• Journal of The Korean Society of Clinical Toxicology
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• v.6 no.1
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• pp.32-36
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• 2008

Purpose: The major complication of acute organophosphate (OP) poisoning is respiratory failure as a result of cholinergic toxicity. Many clinicians find it difficult to predict the optimal time to initiate mechanical ventilation (MV) weaning, and as a result have tended to provide a prolonged ventilator support period. The purpose of this study is to determine any clinical predictors based on patients characteristics and laboratory findings to assist in the optimal timing of mechanical ventilator weaning. Methods: We reviewed medical and intensive care records of 44 patients with acute OP poisoning who required mechanical ventilation admitted to medical intensive care unit between July 1998 and June 2007. Patient information regarding the poisoning, clinical data and demographic features, APACHE II score, laboratory data, and serial cholinesterase (chE) levels were collected. Base on the time period of MV, the patients were divided into two groups: early group (wean time < 7 days, n = 28) and delayed group (${\geq}$ 7 days, n = 16). Patients were assessed for any clinical characteristics and predictors associated with the MV weaning period. Results: During the study period, 44 patients were enrolled in this study. We obtained the sensitivity and specificity values of predictors in the late weaning group. APACHE II score and a reciprocal convert of hypoxic index but specificity (83.8%) is only APACHE II score. Also, the chE concentration (rho = -0.517, p = 0.026) and APACHE II score (rho = 0.827, p < 0.001) correlated with a longer mechanical ventilation duration. Conclusion: In patients with acute OP poisoning who required mechanical ventilation, the APACHE II scoring system on a point scale of less than 17 and decrements in cholinesterase levels on 1-3 days were good predictors of delayed MV weaning.

• Annual Conference of KIPS
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• 2023.05a
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• pp.539-541
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• 2023

COVID-19 is a viral pandemic disease that spreads widely all around the world. The only way to identify COVID-19 patients at an early stage is to stop the spread of the virus. Different approaches are used to diagnose, such as RT-PCR, Chest X-rays, and CT images. However, these are time-consuming and require a specialized lab. Therefore, there is a need to develop a time-efficient diagnosis method to detect COVID-19 patients. The proposed machine learning (ML) approach predicts the presence of coronavirus based on clinical symptoms. The clinical dataset is collected from the Israeli Ministry of Health. We used different ML classifiers (i.e., XGB, DT, RF, and NB) to diagnose COVID-19. Later, classifiers are optimized with the Bayesian hyperparameter optimization approach to improve the performance. The optimized RF outperformed the others and achieved an accuracy of 97.62% on the testing data that help the early diagnosis of COVID-19 patients.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5301-5310
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• 2013

The biological mechanisms of cancer and associations with behavior of tumours need to be studied to understand progression and determine appropriate treatments. Here we investigated expression of VEGF, MMP-9 and E-cadherin in laryngeal SCCs and their relations with clinical behavior. This prospective study was based on 38 surgical specimens from patients with primary laryngeal SCC and data recorded in their cards. Expression of the three factors in tumor tissue was examined using immunohistochemistry and correlations with clinical parameters of primary tumors, regional lymph node metastases, stage of disease, histopathologic differentiation, and vascular/cartilage invasion were investigated. Regarding the cases with positive MMP-9 expression, the difference between well and moderately/poorly differentiated tumors was statistically significant. However, differences between early stage (stage I and II) and late-stage (stage III and IV) tumours, and between positive and negative for pLN metastasis were not. No significant relationship between positive VEGF and tumor differentiation or stage was apparent, but E-cadherin levels significantly differed between well and moderately/poorly differentiated tumours and with the presence of pLN metastasis. E-cadherin staining did not vary between MMP-9 positive and negative cases. In conclusion, MMP-9 may be a negative predictor of differentiation in laryngeal SCC, while E-cadherin is a predictor of differentiation and nodal metastases. Even if the difference between VEGF expression and tumor stage was not statistically significant, it seems that there exists some relationship, which might be clarified with a greater number of cases.

• Clinical and Experimental Pediatrics
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• v.54 no.10
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• pp.414-421
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• 2011

Purpose: Recently, an increase in the number of patients sensitized to rice allergen with or without clinical symptoms has been reported. This study was designed to determine the major allergens in rice and their clinical significance. Methods: Twenty-four children (15 boys and 9 girls; mean age, 16.3 months) with allergic disease, who were sensitized to rice antigen (by UniCAP) in the Pediatric Allergy Respiratory Center at Soonchunhyang University Hospital, were enrolled in this study. The allergenicity of various types of rice (raw, cooked, and heat-treated, simulated gastric fluid [SGF], and simulated intestinal fluid [SIF]) was investigated using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoglobulin E (IgE) immunoblots. The patients' medical records, including laboratory data and allergy symptoms after ingestion of rice were reviewed. Results: Patients were sensitized to an average of 13.5 food antigens and their mean total IgE was 6,888.7 kU/L. In SDS-PAGE, more than 16 protein bands were observed in the raw rice, whereas only 14-16 kDa and 31-35 kDa protein bands were observed in cooked rice. The common SDS-PAGE protein bands observed in SGF-, SIF-, and heat-treated rice were 9, 14, and 31 kDa. In a heated-rice IgE immunoblot, protein bands of 9, 14, and 31-33 kDa were found in 27.8%, 38.9%, and 38.9% of all sera, respectively, and in 50%, 50%, and 75%, of ser a from the 4 symptomatic patients, respectively. Conclusion: The 9-, 14-, and 31-kDa protein bands appeared to be the major allergens responsible for rice allergy symptoms.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.4
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• pp.346-356
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• 2021

Purpose: Campylobacter species are currently the most common cause of bacterial gastroenteritis. In Lebanon, Campylobacter infection occurrence is underdiagnosed owing to the lack of specific culture and rapid test kits, particularly among children. This study aimed to evaluate the prevalence, laboratory findings, and clinical characteristics of Campylobacter infection in hospitalized children with acute gastroenteritis in South Lebanon. Methods: We conducted a 6-month retrospective cohort study between January and June 2018, including 291 children aged between 1 month and 12 years, who were admitted to a tertiary healthcare center in South Lebanon. The medical files of the patients were reviewed to retrieve the required clinical information, including clinical and laboratory data. Results: The prevalence of campylobacteriosis agents in pediatric patients with acute gastroenteritis is 12.02%. Patients infected with Campylobacter had more severe acute gastroenteritis than Campylobacter-negative patients and often presented with high-grade fever, diarrhea episodes more than six times per day, diarrhea lasting for more than five days, and dehydration. Indeed, children with high-grade fever (≥38.5℃) were five times more likely to test positive for Campylobacter than those with low-grade fever. In addition, the results showed a higher Vesikari score for the majority of Campylobacter-positive patients with severe acute gastroenteritis compared to a moderate profile for Campylobacter-negative patients. Conclusion: The present study findings highlight that Campylobacter infection is frequent among children with acute gastroenteritis. Therefore, the detection of Campylobacter should be carried out for the diagnosis of human gastroenteritis in Lebanon, along with the detection of routine enteropathogens.

• Korean Journal of Clinical Laboratory Science
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• v.53 no.1
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• pp.32-40
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• 2021

This study examined the association between hypertension (HTN), estimated glomerular filtration rate (eGFR), and urine microalbumin/creatinine ratio (ACR) in Korean adults. Data for 8,922 adults (3,941 men and 4,981 women) aged ≥20 years from the Sixth Korean National Health and Nutrition Examination Survey VI (2013~2014) were analyzed. In men, after adjusting for the related variables, the odds ratios (ORs) of HTN [systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure (DBP) ≥90 mmHg, or use of HTN medications] were significantly higher in the decreased eGFR group [eGFR <60 mL/min/1.73 ㎡, 1.98 (95% CI, 1.21~3.24)], elevated ACR group [ACR ≥30 mg/g, 2.03 (95% CI, 1.54~2.69)], and decreased eGFR plus elevated ACR group [eGFR <60 mL/min/1.73 ㎡ and ACR ≥30 mg/g, 6.03 (95% CI, 2.82~12.92)] than in the normal group (eGFR ≥60 mL/min/1.73 ㎡ and ACR <30 mg/g). In women, after adjusting for the related variables, the ORs of HTN were significantly higher in the decreased eGFR group (2.29, 95% CI, 1.27~4.13), elevated ACR group (2.22, 95% CI, 1.68~2.94), and decreased eGFR plus elevated ACR group (10.77, 95% CI, 3.89~29.82) than the normal group. In conclusion, HTN was associated with a decreased eGFR and elevated ACR in Korean men and women. In addition, the prevalence of HTN increased greatly when a decreased eGFR and elevated ACR occurred simultaneously.

• Translational and Clinical Pharmacology
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• v.26 no.4
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• pp.155-159
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• 2018

For regulatory approval of a new drug, the most preferred and reliable source of evidence would be randomized controlled trials (RCT). However, a great number of drugs, being developed as well as already marketed and being used, usually lack proper indications for children. It is imperative to develop properly evaluated drugs for children. And expanding the use of already approved drugs for other indications will benefit patients and the society. Nevertheless, to get an approval for expansion of indications, most often with off-label experiences, for drugs that have been approved or for the development of pediatric indications, either during or after completing the main drug development, conducting RCTs may not be the only, if not right, way to take. Extrapolation strategies and modelling & simulation for pediatric drug development are paving the road to the better approval scheme. Making the use of data sources other than RCT such as EHR and claims data in ways that improve the efficiency and validity of the results (e.g., randomized pragmatic trial and randomized registry trial) has been the topic of great interest all around the world. Regulatory authorities should adopt new methodologies for regulatory approval processes to adapt to the changes brought by increasing availability of big and real world data utilizing new tools of technological advancement.

• Journal of Korean Clinical Nursing Research
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• v.24 no.3
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• pp.336-346
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• 2018

Purpose: This study was conducted to identify nurses'critical thinking disposition, self-leadership and clinical competency in small to medium sized hospitals less than 300beds. Methods: Data were collected using the questionnaire from 227 nurses in Incheon city and Gyeonggi province from March to April, 2017. The data were analyzed using t-test, ANOVA and $Scheff{\acute{e}}^{\prime}s$ test to identify differences in critical thinking disposition, self-leadership and clinical competency. Pearson correlation coefficients were used to identify the correlation among the study variables, and multiple regression was used to identify factors contributing to clinical competency. Results: There were significant differences in critical thinking disposition according to age, marital status, clinical career, career in currently working department and education about leadership. Significant differences in self-leadership were identified according to marital status, work position, working department, work type, education about leadership, and turnover intention. Clinical competency was significantly different depending on age, education, monthly income, work position, career in currently working department, work type, education about critical thinking disposition and education about leadership. Clinical competency was positively correlated critical thinking disposition and self-leadership. Critical thinking deposition, monthly income and self-leadership explained 30.1% of clinical competency of nurses working in small to medium sized hospitals. Conclusion: The results of this study suggest that we need to improve nurses'critical thinking disposition, self-leadership, and the clinical competency.

• Journal of Korean Clinical Nursing Research
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• v.24 no.3
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• pp.324-335
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• 2018

Purpose: The purpose of this study was to propose a revised Clinical Ladder System(CLS) Model for nurses based on the evaluation of clinical competence and professional activities of nurses working in general hospitals. Methods: Data were collected between September 10 and October 30, 2017. Participants were 50 head nurses from 10 general hospitals with over 400 beds located in Seoul City and Gyeonggi Province. Each head nurse evaluated clinical competence, qualifications, and professional activities of 5 staff nurses at each of the 5 levels of CLS in her unit. The total number of the nurses evaluated was 245. Data were analyzed with descriptive statistics and t-test, one-way ANOVA, and $Scheff{\acute{e}}$. Results: Over 80% of the nurses were university graduates. As the CLS levels increased, clinical competence, qualifications, and professional activities also increased significantly. Education material development and quality improvement activities were carried out by nurses from level 2, research and evidence based practice activities were carried out from level 3, and nurses at level 4 or 5 participated in most of the professional activities as leaders. Conclusion: In order to retain excellent nurses in general hospitals, recognizing and rewarding nurses according to the revised model of the CLS are recommended.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.16 no.1
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• pp.73-89
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• 2021

Objectives We conducted an online survey to understand the current status of Korean Medicine clinical practice related to carpal tunnel syndrome (CTS) to develop the CTS Korean Medicine Clinical Practice Guidelines (CPG). Methods A thoroughly reviewed questionnaire was distributed by e-mail to 21,719 Korean Medicine doctors between March 26 and April 30, 2021. All raw data were arranged and analyzed systematically. Results The response rate among the doctors was 4%. Of the respondents, 82.1% responded that it is necessary to develop the CTS Korean Medicine CPG. We also obtained data related to the specific diagnosis, treatment, and prognosis management methods used at various treatment sites for patients with CTS. Conclusions This online survey will be helpful in developing the CTS CPG, which will contribute to the standardization of guidelines and improvements in the reliability of Korean Medicine. Our findings will provide valuable data and resources for future clinical studies on CTS.