Oh, Deuk Young;Kim, Jee Hoon;Lee, Paik Kwon;Ahn, Sang Tae;Rhie, Jong Won
Archives of Plastic Surgery
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v.34
no.4
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pp.466-470
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2007
Purpose: Active prevention is an essential component in reducing the development of pressure sores. For the high-risk patient group, following the certified pressure sore screening scale as well as educating the patient and the nurses who care for them can lead to optimal management of these patients. Applying a risk assessment scale along with a prevention strategy can reduce medical costs and length of stays at the hospital. The purpose of this study is to evaluate the efficacy of a new pressure sore risk assessment scale based on the universally recommended Braden scale and our prevention program. Methods: From June to August, 2003, our pressure ulcer risk assessment scale was applied to a total of 1882 patients admitted to the experimental group (intensive care unit, neurosurgery, general surgery, and oncology units). It was based on Braden scale. We analysed sensitivity, specificity, positive and negative predictive value and ROC curve to evaluate its efficacy. Pressure ulcer prevention program was composed of patient's education using protocol and specific nursing care. The incidence of pressure ulcers was also measured during the 3 months period, and those were compared to the control group of 1789 patients from March to May, 2002. Results: 118(6.27%) of the experimental group were high-risk with an incidence of pressure ulcers measuring 4 (0.21%). Sensitivity, specificity, positive and negative predictive value of our scale were 100%, 94%, 4%, 100%, respectively, and AUC(area under the curve) was 0.992. In the control group, the incidence of pressure ulcers was 11(0.61%). Statistical analyses using chisquared tests with a significance level of 5%, the results were such that ${\chi }^2=3.6482$(p=0.0561). The results proved to be statistically significant in borderline. Conclusion: The results from this study proved that pressure sore risk assessment scale based on Braden scale has an excellent efficacy, and shows that our pressure ulcer prevention program is partially effective in reducing pressure ulcer incidence.
Purpose: To investigate optical shop startup awareness of ophthalmic optics students as a basic source for startup education. Methods: Total of 287 students from three ophthalmic optics college in kyung-gi region was surveyed and analyzed using SPSS analysis. Results: Optical shop startup business plan of ophthalmic optics students was very high (80.1%). For startup timing, over 6yrs of employe (37.0%) was most and there was significant difference according to age (p<.001) and optician family present (p<.05). For startup type, single startup type (37%) was most and there was significant difference according to grade (p<.01). For startup unit of space, 30 pyong (43.5%) was most, Seoul metropolitan area and kyung-gi region (54.4%) was most for startup region, and station area (40.8%) was most for startup location. The reason of non-startup was eye hospital and glass related company employe (35.7%) was most and optical shop employe (35.7%) was most for non-startup planner's way. Conclusions: Startup business plan was very high and need to have startup education for there startup provision.
Cha, Seungman;Hong, Sung-Tae;Lee, Jin-Su;Jeong, Hoo Gn;Kwon, In-Sun;Saed, Abd Al Wahab;Elhag, Mousab Siddig;Ismail, Hassan Ahmed Hassan Ahmed;Amin, Mutamad;Lee, Young-Ha
Parasites, Hosts and Diseases
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v.58
no.4
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pp.421-430
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2020
This study aimed to investigate whether mass drug administration (MDA) intervention has an equivalent effect on reducing the prevalence and intensity of Schistosoma haematobium infection regardless of the baseline values. A repeated cross-sectional survey was performed targeting students of 12 primary schools in Al Jabalain and El Salam districts of White Nile State, Sudan, at both 1 week before and 8 months after the MDA. Prior to the baseline survey, schoolaged children in Al Jabalain had received MDA interventions twice in 4 years, while those in El Salam had not. The baseline prevalence was 9.1% in Al Jabalain and 35.2% in El Salam, which were reduced to 1.8% and 5.5% at 8 months after the MDA, respectively. The corresponding reduction rates were 80.3% and 84.4%, not significant difference between both districts. However, changes in the geometric mean intensity (GMI) of egg counts were significantly different between both districts. The baseline GMIs were 14.5 eggs per 10 ml of urine (EP10) in Al Jabalain and 18.5 EP10 in El Salam, which were reduced to 7.1 and 11.2 EP10 after treatment, respectively. The corresponding reduction rates were 51.0% and 39.5%. In conclusion, MDA interventions were found to bring about similar relative reduction in prevalence regardless of the baseline value; however, the relative reduction in infection intensity was more salient in the district with a low baseline value for both prevalence and intensity. This clearly points to the importance of repeated MDA interventions in endemic areas, which will eventually contribute to schistosomiasis elimination.
Objectives : We wanted to evaluate the economic value of a pharmaceutical product, Kremezin, for treating patients with chronic renal failure (CRF) by estimating the amount of cost savings due to its effect for delaying the initiation of dialysis treatments. Methods : We defined a conventional treatment for CRF accompanied by Kremezin therapy as 'the treatment group' and only conventional treatment as 'the alternative group.' The types of costs included were direct medical and nonmedical costs and costs of productivity loss. The information on the effect of Kremezin was obtained from the results of earlier clinical studies. Cost information was derived from the administrative data for 20 hemodialysis and 20 peritoneal dialysis patients from one tertiary care hospital, and also from the administrative data of 10 hemodialysis patients from one free-standing dialysis center. Per-capita cost savings resulting from Kremezin therapy were separately estimated for the cases with delay for the onset of hemodialysis and the cases with immediate performance of peritoneal dialysis. By computing the weighted average for the cases of hemodialysis and peritoneal dialysis, the expected per-capita cost savings of a patient with CRF was obtained. Using a discount rate of 5%, future cost savings were converted to the present value. Results : The present value of cumulative cost savings per patient with CRF from the societal perspective would be $18,555,000{\sim}29,410,000$ Won or $72,104,000{\sim}112,523,000$ Won if Kremezin delays the initiation of dialysis by 1 or 4 years. Conclusions : The estimated amount of cost savings resulting from treating CRF patients with Kremezin confirms that its effect for delaying the onset of dialysis treatments has a considerable economic value.
Purpose : The most important management of congenital hydronephrosis consists of the early diagnosis and evaluation of the pathologic abnormalities of congenital hydronephrosis. This study was conducted to investigate the different causes of hydronephrosis and its clinical outcome. Methods : 54 live neonates who were hospitalized and diagnosed with congenital hydronephrosis at Chungnam National University Hospital from Aug. 1998 to Aug. 2003 were retrospectively analyzed. Results : Hydronephrosis(renal pelvic AP diameter $gt;5 mm) was postnatally detected in 54 cases(2.1%) among 2,539 neonates who were hospitalized from Aug. 1998 to Aug. 2003. There were three times more males than females. Additional imaging studies revealed that ureteropelvic junction obstruction was the most common postnatal diagnosis(48.7%), followed by multicystic dysplastic kidney, vesicoureteral reflux and duplication kidney with ureterocele. Spontaneous regression of hydronephrosis was revealed in 25 renal units(75.8% ) of mild hydronephrosis, 14 renal units of moderate hydronephrosis and 1 renal unit of severe hydronephrosis. Operative correction were carried out in 14 renal units(70%) of severe hydronephrosls. Conclusion : The most common established cause of congenital hydronephrosis in this study was ureteropelvic junction obstruction. There are many cases of spontaneous regression in mild to moderate congenital hydronephrosis. Urinary tract infections occur in many neonates with hydronephrosis. Therefore, early detection and evaluation of congenital hydronephrosis and continuous follow-up at regular intervals are necessary for conservation of renal function. (J Korean Soc Pediatr Nephrol 2005;9:69-75)
Purpose: The Hospice Oriented Medical Record (HOMR) was developed for assessing the pain and symptoms of terminal cancer patients. Methods and Results: The HOMR consists of an instruction for users and 2 assessment pages which include the graph showing vital signs (temperature, blood pressure, pulse, respiration rate and pain score), current problem lists, performance status, laboratory data, pain characteristics and management, sedation score, associated symptoms and drug side effects, etc. Pilot study was performed in the inpatient Hospice Care Unit in Guro Hospital, Korea University Medical Center. Because an one-week progress data was recorded in HOMR as a flow sheet, the patient's condition and pain control status could be seen at a glance. Conclusion: The HOMR is useful for assessing the terminal cancer patients because it is simple and convenient to use. Further research is needed before it can be universally used in the clinical settings.
This study was to determine the microbiological safety and tensile strength of gammairradiated porcine tendon for the development of safe xenografts. Escherichia coli and Bacillus subtilis were used as model pathogens and inoculated as $10^6{\sim}10^7log$ colonies forming unit $(CFU)g^{-1}$. As model virus from porcine, porcine parvovirus (PPV), bovine viral diarrhoea virus (BVDV) and poliovirus were inoculated as $10^5{\sim}10^6$ tissue culture infectious dose $(TCID)_{50}g^{-1}$ into porcine skin. The $D_{10}$ value of E. coli and B. subtilis was measured as $0.32{\pm}0.082kGy$ and $4.0{\pm}0.312kGy$, respectively. Additionally, the $D_{10}$ values of PPV, BVDV and poliovirus were also shown as $1.75{\pm}0.131kGy$, $3.70{\pm}0.212kGy$ and $6.26{\pm}0.332kGy$, respectively. Gamma irradiation decreased the tensile strength of porcine tendon. Results indicate that microbiological safety of porcine tendon can be improved significantly by gamma irradiation. However, further studies are needed to improve the tensile strength of gamma-irradiated porcine tendon.
Kim, Sun;Kim, Jong Seok;Kim, Dong Hyun;Lee, Ji Eun;Kwon, Young Se
Journal of the Korean Child Neurology Society
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v.26
no.4
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pp.276-279
/
2018
Klinefelter syndrome a genetic disorder with various clinical manifestations. Neurological symptoms, such as seizures, are rarely reported with Klinefelter syndrome, and it response well to anti-epileptic drugs. A 5-month-old boy visited the Inha university hospital due to jerking movements and hiccups. The patient had been diagnosed with Klinefelter syndrome at birth and had a medical history of admission to the neonatal intensive care unit due to opisthotonus and ocular deviation at 26 days of age. The patient's serum testosterone level was decreased and his anti-$M{\ddot{u}}llerian$ hormone level was increased. The brain image examination was normal and the electoencephalography and other blood test results showed no specific findings. However, after admission, the patient recurred generalized tonic-clonic-seizures recurred intermittently even after the administration of antiepileptic drugs. This paper reports a case of non-febrile seizures in a child with Klinefelter syndrome who presented with a refractory course.
Purpose: This methodological study was conducted to test the reliability and validity of an instrument that measures attitudes of advance directives (ADs) among nurses. Methods: 1) Sixteen items related to attitudes in the English version of the Knowledge, Attitudinal, and Experiential Survey on Advance Directives (KAESAD) were forward/backward translated into Korean. 2) The content was validated by an expert panel (three nursing professors and eight hospice nursing specialists). 3) The preliminary 12 items were selected as a tool to assess the Korean version of Nurses' Attitudes towards Advance Directives (NAAD-K). 4) The instrument was validated by a survey (n=216). 5) It was confirmed to use the 12 items for the final version of the instrument. Results: NAAD-K was shown to be valid in terms of factors, items and content. The three factors extracted from the factor analysis were named as follows: Caring for patients with an AD (factor 1), nurses' role in informing patients (factor 2) and patient right (factor 3). The three factors explained total variance 57.796%. Factor loadings of the 12 items ranged from 0.47 to 0.93. For the 12 items, Cronbach's alpha was 0.81, and Guttman split-half coefficient was 0.78. Conclusion: This instrument was identified to be applicable with satisfactory reliability and validity for further use in measuring nurses' attitudes towards ADs in hospice and palliative care.
Choi, Seung Jun;Nah, Hyunjin;Kim, Yundeok;Kim, Sinyoung;Kim, Hyun Ok
The Korean Journal of Blood Transfusion
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v.29
no.3
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pp.320-327
/
2018
A 72-year-old man with general weakness visited the outpatient clinic of the hematology department. The patient had been treated under the diagnosis of autoimmune hemolytic anemia for 2 years. His hemoglobin level at the time of the visit was 6.3 g/dL, and a blood transfusion was requested to treat his anemia. The patient's blood type was A, RhD positive. Antibody screening and identification test showed agglutination in all reagent cells with a positive reaction to autologous red blood cells (RBCs). He had a prior transfusion history with three least incompatible RBCs. The patient returned home after receiving one unit of leukoreduced filtered RBC, which was the least incompatible blood in the crossmatching test. After approximately five hours, however, fever, chills, dyspnea, abdominal pain, and hematuria appeared and the patient returned to the emergency room next day after the transfusion. The $anti-Fy^a$ antibody, which was masked by the autoantibody, was identified after autoadsorption using polyethylene glycol. He was diagnosed with an acute hemolytic transfusion reaction due to $anti-Fy^a$ that had not been detected before the transfusion. In this setting, it is necessary to consider the identification of coexisting alloantibodies in patients with autoantibodies and to become more familiar with the method of autoantibody adsorption.
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