• Tuberculosis and Respiratory Diseases
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• v.72 no.1
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• pp.59-62
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• 2012

Tube thoracostomy is known to cause complications such as bleeding or infection, but the incidence of chylothorax secondary to tube thoracostomy is under-reported, and therefore, we report this case. A patient was diagnosed as systemic lupus erythematosus with pleural and pericardial involvement. During repeated therapeutic thoracentesis, which were performed because of poor response to steroids and cylophosphamide, hemothorax developed and we therefore inserted a chest tube. The pleural effusion changed from red to milky color in several hours and we diagnosed the pleural effusion as chylothorax. Total parenteral nutrition based on medium-chain triglycerides was supplied to this patient and chylothorax was improved after 4 days.

• KSBB Journal
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• v.25 no.6
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• pp.497-506
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• 2010

Vaccine is a protective clinical measure capable of persuading immune system against infectious agents. Vaccine can be categorized as live attenuated and inactivated. Live attenuated vaccines activate immunity similar to natural infection by replicating living organisms whereas inactivated vaccines are either whole cell vaccines, eliciting immune response by killed organisms,or subunit vaccines, stimulating immunity by non-replicating sub cellular parts. The components of vaccine play a critical role in deciding the immune response mediated by the vaccine. The innate immune responds against the antigen component. Adjuvants represent an importantcomponent of vaccine for enhancing the immunogenicity of the antigens. Subunit vaccines with isolated fractions of killed and recombinant antigens are mostly co-administered with adjuvants. The delivery system of the vaccine is another essential component to ensurethat vaccine is delivered to the right target with right dosage form. Furthermore, vaccine delivery system ensures that the desired immune response is achieved by manipulating the optimal interaction of vaccine and adjuvantwith the immune cell. The aforementioned components along with routes of administration of vaccine are the key elements of a successful vaccination procedure. Vaccines can be administered either orally or by parenteral routes. Many groups had made remarkable efforts for the development of new vaccine and delivery system. The emergence of new vaccine delivery system may lead to pursue the immunization goals with better clinical practices.

• Korean Journal of Clinical Pharmacy
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• v.24 no.4
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• pp.240-247
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• 2014

Objective: Undernutrition is common amongst esophageal cancer patients and therefore appropriate nutrition support is critical. Nevertheless, the effectiveness of enteral nutrition (EN) versus parenteral nutrition (PN) is still controversial. The aim of this study was to investigate the effect of EN and PN on the nutritional state and the length of hospital stay for patients who underwent an Ivor-Lewis (IL) esophagectomy. Method: A retrospective clinical analysis was performed that utilized the electronic medical records of patients who underwent IL esophagectomy during a 3-year period between January 2010 and December 2012 at a tertiary teaching hospital located in Seoul, Korea. The EN group and PN group were analyzed by comparing the nutrition supply, postoperative complications, length of hospital stay, and weight variation. Results: After an IL esophagectomy, the complication rate between the EN group and PN group was insignificant and the length of hospital stay was significantly shorter for the PN group compared to the EN group (14 vs. 16 days, respectively; p<0.001). At the time of discharge, those in the PN group lost less weight postoperatively (p=0.003). Conclusion: PN may be considered as safe nutrition support for esophageal cancer patients who underwent an esophagectomy.

• Journal of Pharmaceutical Investigation
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• v.29 no.3
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• pp.205-210
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• 1999

To formulate the parenteral delivery of a new cephalosporin derivative, 7-${\beta}$-[(2)-2-(2-arninothiazol-4-yl)-2methoxyiminoacetamido]- 3- [(2,3-cyclopenteno-4-carbamoyl-l-pyridinium)methyl]- 3-cephem-4-carboxylate sulfate( CKD604), the stability and solubility of CKD-604 in various aqueous media were investigated. The degradation kinetics of CKD-604 in aqueous solutions (ionic strength 0.1, pH 1-8) were studied at $37^{\circ}C$. The observed degradation rates followed pseudo first order kinetics. The pH-rate profile exhibited a minimum degradation rate at pH 5. The Arrhenius activation energy was 14.2 kcal/mol in pH 5 buffer solution. Excellent agreement between the cephalosporins' theoretical pH-rate profile and the experimental data indicated that the degradation pathway of CKD-604 could be predicted according to the general pathway of cephalosporins. The solubility of CKD-604 was 8.16 mg/ml at $25^{\circ}C$. To enhance the solubility and adjust the suitable pH, CKD-604 was solubilized by using sodium ascorbate, ascorbic acid and urea. The compositions were obtained to satisfy optimum pH and concentration, and the total amount of additives was several times of the active ingredient, CKD-604.

• Journal of Chest Surgery
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• v.37 no.5
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• pp.456-459
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• 2004

A 16 month old male infant was found with slip down state in a bath room without evidence of trauma to whole body. The infant was treated with several thoracentesis and closed drainage due to persistent right pleural effusion at other hospital and transferred to our hospital for further evaluation and treatment at July 2003. The pleural effusion was confirmed as chylothorax by chemical analysis. He was treated with parenteral feeding for 21 days. Because the amount of chest tube drainage was about 110∼210 cc/day, and could not be decreased with conservative treatment. patients underwent ligation of thoracic duct. Post-operative course was uneventful except post-op. empyema thoracis, The open drainage tube was removed at post operative 30 days, The patient was in very good condition with complete cure until post-operative 3 months.

• Clinical Nutrition Research
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• v.11 no.2
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• pp.146-152
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• 2022

Patients with short bowel syndrome (SBS) have a high risk of developing parenteral nutrition (PN)-associated complications. Therefore, diet or enteral nutrition and PN should be modified to limit such complications. N balance analysis is a method of calculating the amount of protein required to achieve N equilibrium in the body based on intake and excretion. It is important to reduce dependence on PN and achieve the recommended range of N balance 2-4 g with an appropriate diet. We report a recent experience with nutrition modification using N balance analysis and suggest it as a useful method to reduce dependence on PN in nutrition management of SBS patients and in continuing active intestinal rehabilitation.

• Journal of Korean Academy of Nursing
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• v.36 no.6
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• pp.1033-1041
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• 2006

Purpose: Glass particle contamination of the contents of single-dose glass ampules can occur upon opening. Different aspiration techniques, different sizes of needles, different sizes of ampules, and different cutting methods were studied to determine if they had any effect on glass particle contamination. Method: Different aspiration techniques(with filter, without filter), different sizes of needles(18G, 25G), different sizes of ampules(2ml, 20m1), and different cutting methods(with cotton, without cotton) were evaluated. Method: Twenty ampules were randomly assigned in each group. Three slides containing glass particles for each ampule were made and counted under a microscope by 3 study blind persons. Result: The number of glass particle contamination is much less when using a filter rather than without a filter. The number of glass particle contamination is much less when using a 25G needle rather than on 18G needle. The number of glass particle contamination is much less when using 2ml ampules rather than 20m1 ampules. The number of glass particle contamination is much less when using cotton rather than without cotton. Conclusion: It was shown that using a filter, a small size needle, smaller sized ampules and using cotton when cutting the ampule will decrease the risk of parenteral injection of glass particles.

• Korean Journal of Adult Nursing
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• v.14 no.1
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• pp.26-33
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• 2002

Purpose: This is a clinical experimental study aimed to provide basic data to ensure quality care. The purpose of this study is to increase nurses hand washing behavior and decrease respiratory isolation rate of MRSA. Method: This study was conducted in Kangnam St. Marys hospital. The subjects included 5 nurses working at the NS ICU and 165 specimen for nasal swabs and 46 specimen for sputum cultures from 106 patients admitted to the NS ICU. The data were collected from June to September 2000. Results: 1.The percentage of the nurses hand washing was 15.6percent but was improved to 46.5 percent after the educational intervention. In particular, hand washing behavior was increased in situations such as after suctioning, before parenteral nutrition, and after providing hygiene care. 2. Results of nasal swab showed that MRSA isolation rate was reduced from 42.8 percent before the education to 18.6percent after the education. The sputum culture results also showed that the MRSA rate was reduced from 40.7percent before the education to 34.6percent after the education. Conclusion: The findings showed the nurses' strict hand washing behavior and use of disposable gloves and paper towers as well as use of hand sterilization spray by visitors or families can decrease the MRSA isolation rate in the NS ICU patients. Since the NS ICU patients may have respiratory complications due to long-term hospitalization, the nurses regular hand washing is important enough to be emphasized. Future research should be focused on the impact of nurses' hand washing behavior on the incidence of pneumonia, an iatrogenic infection.

• IMMUNE NETWORK
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• v.12 no.5
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• pp.165-175
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• 2012

Vaccination is one of the most effective methods available to prevent infectious diseases. Mucosa, which are exposed to heavy loads of commensal and pathogenic microorganisms, are one of the first areas where infections are established, and therefore have frontline status in immunity, making mucosa ideal sites for vaccine application. Moreover, vaccination through the mucosal immune system could induce effective systemic immune responses together with mucosal immunity in contrast to parenteral vaccination, which is a poor inducer of effective immunity at mucosal surfaces. Among mucosal vaccines, oral mucosal vaccines have the advantages of ease and low cost of vaccine administration. The oral mucosal immune system, however, is generally recognized as poorly immunogenic due to the frequent induction of tolerance against orally-introduced antigens. Consequently, a prerequisite for successful mucosal vaccination is that the orally introduced antigen should be transported across the mucosal surface into the mucosa-associated lymphoid tissue (MALT). In particular, M cells are responsible for antigen up-take into MALT, and the rapid and effective transcytotic activity of M cells makes them an attractive target for mucosal vaccine delivery, although simple transport of the antigen into M cells does not guarantee the induction of specific immune responses. Consequently, development of mucosal vaccine adjuvants based on an understanding of the biology of M cells has attracted much research interest. Here, we review the characteristics of the oral mucosal immune system and delineate strategies to design effective oral mucosal vaccines with an emphasis on mucosal vaccine adjuvants.

• IMMUNE NETWORK
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• v.13 no.4
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• pp.157-162
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• 2013

Application of vaccine materials through oral mucosal route confers great economical advantage in animal farming industry due to much less vaccination cost compared with that of injection-based vaccination. In particular, oral administration of recombinant protein antigen against foot-and- mouth disease virus (FMDV) is an ideal strategy because it is safe from FMDV transmission during vaccine production and can induce antigen-specific immune response in mucosal compartments, where FMDV infection has been initiated, which is hardly achievable through parenteral immunization. Given that effective delivery of vaccine materials into immune inductive sites is prerequisite for effective oral mucosal vaccination, M cell-targeting strategy is crucial in successful vaccination since M cells are main gateway for luminal antigen influx into mucosal lymphoid tissue. Here, we applied previously identified M cell-targeting ligand Co1 to VP1 of FMDV in order to test the possible oral mucosal vaccination against FMDV infection. M cell-targeting ligand Co1-conjugated VP1 interacted efficiently with M cells of Peyer's patch. In addition, oral administration of ligand-conjugated VP1 enhanced the induction of VP1-specific IgG and IgA responses in systemic and mucosal compartments, respectively, in comparison with those from oral administration of VP1 alone. In addition, the enhanced VP1-specific immune response was found to be due to antigen-specific Th2-type cytokine production. Collectively, it is suggested that the M cell-targeting strategy could be applied to develop efficient oral mucosal vaccine against FMDV infection.