• Korean Journal of Clinical Pharmacy
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• v.28 no.2
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• pp.88-94
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• 2018

Background: We strived to evaluate the status of nivolumab use and associated factors on the clinical efficacy of the drug. Methods: The study was retrospectively conducted in patients who had been administered nivolumab at least once at the cancer center of Seoul National University Hospital from June 2015 to April 2017. Data were collected from electronic medical records. A medication-use evaluation was performed based on the American Society of Health-System Pharmacists mediation-use guidelines. Results: Sixty-six of the 74 patients (89.2%) showed indications approved for nivolumab use by the Korean Ministry of Food and Drug Safety (MFDS; n=55) or the US Food and Drug Administration (FDA; n=11). Approximately 73.0% of the patients were administered the approved dose of 3 mg/kg but 25.7% were administered an unapproved fixed dose of 100 mg. The overall response rate was 21.7%, and the response rate of non-small cell lung cancer patients, who accounted for the largest number of indications, was 18.8%. Adverse reactions were found in 90.1% of the patients and were mostly mild (86%). The expression of programmed death-ligand 1 (PD-L1) was analyzed as a factor affecting treatment response (p=0.028, odds ratio [OR]=11.331). Conclusion: PD-L1 expression was found to affect treatment response. However, caution is required while using an unapproved dosage and in the absence of monitoring for effectiveness and safety. Therefore, an effective protocol or instruction manual for the proper use of nivolumab should be considered.

• Archives of Plastic Surgery
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• v.48 no.3
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• pp.295-304
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• 2021

Clinical photography is an essential component of patient care in plastic surgery. The use of unsecured smartphone cameras, digital cameras, social media, instant messaging, and commercially available cloud-based storage devices threatens patients' data safety. This paper Identifies potential risks of clinical photography and heightens awareness of safe clinical photography. Specifically, we evaluated existing risk-mitigation strategies globally, comparing them to industry standards in similar settings, and formulated a framework for developing a risk-mitigation plan for avoiding data breaches by identifying the safest methods of picture taking, transfer to storage, retrieval, and use, both within and outside the organization. Since threats evolve constantly, the framework must evolve too. Based on a literature search of both PubMed and the web (via Google) with key phrases and child terms (for PubMed), the risks and consequences of data breaches in individual processes in clinical photography are identified. Current clinical-photography practices are described. Lastly, we evaluate current risk mitigation strategies for clinical photography by examining guidelines from professional organizations, governmental agencies, and non-healthcare industries. Combining lessons learned from the steps above into a comprehensive framework that could contribute to national/international guidelines on safe clinical photography, we provide recommendations for best practice guidelines. It is imperative that best practice guidelines for the simple, safe, and secure capture, transfer, storage, and retrieval of clinical photographs be co-developed through cooperative efforts between providers, hospital administrators, clinical informaticians, IT governance structures, and national professional organizations. This would significantly safeguard patient data security and provide the privacy that patients deserve and expect.

• Progress in Medical Physics
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• v.29 no.4
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• pp.115-122
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• 2018

Although the current internationally recommended standard for the use factor (U) applied to CyberKnife is 0.05 (5%), the CyberKnife shielding standard is applied more stringently. This study, based on clinical data, was aimed at examining the appropriateness of existing shielding guidelines. Sixty patients treated with G4 CyberKnife were selected. The patients were divided into two groups, according to whether they underwent skull or spine tracking. Based on the results, the use factors for each wall ranged from 0.028 (2.8%) to 0.031 (3.1%) for the intracranial treatment and 0.020 (2.0%) to 0.022 (2.2%) for the body treatment. Excessive barrier thickness resulted in inefficient use of space and higher cost to the institutions. Furthermore, because the use factor is influenced by the position of the robot, the use factor determined based on the clinical data of this study would facilitate more reasonable treatment room design.

• The Journal of Korean Medicine
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• v.21 no.4
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• pp.3-8
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• 2000

Xiexiafa is the one of eight methodes of treatment, the purgatives of oriental medicine was originated from Shanghanlun written by Zhangzhongjing. Traditionally Xiexiafa has been used to treat constipation. But All kinds of researches on Xiexiafa made purgatives possible to use variously for the disease of internal medicine. In the research on clinical use of Xiexiafa, the results were as follow. Xiexiafa is available on emergency medicine because of instant relief. It has an ability of preventive medicine and economical effect. It was considered to treat hard to cure and chronic diseases made by Sushi, Rexie, Shuijie, Tanzhi, Xuxie etc. Considering strong side effects of Xiexiafa and patient conditions, it must be used carefully.

• Journal of Korean Clinical Nursing Research
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• v.21 no.3
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• pp.377-388
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• 2015

Purpose: To identify user requirements for electronic nursing record (ENR) systems so as to ensure system usability. Methods: A mixed methods approach were applied in three steps : (i) task and workflow analysis with literature review of nursing documentation, (ii) literature reviews of system usability, and (iii) Use Case idenfication and consensus-based validation. We analyzed the nursing activity logs collected from a time-motion investigation of six hospitals. The Use Cases were validated by eight clinical experts from different hospitals and two experts from academia in a sequential Delphi survey. Consensus was achieved for the significance score and agreement among the panel. Results: Eight task groups and patterns of task flow were observed, which were translated into nine Use Cases. The specification of Use Cases was derived from principles, guidelines, and recommendations on nursing documentation and electronic health record systems, which was organized into three requirements of each Use Case: functionality, information, and design characteristics. Each Use Case achieved an agreement of 50~70%, and significance scores of 4 or 5 on a 5-point Likert scale. Conclusion: The nine Use Case identified were considered to be important and adequate in terms of both clinical and informatics contexts.

• Korean Journal of Clinical Pharmacy
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• v.24 no.1
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• pp.9-14
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• 2014

Background: It is known to reduce the mortality when glutamine is supplied to patients during the surgery or in intensive care unit through intravenous nutrition supply. The purpose of this study is to establish the appropriate basis for use of glutamine and guidelines of nutrition supply for critically ill patients in the hospital by examining the clinical effects of administration of glutamine with subjects of elderly critically ill patients receiving intravenous nutrition in one hospital in Korea. Method: Among elderly patients with age of 60 or more hospitalized in Yeuido St. Mary's Hospital from August 2012 to July 2013, those who stayed in the intensive care unit for more than a week and received TPN (Total Parenteral Nutrition) for more than 3 days during staying in the intensive care unit were classified to a test group using glutamine and a control group without glutamine. Duration of use of mechanical ventilator, duration of hospitalization, occurrence of infectious disease and death were compared between two groups. We would like to identify the clinical test figures affected by the use of glutamine by examining changes in SCr, Total Protein, Albumin, AST, ALT, TB, DB and GFR at the time of admission and discharge. Results: At the time of admission to intensive care unit, gender, physical measurement information and clinical test figures did not show any significant difference between 72 subjects in a test group and 24 subjects in a control group. Thus, two groups began in the same condition. There were no significant difference in duration of hospitalization, duration of intensive care unit, use of mechanical ventilator, occurrence of infectious disease and death. As the results of statistical analysis of the average changes of clinical test figures at the time of admission and discharge of intensive care unit, SCr and GFR were significantly changed in the test group. GFR was significantly changed in a control group. As the result of analysis of the clinical test figures at the time of discharge with reflection of average changes after clinical test figures were corrected at the time of admission of intensive care unit, TB and GFR were significantly increased in a test group compared with those in a control group. Other clinical test figures were not significantly changed. Conclusion: If glutamine is administered to critically ill patients over age 60 receiving TPN and careful monitoring for total bilirubin is made in the future, it is expected to give the positive effect on renal function andminimize the side effect of arise in total bilirubin.

• Journal of Korean Clinical Nursing Research
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• v.17 no.1
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• pp.101-112
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• 2011

Purpose: The purpose of this study is to develop a detailed clinical model for recording initial nursing assessment items, and to test the applicability of the model to facilitate semantic interoperability for sharing and exchanging nursing information. Methods: First, the researchers extracted items by analyzing initial nursing assessment records. Second, defining characteristics were identified by analyzing nursing records and reviewing the literature. Third, value sets for defining characteristics were identified and types and cardinalities of defining characteristics were defined based on the value sets. Finally, the detailed clinical model was tested through evaluation by experts and comparison with the initial nursing assessment in a clinical setting. Results: Sixty-one detailed clinical models were developed with 178 defining characteristics and value sets. The experts evaluation and comparison with the initial nursing assessment in a clinical setting showed that the detailed clinical model developed in this study was valid. Conclusion: Use of this detailed clinical model can ensure that the Electronic Health Record contains meaningful and valid information and supports semantic interoperability of nursing information. This use will promote quality in the nursing records and eventually quality of nursing care.

• Korean Journal of Radiology
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• v.21 no.1
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• pp.42-57
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• 2020

Appropriate use and analysis of neuroimaging techniques is an inevitable aspect of clinical trials for patients with acute ischemic stroke. Neuroimaging examinations were recently used to define the core eligibility criteria and outcomes in acute ischemic stroke research. Recent clinical trials for endovascular treatment in acute ischemic stroke have also demonstrated the efficacy or safety of endovascular treatment using various imaging modalities as well as clinical indices. Furthermore, independent imaging reviews and imaging core laboratory assessments are essential to manage and analyze imaging data in order to enhance the reliability of the outcomes. Therefore, we systematically reviewed the use of neuroimaging in recent randomized clinical trials for endovascular treatment of acute ischemic stroke in order to provide a thorough summary, which would serve as a resource guiding the use of appropriate imaging protocols and analyses in future clinical trials for acute ischemic stroke. This review will help researchers select appropriate imaging biomarkers among the various imaging protocols available and apply the selected type of imaging examination for each study in accordance with the academic purpose.

• Journal of Korean Medicine Rehabilitation
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• v.28 no.1
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• pp.33-51
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• 2018

Objectives The purpose of this study is to analyze the current status of measurement instruments used to evaluate pain and function for shoulder disease patients in Korean Medicine clinical studies published in South Korea. Methods 5 Korean online databases from January 2007 to July 2017 were used to source articles for the review. Data of pain and function assessment instruments, measurement methods, time point and frequency for shoulder assessment were extracted. And it was analyzed by investigating the frequency of use for each item. Results A total of 78 studies met the selection criteria. There were many studies with no description for pain assessment instruments or inconsistent measurement methods. In the function assessment, the frequency of use was low and there were a lot of use of instruments with low validity and reliability. Conclusions To develop the objectivity of clinical research, further clinical studies, active use of measurement instruments, and standardization of measurement methods are needed.

• The Journal of Korean Academic Society of Nursing Education
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• v.26 no.3
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• pp.299-310
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• 2020

Purpose: This study is a content analysis to understand the nursing informatics competence of clinical nurses. Methods: Focus group interviews were used to collect data. Two focus group interviews were held with a total of nine clinical nurses. All interviews were recorded and transcribed. Content analysis was used to analyze data. Results: The five main categories of nursing informatics competence that emerged are 1) software program use, 2) use of nursing information, 3) use of information communication technology in nursing, 4) professional responsibilities and ethics, and 5) active attitudes and recognition. Next, there are three strategies to improve nursing informatics competence: 1) organizational approach, 2) opportunity of continuous education, 3) presentation of standards in nursing informatics competence. Conclusion: Further studies such as educational program development and evaluation tool development are necessary. Moreover, there is a need to enhance clinical nurses' nursing informatics competence by using the proposed strategies.