• Title/Summary/Keyword: Clinical standards

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A Clinical Study for Postoperative Audiogram in Tympanoplasty (술후 청력상에 대한 임상적 고찰)

  • 이성은;오혜경;이경재;박인용;김영명;권영화;서옥기
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.37.1-37
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    • 1981
  • Even through the methods of improving hearing are widely practiced in Korea, with its 30 years of history, there are many different opinions regarding the selection of surgical technique and the materials to be used in tympanoplasty. Also there are varying standards of postoperative evaluations. Therefore, we have done research to evaluate hearing improvement which in one of the objective of the middle ear surgery. The research was conducted for one year, January to December 1980. This research compared the level of hearing improvement after tympanoplasty, according to materials used in tympanoplasty and collumelization. Following are the data we have obtained; 1) Total number of cases we have reviewed were 306. Out of this, 35% of the cases were tympanoplasty type 1, 12.7% of the cases were collumelization with mastoidectomy, and 11.9% of the cases received collumelization without mastoidectomy. 2) We have conducted audiometry on 41.1% of the tympanoplasty type 1, 64.1% of the collumelization with mastoidectomy, and 45.7% of the collumelization without mastoidectomy. 3) We have observed above 11 dB hearing improvement in 70% of the tympanoplasty type 1, 36% of the collumelization with mastoidectomy, and 44% of the collumelization without mastoidectomy. 4) Over 11 dB decrease of air-bone gap in 61% of the tympanoplasty type 1,32% of the collumelization with mastoidectomy, and 63% of the collumelization without mastoidectomy. 5) If we look at the hearing improvement according to the materials used in the tympanoplasty, there was above 11 dB improvement of the air conduction in 63% with cartilage and 54% with fascia. In air-bone gap, 56% with cartilage and 52% with fascia. 6) If we look at the hearing improvement according to the materials used in the collumelization, there was above 11 dB improvement in 50% with cartilage, 14% with homograft, 55% with autograft. In air-bone gap, 56%, 21%, and 55% respectively.

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Blood Pressure Cuff Bladders Tailored For Koreans (한국인 맞춤형 혈압계 커프 블래더)

  • Hwang, Lark Hoon;Park, Woo Sung;Na, Seung Kwon
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.38C no.9
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    • pp.822-829
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    • 2013
  • Hypertension is one of the most common clinical diseases, with an increasing prevalence globally. Hypertension triggers various harmful consequences and affects multiple organs. Life-long care may be required in some cases. According to the Korea Center for Disease Control and Prevention, the prevalence of hypertension is gradually increasing. A 2011 survey revealed that 28.9% of Korean adults had hypertension. The prevalence rates were slightly higher among men than women. Accurate measurement of blood pressure(BP) is crucial to classify patients, to identify BP-related risks, and to inform correct treatment. For accurate blood pressure measurement, the use of a cuff bladder size appropriate for the mid-upper arm circumference(MUAC) is essential. Incorrect sized cuff bladder is one of the main causes of equipment error affecting sphygmomanometer accuracy. When commercial sphygmomanometers were examined, the cuff bladders differed from the dimensions specified in the ISO 81060-1:2007 standards. Undercuffing is responsible for a spurious overestimation of BP in patients with large arms leading to overdiagnosis of hypertension, whereas overcuffing (that is, use of relatively large cuffs with small arms), may be responsible for an opposite problem, leading to erroneous underestimation of BP levels. The cuff bladder sizes recommended by the American Heart Association(AHA) are an arm circumference(AC) of 17-25 cm for small-sized adults, AC of 24-32 cm for adults, AC of 32-42 cm for normal-sized adults, and AC of 42-50 cm for obese adults. In contrast, the AC of Korean adults ranges from 23-31 cm, belonging to a single type of adult bladder. Three types of bladders are necessary for Korean adults with an AC of 23-31cm. Hospitals often use one or two differently-sized Western cuffs for adult patients, which can yield inaccurate BP determinations. Cuff bladders with dimensions based on anthropometric reference data obtained from Koreans will aid hospitals to measure BP more accurately.

Antibiotic Sensitivity Test of Streptococcus pyogenes Obtained in Patients with Streptococcal Infections, 2000 (2000년 A군 연쇄구균 감염자로부터 분리된 균주의 항균제 감수성 검사)

  • Kim, Yeon-Ho;Cha, Sung-Ho;Ma, Sang-Hyuk;Kim, Ki-Sang;Lee, Young-Hee
    • Pediatric Infection and Vaccine
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    • v.9 no.1
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    • pp.79-84
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    • 2002
  • Purpose : About 41% of obtained group A streptococci in the 1998 was reported as erythromycin-resistant streptococci in Seoul, Korea. The most common T serotype was T12, followed by T4 and T28. We'd like to monitor the serological changes and antibiotic sensitivity test of Streptococcus pyogenes obtained from the patients with pharyngotonsillitis and invasive diseases from 1999 through 2001. Also, it could be proposed to choose the proper antibiotic selection in the area where the rate of erythromycin-resistant streptococci is high. Methods : From Jan. 1999 to Oct. 2001, 208 isolates of group A streptococci were collected from inpatients and outpatients with pharyngotonsillitis, scarlet fever, and invasive infections in Seoul and Southern part of peninsula. All isolates were serotyped by T-agglutination, minimum inhibitory concentrations(MICs) which were determined by agar dilution methods, according to the guidelines of the National Committee for Clinical Laboratory Standards (NCCLS). Results : The most common T serotype was T12(29.8%), followed by T1(23.1%), T4 (14.9%). T1 was prominent serotype compared with previous year. T serotyping, among 25 isolates obtained from the patients with scarlet fever in Southern part of peninsula mostly, was T12, T1, and T4 in order of frequency. All the isolates tested were susceptible to penicillin, cefprozil, vancomycin, ceftriaxone, and chloramphenicol. However, 23 isolates(14.2%) was resistant to erythromycin and 18 isolates(11.1%) was resistant to clarithromycin. Serotype T12 was found to be the most resistant serotype to erythromycin and/or clarithromycin. Conclusion : High rate of erythromycin-resistant streptococci which surveyed in 1998 were reduced to 14.2% in this study. We should have to further evaluate the reason of decreased resistant strains and consider the resistant strains of streptococci in choosing the antibiotics. There was no serological characteristics according to the types of disease entities. Between the serologic distributions in Seoul and the Southern part of peninsula area are same, we could presume that the serological typing of strains obtained over the country may be not different.

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Antibiotics Susceptability of Streptococcus pneumoniae Isolated from Pharynx in Healthy Korean Children and Choice of Proper Empirical Oral Antibiotics Using Pharmacokinetics/Pharmacodynamics Model (국내의 소아에서 분리된 폐구균의 항생제 감수성 양상 및 약력동학 모델을 이용한 적절한 항생제의 선택)

  • Paik, Ji Yeun;Choi, Jae Hong;Cho, Eun Young;Oh, Chi Eun;Lee, Jina;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.109-116
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    • 2011
  • Purpose : Pneumococcus is one of the most important causes of invasive infection through the childhood period. In January 2008, the Clinical and Laboratory Standards Institute (CLSI) published revised penicillin breakpoints for Streptococcus pneumoniae and penicillin susceptibility rates of S. pneumoniae increased in Korea. This study was performed to determine the probability of oral amoxicillin for the empirical treatment achieving bactericidal exposure against pneumococcus using pharmacodynamics model. Methods : Twenty-three isolates of pneumococci were subjected to determine minimum inhibitory concentration (MIC) for ${\beta}$-lactams and macrolide. For the ${\beta}$-lactams, exposure of fT >MIC (time that free drug concentrations remain above the MIC) for 50% of the administration interval have determined the probability of target attainment (PTA), and regimens that had a PTA >90% were considered optimal. An analysis was performed by applying MIC of 23 isolates to a 5000-patient Monte Carlo simulation model. Results : Among 23 isolates from healthy children, 7 (30.4%) isolates were MIC ${\leq}$1.0 ${\mu}g$/mL and 19 (82.6%) were MIC ${\leq}$2 ${\mu}g$/mL for amoxicillin. Amoxicillin 40 mg/kg/day achieved PTA >90% at MIC ${\leq}$1.0 ${\mu}g$/mL but PTA decreased to 52% at MIC 2 ${\mu}g$/mL, whereas amoxicillin 90 mg/kg/day can predict 97% of PTA at MIC 2 ${\mu}g$/mL. Overall, oral amoxicillin 90 mg/ kg/day for the empirical treatment against pneumococcus can expect more successful response in Korean children. Conclusion : Considering the resistantce pattern of pneumococci in Korean children, we estimate that oral amoxicillin 90 mg/kg/day will provide a pharmacodynamic advantage for the empirical treatment against pneumococcus. And low dose amoxicillin or macrolide are expected to have higher chance of treatment failure than high dose oral amoxicillin.

The Validation Study of Beck Depression Scale 2 in Korean Version (한국판 벡 우울 척도 2판의 타당화 연구)

  • Lim, Sun-Young;Lee, Eun-Jeong;Jeong, Seong-Won;Kim, Hee-Chul;Jeong, Cheol-Ho;Jeon, Tae-Yeon;Yi, Min-Soo;Kim, Jae-Min;Jo, Hyeon-Ju;Kim, Jeong-Beom
    • Anxiety and mood
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    • v.7 no.1
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    • pp.48-53
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    • 2011
  • Objective : Korean Version of Beck-II Depression Inventory to verify the reliability and validity of the proposed standards are practical and standardized, cut-off score by establishing a baseline indicating the presence of depression and depression On in the evaluation was to evaluate the clinical usefulness. Methods : 739 patients with major depression using the SCID and normal controls were 302 study subjects. Of patients with clinically significant medical condition, or psychotic disorders, organic mental disorder, epilepsy or seizure disorder, eating disorders are associated with patients taking anti-convulsants experienced in the past, patients were excluded from the study. Results : The main findings of this study were as follows. First, with respect to the KBDI-II items, the correlation between them ranged from 0.51 to 0.74, and was 0.60 over all questions. Further, the overall correlation of the KBDI-II plates showing confidence 'normal' than it was verified that. Second, the BDIII was used in each group to examine internal consistency and thus, whether Cronbach's alpha values were greater than 0.94. Third, the principal component analysis sought to extract factors in a way consistent with the results inspected last 3 factors were extracted and the total variance explained was 47.3%. Fourth, the Cutting calculated the score on the KBDI-II for ROC (Receiver operator characteristic) analysis yielding 18 dot, with the highest sensitivity and specificity was seen. Conclusion : Based on the results of this Study, the KBDI-II cut-off point should be valid as prescribed in 18 is considered.

Evaluation of HbA1c Levels Via the Latex Immunoturbidimetric Method by Using Chemistry Autoanalyzer (자동화학분석기에서의 라텍스 면역비탁법의 Autolab HbA1c 평가)

  • Jo, Yongjun;Lee, So-young;Park, Hae-il;Kim, YeongSic;Lee, Jehoon;Kim, Yonggoo;Han, Kyungja
    • Laboratory Medicine Online
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    • v.2 no.1
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    • pp.10-14
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    • 2012
  • Background: Measurement of HbA1c levels is widely used to diagnose diabetes mellitus and to evaluate and monitor plasma-glucose concentrations over 6-8 weeks. In this study, we evaluated the diagnostic performance of the newly developed latex immunoturbidimetric method by using Autolab HbA1c. Methods: We analyzed and compared the diagnostic performance of Autolab HbA1c with that of Toshiba 200FR between April 2009 and July 2009. According to guidelines (EP5-A2, EP6-P, EP9-A2) of the clinical and laboratory standards institute (CLSI), we compared linearity, precision and correlation of Autolab HbA1c with those of G7 (Tosoh Corp., Kyoto, Japan) by using high-performance liquid chromatography (HPLC) method. Results: Data obtained using Autolab HbA1c showed good linearity in mixtures of samples with low (3.1%) and high (15.1%) levels of HbA1c (r2=0.9997). In the analysis of within-run precision of the samples with HbA1c levels of 5.1% and 12.1%, the SDs were 0.04 and 0.06 and covariances of these samples were 0.8% and 0.5%, respectively. In the Deming regression model, the regression equation was as follows: Autolab HbA1c=1.0859×Tosoh HPLC-0.6957. Conclusions: In this study, Autolab HbA1c method showed better performance characteristics than Tosoh G7 did. In reference review, there was no interference of variant hemoglobin. The data acquisition time of Autolab HbA1c was lower than that of Tosoh G7. The advantages of Autolab HbA1c are that it can be used as an autoanlyzer in routine chemical analysis, it does not require pre-analytical treatment, and the samples are automatically treated with distilled water for hemolysis.

In the Treatment I-131, the Significance of the Research that the Patient's Discharge Dose and Treatment Ward can Affect a Patient's Kidney Function on the Significance of Various Factors (I-131 치료시 환자의 신장기능과 다양한 요인으로 의한 퇴원선량 및 치료병실 오염도의 유의성에 관한 연구)

  • Im, Kwang Seok;Choi, Hak Gi;Lee, Gi Hyun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.62-66
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    • 2013
  • Purpose: I-131 is a radioisotope widely used for thyroid gland treatments. The physical half life is 8.01 and characterized by emitting beta and gamma rays which is used in clinical practice for the purpose of acquiring treatment and images. In order to reduce the recurrence rate after surgery in high-risk thyroid cancer patients, the remaining thyroid tissue is either removed or the I-131 is used for treatment during relapse. In cases of using a high dosage of radioactive iodine requiring hospitalization, the patient is administered dosage in the hospital isolation ward over a certain period of time preventing I-131 exposure to others. By checking the radiation amount emitted from patients before discharge, the patients are discharged after checking whether they meet the legal standards (50 uSv/h). After patients are discharged from the hospital, the contamination level is checked in many parts of the ward before the next patients are hospitalized and when necessary, decontamination operations are performed. It is expected that there is exposure to radiation when measuring the ward contamination level and dose check emitted from patients at the time of discharge whereby the radiation exposure by health workers that come from the patients in this process is the main factor. This study analyzed the correlation between discharge dose of patients and ward contamination level through a variety of factors such as renal functions, gender, age, dosage, etc.). Materials and Method: The study was conducted on 151 patients who received high-dosage radioactive iodine treatment at Soon Chun Hyang University Hospital during the period between 8/1/2011~5/31/2012 (Male: Female: 31:120, $47.5{\pm}11.9$, average dosage of $138{\pm}22.4$ mCi). As various factors expected to influence the patient discharge dose & ward contamination such as the beds, floors, bathroom floors, and washbasins, the patient renal function (GFR), age, gender, dosage, and the correlation between the expected Tg & Tg-Tb expected to reflect the remaining tissue in patients were analyzed. Results: In terms of the discharge dose and GFR, a low correlation was shown in the patient discharge dose as the GFR was higher (p < 0.0001). When comparing the group with a dosage of over 150mCi and the group with a lower dosage, the lower dosage group showed a significantly lower discharge dose ($24{\pm}10.4uSv/h$ vs $28.7{\pm}11.8uSv/h$, p<0.05). Age, gender, Tg, Tg-Tb did not show a significant relationship with discharge dose (p> 0.05). The contamination level in each spot of the treatment ward showed no significant relationship with GFR, Tg, Tg-Tb, age, gender, and dosage (p>0.05 ). Conclusion: This study says that discharge of the dose in the patient's body is low in GFR higher and Dosage 150mCi under lower. There was no case of contamination of the treatment ward, depending on the dose and renal association. This suggests that patients' lifestyles or be affected by a variety of other factors.

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