• The Korean Journal of Pain
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• v.30 no.3
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• pp.176-182
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• 2017

Background: Current evidence suggests that intravenous magnesium sulfate might be effective for reducing migraine pain. In a recent pilot study, we showed that intravenous caffeine citrate could reduce the severity of migraine headache. The objective of this study is to investigate the efficacy of intravenous caffeine citrate vs. magnesium sulfate for management of acute migraine headache. Methods: We conducted a prospective quasi-experimental study from January until May 2016 in two educational medical centers of Shahid Beheshti University of Medical Sciences (Shoahadaye Tajrish Hospital and Imam Hossein Hospital), Tehran, Iran. The study included patients who were referred to the emergency department and met the migraine diagnosis criteria of the International Headache Society. Patients were allocated into 2 groups receiving either 60 mg intravenous caffeine or 2 g intravenous magnesium sulfate. The pain scores, based on the visual analog scale, were recorded on admission, as well as one and two hours after receiving the drug. A Chi-Square test and student t-test were used for analysis of baseline characteristics. A Mann-Whitney U test and Wilcoxon singed rank test were used to analyze differences in the visual analogue scale (VAS) score between and within the groups respectively. Results: In total, 70 patients (35 patients in each group) with the mean age of $33.1{\pm}11.3years$ were included (64.3% female). For the Caffeine citrate group, the median pain score decreased from 9.0 (2.0) to 5.0 (4.0) after one hour and to 3.0 (4.0) after two hours. For the magnesium sulfate group, the pain score decreased from 8.0 (2.0) to 2.0 (2.0) after one hour and to 0.0 (1.0) after two hours. Both intravenous caffeine citrate and intravenous magnesium sulfate reduced pain scores significantly but the magnesium sulfate group showed more improvement than the Caffeine citrate group after one hour (P < 0.001) and after two hours (P < 0.001). Conclusions: It is likely that both intravenous caffeine and intravenous magnesium sulfate can reduce the severity of migraine headache. Moreover, intravenous magnesium sulfate at a dose of 2 g might be superior to intravenous caffeine citrate 60 mg for the short term management of migraine headache in emergency departments.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.4
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• pp.403-411
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• 2018

The purpose of this study was to identify the experience of patients with uterine benign neoplasms in response to high-intensity focused ultrasound treatment. The study participants were patients who received high-intensity focused ultrasound treatment after diagnosis of benign uterine neoplasms and were contacted through purposive techniques. Five patients agreed to participate in this study. Data were collected from February, 2018 to May, 2018 at Women's hospital in D city. The interview data were analyzed by the phenomenological analysis method developed by Colaizzi using open-ended questions during in-depth interviews. Three categories emerged from the analysis using Colaizzi's method: 1) Discomfort. 2) Ambivalence. 3) Will and need. These study results contribute to a deeper understanding of the experience of patients with uterine benign neoplasms in response to high-intensity focused ultrasound treatment. Therefore, it should be developed as part of an effective nursing education program to provide evidence-based guidelines and nursing interventions that alleviate health problems in patients receiving high-intensity focused ultrasound treatment and proper nursing understanding of the development of new treatment methods for woman's health.

• Korea Journal of Hospital Management
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• v.23 no.1
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• pp.87-106
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• 2018

Objective: The objective of this study is to examine the association between process quality of inpatient care and risk-adjusted, thirty-day potentially preventable hospital readmission (PPR) rates. Data Sources/Study Setting: This was an observational cross-sectional study of nonfederal acute-care hospitals located in two states California and Florida, discharging Medicare patients with a principal discharge diagnosis of heart failure, acute myocardial infarction, or pneumonia January through December 31, 2007. Data were obtained from the Healthcare Cost and Utilization Project State Inpatient Database of the Agency for Healthcare Research and Quality, Centers for Medicare and Medicaid Services Hospital Compare database, and the American Hospital Association Annual Survey of Hospitals. Study Design: The dependent variable of this study is condition-specific, risk-adjusted, thirty-day potentially preventable hospital readmission (PPR). 3M's PPR software was utilized to determine whether a readmission was potentially preventable. The independent variable of this study is hospital performance for process quality of inpatient care, measured by hospital adherence to recommended processes of care. We used multivariate hierarchical logistic models, clustered by hospitals, to examine the relationship between condition-specific, risk-adjusted, thirty-day PPR rates and process quality of inpatient care, after taking clinical and socio-demographic characteristics of patients and structural and operational characteristics of hospitals into account. Findings: Better performance on the process quality metrics was associated with better patient outcome (i.e., low thirty-day PPR rates) in pneumonia, but not generally in two cardiovascular conditions (i.e., heart failure and acute myocardial infarction). Practical Implication: Adherence to the process quality metrics currently in use by CMS is associated with risk-adjusted, thirty-day PPR rates for patients with pneumonia, but not with cardiovascular conditions. More evidence-based process quality metrics closely linked to 30-day PPR rates, particularly for cardiovascular conditions, need to be developed to serve as a guideline to reduce potentially preventable readmissions.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6733-6738
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• 2013

Multiple genetic studies have confirmed association of 8q24 variants with susceptibility to prostate cancer (PCa). As PCa risk SNPs may also influence disease outcome, we studied here eight 8q24 risk alleles, and evaluated their role in PCa clinical covariates in northern Chinese men. Blood samples and clinical information were collected from ethnically Chinese men from Northern China with histologically-confirmed PCa (n=289) and from age-matched normal controls (n=288). Eight 8q24 SNPs were genotyped by polymerase chain reaction-high- resolution melting analysis in 577 subjects. We examined the prevalence distribution of 8q24 risk alleles and analyzed the associations between the risk allele and PCa and clinical covariates to infer their impact on aggressive PCa. Three of the eight SNPs were associated with PCa risk in northern Chinese men, including rs16901966 (OR 1.31, 95% CI 1.01-1.70, p=0.042), rs1447295 (OR 1.47, 95% CI 1.09-1.98, p=0.011) and rs10090154 (OR 1.55, 95% CI 1.14-2.12, p=0.005). Haplotype analysis based association with the risk alleles revealed significant differences between cases and controls (OR 1.43, 95%CI 0.99-2.06, p=0.049). The risk alleles rs16901966, rs1447295 and rs10090154 were associated with age at diagnosis and tumor stage as compared with controls, while rs16901966 was associated with aggressive PCa (OR 1.43, 95% CI 1.01-2.03, p=0.042). The evidence for 8q24 SNPs with PCa risk in northern Chinese men showed rs16901966, rs1447295 and rs10090154 at 8q24 (region 1, region 2) to be strongly associated with PCa and clinical covariates. The three SNPs at 8q24 could be PCa susceptible genetic markers in northern Chinese men.

• Journal of Physiology & Pathology in Korean Medicine
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• v.32 no.2
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• pp.134-140
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• 2018

This study aims to evaluate healthcare providers' satisfaction and demands pertaining to the collaborative first-stage pilot project between Korean medicine and Western medicine. This survey was conducted via electronic mail among 33 healthcare providers participating in the pilot project. Likert type 5-point scale or Likert type 7-point scale was used to evaluate each item. The response of '${\geq}4$' on the 5-point scale, and '${\geq}5$' on the 7-point scale were analyzed as positive answers. A total of 27 healthcare providers (81.8%) responded, of which 9 were western medical doctors (33.3%) and 18 were Korean medical doctors (66.7%). In respect to satisfaction of the pilot project, 88.9% gave positive responses on improved patients' convenience, 59.3% on treatment efficiency and 55.6% on diagnosis efficiency. In terms of self-evaluation on the pilot project, 70.4% gave positive answers on changes in quality of collaborative treatment, 74.1% on cooperation of results, 63.0% on cooperation of structure and 51.9% on cooperation of process. In terms of demand for collaborative treatment or the pilot project, 'standardized manual' and 'simplification of administrative procedures' showed highest demand, resulting up to 88.9%, followed by 85.2% demanding more public relations and 63.9% demanding enlargement of participating hospitals. This survey revealed that healthcare providers are generally satisfied with patients' convenience and treatment effects. Further studies are needed to develop a standardized manual, simplified administrative procedures, and expanded pilot project contents.

• Journal of Yeungnam Medical Science
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• v.24 no.1
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• pp.1-10
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• 2007

The chronic fatigue immune dysfunction syndrome (abbreviated CFIDS or CFS) is a disorder characterized by debilitating fatigue(over 6 months.), along with cognitive, musculoskeletal, and sleep abnormalities. The etiology of this illness is unlikely to be a single agent. Findings to date suggest that physiological and psychological factors work together to predispose and perpetuate the illness. Diagnosis is made difficult by the nonspecific clinical findings and no available diagnostic testing. With no known cause or cure for the chronic fatigue and immune dysfunction syndrome, treatment is based on relieving symptoms and improving the quality of life of affected patients. There is emerging evidence that chronic fatigue syndrome may be familial. In the future, studies will examine the extent to which genetic and environmental factors play a role in the development of chronic fatigue syndrome. Most patients with CFS have psychiatric problems such as a generalized anxiety disorder, or major or minor depression, therefore, these mental health disorders may be correlated with the pathophysiology of the CFS. The treatment for CFS must be individualized, due to the heterogeneity of the CFS population. Also the treatment of CFS is built on a foundation of patient-physician relationship, respect and advocacy.

• Journal of Veterinary Clinics
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• v.22 no.2
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• pp.157-159
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• 2005

Two-month old male Shih Tzu weighing 2.1 kg was presented with alopecia in black-haired areas of the skin. The hair loss had been present since five weeks of age. There was no history of pruritus on any part of the body. No other symptoms had been recognized. Physical examination found no abnormalities other than hair loss. Skin examination showed marked alopecia of black-haired area of the body. The white areas appeared to have hair growth of normal density and texture. Affected pigmented areas showed no evidence of skin lesions. Skin scraping and fungal culture were negative. Microscopic examination of plucked black hairs showed marked pigment clumping in the remnants of the follicles and were mainly in telogen phase. But white hairs were normal in various stages of hair growth. The diagnosis of black hair follicular dysplasia was made based on the history, alopecia of the pigmented areas, the confinement of abnormalities to dark areas, and the normal unpigmented areas.

• Korean Journal of Veterinary Service
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• v.34 no.4
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• pp.321-331
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• 2011

Mycobacterium bovis, a member of the M. tuberculosis complex (MTC), is the causative agent of bovine tuberculosis. Detection of M. bovis and M. tuberculosis using conventional culture- and biochemical-based assays is time-consuming. Therefore, a simple and sensitive molecular assay for rapid detection would be of great help in specific situations such as faster diagnosis of bovine tuberculosis (bTB) infection in the abattoirs. We developed a novel multiplex real-time PCR assay which was applied directly to biological samples with evidence of bTB and it was allowed to differentiate between M. bovis and M. tuberculosis. The primers and TaqMan probes were designed to target the IS1081 gene, the multi-copy insertion element in the MTC and the 12.7-kb fragment which presents in M. tuberculosis, not in the M. bovis genome. The assay was optimized and validated by testing 10 species of mycobacteria including M. bovis and M. tuberculosis, and 10 other bacterial species such as Escherichia coli, and cattle lymph nodes (n=113). The tests identified 96.4% (27/28) as M. bovis from the MTC-positive bTB samples using conventional PCR for specific insertion elements IS1081. And MTC-negative bTB samples (n=85) were tested using conventional PCR and the real-time PCR. When comparative analyses were conducted on all bovine samples, using conventional PCR as the gold standard, the relative accuracy of real-time PCR was 99.1%, the relative specificity was 100%, and the agreement quotient (kappa) was 0.976. The detection limits of the real-time PCR assays for M. bovis and M. tuberculosis genomic DNA were 10 fg and 0.1 pg per PCR reaction, respectively. Consequently, this multiplex real-time PCR assay is a useful diagnotic tool for the identification of MTC and differentiation of M. bovis and M. tuberculosis, as well as the epidemiologic surveillance of animals slaughtered in abattoir.

• Childhood Kidney Diseases
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• v.17 no.2
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• pp.149-153
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• 2013

We report the case of a 14-year-old girl, diagnosed with atypical thrombotic microangiopathy (TMA). The patient presented with persistent fever, nausea, and newly developed peripheral edema. Her laboratory findings indicated chronic anemia with no evidence of hemolysis, thrombocytopenia, or elevated serum creatinine level. A few days after hospitalization, acute renal failure and fever worsened, and proteinuria developed. On day 40 of hospitalization, she experienced a generalized tonic seizure for 5 min, accompanied by renal hypertension. Brain magnetic resonance imaging revealed posterior reversible leukoencephalopathy syndrome. After steroid pulse therapy, a renal biopsy was performed because of delayed recovery from thrombocytopenia. The biopsy findings showed features of thrombotic microangiopathic hemolysis with fibrinoid change restricted. Current diagnostic criteria for TMA have focused on thrombotic thrombocytopenic purpura and hemolytic uremic syndrome, and diagnosis is based on the clinical presentation and etiology, with the consequence that idiopathic and atypical forms of TMA can be overlooked. Developing effective tools to diagnose TMA, such as studying levels of ADAMTS13 or testing for abnormalities in the complement system, will be the first step to improving patient outcomes.

• Journal of Sasang Constitutional Medicine
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• v.33 no.2
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• pp.1-13
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• 2021

Introduction The previous study showed that the psychological Sasang Personality Questionnaire (SPQ) and physical Body Mass Index (BMI) were clinically useful for predicting Sasang types diagnosed with certified clinical specialist and QSCCII. The purpose of current study was to examine its clinical usefulness using large sized clinical sample. Methods The age, sex, height, weight, circumference of waist and hip, Sasang Personality Questionnaire (SPQ), and Sasang type of 2,049 participants listed on the Korean Medicine Data Center were acquired. The anthropometrics of BMI, Ponderal Index (PI), Waist-Hip Ratio (WHR), and Basal Metabolic Rate (BMR) were calculated. The discriminant analysis using SPQ subscales, BMI, age and sex were performed to predict Sasang types. And, the ANCOVA with age and sex as covariate was also used to examine differences among diagnosed and predicted Sasang type groups in biopsychological features. Results The discriminant analysis showed 82.0% of percentage correctly predicted. And, the biopsychological characteristics of predicted Sasang type groups were significantly similar to those of diagnosed Sasang type groups. In both predicted and diagnosed Sasang type groups, the anthropometric measures were in increasing order of So-Eum, So-Yang, and Tae-Eum types, and the psychological measures were in increasing order of So-Eum, Tae-Eum, and So-Yang types as shown in previous studies. Discussion and Conclusion The well validated biopsychological variables of SPQ and BMI showed theoretical and clinical usefulness, and were found to be useful for diagnosing Sasang types in clinical setting. The current study might be useful for the East-West integrative medicine and evidence-based teaching.