• Title/Summary/Keyword: Treatment Outcomes

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Imported Malaria in Korea: a 13-Year Experience in a Single Center

  • Cheong, Hae-Suk;Kwon, Ki-Tae;Rhee, Ji-Young;Ryu, Seong-Yeol;Jung, Dong-Sik;Heo, Sang-Taek;Shin, Sang-Yop;Chung, Doo-Ryun;Peck, Kyong-Ran;Song, Jae-Hoon
    • Parasites, Hosts and Diseases
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    • v.47 no.3
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    • pp.299-302
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    • 2009
  • The incidence of imported malaria has been increasing in Korea. Were viewed data retrospectively to evaluate the epidemiology, clinical features, and outcomes of imported malaria from 1995 to 2007 in a university hospital. All patients diagnosed with imported malaria were included. Imported malaria was defined as a positive smear for malaria that was acquired in a foreign country. A total of 49 patients (mean age, 35.7 year; M: F = 38 : 11)were enrolled. The predominant malarial species was Plasmodium falciparum (73.5%), and the most frequent area of acquisition was Africa (55.1%), followed by Southeast Asia (22.4%) and South Asia (18.4%). Fourteen-patients (30.6%) suffered from severe malaria caused by P. falciparum and 1 patient (2.0%) died of multiorgan failure. Most of the patients were treated with mefloquine (79.2%) or quinine (10.2%); other antimalarial agents had to be given in 13.2% treated with mefloquine and 44.4% with quinine due to adverse drug events (ADEs). P. falciparum was the most common cause of imported malaria, with the majority of cases acquired from Africa, and a significant number of patients had severe malaria. Alternative antimalarial agents with lower rates of ADEs might be considered for effective treatment instead of mefloquine and quinine.

Prediction of Pregnancy Outcomes by Uterine Artery Impedances on the Day of Embryo Transfer in Human IVF (인간 체외수정술에서 배아 이식일의 자궁동맥 임피던스에 따른 임신의 예측)

  • Jeong, Ju-Eun;Jo, Moo-Sung;Kim, Seung-Chul;Joo, Jong-Kil;Choi, Jong-Ryeol;Lee, Kyu-Sup
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.4
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    • pp.293-300
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    • 2009
  • Objective: This study was aimed to investigate whether uterine blood flow on the day of embryo transfer can be a predictor of pregnancy outcome in human IVF. Methods: Fifty-one patients undergoing IVF program were included in this study. Serum estradiol levels were measured on the day of hCG administration and uterine pulsatility index (PI) and resistance index (RI) was examined for at embryo transfer of day 3. Results: Of 51 cycles, 22 cycles were clinically pregnant (43.1%) and the implantation rate was 14.7%. Uterine PI and RI had a significant inverse correlation with serum estradiol levels (p<0.05). These uterine blood flows were not significantly different between pregnant and nonpregnant groups. The pregnancy rate was slightly higher in patients with PI more than 3.0 compared to those with PI of 3.0 or less, but there was no significant difference. Conclusion: These results suggest that uterine PI and RI at the day of embryo transfer could not be a good predictor of pregnancy in IVF treatment. But they had an inverse correlation with serum estradiol levels on the day of hCG administration.

Analysis of nursing records of cancer patients with standardized nursing language systems (표준화된 간호용어체계를 이용한 암환자 간호기록의 분석)

  • Lee, Mi-Soon;Lee, Byoung-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.10 no.2
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    • pp.243-254
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    • 2004
  • Purpose: The purpose of this study was cross-mapping unique nursing statements which were identified in the nursing records of patients with six most common cancers in Korea with the standardized nursing languages of NANDA, NIC, NOC and ICNP. Method: The subjects were 72 nursing records which covered 1,502 admission days from August 1, 2003 to June 30, 2003. They were the records of the patients of six most common cancers who were treated at the six 3rd level general hospitals in Busan and Daegu. The unique nursing statements were identified by dividing the statements from the nursing records into the single statements according to their meanings. For cross-mapping, identified unique nursing statements were classified as 'Data(D)' for the subjective, objective data of the patients and the other data such as treatment, admission, discharge, and residence of patient, 'Problem(P)' for nursing problem or diagnosis defined by the nurse's decision, 'Intervention(I)' for nursing intervention for problem solving, and 'Outcome(O)' for patient reaction and results of the provided nursing interventions. Unique nursing statements classified to D, P, I, O were cross-napped by using Microsoft Excel 2000. The statements of D were cross-mapped with ICNP Nursing phenomena, P with NANDA nursing diagnosis and ICNP nursing phenomena, I with NIC and ICNP nursing intervention, and O with NOC and ICNP nursing phenomena Result: The results of this study were as follows. 1. Number of unique nursing statements were 506 in the records of lung cancer patients (18.12%), 480 in stomach cancer(17.19%), 458 in liver cancer(16.40%), 456 in colon cancer (16.33), 457 in breast cancer (16.36%) and 436 in cervix cancer (15.60%). 2. The range of percentage of cross-mapped unique nursing statements with the standardized nursing languages were as follows: P with NANDA nursing diagnosis $87.50{\sim}100%$, I with NIC $59.72{\sim}74.43$, O with NOC $61.05{\sim}72.64%$, and D, P, I and O with ICNP $60.92{\sim}69.95%$. 3. Number of the standardized nursing languages identified in this study were 21(12.66%) from 155 NANDA nursing diagnosis, 76(15.64%) from 486 NIC Nursing interventions, 54(17.47%) from 260 NOC nursing outcomes, and 343(13.03%) from ICNP 2,634. Conclusions: By the results of this study, NANDA, NIC, NOC and ICNP were found that they can be used as the language systems for nursing record and nursing information system for cancer patients. But, further study on the unique nursing statements which were not cross-mapped with the standardized nursing language systems will be necessary.

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Splenic Arterial Embolization in Salvage of the Injured Spleen in Children (소아의 비장 손상시 비장 보존을 위한 비장동맥색전술)

  • Hong, Soon-Hoon;Yoo, Soo-Young;Park, Jin-Su;Kim, Young-Ju
    • Advances in pediatric surgery
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    • v.5 no.1
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    • pp.15-25
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    • 1999
  • Injured spleens have been successfully managed without operation in a number of children; however, splenectomy or splenic-conserving surgery may not be avoided because of exsanguinating hemorrhage. This study was performed to evaluate the efficacy of splenic arterial embolization (SAE) to control hemorrhage from injured spleens in children. We compared the outcomes of two groups of children with splenic injury. The first group (G1) consisted of eighteen children who were managed with conventional selective nonoperative treatment between 1993 and 1994. The second group (G2) consisted of 23 children prospectively studied from 1996 to 1997 after SAE was added in the management protocol of splenic injury. The criteria for SAE were grade III or IV injury, extravasation of contrast material revealed by CT, or unstable vital signs without evidence of associated injuries. Laparotomy was performed in 6 patients of G1 (33.3 %), 2 of whom had associated injuries. Five underwent splenectomy and the overall salvage rate in G1 was 72.2 % (13/18). In G2, eight patients (34.8 %) had SAE, which stopped bleeding successfully in all patients. Two of G2 (8.7 %) had laparotomy because of associated injuries. Only one patient underwent splenectomy and the salvage rate was 95.6 % (22/23). No patients required transfusion after SAE. In conclusion, the SAE effectively controlled hemorrhage from injured spleens. More spleens were salvaged with a reduced laparotomy rate after application of SAE in splenic injury.

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Comparison of Partial Pulpotomy in Permanent Molars Using Different Pulp Capping Agents and Restoration Materials (치수복조재와 최종수복재에 따른 대구치 부분치수절단술의 비교)

  • Lee, Jimi;Lee, Nanyoung;Lee, Sangho;Jih, Myeongkwan
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.2
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    • pp.148-156
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    • 2020
  • The purpose of this study was to compare the success rates of two pulp capping materials, Biodentine™ and RetroMTA®, used for partial pulpotomy in permanent molars after carious exposures and to compare the final restorative outcome of using composite resin to that of using a stainless steel crown. We studied children who were diagnosed with dental caries of permanent molars and underwent partial pulpotomy. The patients were followed up for more than 1 year. Clinical and radiographic evaluation were used to evaluate the success of each treatment. Fisher's exact test was used to compare the outcomes of two groups. For pulp capping agents, the success rate of using RetroMTA® was lower than that of using Biodentine™(p < 0.05). Final restoration with composite resin was less successful than restoration with an stainless steel crown(p < 0.05). In combination of pulp capping agents and final restoration material, RetroMTA®-composite resin shows the lowest success rate(p < 0.05).

Needs Assessment of Nurses and Educators toward Gerontological Nursing Curriculum Development (노인간호학 교과개발을 위한 요구 사정 연구)

  • Bae Young-Sook;Lee Kap-Soon
    • The Journal of Korean Academic Society of Nursing Education
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    • v.3 no.2
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    • pp.163-192
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    • 1997
  • As the population over the age of 65 increases, the demand for nurses who care for this group also continues to grow. Well-prepared nurses who are knowledgeable and skilled for the elderly can be prepared through systematic gerontological nursing curricula. This study was carried out to identify the needs for gerontological nursing curricular contents. The subjects for this study were two participant groups the educators who teach gerontological nursing in three-year and four-year baccalaureate nursing programs, and the nurses who are working with the elderly in hospitals, community health centers, social welfare agencies, and community health practioner's posts. The major findings of the study are as follows : 1. The differences between actual contents and essential contents of the educators : Concerning the actual contents that is actually taught, the educators showed the highest scores on the demographics of older adults and the lowest scores on the cultural variations affecting health care. Regarding the essential contents, the educators showed the highest scores on the demographics and the lowest scores on the economics of aging. Aside from the demographics, all of the items were found to have significant differences between essential and actual contents. This implies that all the content areas except demographics should be emphasized. 2. The differences between actual knowledge and essential knowledge of the nurses : Concerning the nurses' actual knowledge, the nurses showed the highest scores on the common health problems and their treatment and the lowest scores on the politics of aging. Regarding the essential knowledge, nurses showed the highest scores on the chronic illness and common health problems and the lowest scores on their roles and functions. However, they thought all the items to be essential. All of the items were found to have significant differences between actual and essential knowledge. The nurses who studied gerontological nursing in their school years and after graduating had more knowledge. However, they felt more knowledge was needed. This implies that the nurses need more education in all content areas of gerontological nursing. 3. The differences between educators and nurses : Concerning the essential contents, the educators showed higher scores on the demographics and growth and development than the nurses. Whereas, the nurses showed higher scores on the cultural variations, long-term care, economics of aging, politics of aging, legal and ethical issues, and common health problems than the educators. 4. Activities of nursing care for the elderly : Most common activities were related to direct nursing care such as giving physical care, counseling/teaching clients, and assessing and planning care for the clients. Nurses thought that all the items were critical, but they showed relatively low scores on the following :'serve on multidisciplinary committee', 'preparing reports', 'evaluation of outcomes of care', 'determine policy for nursing service', 'set patient care standards', and 'participate in nursing research' The constraints in providing better nursing service were time constraints, administrative restraints, social restraints, and inadequate knowledge.

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Analysis of the Spillover Effects on the Management Profits of Offshore Fishery by the Fluctuations in the Crude Oil Prices (원유가상승이 근해어업의 경영수지에 미치는 파급효과 분석)

  • 김현용;강연실
    • The Journal of Fisheries Business Administration
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    • v.32 no.1
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    • pp.15-39
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    • 2001
  • The study, using the input-output analysis of 402 industrial sectors by Bank of Korea(BOK) and the resulting outcomes of price model, aims to evaluate the spillover effects the international fluctuations in crude oil prices have on the commodities prices and consequently, analyse the management and profitability of the offshore fisheries in Korea. At present, the fisher men are provided with tax-free oils for their fishing operations as specified under the Special Tax Treatment Control Law. However, the exhaustion of marine resources and new international fisheries agreements, which resulted in the loss of fishing grounds, made the stable catch even more unpredictable and the hike in the price of the international crude oil would have adverse effects on the fishing industry. The study revealed that the increasing rise in the price of crude oil would exert sweeping spillover effects on other industry sectors in general and accordingly, lead to a poorer performance by fisheries. The price spillover coefficients for the diesel oil was 0.6026, which would translate into the 42.6% increase in the prices of oil when the increase ratio of 73.3% for the base crude oil was applied based on the calculation methods employed in the study. This in turn increased the ratio of diesel oil required in the offshore fisheries from 23.3% to 16.6%, diminishing the ratio of current net profits to minus 2.0% from 4.2% otherwise. By fishing type, the Pair Trawl suffered current net profits loss most by ratio of minus 9.4% and other fisheries such as Coastal Stow Nets, Coastal Angling, Danish Sein also suffered ratio of 7% and more in the loss of current net profits. With the deteriorating fishing performance, coupled with the increasing international crude oil prices, it is urgently required that the authorities concerned deliberate in depth on such schemes as follows in efforts to secure stable fishing production. First, provision of large-scale storage facilities for oil is needed to timely adapt to the fluctuations in international crude oil prices. Secondly, in line with the stabilization of tax-free oil prices, duty levied on oils for fishing and tax collected from the refineries need to be tax-exempt. Thirdly, the beneficiaries from the provision of tax-free oil should be broadened, not limited to special fishing operation only. Fourth, investment in stabilization of the oil prices should be encouraged, possibly through funding from the formation of fisheries development funds underway.

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Comparison of In Vitro Cell Transformation Assay Using Murine Fibroblasts and Human Keratinocytes

  • Ahn, Jun-Ho;Park, Sue-Nie;Yum, Yung-Na;Kim, Ji-Young;Lee, Michael
    • Toxicological Research
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    • v.24 no.1
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    • pp.37-44
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    • 2008
  • The in vitro cell transformation assays (CTA) were performed using BALB/3T3 murine fibroblasts and HaCaT human keratinocytes in order to evaluate concordance between both in vitro CTAs and carcinogenicity with compounds differing in their genotoxic and carcinogenic potential. Six test articles were evaluated, two each from three classes of compounds: genotoxic carcinogens (2-amino-5-nitrophenol and 4-nitroquinoline-N-oxide), genotoxic noncarcinogens (8-hydroxyquinoline and benzyl alcohol), and nongenotoxic carcinogens (methyl carbamate and N-nitrosodiphenylamine). Any foci of size $\geq$2 mm regardless of invasiveness and piling was scored as positive in CTA with BALB/3T3. As expected, four carcinogens regardless of their genotoxicity had positive outcomes in two-stage CTA using BALB/3T3 cells. However, of the two genotoxic noncarcinogens, benzyl alcohol was positive CTA finding. We concluded that, of the 6 chemicals tested, the sensitivity for BALB/3T3 system was reasonably high, being 100%. The respective specificity for BALB/3T3 assay was 50%. We also investigated the correlation between results of BALB/3T3 assay and results from HaCaT assay in order to develop a reliable human cell transformation assay. However, evaluation of staining at later time points beyond the confluency stage did not yield further assessable data because most of HaCaT cells were detached after $2{\sim}3$ days of confluency. Thus, after test article treatment, HaCaT cells were split before massive cell death began. In this modified protocol for this HaCaT system, growing attached colonies were counted instead of transformed foci 3 weeks since last subculture. Compared to BALB/3T3 assay, HaCaT assay showed moderate low sensitivity and high specificity. Despite these differences in specificity and sensitivity, both cell systems did exhibit same good concordance between in vitro CTA and rodent carcinogenicity findings (overall 83% concordant results). At present the major weakness of these in vitro CTA is lack of validation for regulatory acceptance and use. Thus, more controlled studies will be needed in order to be better able to assess and quantitatively estimate in vitro CTA data.

The Development on Medical Malpractice Lawsuit and its Burden of Proof (의료과오소송 입증책임론의 전개와 발전)

  • Shin, Eun-Joo
    • The Korean Society of Law and Medicine
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    • v.9 no.1
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    • pp.9-56
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    • 2008
  • The medical practice does not always get a satisfatory result since the disease progress of patients are depended on patients' physical constitution and the doctors cannot control the outcomes about patients' physiological and biological reaction after the treatment. Moreover, the medical practice may bring wrong result fatalistically because of the unpredictablility of life. To demand for compensation of the damage to the doctors about these wrong result, the patient side holds the burden of proof that is between medical practice and demage, and there is damage from doctor's malpractice according to the accepted theory about the fundamental principle of distribution of the burden of proof. This falls not only under the liability of Tort Law, but also liability of Contract Law. However, the patient may be in difficult situation to prove the malpractice of doctors since he or she cannot recognize the facts because he or she was in unconscious while the medical practice was conducted, or they cannot judge precisely even though they recognize the facts. Nevertheless, the lawsuits against medical malpractice are the field that never achieves the equality of arms since the most of the evidence belong to the doctor's side. Hence, to maintain the principle of the equality of arms under the constitution, the theory leads to alleviate the burden of proof that patients hold. However, the doctors cannot be asked for the burden of proof that they conduct medical practice without errors. Because the doctors may experience difficulty to prove their innocence as the patients because of the unique characteristic that medical practices have. Therefore, the methods of the alleviation of the patient's burden of proof should have the equality of arms and the equal opportunity between the patients and the doctors with the evaluation of the justifiable interest from both the patients and the doctors. As the methods of the alleviation of the burden of proof, the alleviation of the demands and the degree of the burden of proof or resolutely the conversion of the burden may be considered. However, Recognizing the exception from general principle with converting the burden of proof is not proper in principle because the doctors may experience difficulty of the proof as the patients may have. If the difficulty of proof can be resolved by alleviating of the demands and the degree of the burden of proof, it is more desirable resolution rather than converting the burden of proof.

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Diagnosis of Spinal Arachnoid Cyst using Magnetic Resonance Imaging in a Dog (개에서 자기공명영상을 이용한 척추부 지주막 낭종의 진단)

  • Shin, Chang-ho;Kim, Young-ki;Hwang, Tae-sung;Yoon, Young-min;Jung, Dong-in;Yeon, Seong-chan;Lee, Hee-chun
    • Journal of Veterinary Clinics
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    • v.32 no.5
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    • pp.464-468
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    • 2015
  • A 6-year-old, intact male maltese was presented with hindlimb ataxia of 4 day duration. Physical and neurological examinations revealed a bright, alert, and responsive dog, with no evidence of cranial nerve deficits, conscious proprioceptive deficits. Spinal reflexes of the hind and forelimbs were normal. Patellar, cranial tibial, and withdrawal reflexes were normal. Pain could not be elicited on manipulation of the neck or palpation of the spinal column. Survey radiographs of the vertebral column were unremarkable. Computed tomography (CT) scans in the transverse plane were performed. The results of CT imaging were unremarkable. Magnetic resonance imaging (MRI) in both sagittal and transverse planes was performed. The extent of the lesion was 25 mm in length by 4 mm in thickness. The spinal cord was deviated ventrally and appreared thinner. On T1-weighted and FLAIR images, a discrete hypointense lesion dorsal to the spinal cord was observed at L1-2 which was contiguous with the subarachnoid space. On T2-weighted images, this region was hyperintense, consistent with a fluid-filled structure. The signal intensity of the cysts was equivalent to cerebrospinal fluid (CSF). Surgical treatment involving dorsal laminectomy had successful outcomes.