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The Etiologic Agents and Clinical Outcomes of Adult Community-acquired Pneumonia in Jeju (제주지역 성인 지역사회획득 폐렴의 원인균 및 임상양상)

  • Jeon, Bong-Hee;Kim, Miok;Kim, Jeong Hong;Shin, Sang Yop;Lee, Jaechun
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.5
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    • pp.358-364
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    • 2009
  • Background: The appropriate empirical antimicrobial choice in the treatment of community-acquired pneumonia (CAP) should be advocated by community-based information on the etiologic pathogens, their susceptibility to antimicrobials, clinical characteristics and outcomes. Jeju is a geographically isolated and identical region in Korea. However, there is no regional reference on adult CAP available. This study investigated the etiologic agents and clinical outcomes of adult patients diagnosed with CAP in Jeju, Korea, to help guide the empirical antimicrobial choice. Methods: A prospective observational study for one year in a referral hospital in Jeju, Korea. Patients diagnosed with CAP were enrolled with their clinical characteristics. Microbiological evaluations to identify the etiologic agents in the adult patients with CAP were performed with blood culture, expectorated sputum smear and culture, antibody tests for mycoplasma, chlamydophila, and antigen tests for legionella and pneumococcus. The clinical outcomes of the initial empirical treatment were analyzed. Results: Two hundred and three patients with mean age of 64 and 79 females were enrolled. Ten microbials from 90 cases (44.3%) were isolated and multiple isolates were confirmed in 30. Among the microbial isolates, S. pneumoniae (36.3%) was the most common, followed by M. pneumoniae (23.0%), C. pneumoniae (17.0%), S. aureus (9.6%) and P. aeruginosa (5.9%). The initial treatment failure (23.8%) was related to the isolation of polymicrobial pathogens, elevated inflammatory markers, and the presence of pleural effusion. Among the 30 isolates of S. pneumoniae, 16 (53.3%) were not susceptible to penicillin, and 19 isolates (63.3%) to erythromycin and clarithromycin. However, 29 isolates (96.7%) were susceptible to levofloxacin and ceftriaxone. Conclusion: S. pneumoniae, M. pneumoniae, S. aureus, and P. aeruginosa are frequent etiologic agents of adult CAP in Jeju, Korea. The clinical characteristics and antibiotic resistance should be considered when determining the initial empirical antimicrobial choice. Respiratory quinolone or ceftriaxone is recommended as an empirical antimicrobiotic in the treatment of adult CAP in Jeju, Korea.

A Study on the State of Health Functional Foods & Herbal Medicine Consumed by Elementary School Students (초등학생의 건강기능식품 및 한약 복용 실태에 대한 연구)

  • Kim, Mi-Ki;Jung, Ji-Ho;Ahn, Jae-Sun;Yim, Jung-Hoon;An, Min-Seop;Park, Jin-Su;Lee, Hai-Ja;Park, Eun-Jung
    • The Journal of Pediatrics of Korean Medicine
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    • v.23 no.3
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    • pp.143-153
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    • 2009
  • Objectives The purpose of this study is to get the basic information from patients how much they understood about their medication and also to know whether patients are making reasonable drug choice between Health Functional Foods and Herbal medicine. Methods 500 questionnaires were handed out to the parents of students in two elementary schools located in OO, Junlabukdo province. 421 questionnaires were completed to be evaluated. Results Among 421 subjects, 53.0% were female, and 47.0% were male. The percentages of the subjects consuming Health Functional Foods and herbal medicine were67.7% and 67.8%, respectively. Among those people who consumed Health Functional Food, 44.1% were using nutritional supplements, red ginseng or ginseng products (26.9%), chlorella products (11.5%), and plum extract products (7.7%). As for the reason to consume Health Functional Foods were varied, but 'in order to be healthy, although currently displaying no illness.'(43.0%) were the most responses among the given choices. On the other hand, the reason for consuming herbal medicine was 'In order to grow taller'(26.1%), 'In order to cure weak physical state frequently displaying common illnesses',(25.9%), and 'In order to cure diseases.'(23.3%). For the questions about effectiveness after consumption,the 69.9% subjects said that it seemed to be effected, and that % was slightly higher than that of subjects with consuming Health Functional Foods(64.4%). For question concerning preferences between Health Functional Foods and herbal medicine, 57.5% chose herbal medicine, and this percentage was higher than that of Health Functional Foods(42.5%).As for the reasons of additional consumption of the Health Functional Foods, subject answered as 'Easy to consume.'(41,6%), which was the most common among the subjects consuming Health Functional Foods. On other hand, the subjects of herbal medicine answered as that herbal medicine is 'more effective'(45.7%), and 'more trustworthy in preventing side-effects.'(40.3%). After consumption of the herbal medication, only 3.9% of the subjects consuming either Health Functional Foods or herbal medicine had side-effects. The most common side-effects were 'dermal reaction' which is normally caused by Health Functional Foods and 'indigestion' problems caused by herbal consumption. Conclusions According to the 421 subjects those involved in study, the percentages of consuming Health Functional Foods(67.7%) and herbal medicine(67.8%) were similar. The most commonly consumed products were a type of Health Functional Foods which were the nutrition-supplying products. Ginseng or red ginseng products were the next commonly used products. Health Functional Foods were commonly consumed for preventing illness and maintaining health rather than any other purpose. In contrary, herbal medicines were more commonly consumed for purposes such as for growth or treating certain type of disease. As a result of consumption, more than half of both subject replied as 'satisfied'. As for the side effects, dermal reaction was the most common problem for those with consuming Health Functional Foods, while indigestion was the most common side effect from the subjects with consuming herbal medicine.

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Review of Anti-Leukemia Effects from Medicinal Plants (항 백혈병작용에 관련된 천연물의 자료조사)

  • Pae Hyun Ock;Lim Chang Kyung;Jang Seon Il;Han Dong Min;An Won Gun;Yoon Yoo Sik;Chon Byung Hun;Kim Won Sin;Yun Young Gab
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.3
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    • pp.605-610
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    • 2003
  • According to the Leukemia and Lymphoma Society, leukemia is a malignant disease (cancer) that originates in a cell in the marrow. It is characterized by the uncontrolled growth of developing marrow cells. There are two major classifications of leukemia: myelogenous or lymphocytic, which can each be acute or chronic. The terms myelogenous or lymphocytic denote the cell type involved. Thus, four major types of leukemia are: acute or chronic myelogenous leukemia and acute or chronic lymphocytic leukemia. Leukemia, lymphoma and myeloma are considered to be related cancers because they involve the uncontrolled growth of cells with similar functions and origins. The diseases result from an acquired (not inherited) genetic injury to the DNA of a single cell, which becomes abnormal (malignant) and multiplies continuously. In the United States, about 2,000 children and 27,000 adults are diagnosed each year with leukemia. Treatment for cancer may include one or more of the following: chemotherapy, radiation therapy, biological therapy, surgery and bone marrow transplantation. The most effective treatment for leukemia is chemotherapy, which may involve one or a combination of anticancer drugs that destroy cancer cells. Specific types of leukemia are sometimes treated with radiation therapy or biological therapy. Common side effects of most chemotherapy drugs include hair loss, nausea and vomiting, decreased blood counts and infections. Each type of leukemia is sensitive to different combinations of chemotherapy. Medications and length of treatment vary from person to person. Treatment time is usually from one to two years. During this time, your care is managed on an outpatient basis at M. D. Anderson Cancer Center or through your local doctor. Once your protocol is determined, you will receive more specific information about the drug(s) that Will be used to treat your leukemia. There are many factors that will determine the course of treatment, including age, general health, the specific type of leukemia, and also whether there has been previous treatment. there is considerable interest among basic and clinical researchers in novel drugs with activity against leukemia. the vast history of experience of traditional oriental medicine with medicinal plants may facilitate the identification of novel anti leukemic compounds. In the present investigation, we studied 31 kinds of anti leukemic medicinal plants, which its pharmacological action was already reported through many experimental articles and oriental medical book: 『pharmacological action and application of anticancer traditional chinese medicine』 In summary: Used leukemia cellline are HL60, HL-60, Jurkat, Molt-4 of human, and P388, L-1210, L615, L-210, EL-4 of mouse. 31 kinds of anti leukemic medicinal plants are Panax ginseng C.A Mey; Polygonum cuspidatum Sieb. et Zucc; Daphne genkwa Sieb. et Zucc; Aloe ferox Mill; Phorboc diester; Tripterygium wilfordii Hook .f.; Lycoris radiata (L Her)Herb; Atractylodes macrocephala Koidz; Lilium brownii F.E. Brown Var; Paeonia suffruticosa Andr.; Angelica sinensis (Oliv.) Diels; Asparagus cochinensis (Lour. )Merr; Isatis tinctoria L.; Leonurus heterophyllus Sweet; Phytolacca acinosa Roxb.; Trichosanthes kirilowii Maxim; Dioscorea opposita Thumb; Schisandra chinensis (Rurcz. )Baill.; Auium Sativum L; Isatis tinctoria, L; Ligustisum Chvanxiong Hort; Glycyrrhiza uralensis Fisch; Euphorbia Kansui Liou; Polygala tenuifolia Willd; Evodia rutaecarpa (Juss.) Benth; Chelidonium majus L; Rumax madaeo Mak; Sophora Subprostmousea Chunet T.ehen; Strychnos mux-vomical; Acanthopanax senticosus (Rupr.et Maxim.)Harms; Rubia cordifolia L. Anti leukemic compounds, which were isolated from medicinal plants are ginsenoside Ro, ginsenoside Rh2, Emodin, Yuanhuacine, Aleemodin, phorbocdiester, Triptolide, Homolycorine, Atractylol, Colchicnamile, Paeonol, Aspargus polysaccharide A.B.C.D, Indirubin, Leonunrine, Acinosohic acid, Trichosanthin, Ge 132, Schizandrin, allicin, Indirubin, cmdiumlactone chuanxiongol, 18A glycyrrhetic acid, Kansuiphorin A 13 oxyingenol Kansuiphorin B. These investigation suggest that it may be very useful for developing more effective anti leukemic new dregs from medicinal plants.

Safety and Reactogenicity of the Inactivated Poliomyelitis Vaccine (PoliorixTM) in Korea (2006-2012) (우리나라 영아에서 주사용 소아마비 백신(PoliorixTM)의 안전성 및 이상반응에 대한 연구)

  • Sin, Jong Beom;Park, Moon Sung;Ma, Sang Hyuk;Choi, Young Youn;Shin, Son Moon;Kim, Won Duck;Kuriyakose, Sherine;Ulianov, Liliana;Hardt, Karin
    • Pediatric Infection and Vaccine
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    • v.20 no.3
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    • pp.139-146
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    • 2013
  • Objective: As per the requirement of Korean Food and Drug Administration, this post-marketing surveillance was conducted in Korea to evaluate the safety and reactogenicity of Poliorix$^{TM}$ following its introduction in 2006. Methods: In this open, multicenter study, the vaccine was administered as per the current practice of Korean doctors and in reference to the guidebook by the Korean Pediatric Society and as indicated in the Korean label which was as follows - for primary vaccination three doses were given to infants at ages 2, 4 and 6 months whereas, for the booster dose a single dose was given to children aged 4-6 years. Safety data during this six year surveillance was collected using diary cards which were distributed to the parents to record adverse events. Results: A total of 639 subjects were enrolled into the study. Of these, 617 subjects and 22 subjects received the vaccine as a primary and booster dose, respectively. At least one unsolicited symptom was reported in 11.4% (73/639) of the subjects during the 7-day follow-up period; upper respiratory tract infection (2.5%;16/639) was the most frequently reported unsolicited symptom. One subject reported at least one unsolicited symptom (gastroenteritis) of grade 3 intensity within the 31-day post-vaccination period. Approximately 1.7% (11/639) of subjects reported 13 serious adverse events (SAEs). All SAEs were resolved by the end of the study. Conclusion: In Korea, primary and booster vaccination with Poliorix$^{TM}$ was well-tolerated in healthy subjects when administered according to the prescribing information as part of routine clinical practice.

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A Study on the Status of Seeking Intervention among the Workers with Health Problems Identified by the Workers' Periodic Health Examination (특수건강진단에서 발견된 고혈압 및 간질환 유소견자의 건강관리 실태에 관한 조사)

  • Cheong, Hae-Kwan;Kim, Joung-Soon;Moon, Ok-Ryun;Lim, Hyun-Sul
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.4 s.40
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    • pp.343-356
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    • 1992
  • Authors studied the workers' knowledge about the health problems detected through the previous workers' periodic health examination, content of follow-up management ana actions taken for their health problem detected on previous health examination. From June to September 1992, workers' periodic health examination was peformed on workers employed in 10 companies located in 2 middle-sized Korean cities. A questionnaire survey was done far 150 workers who reported to have $D_2$ result of either hypertension or liver disorder at the previous workers' periodic health examination done in 1991. The results are as follows; 1. Of 160 workers who had $D_2$ result of either hypertension or liver disorder in previous examination one year before, only 85 workers(51.3%, 43 workers with hypertension, 38 workers with live disorder) responded that they have such disorders. The other 65 workers responded to questionnaire were all those with C results. Respondents' knowledge about their diagnoses was relatively precise (95.2% in hypertension group, 94.6% in liver disorder group) but knowledge about classification of diseases was poor. 2. The main efforts to solve the health problem nab self management (20 spells, 55.3%), visiting clinic or hospital(6 spells, 12.8%), use of herb medicine (2 spells, 4.3%) and use of drug store(2 spells, 4.3%) in hypertension group. In liver disorder group, 30 spells (71.4%) relied on self management,6 spells (14.3%) on hospital or clinic and 9 spells (21.4%) had no effort to improve the health problem. Content of self management was low salt diet, quit smoking, regular exercise and quit alcohol drinking in order. Avoidance of salt in diet was high in hypertension group and quitting alcohol drinking was high in liver disorder group. In those with self management, 80.7% of hypertension group and 83.3% of liver disorder group continued previous effort. Those, however, who utilized clinic or hospital, only 16.7% and 50.0% were still visiting hospital or clinic. 3. Fifty seven percent of hypertension group and 64.3% of liver disorder group was presently smoking,8.5% and 11.9% reduced smoking and 21.3% and 14.3% stopped smoking. Forty nine percent of hypertension group and 28.6% of liver disorder group was presently drinking. Reduced alcohol intake was reported in 29.8% and 40.5%, 12.8ole and 23.8% stopped alcohol drinking. Sixty six percent of hypertension group and 73.8% of liver disorder group did no regular exercise, but 12.8% and 11.9% of each group increased their physical exercise far last one year. Forty three percent of hypertension group and 38.l% of liver disorder group was overweight (defined by bodymass index greater or equal than 25). Reduced body Weight was reported in 17.2% and 16.7% of each group. Reduced dietary salt intake was high in hypertension group (51.5%). The study results suggest that follow-up management after workers' periodic health examination is not satisfactory. In order to improve this situation, adequate information on the result of the workers' periodic health examination should be distributed to each worker group with health education and counselling.

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A Study on the Guideline Amounts of Sugar, Sodium and Fats in Processed Foods Met to Children's Taste (어린이 기호식품의 당, 나트륨 및 지방류의 영양기준안 설정에 관한 연구)

  • Choi, Young-Sun;Chang, Nam-Soo;Joung, Hyo-Jee;Cho, Sung-Hee;Park, Hye-Kyung
    • Journal of Nutrition and Health
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    • v.41 no.6
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    • pp.561-572
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    • 2008
  • Currently, Korea is facing dramatic nutrition transition among children, which may increase risk of degenerative diseases due to excessive intakes of fats, sugars and sodium. Promotion of eating healthier foods among children is difficult because the present nutrition label is not easily understood. Therefore, to promote healthier foods this study was aimed at developing guidance of standard amounts of high, medium and low levels of sugars, sodium, fats and other components contained in foods or drinks that are promoted to or formulated for consumption by children. Multipronged approach was used to collecting information, including key word searches in Medline and other databases, internet searches, reports from world organization, and contact of key individuals who work in organizations. We reviewed dietary reference intakes for Koreans, nutrient reference values, nutrient content claims of nutrition labeling, guideline daily amounts of United Kingdom, dietary guidelines and consumption data of nutrients, and selected components for labeling. And we decided goals of guideline daily amounts for children and nutrient criteria to underpin the high, medium and low content of each component. Then we collected data on processed foods sold at 12 middle schools and 11 high schools in Seoul, and classified processed foods into food category. Sales per one student per day were in the order of snacks, breads, and non-carbonated drinks. One hundred forty five mostly consumed products were selected and classified into criteria of high, medium and low total fat or sodium. Eighty five(58.6%) were classified into high fat food and only 11(7.6%) into high sodium food, in case that the base is chosen per 100 g or 100 mL. In conclusion, the nutrient criteria and choice of 100 g base, which we suggest in this study, need to be tested by simulation with more processed foods and refined in view of the practical issues suggested by stakeholders in future.

A Statistical Study on the Key Words in the Titles of Nursing Related Theses (학위논문의 주요어 분석 (간호학 및 간호학관련 학위논문을 중심으로 : 1960-1991. 8))

  • 고옥자;김상혜;김희걸;이금재;이영숙
    • Journal of Korean Academy of Nursing
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    • v.24 no.1
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    • pp.58-69
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    • 1994
  • In order to see the development of Nursing related research activities in Korea over the last three decades, abstracts of almost all of the Master and Ph.D theses that appeared from 1961 up to August 1991 were collected. The number of theses was 2354, from which an index of key words has been constructed. Key words were defined as those terms in each thesis title that convey major objectives of the given thesis study and the important nursing concepts dealt with in the thesis. Although all the key words were picked from the thesis title only, full use was made of the abstracts in deciding the principal objectives and essential contents of the thesis studies and their important concepts as well. In total, 539 kinds of key words were identified from the 2354 titles, and the identified words were all found to be in the International Nursing Index. On an average each title has two key words. Which key words were most frequently used, how they have changed with time, what kind of concept is preferably dealt with by each graduate school, and the concepts to which a given key word is likely to be connected were examined. The results are summerized below : 1) For each decade the theses numbers were as follows : 54(2.3%) from the 60’s, 413(17.5%) from the 70’s, 1523(64.7%) from the 80’s, and 364(15.5%) from the 90’s. Master’s thesis contributed 96% (2252) of the papers and Ph. D’s theses filled the remaining 4%(102). 2) A total of 539 key words were used, averaging about 2 for each thesis. The most frequently used key words were ‘Nurse’, ‘Anxiety’, ‘Knowledge / Attitude /Practice’, ‘Stress /Stressor’, ‘Attitude’, ‘Job-Satisfaction’, ‘Mental Disorder’, ‘Operation’, ‘Elderly’, ‘Nursing Role’. 3) Each decades key words can be classified as : the 60’s : ‘Nursing Education’, ‘Pulmonary Tuberculosis’, ‘Mother-Child Health’, ‘Growth & Development’, ‘Public Facilities’, ‘Mental Disorder’ : the 70’s : ‘Nurse’, ‘Family Planning’, ‘Attitude’ / ‘Knowledge, Attitude / Practice’, ‘Curriculum in Nursing Education’, ‘Clinical Practice in Nursing’, ‘Analysis of the Work of the Nurse’, ‘Health Education of School’, : the 80’s : ‘Nurse’, ‘Anxiety’, ‘Stress /Stressor’, ‘Operation’, ‘Nursing Role’, ‘Job Satisfaction’ : the 90’s : ‘Nurse’, ‘Elderly’, ‘Family-Support’, ‘Stress /Stressor’, ‘Home Care’. Key word ‘Nurse’ appears continuously and most frequently through the years, which indicates that there has been active study of the characteristics of nurses and related fields. The concept ‘Anxiety’ has been studied steadly from the 80’s and it shows that interest in health and disease are increasing Which comes as a result of society changing to an industrial and informational community. 4) Looking into each graduate school’s study area key words ‘Anxiety’, ‘Nurse’, ‘Mental Disorder’, ‘Stress /Stressor’, ‘Operation’, ‘Attitude’, ‘Hemo-dialysis’, were studied in the regular graduate school : ‘Family Planning /Contraception’, ‘Knowledge / Attitude /Practice’, ‘Physical Health-State /Physical Health Examination’, ‘Nurse’, ‘Using Clinical Facilities’, ‘Health Education of School’, were studied in the Graduate School of Public Health’ ; ‘Nurse’, ‘Anxiety’, ‘Stress / Stressor’, ‘Job-Satisfaction’, ‘Clinical Practice Education’, ‘Nursing Education’, were studied in the Graduate School of Education : ‘Nurse’, ‘Job Satisfaction’, ‘Nursing Role’, ‘Administration - Employment /Employment Management’, ‘Leadership’, ‘Personnel Profile’, ‘Nursing Manpower / Changing Working Place’, were studied in the Graduate School of Public Administration. 5) The Connection between key words were : ‘Nurse Job Satisfaction’, ‘Stress / Stressor ⇔ Coping / Ajustment’, ‘Nurse ⇔ Nursing Role’, ‘Anxiety ⇔ Giving Information’, ‘Nurse ⇔ Stress / Stressor’, ‘Anxiety ⇔ Operation’, ‘Nurse ⇔ Burnout’, ‘Knowledge, Attitude, Practice ⇔ Family Planning’, ‘Nurse Administration ⇔ Employment’, ‘Anxiety Muscle ⇔ Relaxation Technic’, ‘Anxiety ⇔ Mental Disorder’. From the above it can be noted that many nursing concepts were handled in the thesis titles. But there were more than enough papers on the characteristics of the nurse. It is suggested that in depth research be made on ‘Nursing Accidents’, t-‘Ethics’, ‘Nurse - Patient Interactions’, ‘Spritual Care’, ‘Dying’, ‘Hospice’, ‘Resident Helper’ and that there should be in depth research relating to the physical and mental development of youth and in particular physical concepts like ‘Drug - Abuse’, ‘Child -Abuse and Teaching’.

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Anti-Inflammatory Effect of Ethanolic Extract from Polyopes affinis through Suppression of NF-κB and MAPK Activation in LPS-Stimulated RAW 264.7 Cells (LPS로 자극된 대식세포에서의 NF-κB와 MAPK 활성 조절을 통한 참까막살(Polyopes affinis) 에탄올 추출물의 항염증 효과)

  • Kim, Min-Ji;Kim, Koth-Bong-Woo-Ri;Park, Sun-Hee;Park, So-Young;Choi, Hyeun-Deok;Choi, Jung-Su;Jang, Mi-Ran;Im, Moo-Hyeog;Ahn, Dong-Hyun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.5
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    • pp.537-544
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    • 2017
  • In this study, the anti-inflammatory effect of Polyopes affinis ethanol extract (PAEE) was investigated using LPS-stimulated RAW 264.7 cells and a croton oil-induced ICR mice model. Treatment with PAEE significantly reduced production of nitric oxide (NO) and pro-inflammatory cytokines [interleukin (IL)-6, tumor necrosis factor $(TNF)-{\alpha}$, and $IL-1{\beta}$] in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells. PAEE treatment also reduced expression of inducible NO synthase, cyclooxygenase-2, nuclear $factor-{\kappa}B$, and mitogen-activated protein kinases in LPS-stimulated RAW 264.7 cells. In the croton oil-induced ear edema test, application of PAEE (10~250 mg/kg body weight) reduced ear edema in a dose-dependent manner, and PAEE treatment at 50 mg/kg body weight showed similar inhibitory effects compared with prednisolone (10 mg/kg body weight). Histological analysis revealed reduced dermal thickness and lower number of infiltrated mast cells. These results suggest that PAEE might be used as a promising anti-inflammatory agent for inhibition of LPS-induced inflammation and ear edema formation.

A Study on Establishing a Standardized Process for the Development and Management of Food Safety Health Indicators in Korea (우리나라 식품안전보건지표의 개발 및 운용과정 정립에 대한 연구)

  • Byun, Garam;Choi, Giehae;Lee, Jong-Tae
    • Journal of Food Hygiene and Safety
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    • v.30 no.3
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    • pp.217-226
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    • 2015
  • This study was conducted to establish a standardized process for developing food safety health indicators. With this aim, we proposed a standardized process, accessed the validity of the suggested process by performing simulations, and provided a method to utilize the indicators. Developing process for domestic environmental health indicators was benchmarked to propose a standardized process for developing food safety health indicators, and DPSEEA framework was applied to the development of indicators. The suggested standardized process consists of an exploitation stage and a management stage. In the exploitation stage, a total of 6 procedures (initial indicators suggestion, candidate indicators selection, data availability assessment, feasibility assessment, pilot study, and final indicator selection) are conducted, and the indicators are routinely calculated and officially announced in the management stage. The exploitation stage is operated by an interaction between a task force team who manages the overall process, and an advisory committee (minimum of 4 in academia, 2 in research, 4 in specialists of Ministry of Food and Drug Safety) who reviews and performs evaluations on the indicators. The standardized process was simulated with 45 initial indicators, and total of 4 indicators (17 detailed indicators) were selected: 'Proportion of domestic fruit/vegetable receiving 'acceptable' in the evaluation of pesticide/herbicide residues', 'Food-borne disease outbreaks', 'Food-borne legal infectious disease incidence', 'Salmonellosis incidence'. Synthetic food safety health index was derived by calculating percent difference with the data from 2010 to 2012. Results showed that when comparing the year 2010 to 2011, and 2011 to 2012, the overall food safety status improved by 10.37% and 9.87%, respectively. In addition, the contribution of indicators to the overall food safety status can be determined by looking into the individual indicators, and the synthetic index may be illustrated to enhance the ease of interpretation to the public and policy makers. In overall, food health safety indicators can be useful in many ways and therefore, attention should be drawn to conduct further studies and establish related legislations.

Quality of Anticoagulation and Treatment Satisfaction in Patients with Non-Valvular Atrial Fibrillation Treated with Vitamin K Antagonist: Result from the KORean Atrial Fibrillation Investigation II

  • Oh, Seil;Kim, June-Soo;Oh, Yong-Seog;Shin, Dong-Gu;Pak, Hui-Nam;Hwang, Gyo-Seung;Choi, Kee-Joon;Kim, Jin-Bae;Lee, Man-Young;Park, Hyung-Wook;Kim, Dae-Kyeong;Jin, Eun-Sun;Park, Jaeseok;Oh, Il-Young;Shin, Dae-Hee;Park, Hyoung-Seob;Kim, Jun Hyung;Kim, Nam-Ho;Ahn, Min-Soo;Seo, Bo-Jeong;Kim, Young-Joo;Kang, Seongsik;Lee, Juneyoung;Kim, Young-Hoon
    • Journal of Korean Medical Science
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    • v.33 no.49
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    • pp.323.1-323.12
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    • 2018
  • Background: Vitamin K antagonist (VKA) to prevent thromboembolism in non-valvular atrial fibrillation (NVAF) patients has limitations such as drug interaction. This study investigated the clinical characteristics of Korean patients treated with VKA for stroke prevention and assessed quality of VKA therapy and treatment satisfaction. Methods: We conducted a multicenter, prospective, non-interventional study. Patients with $CHADS_2{\geq}1$ and treated with VKA (started within the last 3 months) were enrolled from April 2013 to March 2014. Demographic and clinical features including risk factors of stroke and VKA treatment information was collected at baseline. Treatment patterns and international normalized ratio (INR) level were evaluated during follow-up. Time in therapeutic range (TTR) > 60% indicated well-controlled INR. Treatment satisfaction on the VKA use was measured by Treatment Satisfaction Questionnaire for Medication (TSQM) after 3 months of follow-up. Results: A total of 877 patients (age, 67; male, 60%) were enrolled and followed up for one year. More than half of patients (56%) had $CHADS_2{\geq}2$ and 83.6% had $CHA_2DS_2-VASc{\geq}2$. A total of 852 patients had one or more INR measurement during their follow-up period. Among those patients, 25.5% discontinued VKA treatment during follow-up. Of all patients, 626 patients (73%) had poor-controlled INR (TTR < 60%) measure. Patients' treatment satisfaction measured with TSQM was 55.6 in global satisfaction domain. Conclusion: INR was poorly controlled in Korean NVAF patients treated with VKA. VKA users also showed low treatment satisfaction.