• Journal of Gastric Cancer
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• v.21 no.1
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• pp.16-29
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• 2021

Purpose: Incidence, risk factors, and clinical consequences of pancreatic fistula (POPF) after D1+/D2 radical gastrectomy have not been well investigated in Western patients, particularly those from Eastern Europe. Materials and Methods: A total of 358 D1+/D2 radical gastrectomies were performed by surgeons with high caseloads in a single surgical center from 2002 to 2017. A retrospective analysis of data that were prospectively gathered in an electronic database was performed. POPF was defined and graded according to the International Study Group for Pancreatic Surgery (ISGPS) criteria. Uni- and multivariate analyses were performed to identify potential predictors of POPF. Additionally, the impact of POPF on early complications and long-term outcomes were investigated. Results: POPF was observed in 20 patients (5.6%), according to the updated ISGPS grading system. Cardiovascular comorbidities emerged as the single independent predictor of POPF formation (risk ratio, 3.051; 95% confidence interval, 1.161-8.019; P=0.024). POPF occurrence was associated with statistically significant increased rates of postoperative hemorrhage requiring re-laparotomy (P=0.029), anastomotic leak (P=0.002), 90-day mortality (P=0.036), and prolonged hospital stay (P<0.001). The long-term survival of patients with gastric adenocarcinoma was not affected by POPF (P=0.661). Conclusions: In this large series of Eastern European patients, the clinically relevant rate of POPF after D1+/D2 radical gastrectomy was low. The presence of co-existing cardiovascular disease favored the occurrence of POPF and was associated with an increased risk of postoperative bleeding, anastomotic leak, 90-day mortality, and prolonged hospital stay. POPF was not found to affect the long-term survival of patients with gastric adenocarcinoma.

• Korean Journal of Clinical Pharmacy
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• v.22 no.3
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• pp.268-273
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• 2012

The definition of anaphylaxis is 'a serious, life-threatening generalized or systemic hypersensitivity reaction' and is considered as the life threatening adverse drug reaction. We experienced a case of cefotetan induced anaphylaxis with negative pre-skin test, used for surgical prophylaxis. A 82-year-old female was scheduled for total knee replacement therapy. She had no previous history of allergy and her skin test results were also negative. On her right knee surgery, she underwent cefotetan therapy as a surgical prophylaxis for a week with no problems identified. Next left knee surgery, she also received the prophylaxis of intravenous cefotetan. However, a few minutes later, anaphylactic reaction developed with vomiting, severe hypotension, bronchospasm, and dyspnea. After immediate intensive care treatment, she recovered without significant complications. Though commonly used laboratory data in case reports, such as the specific IgE, tryptase, histamine, or allergic skin prick test were limited, we successfully confirmed anaphylaxis based on clinical criteria for diagnosing anaphylaxis based on WAO 2011 guideline with through concurrent patient°Øs medical history review and the process of identifying the causes.

• Journal of Korean Academy of Nursing Administration
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• v.19 no.2
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• pp.304-314
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• 2013

Purpose: The purpose of this study was to analyze factors affecting burnout among clinical nurses according to Positive Psychological Capital. Methods: The study design was a descriptive survey and questionnaires were collected from 412 clinical nurses who worked in a general hospital in "J" city. Data were analyzed using frequency, percentage, mean, standard deviation, independent t-test, One-way ANOVA, Scheff$\acute{e}$ test, Pearson Correlation, and hierarchical multiple regression. Results: In Model individual characteristics accounted for 27.8% of the influence on burnout. In model II with the addition of the 4 factors; Self-efficacy, Hope, Resilience, Optimism, individual characteristics accounted for 48.5% of the influence on burnout. Optimism and Resilience of the Positive Psychological Capital sub-variables were statistically useful as factors influencing burnout. Conclusion: The results indicate that it is necessary to develop active human resource management and educational programs to decrease burnout and strengthen the Positive Psychological Capital of the nurses.

• Child Health Nursing Research
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• v.23 no.2
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• pp.199-206
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• 2017

Purpose: The purpose of this study was to explore perception of the clinical learning environment, resilience and perfectionism in relation to practice burnout and to identify factors influencing practice burnout in student nurses. Methods: A descriptive correlational study was conducted. The participants were 313 student nurses from three universities in B and U city. Data were analyzed using t-test, ANOVA, Pearson correlation coefficient, $Scheff{\acute{e}}s$ test and multiple regression analysis. Results: Mean score for practice burnout in student nurses was 2.92 out of 5 points. Practice burnout explained 44.7% of the variance in perfectionism (${\beta}=.245$, p<.001), satisfaction with college life (${\beta}=.232$, p<.001), resilience (${\beta}=-.228$, p<.001), clinical learning environment (${\beta}=-.193$, p<.001), satisfaction with major (${\beta}=.180$, p=.001), practical relationships with peers (${\beta}=.128$, p=.005), and satisfaction with clinical practice (${\beta}=.124$, p=.039). Conclusion: Research results suggest that the important variable for student nurses' practice burnout is perfectionism. Therefore education is needed to develop strategies to manage perfectionism and reduce practice burnout.

• Journal of Korean Academy of Nursing Administration
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• v.19 no.4
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• pp.525-535
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• 2013

Purpose: The purpose of this study was to analyze factors affecting work engagement and burnout among clinical nurses according to resilience. Methods: The study design was a descriptive survey and questionnaires were collected from 182 clinical nurses who worked in hospitals in "J" province. Data were analyzed using frequency, percentage, mean, standard deviation, independent t-test, one-way ANOVA, Scheff$\acute{e}$ test, Pearson correlation, and hierarchical multiple regressions. Results: The mean score of resilience, work engagement, burnout were $3.47{\pm}0.38$, $4.29{\pm}0.98$, $2.25{\pm}0.82$ respectively. Resilience had 26.3% of the influence on work engagement and 50.5% of the influence on burnout. Sub-variables of causal analysis and empathy of resilience were statistically useful as factors influencing burnout. Conclusion: Resilience has been identified as a factor affecting work engagement and burnout. Therefore, nursing departments and nurse managers should strive to develop programs for the promotion of resilience.

• Restorative Dentistry and Endodontics
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• v.47 no.1
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• pp.5.1-5.11
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• 2022

Objectives: This study aimed to assess the clinical longevity of a bulk-fill resin composite in Class II restorations for 3-year. Materials and Methods: Patient record files acquired from the 40 patients who were treated due to needed 2 similar sizes Class II composite restorations were used for this retrospective study. In the experimental cavity, the flowable resin composite SDR was inserted in the dentinal part as a 4 mm intermediate layer. A 2 mm coverage layer with a nano-hybrid resin composite (CeramX) was placed on SDR. The control restoration was performed by an incremental technique of 2 mm using the nano-hybrid resin composite. The restorations were blindly assessed by 2 calibrated examiners using modified United States Public Health Service criteria at baseline and 1, 2, and 3 years. The data were analyzed using non-parametric tests (p = 0.05). Results: Eighty Class II restorations were evaluated. After 3-years, 4 restorations (5%) failed, 1 SDR + CeramX, and 3 CeramX restorations. The annual failure rate (AFR) of the restorations was 1.7%. The SDR + CeramX group revealed an AFR of 0.8%, and the CeramX group an AFR of 2.5% (p > 0.05). Regarding anatomical form and marginal adaptation, significant alterations were observed in the CeramX group after 3-years (p < 0.05). The changes in the color match were observed in each group over time (p < 0.05). Conclusions: The use of SDR demonstrated good clinical durability in deep Class II resin composite restorations.

• Journal of Korean Medical Science
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• v.33 no.53
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• pp.343.1-343.8
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• 2018

Background: Linkage of public healthcare data is useful in stroke research because patients may visit different sectors of the health system before, during, and after stroke. Therefore, we aimed to establish high-quality big data on stroke in Korea by linking acute stroke registry and national health claim databases. Methods: Acute stroke patients (n = 65,311) with claim data suitable for linkage were included in the Clinical Research Center for Stroke (CRCS) registry during 2006-2014. We linked the CRCS registry with national health claim databases in the Health Insurance Review and Assessment Service (HIRA). Linkage was performed using 6 common variables: birth date, gender, provider identification, receiving year and number, and statement serial number in the benefit claim statement. For matched records, linkage accuracy was evaluated using differences between hospital visiting date in the CRCS registry and the commencement date for health insurance care in HIRA. Results: Of 65,311 CRCS cases, 64,634 were matched to HIRA cases (match rate, 99.0%). The proportion of true matches was 94.4% (n = 61,017) in the matched data. Among true matches (mean age 66.4 years; men 58.4%), the median National Institutes of Health Stroke Scale score was 3 (interquartile range 1-7). When comparing baseline characteristics between true matches and false matches, no substantial difference was observed for any variable. Conclusion: We could establish big data on stroke by linking CRCS registry and HIRA records, using claims data without personal identifiers. We plan to conduct national stroke research and improve stroke care using the linked big database.

• Biomedical Science Letters
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• v.19 no.3
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• pp.245-253
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• 2013

To provide reference data or guideline for empirical treatment of bloodstream infection, we studied a change pattern in causative microorganisms and antimicrobial susceptibility in a general hospital at Gyeonggi province during five years. We retrospectively reviewed the frequency of causative microorganisms and antimicrobial susceptibility results of 5,782 microorganisms isolated from blood culture in a general hospital during the period from January 2008 to December 2012. The most common pathogens were Escherichia coli (14.7%), Staphylococcus aureus (7.5%), Streptococcus viridans group (4.9%), and Klebsiella pneumoniae (4.1%). The multiple microorganisms were isolated in 4.3% of bloodstream infection patients. The average contamination rate of blood culture during five years was 3.0%. Methicillin-resistant S. aureus (MRSA), vancomycin-resistant Enterococcus faecium (VRE), and penicillin-resistant Streptococcus pneumoniae were isolated at 62%, 27% and 11%, respectively. Cefotaxime-resistant E. coli and K. pneumoniae was 20% and 18%, respectively. Imipenem-resistant Pseudomonas aeruginosa (IRPA) and Acinetobacter baumannii (IRAB) was 25% and 66%, respectively. E. coli and S. aureus were most common pathogens isolated from blood culture for five years. The increase of multidrug-resistant microorganisms, such as MRSA, VRE, ESBL, IRPA and IRAB, requires more strict control of antibiotics and causes the need of the more updated guideline for the treatment of blood stream infection.

• The Journal of Internal Korean Medicine
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• v.31 no.1
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• pp.177-188
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• 2010

Objective : This study was designed to evaluate the treatment effects and the prevention of side effects from antituberculosis drugs by using oriental medicine on a pulmonary tuberculosis patient. Methods : The clinical data was analyzed on a patient with pulmonary tuberculosis whose main symptoms were general weakness, anorexia, weight loss, tachycardia, night sweats, fever, coughing and chest pain. The patient was treated from June 17, 2008 to April 1, 2009, using herbal medicine (Cheongpyebyeolgab-tang) with antituberculosis drugs. Results : After treatment, the symptoms disappeared faster than with western medicine treatment only. Laboratory examinations and radiograph impressions also improved. No side effects of the antituberculosis drugs were noted. Conclusions : This suggests that oriental medicine therapy is effective for pulmonary tuberculosis and prevents the side effects of the antituberculosis drugs.

• Molecules and Cells
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• v.37 no.9
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• pp.685-690
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• 2014

Osteoclasts are large polykaryons that have the unique capacity to degrade bone and are generated by the differentiation of myeloid lineage progenitors. To identify the genes involved in osteoclast development, we performed microarray analysis, and we found that carboxypeptidase E (CPE), a prohormone processing enzyme, was highly upregulated in osteoclasts compared with their precursors, bone marrow-derived macrophages (BMMs). Here, we demonstrate a novel role for CPE in receptor activator of NF-${\kappa}B$ ligand (RANKL)-induced osteoclast differentiation. The overexpression of CPE in BMMs increases the formation of tartrate-resistant acid phosphatase (TRAP)-positive multinuclear osteoclasts and the expression of c-Fos and nuclear factor of activated T cells c1 (NFATc1), which are key regulators in osteoclastogenesis. Furthermore, employing CPE knockout mice, we show that CPE deficiency attenuates osteoclast formation. Together, our data suggest that CPE might be an important modulator of RANKL-induced osteoclast differentiation.