• Title/Summary/Keyword: Medical organization

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Utility of Integrated Analysis of Pharmacogenomics and Pharmacometabolomics in Early Phase Clinical Trial: A Case Study of a New Molecular Entity

  • Oh, Jaeseong;Yi, Sojeong;Gu, Namyi;Shin, Dongseong;Yu, Kyung-Sang;Yoon, Seo Hyun;Cho, Joo-Youn;Jang, In-Jin
    • Genomics & Informatics
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    • v.16 no.3
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    • pp.52-58
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    • 2018
  • In this report, we present a case study of how pharmacogenomics and pharmacometabolomics can be useful to characterize safety and pharmacokinetic profiles in early phase new drug development clinical trials. During conducting a first-in-human trial for a new molecular entity, we were able to determine the mechanism of dichotomized variability in plasma drug concentrations, which appeared closely related to adverse drug reactions (ADRs) through integrated omics analysis. The pharmacogenomics screening was performed from whole blood samples using the Affymetrix DMET (Drug-Metabolizing Enzymes and Transporters) Plus microarray, and confirmation of genetic variants was performed using real-time polymerase chain reaction. Metabolomics profiling was performed from plasma samples using liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. A GSTM1 null polymorphism was identified in pharmacogenomics test and the drug concentrations was higher in GSTM1 null subjects than GSTM1 functional subjects. The apparent drug clearance was 13-fold lower in GSTM1 null subjects than GSTM1 functional subjects (p < 0.001). By metabolomics analysis, we identified that the study drug was metabolized by cysteinylglycine conjugation in GSTM functional subjects but those not in GSTM1 null subjects. The incidence rate and the severity of ADRs were higher in the GSTM1 null subjects than the GSTM1 functional subjects. Through the integrated omics analysis, we could understand the mechanism of inter-individual variability in drug exposure and in adverse response. In conclusion, integrated multi-omics analysis can be useful for elucidating the various characteristics of new drug candidates in early phase clinical trials.

Adjuvant Glucocorticoids Therapy in Canine Mast Cell Tumor (Canine Mast Cell Tumor에서 Adjuvant Glucocorticoids 치료)

  • Kim Myung-jin;Lee Jae-il;Kim Young-suk;Son Hwa-young;Jun Moo-hyung;Park Chang-sik;Kim Myung-cheol
    • Journal of Veterinary Clinics
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    • v.22 no.3
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    • pp.264-267
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    • 2005
  • A 12-year-old, 8.0 kg, spayed female, mixed-breed dog was presented to the Veterinary Medical Teaching Hospital of Chungnam National University (VMTH, CNU). That case has been growing up mass in her left upper hindlimb about for 2 years and has showed vomiting and anorexia for 3 days. The patient was diagnosed with mast cell tumor on the basis of fine-needle aspiration (FNA) cytology techniques. According to World Health Organization clinical staging system for diagnosing mast cell tumors, it was classified into stage IIIa. The patient was treated by adjuvant corticosteroid therapy, but complete surgical excision was not achieved by owner's request. In the early stage of therapy, the size of the mass was gradually reduced with only adjuvant glucocorticoid therapy, so the patient's general condition was maintained well. But after 53 days later, the treatmant was not effective anymore and mass size was increased. Two months later, she was euthanized because of intermittent vomiting and severe respiratory distress. Splenic mass, duodenal ulceration, liver mass and infiltrated mast cell tumor in upper hindlimb muscle region were found in necropsy examination.

Self-Organizing Middleware Platform Based on Overlay Network for Real-Time Transmission of Mobile Patients Vital Signal Stream (이동 환자 생체신호의 실시간 전달을 위한 오버레이 네트워크 기반 자율군집형 미들웨어 플랫폼)

  • Kang, Ho-Young;Jeong, Seol-Young;Ahn, Cheol-Soo;Park, Yu-Jin;Kang, Soon-Ju
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.38C no.7
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    • pp.630-642
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    • 2013
  • To transmit vital signal stream of mobile patients remotely, it requires mobility of patient and watcher, sensing function of patient's abnormal symptom and self-organizing service binding of related computing resources. In the existing relative researches, the vital signal stream is transmitted as a centralized approach which exposure the single point of failure itself and incur data traffic to central server although it is localized service. Self-organizing middleware platform based on heterogenous overlay network is a middleware platform which can transmit real-time data from sensor device(including vital signal measure devices) to Smartphone, TV, PC and external system through overlay network applied self-organizing mechanism. It can transmit and save vital signal stream from sensor device autonomically without arbitration of management server and several receiving devices can simultaneously receive and display through interaction of nodes in real-time.

Software Development for the Visualization of the Orientation of Brain Fiber Tracts in Diffusion Tensor Imaging Using a 24 bit Color Coding

  • Jung-Su Oh;In Chan Song;Ik-Hwan Cho;Jong-Hyo Kim;Kee Hyun Chang;Kwang-Suk Park
    • Journal of Biomedical Engineering Research
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    • v.25 no.1
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    • pp.43-47
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    • 2004
  • Interests in human brain functionality and its connectivity have much frown up. DTI (Diffusion tensor imaging) has been known as a non-invasive MR) technique capable of providing information on water diffusion in tissues and the organization of white matter tract. Thus. It can provide us the information on the direction of brain fiber tract and the connectivity among many important cortical regions which can not be examined by other anatomical or functional MRI techniques. In this study. was used the 24 bit color coding scheme on the IDL platform in the windows environment to visualize the orientation of major fiber tracts of brain such as main association, projection, commissural fibers and corticospinal tracts. We additionally implemented a color coding scheme for each directional component and FA (fractional anisotropy), and used various color tables for them to be visualized more definitely. Consequently we implemented a fancy and basic technique to visualize the directional information of fiber tracts efficiently and we confirmed the feasibility of the 24 bit color coding scheme in DTI by visualizing main fiber tracts.

The Development of Satisfaction Tool to Health Care Services - focused on Patients and their families - (의료 서비스에 대한 만족도 측정 도구의 개발)

  • Kang, So-Young;Lee, Sun-Mi
    • Quality Improvement in Health Care
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    • v.3 no.1
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    • pp.104-124
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    • 1996
  • Background : In these days, the health care organizations have concerned about customer-centered care in order to empower the competitiveness on the health care markets. The departments working for quality management of the hospitals have used health care quality indicators in terms of medical areas as well as service areas of the hospitals. However, there were insufficient efforts to develop the credible measurement to seek the customers' needs, their expectations and their satisfaction levels related to health care services because various kinds of challenges were in the process of scale development to measure customers' satisfaction in health care. The purpose of this study was to develop the satisfaction scale to health care services in a Korea health care organization and to test its tool with validity and reliability. Method : The concept of this tool was acceptability that one of the components of health care quality defined by Donabedian. Acceptability has the five dimensions of concept: Accessibility; Patient-Practitioner Relations; Amenities; Patient Preferences as to the effects of care; and Patient Preferences as to the costs of care. The Satisfaction Tool to Health Care Services was reviewed by expert panel with five researchers, including hospital managers and a professor related to quality management of the hospitals. As a result, the content validity index was .84 in the outpatient satisfaction tool. The inpatient satisfaction tool had .87 of the content validity index. The Satisfaction Tools to Health Care Services finally consisted of 44 items for outpatients/their families and of 60 items for inpatients/their families. Study subjects of the construct validity test were 479 outpatients/their families and 561 inpatients/their families who visited or admitted at a University hospital from July 1, 1996 through August 10, 1996. The data were examined by Factor Analysis with SPSS. Result : The items of Satisfaction tools for outpatients/their families were categorized by eleven factors with eigenvalue greater than 1.0 accounting for 64.2 percent of the variation in item scores. Also, the items of inpatient tool had eleven factors with eigenvalue greater than 1.0 accounting for 60.3 percent of the variation in item scores. The reliability of overall scale were .95 and .96 for the outpatients/their families satisfaction scores and inpatient/their families satisfaction scores. The internal consistency reliability with eleven factors was ranged from .30 to .94 for inpatients/their families. The Satisfaction Tool with eleven factors for inpatients/their families had internal consistency reliability ranged from .53 to .89. Conclusion : The Satisfaction Tools to Health Care Services focused on outpatients/their families and inpatients/their families developed in this study had a high reliability and the strong evidence of content validity and construct validity based on quality concept. Therefore, this tool would be utilized as a credible quality indicator of health care services to assess the quality problems and to monitor the quality improvement activities in Korean Health Care Organizations.

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Effects of Perceived Health Status, Health Attitude, and Health Concern on Health Promoting Behavior in Adults (성인의 지각된 건강상태, 건강태도, 건강관심도가 건강증진행위에 미치는 영향)

  • Park, Soonjoo;Lee, Young-Hye
    • The Journal of the Korea Contents Association
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    • v.16 no.12
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    • pp.192-202
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    • 2016
  • The aim of this study was to examine whether health promoting behavior was dependent on perceived health status and health attitude in adults, and whether health concern mediated the relationships among these variables. Structural equation modeling was applied to test a model in which perceived health status and health attitude were considered as exogenous variables while health concern as a mediating variable. The participants were 292 adults aged from 20 to 59 and completed the self-report measures. The results of the structural equation model showed that perceived health status and health attitude were positively associated with health concern and health promoting behavior. Health concern mediated the relationships between perceived health status and health promoting behavior, and also health attitude and health promoting behavior. The findings suggest that enhancing health attitude may play important roles to promote health promoting behavior in adults, and the development of various health education for adults in schools, work place, and health and medical organization might promote positive health attitude and health concern. Health education program in connection with preventive health examination also might contribute to activate health promoting behavior.

The Effect of Depression and Self-efficacy on the Quality of Life (요양병원 입원노인의 우울과 자아효능감이 삶의 질에 미치는 영향)

  • Kwag, Sung-Won;Sim, Kyoung-Bo;Roh, Heo-Lyun;Kim, Dong-Hyun
    • The Journal of Korean society of community based occupational therapy
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    • v.8 no.1
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    • pp.23-31
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    • 2018
  • Objective : Purpose of this study was to investigate the effect of depression and self - efficacy on the quality of life of the elderly hospitalized in a nursing hospital and to suggest a new direction for improving the quality of life of the elderly. Methods : The target was 212 senior citizens who were hospitalized at a nursing hospital located in K city in North Gyeongsang Province. The questionnaire was structured by adding the characteristics of the subjects, the Korean Senior Depression Index (GDS-K), the Self-effective Index (WHQOL-BRFA), and the World Health Organization's Life-Enhanced scale. coded using SPSS ver.18, the depression, self-efficiency, and quality of life differences according to the general characteristics (t-test, ANOVA), and Self-efficacy, depression, and the correlation coefficient between quality of life and A multI-sentence analysis to see the impact of depression and self-efficacy on the quality of life. Results : Self - efficacy and depression according to subject characteristics were different according to length of stay, and quality of life was different in religion. The correlation between depression, self - efficacy, and quality of life of admitted elderly showed statistically significant negative correlation (p <.01) with depression in both the quality of life and self - efficacy sub - variables. The depression and the self - efficacy of the elderly had the greatest effect on the quality of life. The variables were depression (${\beta}=-.328$), social efficacy (${\beta}=.248$), and physical efficacy (${\beta}=.193$). Conclusion : In order to improve the quality of life of the elderly, it will be necessary to provide and develop medical care services that reduce depression and improve self - efficacy (physical and social).

Association between job types of economically active population and sleep appropriateness among South Koreans (국내 경제활동 인구의 직업유형별 적정수면과의 연관성)

  • Kim, Sun Jung;Kim, Dong Jun;Gim, Eun Na;Yu, Tae Gyu
    • Korea Journal of Hospital Management
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    • v.25 no.3
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    • pp.67-77
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    • 2020
  • Background: As of 2016, average Koreans sleep 7 hours and 42 minutes, the lowest figure among Organization for Economic Cooperation and Development(OECD) countries, and the number of people with sleep disorders reached 561,000. Accordingly, the government has promoted the provision of 'Multiple Sleep Test' to strengthen the diagnosis service for patients with 'sleep disorder' in july 2018. As a result, healthcare costs for patients with sleep disorder is on the rise every year. In this study, we utilized 'Appropriate Sleep' criteria of United States's National Sleep Foundation(NSF) then investigated Korean's sleep pertinence using 「7th National Health and Nutrition Survey for 2016-2018」 by different occupational type, demographic characteristics, socio-economic characteristics, and health behaviors. Methods: We performed descriptive analysis to examine differences of sleep appropriateness by various sample characteristics. Multivariate logistic regression models were used to examine sleep appropriateness by occupational type and other variables. We also analyzed subgroup models to investigate. Results: As a result, a total of 1,948 (18.37%) study subjects experienced in-appropriate sleep. Results of the Multivariate logistic regression analysis revealed that blue color group had a higher odds ratio (OR) for experiencing in-appropriate sleep (OR=1.179). In addition, the odds ratio of experienced in-appropriate sleep among the elderly aged 70 and over was 2.698, and the odds ratio of the overstressed group was 1.299. Furthermore, sub-group analysis showed that blue color job of female(Or=1.334), high school or below(OR=1.404), divorce/death/separation(OR=2.039), 25%ile-50%lie income group(OR=1.411) more likely experienced in-appropriate sleep. Conclusion: Growing sleep disorder patients and related health care costs are expected. Government should apply detailed 'total periodic sleep disorder management policy' including pre-consultation, examination, diagnosis, treatment, post-consultation, self-management especially to vulnerable population that this study found.

Analysis and Implications of Korean Health Authorities' Fulfillment on World Health Organization's Recommendations for Mask Use: Focused on COVID-19 (세계보건기구의 마스크 사용 지침에 대한 한국 보건당국의 이행 분석과 함의: 코로나 바이러스 감염병을 중심으로)

  • Kim, MyungHee
    • Journal of Convergence for Information Technology
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    • v.10 no.8
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    • pp.77-86
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    • 2020
  • The study aims to analyze the compliance and non-compliance of the Korean health authorities regarding WHO's mask use recommendations following the spread of Covid-19, and to suggest the limitations and implications of the recommendations in the prevention of epidemics by deriving the causes of non-compliance with the results of alternative options. To this end, documents related to masks at home and abroad are reviewed, and WHO's mask recommendations and the Korean health authorities' mask guidelines are targeted for analysis. The analysis results are as follows. First, Korea's health authorities have basically accepted and applied WHO's "limited mask user perspective" in two recommendations. Second, Korea's health authorities have implemented differently from WHO mask recommendations due to the lack of supply and demand of masks. Third, Korea's health authorities were able to succeed in the initial prevention of Corona 19 based on the stabilization of the mask supply. Fourth, in the WHO mask recommendations, mask user restriction resulted in partial errors as a recommendation. The implication derived from the analysis is that even international recommendations based on medical evidence need to be allowed to follow autonomous guidelines according to the country's quarantine situation and competence, rather than strict adherence to international rules, in the infectious disease pandemic situation.

An Analysis of Internet based Child Care Portal sites (인터넷 육아전문 사이트의 육아정보 분석)

  • Lee, Ja-Hyung;Lee, Jung-Eun;Oh, Jin-A;Kim, Hye-Young;Kim, Kyung-Won;Park, Young-Ae;Kim, Sung-Hee;Kim, Ji-Hyun;Jung, Hyang-Jin;Cheon, Kee-Jeong
    • Korean Parent-Child Health Journal
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    • v.4 no.2
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    • pp.56-72
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    • 2002
  • Web sites on the internet are getting major resources to gain information related to child care. Though the numerous web sites deliver child care information, they have never been evaluated with criteria before. The purpose of this study is to identify existence and organization of child care portal sites and to analysis their contents, therefore to suggest guidelines for parents. The survey was conducted from Sep. 1. to Oct. 30., 2001. by means of Lycos Korea and Daum search engine and finally 45 portal sites related to child care were selected eliminating the commercial and personal homepages. The results were as follows: 1. Most of the sites(95.6%) were operated by corporations without registration(82.2%). Consultants were mostly professional (71.1%). 2. The contents were analyzed 4 categories including 19 themes. 3. Diet & Nutrition category include weaning food, breast feeding, bottle feeding and snack. The recipe and type of weaning food on months were topped(64.44%). 4. Infant Care category include bathing, sleeping, clothes, skin care and cord care. bathing method and heat of bathing water were topped(44.44%). 5. Growth & Development category was consisted of developmental characteristics, dental growth, play & exercise and learning & guidance. Developmental stage and motor development were topped (62.22%). 6. Health maintenance & promotion category was consisted of emergency care, prevention of accidents, vaccination, common pediatric disease and parental role. Care of diarrhea, constipation and fever, and precautions for vaccination were topped(48.89%).

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