• Clinical and Experimental Reproductive Medicine
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• v.37 no.2
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• pp.115-124
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• 2010

Objective: To testify whether the increased peripheral blood natural killer (pbNK) cells fraction and their cytolytic activity could coincide with patient's history of recurrent spontaneous abortion (RSA) and to evaluate these factors are can be valuable diagnostic markers in RSA. Methods: Women with a history of RSA comprised the patient group (n=35). Normal fertile women, who were experienced at least one healthy term birth without history of infertility or recurrent miscarriage, were included as the healthy control group (n=15). The pbNK cells of $CD3^-/CD56^+/CD16^+$ and their cytolytic activities against K562 cells were measured by flow cytometry and the values were compared between study and control groups. Results: Proportions of pbNK cells among peripheral blood monocytes (PBMC) ($14.2{\pm}5.2$ vs. $9.4{\pm}3.7%$, p=0.002, 95% confidence interval [CI], 1.8 to 7.8) was significantly higher in the patient group. The odds ratio of having RSA history was increased as 8.4 folds (59% of sensitivity, 80% of specificity, and 95% CI: 2.0 to 35.8) in patients who showed pbNK cells fraction above 12.1% which was determined as cut-off value by using ROC curve analysis. The cytolytic activities of pbNK cells which measured by three different ratio of effecter pbNK cells to target K562 cells and calculated by the percent of cytolytic K562 cells, were significantly higher in study group than that of control group (in 50:1 ratio, $48.3{\pm}19.0$ vs. $31.3{\pm}11.9%$, p=0.002; in 25:1 ratio, $37.0{\pm}18.1$ vs. $20.2{\pm}9.2%$, p<0.001; in 12.5:1 ratio, $23.5{\pm}12.7$ vs. $12.4{\pm}7.3%$, p=0.001). With the cut-off values of cytolytic activity of pbNK cells as 43.1% (50:1), 26.9% (25:1), and 17.4% (12.5:1) each, the risk of having RSA history was increased by 10.0, 11.4, and 15.0 folds in patients who had increased in each effector of pbNK to target of K562 cells ratio. Conclusion: The analysis of pbNK cells fraction and their cytolytic activity can be valuable diagnostic markers for RSA. We are going to planning the large scaled studies which include the data of obstetric outcomes in subsequent pregnancies to clarify our results of this study.

• Journal of Food Hygiene and Safety
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• v.39 no.2
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• pp.134-151
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• 2024

Salmonella spp. is among the most important water-borne and food-borne pathogens and is one of the most common causes of human gastroenteritis and diarrheal diseases globally. In this study, Salmonella spp. isolated from food, environmental samples, and patients with food poisoning or diarrhea were investigated Salmonella serovars, antibiotic resistance using Vitek2, and genetic characteristics through pulsed-field gel electrophoresis (PFGE). Salmonella spp. of 339 strains, including 26 strains from food or environmental samples and 313 strains from patients, were isolated from Jeju Island of South Korea between 2020 and 2023. The monthly number of isolated Salmonella spp. gradually increased from March, with the highest number being in August. No significant differences in Salmonella spp. isolated from patients according to gender was observed. However, Salmonella spp. was most frequently isolated from people aged 70 years or older and least frequently isolated from those between ages 10 and 19 years. Salmonella spp. isolated from food or environmental samples were distributed among eight different serovars and the main serovars were identified in the order of S. Bareilly (26.9%), S. Rissen (23.1%), and S. Thompson (19.3%). Salmonella spp. isolated from patients were distributed among 27 different serovars and the main serovars were identified in the order of S. Bareilly (31.0%), S. Typhimurium (24.6%), and S. Enteritidis (11.5%). The main cause serovars of Salmonella spp. outbreaks are S. Bareilly, S. Enteritidis, S. Thompson. Antibiotic resistance tests indicated resistance to various antibiotics and some Salmonella spp. exhibited multidrug resistance. Salmonella spp. showed various genetic correlations among the 17 serovars. These results indicate that they can be used as basic data for epidemiological investigations by predicting the appearance of Salmonella spp. and providing a scientific basis.

• The Korean Society of Law and Medicine
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• v.17 no.2
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• pp.315-346
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• 2016

With the development of big data processing technology, the potential value of healthcare big data has attracted much attention. In order to realize these potential values, various research using the healthcare big data are essential. However, the big data regulatory system centered on the Personal Information Protection Act does not take into account the aspect of big data as an economic material and causes many obstacles to utilize it as a research purpose. The regulatory system of healthcare information, centered on the primary purpose of patient treatment, should be improved in a way that is compatible with the development of technology and easy to use for public interest. To this end, it is necessary to examine the trends of overseas legal system reflecting the concerns about the balance of protection and utilization of personal information. Based on the implications of the overseas legal system, we can derive improvement points in the following directions from our legal system. First, a legal system that specializes in healthcare information and encompasses protection and utilization is needed. De-identification, which is an exception to the Privacy Act, should also clearly define its level. It is necessary to establish a legal basis for linking healthcare big data to create synergy effects in research. It is also necessary to examine the introduction of the opt-out system on the basis of the discussion on the foreign debate and social consensus. But most importantly, it is the people's trust in these systems.

• Clinical and Experimental Pediatrics
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• v.52 no.11
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• pp.1279-1282
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• 2009

Hepatomegaly and liver dysfunction might develop in patients with diabetes mellitus due to glycogen deposition or nonalcoholic steatohepatitis. We experienced a case of hepatic glycogenosis in a patient with type 1 diabetes mellitus who presented with recurrent hypoglycemia, suggesting impairment of glycogenolysis and gluconeogenesis. A 10-year-old girl with a 4-year history of type 1 diabetes mellitus was admitted because of recurrent hypoglycemia and abdominal pain in the right upper quadrant. She had Cushingoid features and hepatomegaly that extended 6 cm below the right costal margin. Laboratory data and radiologic examination revealed elevated liver enzyme levels due to fatty liver. Periodic acid-Schiff (PAS) staining revealed intense glycogen deposition in the cytoplasm of the hepatocytes and PAS reactivity was lost with diastase treatment. At 2 months after administration of glucagon injection and uncooked cornstarch between meals and at bedtime, the hypoglycemic episodes and liver dysfunction improved. It is important to distinguish hepatic glycogenosis from steatohepatitis, because it is possible to prevent excessive hepatic glycogen storage in hepatic glycogenosis cases by strictly controlling blood glucose level and by glucagon administration. To prevent severe hypoglycemic symptoms accompanied by hepatic glycogenosis, we suggest that uncooked cornstarch, which is effective in maintaining blood glucose level, can also be administered.

• Quality Improvement in Health Care
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• v.1 no.2
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• pp.60-72
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• 1994

Background: The number of outpatients visiting large university teaching hospitals has increased drastically with the introduction of a nationwide health care insurance in 1989 and the improvement of the socio-economic status of the population. This resulted in long waiting times for services, particularly prescribed drugs, which have been patients' chief complaints. Hospitals have tried to solve the problem with limited success because their approach lacked comprehensive research. The objective of this study is to investigate associations between waiting times and variables defining a total work system. Methods: Data for the outpatient pharmacy department in a tertiary care university teaching hospital located in Seoul was analyzed to achieve the study objective. Associations of pharmacy system variables -- work load, work force, pharmacist work schedule, machine problems, and inventory control -- with mean and 99th percentile of waiting times were examined by the hierarchical stepwise regression method. Day was a unit of the analyses. Results: The regression models explained 65.8% of variance in the mean waiting time and 61.34% in the 99th percentile of waiting times. The break-down of the printer for drug envelops, Automatic Tablet Counters (ATCs), and main computer system lasted longer than 30 minutes increased the mean for 7.7 minutes, 4.5 minutes, and 7.0 minutes, respectively, and the 99th percentile for 14.8 minutes, 9.0 minutes, and 15.7 minutes, respectively. Concerning the work force, study results showed that there were significant differences in the productivity of pharmacists with work experience more than three years, one to three years, and less than one year, and showed that peak time aid work by pharmacists at job assignments other than the outpatient pharmacy, part-time pharmacists, and the installation of ATCs were effective in reducing waiting times, Finally, study findings indicated that the operational policy of work assignment and rotation schedule, supply and inventory of drugs at work tables, and readiness for undisrupted work during the work hours could have a significant effect on waiting times. Conclusion: The study results indicated that efforts to reduce waiting times for prescribed drugs should be geared toward every components of the pharmacy work system ranging from work schedule of pharmacists and supply of dugs at work tables. These findings should provide hospital managers with right directions in battling the problem.

• Journal of Korean Neurosurgical Society
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• v.30 no.11
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• pp.1263-1270
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• 2001

Objective : To analyze the radiosurgical results of intracranial meningiomas after Gamma Knife radiosurgery (GKS) and to assess the possible factors related to the outcome and complications in treating meningiomas. Patients and Methods : We retrospectively reviewed the clinical and radiological data in 179 patients(194 lesions) treated with GKS for intracranial meningiomas between May 1992 and October 2000. Radiosurgical responses were categorized as shrinkage, stasis and enlargement, and we defined the shrunken and static group as a radio-logical control. A Cox proportional hazards model was used to evaluate the correlation between the radiosurgical outcomes and various factors such as location and size of tumor, age and gender of patients, relation to venous sinus, pre-GKS degree of edema, treatment modality, radiosurgical parameters, and pathologic findings. Results : Patients were grouped into skull base meningiomas(57.7%), non-skull base tumor including convexity, parasagittal, and falx meningiomas(37.1%), and others(5.2%) according to the location of tumors. The mean maximum dose and the margin dose of tumor was 30.0Gy(19-45Gy) and 15.1Gy(9.5-24.5Gy), respectively. The mean volume of the tumors was 9.4cc(0.003-45.0cc). The radiologic control rate was 97.1%. The radiation induced imaging change with or without neurologic deficit was the most common complication(23.6%). There were seen mostly in convexity, parasagittal, and falx meningiomas which were deeply embedded in cortex. Conclusion : GKS for intracranial meningioma seems to be safe and effective treatments. However, GKS should be considered very cautiously in non-skull base tumor such as convexity, parasagittal, or falx meningiomas with regards to patient's age and general condition, size and location of tumor, pattern of embedding into cortex, presenting symptoms and patient's preference.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2605-2610
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• 2016

The International Myeloma Working Group considers the serum free light chain (SFLC) assay to be an adjunct to traditional tests. Apart from the FLC ratio, the absolute values of individual free light chains also are gaining importance as they appear to be more relevant in certain clinical settings. Automated assays are available for their determination. As laboratories put new test systems into use catering to different disease populations, they are required by accreditation and certification bodies to verify or establish performance specifications, including reference intervals (RIs) representative of their population. Our aim was to establish local RIs for SFLC in a multicentre representative healthy population using a robust method. There was no significant relationship between SFLC levels and age, gender and creatinine levels. The 95% RI for ${\kappa}SFLC$ was 4.81 to 33.86mg/L, for ${\lambda}$ SFLC was 5.19 to 23.67mg/L and for ${\kappa}/{\lambda}SFLC$ was 0.36 to 2.33, significantly higher than the values given by the manufacturer. The ${\kappa}/{\lambda}$ SFLC ratio at 2.23, covering 100% of the data, showed 72% sensitivity (95% CI=39.0 - 94.0), 100% specificity (95% CI=71.5 - 100.0), 100% PPV (95% CI=21.5 - 100.0), 95% NPV (95% CI=75.4 - 99.9), and 79% accuracy (95% CI=56.0 - 93.0). In the patient group, kit RI for ${\kappa}/{\lambda}$ SFLC ratio classified 45.5% (n=5) as positive vs 9.1% (n=1) positive by the study RI, while the kit RI for kappa FLC classified 90.9% (n=10) as positive vs 54.5% (n=6), indicating increased probability of false positive test results with the kit RI when applied to our patient population. Appropriate and specific reference intervals and criteria values result in fewer false-positive and false-negative results which means fewer wrong or missed diagnoses.

• Journal of Yeungnam Medical Science
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• v.33 no.2
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• pp.90-97
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• 2016

Background: We have previously found that intra-peritoneal lidocaine instillation before pneumoperitoneum attenuates pneumoperitoneum-induced hypertension. Whether this procedure alters patient's hemodynamic status during operation should be determined for clinical application. This study elucidated the possible mechanism of the attenuation of the pneumoperitoneum-induced hypertension by intra-peritoneal lidocaine before pneumoperitoneum. Methods: Thirty-four patients underwent laparoscopic cholecystectomy (LC) were randomly allocated into two groups. After induction of general anesthesia, 200 mL of 0.2% lidocaine (lidocaine group, n=17), or normal saline (control group, n=17) were sub-diaphragmatically instilled 10 minutes before pneumoperitoneum. The changes in systolic blood pressure, heart rate, central venous pressure, stroke volume, cardiac output, and systemic vascular resistance were compared between the groups. The number of analgesics used during post-operative 24 h was compared. Results: Systolic blood pressure was elevated during pneumoperitoneum in both groups (p<0.01), but the degree of elevation was significantly reduced in the lidocaine group than in the control (p<0.01). However, stroke volume and cardiac output were decreased and systemic vascular resistance was increased after induction of pneumoperitoneum (p<0.05) without statistical difference between two groups. The number of analgesics used was significantly reduced in the lidocaine group (p<0.01). Conclusion: These data suggest that intra-peritoneal lidocaine before pneumoperitoneum does not alter patient's hemodynamics, and attenuation of pneumoperitoneum-induced hypertension may be the consequence of reduced intra-abdominal pain rather than the decrease of cardiac output during pneumoperitoneum. Therefore, intra-peritoneal lidocaine instillation before pneumoperitoneum is a useful method to manage an intraoperative pneumoperitoneum-induced hypertension and to control postoperative pain without severe detrimental hemodynamic effects.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.12
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• pp.4873-4880
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• 2010

This study adopted two instruments, i.e. Oral Health Impact Profile-14 (OHIP-14: index of patient's subjective oral health impact) and Todai Health Index (THI: index of patient's subjective systemic health) The Purpose of this study was to determine potential effects of oral health upon systemic health and quality of life (QOL) and provide required basic reference data for developing oral diseases prevention program and public oral health improvement As a result, it may contribute to improving health and quality of life in local community. Analysis on OHIP for subjective oral health conditions revealed that there were significant differences among all categories of self-aware oral health conditions on statistic basis and good oral health group showed significantly higher total OHIP points (4.33) than any other group. Analysis on THI for subjective oral health conditions showed that there were significant differences among all categories of self-aware oral health conditions on statistical basis and very good oral health group got higher total THI points (3.83) than any other group. Analysis on QOL for subjective oral health conditions suggested that there were significant differences among all categories of self-aware oral health conditions but social category and good oral health group got highest total QOL points (3.39) of all groups.

• Journal of Physiology & Pathology in Korean Medicine
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• v.18 no.2
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• pp.376-380
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• 2004

The purpose of this study is the develop a questionnaire for measuring Yin-Deficiency and examine the reliability and validity for its' value as a barometer for evaluating Yin-Deficiency. Questionnaire was developed according to the symptoms of Yin-Deficiency suggested in the 'Standardization of diagnostic terms and requirements of Korean Medicine', With and as a reference, each symptom has been worked on to be put on the questionnaire. Visual analogue scales(VAS) was used as a barometer for measuring frequency of manifestation of symptoms. A study was performed to measure validity and reliability of the final questionnaire for analysis. reliability of YinDQ was measured by Cronbach's alpha coefficient and test-retest method. This study utilized factor analysis and clinical validity for evaluation of validity. For the purpose of decreasing the amount of data-the number of factors, and at the same time minimize the loss of information factor analysis was performed Component factors were extracted using Principal Component Analysis. This study evaluated the clinical validity for examination of difference between the normal group and the patient group. Evaluation on the's internal consistency showed strong internal consistency with value of 0.8615. reliability from test-rest with three-week interval, followed by comparisons of the correlation coefficient and mean values of each item between the two. The Spearman correlation coefficient was 0.54-0.79. By factor analyse two factors with Eigen value of greater than 2.2 were selected. Factor 1 consists of items of 'irritable fever on the five Hearts', 'flushing of the zygomatic region in the afternoon', 'tidal fever', 'night sweats', and 'dryness on the mouth or the throat'. Factor two consists of items of 'emaciation', 'dizziness', 'insomnia', 'decreased amount of urine with yellowish color', and 'constipation'. The comparison between the patient group and the normal group showed significant differences for every ten questions. The results implies that YinDQ is a barometer with sufficient reliability and validity. The questionnaire for Yin-Deficiency may not be enough to replace the specific differential diagnosis by a doctor of Oriental medicine. Nevertheless, it can be effectively utilized as an assisting method in consultation or a method of measuring the degree of Yin-Deficiency in a group.