reaction (QF-PCR) allows for the rapid prenatal diagnosis of common aneuploidies. The main advantages of this assay are its low cost, speed, and automation, allowing for large-scale application. However, despite these advantages, it is not a routine method for prenatal aneuploidy screening in Korea. Our objective in the present study was to validate the performance of QF-PCR using short tandem repeat (STR) markers in a Korean population as a means for rapid prenatal diagnosis. Material and Methods: A QF-PCR assay using an Elucigene kit (Gen-Probe, Abingdon, UK), containing 20 STR markers located on chromosomes 13, 18, 21, X and Y, was performed on 847 amniotic fluid (AF) samples for prenatal aneuploidy screening referred for prenatal aneuploidy screening from 2007 to 2009. The results were then compared to those obtained using conventional cytogenetic analysis. To evaluate the informativity of STR markers, the heterozygosity index of each marker was determined in all the samples. Results: Three autosomes (13, 18, and 21) and X and Y chromosome aneuploidies were detected in 19 cases (2.2%, 19/847) after QF-PCR analysis of the 847 AF samples. Their results are identical to those of conventional cytogenetic analysis, with 100% positive predictive value. However, after cytogenetic analysis, 7 cases (0.8%, 7/847) were found to have 5 balanced and 2 unbalanced chromosomal abnormalities that were not detected by QF-PCR. The STR markers had a slightly low heterozygosity index (average: 0.76) compared to those reported in Caucasians (average: 0.80). Submicroscopic duplication of D13S634 marker, which might be a unique finding in Koreans, was detected in 1.4% (12/847) of the samples in the present study. Conclusion: A QF-PCR assay for prenatal aneuploidy screening was validated in our institution and proved to be efficient and reliable. However, we suggest that each laboratory must perform an independent validation test for each STR marker in order to develop interpretation guidelines of the results and must integrate QF-PCR into the routine cytogenetic laboratory workflow.

Development of Protein-rich Food Mixtures for Infants and Growing Children in Korea -(4) Nutritional and Biochemical Evaluation of Formulas F-P-5, F-P-6, F-P-7 and storage stability of F-P-4- (유유아(乳幼兒) 및 성장기아동을 위한 영양식품 개발에 관한 연구 -(4) F-P-5, F-P-6 및 F-P-7의 영양학적, 생화학적 검토 및 그 저장성-)

  • Kwon, Tai-Wan;Cheigh, Hong-Sik;Kim, Sook-He;Lee, Hyun-Keum
    • Journal of Nutrition and Health
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    • v.3 no.3
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    • pp.129-135
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    • 1970
  • From the previous studies, F-P-4 formula was found to be comparable to full fat dry milk in its nutritive value and feeding performance. However, an attempt was made in order to make sure whether or not any possibility might exist, by which further improvement of nutritive quality and simultaneous reduction of product costs may be achieved. Using F-P-4 as a control, modifications were made in new formulas, F-P-5, F-P-6 and F-P-7 by reducing FPC, eliminating yeast from the mixture, and by enriching with methionine as needed. In particular, F-P-7 is completely free of FPC, hydrogenated oil and yeast. Yet, levels of total protein and fat were kept equal to those of F-P-4 in all formulas. An animal feeding test for all formulas using 10 female rats per group for 8 weeks and an infant feeding trial for F-P-5 and F-P-6 with 5 of each female infants under age of one for one month were conducted along with F-P-4 as a control. Almost the same results were obtained with F-P-4, 5 and 6, but F-P-7 showed the lowest body weight gain. FER of F-P-5 and 6 was 0.20 as was with F-P-4, while that of F-P-7 was 0.16. Acceptability to infants was excellent; growth, appearance and biochemical data were normal. As an example F-P-4 packed in 0.04mm polyethylene bags was used for storage study at $25^{\circ}C$ and relative humidity of $65{\sim}85%$ for 8 months. Although viable bacterial counts and vitamin C contents were reduced, peroxide and TBA values were increased gradually during such storage. Since there are also significant changes in color and organoleptic quality, the expected shelf life under the given conditions is considered to be about 2 months and thus further works are needed both on the product and packaging in order to improve the storage stability. Either elimination of yeast form F-P-4, that is F-P-5, or partial replacement of FPC with methionine, that is F-P-6 may well reduce material costs about 10%. Considering blending process of ingredients, F-P-5 is thus found to be the best formula developed. While F-P-7 free of FPC is inferior in its nutritive quality than that of others, but significantly superior than of rice. Furthermore, the material cost of the product can be reduced about 20% from that of F-P-4. And thus this vegetable blend is considered to be useful as a low cost supplementary food mixture for growing children.

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A Study on the Protection for Original Technology and Improved Patent when Research Institutes or Universities Transfer their Research Outputs (출연연 및 대학에서 연구성과물의 기술이전 시 개량특허와 원천기술의 보호에 관한 검토 : H대학교와 D제약사의 신약후보물질 관련 개량특허 탈취논쟁여부를 중심으로 (대상판결: 서울중앙지방법원 2014.12.24. 선고 2013가합85597 판결))

  • Kang, Sun Joon;Kim, Min Ji;Won, Yoo Hyung;Oh, Keon Taek
    • Journal of Korea Technology Innovation Society
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    • v.20 no.2
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    • pp.313-333
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    • 2017
  • As science and technology advanced, specialized and massive, development through mutual cooperation or research based on patent licensing such as material transfer contract, technology transfer contract etc are actively taking place to minimize or separate the cost and risk of R&D. In R&D, such mutual work can enjoy the merit of division of labor by effectively allocating resources and manpower to accomplish its goal. Inevitably, however, there are also many possibilities of disputes regarding the ownership and use of intellectual property rights resulting from such mutual/post-studies, or inventions upgraded by using prior patents. The case reviewed by this paper is noticeable regarding the recent trend of upgraded inventions. In the case, a pharmaceutical company conducted tests/assessments on the complete technology of patent owned by a university on the premise of transferring the technology, and then terminated the technology transfer contract due to reasons of toxicity. The university then filed a damage claim suit against the company for infringing the contract. This is a dispute case betw een a university which developed a potential ingredient for new medicine and a pharmaceutical company which agreed to transfer and receive the technological later on. Regarding the upgraded inventions of source patents, this case has many implications on the protection of prior patents, research contract, and research security to protect the accomplishment of research. This paper reviews the subject ruling and the protection of upgraded patents and source technologies. As critical notes, the paper also summarizes the major issues of case ruling to observe the standard of ruling patent infringement related to the extortion of upgraded patents. Then, through the ruling of the case above, the paper suggests implications and future strategies.

A Study on the Demand for Equipent Development in Nursing (간호기기 개발수요 조사연구)

  • Chang, Soon-Book;Kim, Eui-Sook;Whang, Ae-Ran;Kang, Kyu-Sook;Suh, Mi-Hae
    • The Korean Nurse
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    • v.35 no.2
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    • pp.71-91
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    • 1996
  • The objectives of thes study were to identify the need for equipment development in nursing, and to determine the priorities for that development. The study was descriptive study done between March 2 and May 30, 1995, in which the subjects, including 421 patients, 223 family members, and 198 nurses from neurosurgery, orthopedic, rehabilitation medicine, internal medicine and intensive care units of nine general hospitals in Seoul, completed a questionnarie developed by the research team. The questionnaire consisted of 35 open and closed questions. Data was analyzed using frequencies and percentages. The results ware summarized as follows: 1) The average age of the nurses was 27.9 years, 48% of the patients were between 20 and 40 years of age, and 17% were over 60. The average lingth of experience for the nurse subjects was four years five months with 36.9%. having over five years experience. The most frequent diagnoses of patients were spinal disc(35.9%), internal medicine disease(26.0%), cerebral vascular accident(16.6%) and spinal cord injury(10%) 2) Many of the nurses(96.4%) reported deficiencies with existing equipment and 96.5% of the nurses, but only 79.8% of the patients, nurses' time. Further, 82.3% of the nurses and 75.8% of the patients felt that the development of new equipment would lead to a decrease in the cost of nursing care. 3) Nurses felt that the greatest areas of inconvenience were patient feeding(71.7%), hygiene(71.2%), caring for a patient confined to bed(70.7%), patient clothing(67.2%), mobility transfers(63.5%) and urinary elimination(52.0%). However, patients and family members listed the following as being the most inconvenient: urinary elimination(58.7%), Hygiene(50.5), feeding(48.4%), mobility transfers(47.1%) and bed care(45.2%). 4) Generally the nurses listed more inconveniences and patients and family members listed more demands for the development of equipment. These included utensils with large handles, and regulators for tube feedings; mattresses that provide for automatic position change and massage, which have patient controlled levers and a place for bed pan insertion; automatic lifts or transfer from bed to wheelchair; equipment to facilitate washing and oral hygiene as well as equipment that will allow patients with spinal cord injuries easy access to showers; a bed pan/urinal for women that is comfortable and effective from which urine can be measured and disposed of easily; disposable dressing sets and tracheostomy care sets and a convenient way of measuring changes in wound size; a safe delivery system for oxygen, a variety of mask sizes and better control of humidity, tracheal material than at present, as well as a communication system for patients with tracheostomies; clothing that will allow access to various parts of the body for treament or assessment without patients having to remove all of their clothing; and finally a system that will allow the patient to control lighting, telephones and pagers. Priority areas for equipment development reported by the nurses were, urinary elimination(58. 7%), hygiene(50.5%), feeding(48.4%), mobility transfers(47..1%), bowel elimination(40.8%). Those reported by the patients family members were feeding(71.7%), hygiene(70.0%), bedcare(70.7%), clothing(67.2%), mobility transfers(63.6%), urinary elimination(52.9%) and bowel elimination(50.5%) Altogether, nurses, patients and family members listed the following as priorities; clothing (178), bed care(144), urinary elimination(92), environment(81), hygiene(70). Further, a health professional forum listed urinary elimination, oxygen delivery, medication delivery, mobility transfers, bed care and hygiene in that order as priority areas. From this study it can be concluded that the first need is to develop equipment that will address the problems of urinary elimination. To do (l)This nurses who are interested in equipment development should organize an equipment development team to provide a forum for discussion and production of equipment for nursing.

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Outpatient Chest Tube Management with Using a Panda Pneumothorax Set with a Heimlich Valve (Panda Pneumothorax Set with Heimlich Valve에 의한 외래에서의 흉관 관리)

  • Choi, Soon-Ho;Lee, Mi-Kyung;Ryu, Dae-Woong
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.497-501
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    • 2009
  • Background: Prolonged air leakage and pleural fluid drainage from a chest tube may delay removing the chest tube after a patient undergoes video-assisted thoracoscopic wedge resection and the patient is otherwise ready for discharge. We reviewed 37 outpatients patients who were being managed with a postoperative chest tube (a Panda Pneumothorax set with a Heimlich valve). Material and Method: From January 2005 to December 2007, 294 patients underwent video-assisted thoracoscopic wedge resections & pleurodesis. Of them, 37 patients met the criteria for outpatient chest drainage management with using a Panda Pneumothorax set with a Heimlich valve. The patients received written instructions, and they demonstrated competence with using the Panda system. The patients returned for chest tube removal after satisfactory resolution of their air leak and pleural fluid drainage. Result: The patients discharged with a Panda pneumothorax set had a longer duration of hospital stay (mean: 10.3$\pm$1.7 days, range: 11 to 17 days) as compared with the patients without a Panda pneumothorax set (mean: 6.2$\pm$1.5 days, range: 4 to 7 days). The chest tube was removed successfully from the patients with a Panda pneumothorax set at an average of 9.8$\pm$1.6 days (range: 9$\sim$18 days) after discharge. There were no major complications. Four patients experienced minor complications. Thirty six patients (97.3%) experienced uneventful and successful outpatient chest tube management. Conclusion: Successful postoperative outpatient chest tube management with using the Panda set was accomplished in 36 selected patients. This program resulted in a substantially reduced hospital cost and enhanced patient satisfaction by allowing earlier discharge.

Rectal Temperature Maintenance Using a Heat Exchanger of Cardioplegic System in Cardiopulmonary Bypass Model for Rats (쥐 심폐바이패스 모델에서 심정지액 주입용 열교환기를 이용한 직장체온 유지)

  • Choi Se-Hoon;Kim Hwa-Ryong;Paik In-Hyuck;Moon Hyun-Jong;Kim Won-Gon
    • Journal of Chest Surgery
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    • v.39 no.7 s.264
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    • pp.505-510
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    • 2006
  • Background: Small animal cardiopulmonary bypass (CPB) model would be a valuable tool for investigating path-ophysiological and therapeutic strategies on bypass. The main advantages of a small animal model include the reduced cost and time, and the fact that it does not require a full scale operating environment. However the rat CPB models have a number of technical limitations. Effective maintenance and control of core temperature by a heat exchanger is among them. The purpose of this study is to confirm the effect of rectal temperature maintenance using a heat exchanger of cardioplegia system in cardiopulmonary bypass model for rats. Material and Method: The miniature circuit consisted of a reservoir, heat exchanger, membrane oxygenator, roller pump, and static priming volume was 40 cc, Ten male Sprague-Dawley rats (mean weight 530 gram) were divided into two groups, and heat exchanger (HE) group was subjected to CPB with HE from a cardioplegia system, and control group was subjected to CPB with warm water circulating around the reservoir. Partial CPB was conducted at a flow rate of 40 mg/kg/min for 20 min after venous cannulation (via the internal juglar vein) and arterial cannulation (via the femoral artery). Rectal temperature were measured after anesthetic induction, a ter cannulation, 5, 10, 15, 20 min after CPB. Arterial blood gas with hematocrit was also analysed, 5 and 15 min after CPB. Result: Rectal temperature change differed between the two groups (p<0.01). The temperatures of HE group were well maintained during CPB, whereas control group was under progressive hypothermia, Rectal temperature 20 min after CPB was $36.16{\pm}0.32^{\circ}C$ in the HE group and $34.22{\pm}0.36^{\circ}C$ in the control group. Conclusion: We confirmed the effect of rectal temperature maintenance using a heat exchanger of cardioplegia system in cardiopulmonary bypass model for rats. This model would be a valuable tool for further use in hypothermic CPB experiment in rats.