• Title/Summary/Keyword: Medical prophylaxis

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Study on Companion Dog Practice and Management System on Animal Hospital in Seoul City (서울시내 동물병원의 애완견 진료와 관리시스템에 관한 연구)

  • Kang, Dong-Joon;Chung, Byung-Hyun;Heo, Jung;Kang, Chung-Boo
    • Journal of agriculture & life science
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    • v.43 no.2
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    • pp.39-46
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    • 2009
  • Ten animal hospitals in Seoul were selected, and of which 41,305 practice in total for recent 1 year were analyzed based on international classification of disease(ICD) of WHO. Of the entire practice, prophylaxis cases accounted for 42.2%. Of the 9,376 cases of internal diseases, digestive system diseases accounted for 4,957 cases(52.9%), respiratory system diseases 1,776 cases(18.9%), circulatory system diseases 1,239 cases(13.2%), and neoplasms diseases 413 cases(4.4%), respectively. In the estate investment expenses, to be specific, rental guarantee deposit accounted for about 50% of the entire estate cost, foregift(48%), and monthly rent(2%). Dividing the income of animal hospitals into medical service, articles selling, and pet-dog beauty, medical service accounted for 71.6% of the entire sales, selling of articles 16.7%, and pet-dog beauty 11.6%. Publicity work for the animal hospital was done mostly through web sites on internet(47%), then through local advertising papers(23.5%), and through bulletins and telemarketing(11.8%). Manpower of the animal hospitals in this study was mostly composed of veterinarians(45.5%) up to about half of the entire staffs, while there was no veterinary technician who had specialized education in that area.

Effect of prophylactic indomethacin in extremely low birth weight infants (초극소 저출생체중아에서 예방적 indomethacin 투여효과)

  • Lee, Bo Lyun;Kim, Su Jin;Koo, Soo Hyun;Jeon, Ga Won;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.49 no.9
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    • pp.959-965
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    • 2006
  • Purpose : The purpose of this study was to investigate the effect of prophylactic indomethacin on reduction of patent ductus arteriosus(PDA) and intraventricular hemorrhage(IVH) in extremely low birth weight infants(ELBWI). Methods : Retrospective review of 84 ELBWI who were admitted to our neonatal intensive care unit from June 2004 to April 2006 was performed. Patients were divided into prophylactic group(n=28) and control group(n=56), where prophylactic indomethacin were given within 6 hours after birth. Clinical outcomes were compared between these groups. Results : There were no significant differences in gestational age, birth weight, incidence of hemodynamically significant PDA and severe IVH, and mortality between prophylactic group and control group. However, there were more frequent indications for therapeutic indomethacin, higher incidence of intestinal perforation, and longer time to achieve full enteral feeding in prophylactic group than control group. The incidence of other adverse events attributed to indomethacin prophylaxis did not differ between two groups. Conclusions : Prophylactic indomethacin may not prevent hemodynamically significant PDA and severe IVH in ELBWI. On the contrary, it may be associated with increased risk of adverse events. Further efforts should be investigated to decrease PDA and severe IVH in ELBWI.

Spontaneous Resolution Rate and Predictive Factors of Resolution in Children with Primary Vesicoureteral Reflux (소아에서 일차성 방광요관역류의 자연소실율 및 관련 인자)

  • Kang, Eun-Young;Kim, Min-Sun;Kwon, Keun-Sang;Park, Eun-Hye;Lee, Dae-Yeol
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.74-82
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    • 2007
  • Purpose : To analyze the clinical characteristics, spontaneous resolution rate and predictive factors of resolution in children with primary vesicoureteral reflux(VUR). Methods : Between October 1991 and July 2003, 149 children diagnosed with primary VUR at Chonbuk National University Hospital were reviewed retrospectively. All of the patients were maintained on low-dose antibiotic prophylaxis and underwent radionuclide cystograms at 1 year intervals over 3 years after the initial diagnosis of VUR by voiding cystourethrogram was made. Results : The median time to resolution of VUR was 24 months and the total 3 year-cumulative resolution rate of VUR was 61.7%. The following variables were associated with resolution of VUR according to univariate analysis-; age<1 year, male gender, mild grade of reflux, unilateral reflux, congenital hydronephrosis as clinical presentation at time of diagnosis of VUR, absence of focal defects in the renal scan at diagnosis, absence of recurrent UTI, renal scars and small kidney during follow-up. After adjustment by Cox regression model, five variables remained as independent predictors of VUR resolution; age<1 yew, relative risk 1.77(P<0.05), VUR grade I+II 2.98(P<0.05), absence of renal scars 2.23(P<0.05), and absence of small kidney 5.20(P<0.01) during follow-up. Conclusion : In this study, spontaneous resolution rate of VUR, even high grade reflux, is high in infants during medical management, and it was related to age, reflux grade at diagnosis, absence of renal scars and small kidney during follow-up. Therefore early surgical intervention should be avoided and reserved for the selected groups.

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Clinical experience with amitriptyline for management of children with cyclic vomiting syndrome (주기성 구토 증후군 소아에서 구토 예방을 위한 amitriptyline의 임상 경험)

  • Sim, Ye-Jee;Kim, Jung-Mi;Kwon, Soonhak;Choe, Byung-Ho
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.538-543
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    • 2009
  • Purpose : To report the clinical experience with amitriptyline for managing children with cyclic vomiting syndrome (CVS). Methods : Totally, eleven children (eight males) were diagnosed with CVS. Of these, medical records were reviewed for eight children treated with amitriptyline; three children were not treated because one was not followed up and two were kept under observation to study the natural course without medication, because the frequency of vomiting had recently decreased to less than one episode per year. The eight amitriptyline-treated children were divided into three groups by the therapeutic response: (1) complete remission (CR), with no recurrence of symptoms after treatment; 2) partial remission (PR), in which the frequency of symptoms decreased by almost 50% after treatment; and (3) no response. Results : For the eight amitriptyline-treated children, the mean age of symptom onset was 4.7 (0.3-7) yr and mean age at diagnosis was 8.9 (6.0-11.3) yr. The mean number of vomiting episodes was 8.8 (2-25) per year, and the duration of vomiting in each episode ranged from 3 hours to 5 days. CR was achieved in five (62.5%) of the eight amitriptyline-treated children (0.2-0.8 mg/kg/day orally, at night) and PR was achieved in three children (37.5%). Two children relapsed on discontinuation of amitriptyline by their parents decision but showed improvement on remedication. No adverse effects were noted throughout the study period. Conclusion : Amitriptyline can be used in long-term prophylaxis for the management of children with CVS aged over 6 yr. However, a large-scale study is needed to ascertain its effects.

Prophylactic Cranial Irradiation for Acute Lymphoblastic Leukemia in Childhood (소아 급성 림프모구성 백혈병의 예방적 전뇌 방사선조사)

  • Kim, In-Ah;Choi, Ihl-Bhong;Kang, Ki-Mun;Shinn, Kyung-Sub;Kim, Hack-Ki
    • Radiation Oncology Journal
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    • v.14 no.2
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    • pp.137-147
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    • 1996
  • Purpose : This report is the result f retrospective analysis for children who received prophylactic cranial irradiation combined with intrathecal chemotherapy. Materials and Methods : Ninety children with ALL who had got bone marrow remission after induction chemotherapy received PCI. All but 3 children were treated with a dose of 1800 cGy as a standard regimen. While the PCI was given, all patients received intrathecal chemotherapy. Results : Nine of 90 patients experienced CNS relapse during the duration of follow-up ranged from 36 to 96 months (median 60 months). Three children experienced BM relapse prior to CNS relapse. Therefore, CNS relapse rate as the first adverse event was $6.7\%$. Median time interval of CNS relapse was 16 months from the first day of hematologic complete remission. Eighty-nine percent of patients who had CNS relapse were associated with hematologic relapse. and $78\%$ of CNS relpase occurred during maintenance chemotherapy (on-therapy relapse). The CNS RFS at 2 and 5 years are $68\%$ and $42\%$, respectively with median of 43 months. The Prognostic factors affecting CNS RFS are initial WBC count (cut-off point of 50,000/ul), FAB subtype and CALGB risk criteria. The DFS at 2 and 5 years are 61 and $39\%$, respectively with median of 34 months. The prognostic factors affecting DFS are initial WBC count (cut-off point of 50,000/ul), FAB subtype, POG and CALGB risk criteria. Conclusions : In our study, $6.7\%$ of CNS relapse rate as a first adverse event was comparable with other studies. Various risk criteria was based on age at diagnosis and initial WBC count such as POG and CALGB criteria, had prognostic significance for CNS RFS and DFS. Prospective randomized trial according to prognostic subgroup based on risk criteria and systematic study about neuropsychologic function for long term survivors, are essential to determine the most effective and least toxic form of CNS prophylaxis.

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Use of Antimicrobial Agents for the Treatment of Inpatients in Chonbuk National University Hospital (전북대학교병원 입원환자에서의 항생제 사용 실태)

  • Song, Jae Ho;Kim, Jung Soo
    • Pediatric Infection and Vaccine
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    • v.7 no.2
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    • pp.225-232
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    • 2000
  • Purpose : The use antimicrobial agents is one of the important strategies for the treatment and prophylaxis of microbial infections. But injudicious abuse and misuse of antimicrobial agents is problem to add an extra weight on medical fee, increase of resistant bacteria and side effects according to the antibiotic use. This study was performed to establish the pertinent use of antimicrobial agent in Chonbuk National University Hospital(CNUH). Characteristics of antibiotics use was analysis by reviewing the medical records of patients admitted to CNUH during the period of May 1998. Methods : One thousand eight hundred and thirty three patients were enrolled in this study(medical division 1,014 cases, surgical division 819 cases). Medical records were retrospectively reviewed to classify the rate of antibiotics use, name of antibiotics used, appropriateness of antibiotics use. Results : The overall rate of antibiotic usage in CNUH was 67.2%(1,231/1,833), showing higher rate in surgical division(89.6%) compare to that of medical division(49.0%). Among 1,231 patients to whom antimicrobial agents were given, only 125(10.2%) were treated with single antimicrobial agents. 311(25.3%) were treated with two antimicrobial agents, and 795(64.5%) patients received 3 or more antibiotics. ${\beta}$-lactams(56.4%) were most frequently used followed by aminoglycosides(35.3%), the others(4.9%) and quinolons(3.4%). Amoxicillin-clavulanate was the mostly commonly used antibiotics followed by amoxicillin and unasyn. Prophylactic use of antibiotics was carried in seven hundred six patients(57.4%), mostly in surgical division, which can be considered somewhat inappropriate in the initiation time and duration of antibiotic use. Conclusion : Importance of monotherapy and appropriate prophylactic antibiotic use should be emphasized. Strategies of antibiotics use, such as restriction of drug use, continuous monitoring system, flow sheet system should be considered to reduce antibiotics use and establish the appropriate use of antibiotics as well as inhibiting the occurrence of resistant strains.

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A study on the job awareness of dental hygienists and their job performance (치과위생사의 수행업무에 대한 인식도 및 실태조사)

  • Sim, Su-Hyun;Hwang, Yoon-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.7 no.2
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    • pp.153-166
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    • 2007
  • The job of dental hygienists is specialized, and they have to be capable of performing their primary duties including prevention of oral diseases, oral prophylaxis, and oral health education. To ensure their successful job performance, dentists should have an accurate understanding of their duties and need a change of mind-set about them. And there should be written legal and concrete regulations on the coverage of their work in order to let them boost their job performance with pride and a sense of responsibility. The purpose of this study was to examine the actual roles and job performance of dental hygienists in clinical field in an attempt to discuss the substantial job performance of dental hygienists and their job enlargement. It's basically meant to help enhance the efficiency and quality of medical services. The subjects in this study were 471 dental hygienists in dental clinics, dental hospitals, university hospitals and general hospitals across the nation, on whom a survey was conducted in person from March 2 to 25, 2005. The collected data were analyzed with SPSS Win 12.0 program, and the findings of the study were as follows: 1. The major jobs they currently performed included oral health education, hospital management, simple duties, extensive dental hygiene duties and joint treatment assistance. They hoped to continue to be responsible for oral health education, preventive treatment and extensive dental hygiene duties. 2. As for their current job by age, extensive dental hygiene duties, preventive treatment, joint treatment assistance, preserving treatment, prosthetic treatment and pediatric treatment were most conducted by the dental hygienists who were at the age of 26 to less than 31, and those who were at the age of 31 and up were most responsible for hospital management and simple duties. 3. As to job awareness by workplace, their workload was statistically significantly different according to their workplace. The hospital employees took care of more work than those in clinics. 4. Concerning job awareness by age, the younger dental hygienists suffered more role conflicts and were given a less free hand in work handling, the middle-aged group's job was uncertain. Legal regulations about the coverage of their work should be prepared in detail as a measure to stir up their responsible job performance and pride. In order to take advantage of experienced dental hygienists, their duties should be more differentiated and specialized, and their working conditions should be improved to boost their job satisfaction. That is, they should be given ample chances for promotion and serving as a middle manager and be given fair treatment according to their career. If their work is accurately darified and specialized based on career, it will boost the efficiency of dental treatment. Dental hygienists also should direct sustained efforts into self-development in order to become a skilled and professional oral health personnel.

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CNS Complications in Childhood Cancer (소아 종양 환아의 중추 신경계 합병증)

  • Jeong, Yoo Jin;Seo, Yeon Kyong;Hong, Seung-A;Kim, Heung Sik;Kim, Jun Sik;Lee, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1112-1117
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    • 2003
  • Purpose : Recent advances in the methods of treating cancer in young patients have led to both an increased frequency of CNS complications as well as prolonged life expectancy. We intend to analyze the clinical aspects and laboratory findings of patients with CNS complications during and after treatment. Methods : We reviewed the medical records of 174 childhood cancer patients treated with chemotherapy admitted to the Dept. of Pediatrics, Keimyung University Dongsan Hospital, from January 1995 to November 2002. Among them, 15 cases with CNS complications were investigated in this study. Results : CNS abnormalities were found in 13 patients by CT or MRI during treatment such as leukoencephalopathy(n=7), mineralizing microangiopathy(n=4), brain infarction(n=3), intracranial hemorrhage(n=1), and hypoxic ischemic encephalopathy(n=1). It was found that two patients had two or more CNS abnormalities. Two patients who had no imaging abnormalities had convulsions, possibly after the addition of intrathecal methotrexate. The patients with intracranial hemorrhage and brain infarction had rapid and fatal clinical courses. The hypoxic ischemic encephalopathy following electrolyte imbalance completely recovered after correction of electrolyte. Conclusion : The CNS complications that occur during and after chemotherapy influence prognoses significantly, and remain neurologic sequelae. Therefore early diagnosis and prophylaxis for CNS complications and regular physical examination of patients who have recieved cancer therapy are strongly recommended.

Impaired Functions of Lymphocytes on Nitric Oxide Production in Endotoxin- Tolerant Mice (내독소내성 마우스에서 Nitric Oxide 생성에 미치는 림프구 부전)

  • Gil, Young-Gi;Kang, Mi-Kyung
    • Journal of Life Science
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    • v.18 no.11
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    • pp.1471-1478
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    • 2008
  • In this study, nitric oxide (NO) production in a macrophage-lymphocyte co-culture system was used to assess the cytokine producing capability of cells during endotoxin tolerance in mice. Incubation of peritoneal macrophages with interferon-$\tau$ (IFN-$\tau$) in the presence of lipopolysaccharide (LPS) augmented NO synthesis. Exogenous tumor necrosis factor-$\alpha$(TNF-$\alpha$) could also replace LPS for the stimulation of NO production. Macrophages co-cultured with splenic lymphocytes showed augmented NO synthesis by LPS alone. However, pretreatment of mice with 2.5 mg/kg LPS completely prevented the lethality and the increase of blood TNF-$\alpha$ and IFN-$\tau$ after the second challenge with a lethal dose of LPS. In addition, when macrophages prepared from LPS-tolerant mice were co-cultured with normal splenocytes, LPS also could not induce the production of NO, even in the presence of exogenous TNF-$\alpha$. Moreover, when normal macrophages were co-cultured with splenocytes obtained from LPS-tolerant mice, stimulation with LPS could not evoke the NO production enhancement. However, this down-regulation was able to reverse by exogenous IFN-$\tau$ or concanavalin A (ConA), a stimulator of IFN-$\tau$ production. Our results indicate that not only macrophages but also lymphocytes contribute to LPS tolerance. As INF-$\tau$ can enhance the expression of TNF-$\alpha$, the decrease of INF-$\tau$synthesis from lymphocytes may orchestrate with the decrease of TNF-$\alpha$ synthesis from LPS-tolerant macrophages for the production of tolerant state and the prevention of excessive inflammation. Therefore, LPS tolerance may be exploited for prophylaxis of severe sepsis in patients at risk.

Importance of Job Tasks, Job Training Requirement and Work Satisfaction felt by Dental Hygienists (치과위생사의 수행업무의 중요성·업무에 대한 교육훈련의 필요도와 만족도 조사연구)

  • Kang, Yong-Ju
    • Journal of Korean society of Dental Hygiene
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    • v.5 no.1
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    • pp.1-13
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    • 2005
  • The study aimed to estimate the importance of job tasks, job training requirement and work satisfaction felt by dental hygienists to help dental hygienists work efficiently and effectively. A total of 142 dental hygienists working in dental hospitals located in J participated in the study. A SPSS 10.10 for Windows was used for statistical analysis. The statistical significance was defined as ${\alpha}$=.05. The results of the study are summarized as follows: 1. The mean score for the importance of job tasks was 4.09. The respondents considered dental clinic management and assistance to dentists the most important among their job descriptions showing the mean score of 4.44. The need for job training was 4.15 in average. The respondents wanted to have training on how to make a dental health insurance claim to receive payment other than any training with the mean score of 4.42. The work satisfaction of the respondents was 3.65 in average. The respondents were most satisfied with their work in dental assistance. 2. By the category of job tasks, the levels of importance of job tasks, job training requirement and work satisfaction were higher in plague removal with an ultrasonic scaler related to clinical oral prophylaxis, pit and fissure sealants related to preventive dental treatment and instruction in the correct usage of toothbrush related to public dental health education 3. In dealing with dental radiation machines, the radiation protection was considered the most important. While the training for periapical radiography was most needed, the respondents were satisfied with working in the same area. The levels of job importance, training requirement and work satisfaction were high in preventive dental care in the community performed in relation to the public dental health care. 4. In the dental health insurance claim category, the levels of importance of job task, training requirement and work satisfaction were higher in insurance claiming. The levels of job importance and training requirement were high in dental clinic management and assistance to dentists performed for preventive dental treatment. The work satisfaction was higher in maintaining medical chart records. The levels of job importance, training requirement and work satisfaction were higher in dental assistance in relation to dental protection. 5. There was significant relationship between the level of importance and work experience. Those with a longer period of work experience had higher levels of job importance in dental health insurance claim, dental clinic management and assistance to dentists and the overall task(pE0.05). 6. A significant relationship was observed between the need for job training in dental cleaning and preventive dental treatment and work experience. Those with more than 8 years of work experience demonstrated that job training is most needed(pE0.05). 7. The work satisfaction level was higher in the group with more than 8 years of work experience, compared with those in other work experience periods(pE0.05). 8. A positive correlation was seen between the level of importance and the need for job training among three variables.

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