• Quality Improvement in Health Care
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• v.9 no.2
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• pp.230-240
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• 2002

Background : The purpose of this study was to develop, implement and evaluate the pharmacist intervention program designed to identify and correctly adjust the dosage of $H_2$-receptor antagonists ($H_2RA$) in renally impaired patients and promote timely conversion of $H_2RA$ from IV to PO therapy. Methods : The study population consisted of renally impaired patients who received $H_2RA$ therapy from April 9 to May 8, 2001 at Hallym Medical Center. Each morning a specifically developed software program identified patients with serum creatinine (Scr) greater than 1.2 mg/dl or age greater than 65 years. The pharmacist, then screened the pharmacy profiles of the identified patients to determine if the patient was on $H_2RA$. For these patients on $H_2RA$ with renal impairement the creatinine clearance (CrCl) was calculated using Cockroft & Gault equation. The pharmacist determined the proper dosage for each identified patients based on the calculated CrCl and the oral dosage that would be appropriate for whom IV therapy was no longer indicated. Result : A total of 149 cases (101 patients) were monitored during the study period. The dosage was inappropriately prescribed for renal function in 61 of 149 cases (41%), and of those, pharmacist made recommendations for 58 cases of which 33 cases (57%) were accepted by the physicians. The administration route of H2RA was inappropriately used as IV in 22 of 53 cases (42%), and pharmacist made recommendations for those 22 cases of which 15 cases (68%) were accepted. Conclusion : Monitoring of patients with renal dysfunction by a pharmacist improved the dosing of $H_2RA$ and a dosing program of patients with renal impairment would be of benefit to other clinicians and institutions seeking to optimize patient care.

• Journal of the Mineralogical Society of Korea
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• v.15 no.3
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• pp.231-240
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• 2002

Microbial metal reduction influences the biogeochemical cycles of carbon and metals as well as plays an important role in the bioremediation of metals, radionuclides, and organic contaminants. The use of bacteria to facilitate the production of magnetite nanoparticles and the formation of carbonate minerals may provide new biotechnological processes for material synthesis and carbon sequestration. Metal-reducing bacteria were isolated from a variety of extreme environments, such as deep terrestrial subsurface, deep marine sediments, water near Hydrothemal vents, and alkaline ponds. Metal-reducing bacteria isolated from diverse extreme environments were able to reduce Fe(III), Mn(IV), Cr(VI), Co(III), and U(VI) using short chain fatty acids and/or hydrogen as the electron donors. These bacteria exhibited diverse mineral precipitation capabilities including the formation of magnetite ($Fe_3$$O_4$), siderite ($FeCO_3$), calcite ($CaCO_3$), rhodochrosite ($MnCO_3$), vivianite [$Fe_3$($PO_4$)$_2$ .$8H_2$O], and uraninite ($UO_2$). Geochemical and environmental factors such as atmospheres, chemical milieu, and species of bacteria affected the extent of Fe(III)-reduction as well as the mineralogy and morphology of the crystalline iron mineral phases. Thermophilic bacteria use amorphous Fe(III)-oxyhydroxide plus metals (Co, Cr, Ni) as an electron acceptor and organic carbon as an electron donor to synthesize metal-substituted magnetite. Metal reducing bacteria were capable of $CO_2$conversion Into sparingly soluble carbonate minerals, such as siderite and calcite using amorphous Fe(III)-oxyhydroxide or metal-rich fly ash. These results indicate that microbial Fe(III)-reduction may not only play important roles in iron and carbon biogeochemistry in natural environments, but also be potentially useful f3r the synthesis of submicron-sized ferromagnetic materials.