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Utility of CoaguChek XS for Monitoring the Prothrombin Time (프로트롬빈시간 모니터링을 위한 CoaguChek XS의 유용성)

  • Park, Rojin;Kim, Yong-Hyun;Kwon, Kyung Ock;Na, Jongsung;Won, Yong Soon;Sung, Ki Bum;Lee, Nae-Hee;Choi, Tae Youn;Shin, Jeong Won;Shin, Hee Bong;Lee, Yong-Wha;Lee, You Kyeong
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.471-475
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    • 2008
  • Background: In order to achieve a maintenance level and to prevent hemorrhagic complications, regular monitoring of the INR is mandatory for patients on oral anticoagulation therapy (OAT). A point-of-care instrument for INR monitoring is convenient for users, but the accuracy of the results has been controversial, and so this calls for exact evaluation of the point-of-care instrument that is used for INR monitoring. Methods: From Aug 2007 through Feb 2008, 85 patients on OAT among the all the patients who were admitted to Soonchunhyang University Bucheon Hospital were involved in this study. Parallel measurements of the PT INR were performed using a CoaguChek-XS and, a CA-7000 laboratory reference instrument and the results were analyzed. In addition, the patients' clinical data, including the diagnosis and the frequency and interval of the INR measurements, were also analyzed. Results: Of the 85 patients, 25 were admitted more than once to undergo INR testing and the mean interval between testing was 8.6 weeks with 39% and 38% of the tests being less than INR 2 units with using the CoaguChek-XS and the reference method, respectively. The coefficients of variation of CoaguChek-XS were 4.50 and 2.45 for the high and low INR patients, respectively. An excellent correlation was found between the two methods with a $R^2$ of 0.966 (p<0.001). Through Bland-Altman analysis, the mean INR difference between the two methods was 0.13 with the limit of agreement being -0.47~+0.72 with a 95% confidence interval. CoaguChek-XS was shown to overestimate the INR value for patients with an increasing INR, as compared to the reference method. Conclusion: CoaguChek-XS demonstrated great precision and accuracy for patients on OAT when compared to the laboratory INR results. Accordingly, the instrument should help to monitor the INR in the patients on OAT.

Classification and identification of organic aerosols in the atmosphere over Seoul using two dimensional gas chromatography-time of flight mass spectrometry (GC×GC/TOF-MS) data (GC×GC/TOF-MS를 이용한 서울 대기 중 유기 에어로졸의 분류 및 동정)

  • Jeon, So Hyeon;Lim, Hyung Bae;Choi, Na Rae;Lee, Ji Yi;Ahn, Yun Kyong;Kim, Yong Pyo
    • Particle and aerosol research
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    • v.14 no.4
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    • pp.153-169
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    • 2018
  • To identify a variety of organic compounds in the ambient aerosols, the two-dimensional gas chromatography-time of flight mass spectrometry (GCxGC) system (2DGC) has been applied. While 2DGC provides more peaks, the amount of the generated data becomes huge. A two-step approach has been proposed to efficiently interpret the organic aerosol analysis data. The two-dimensional 2DGC data were divided into 6 chemical groups depending on their volatility and polarity. Using these classification standards, all the peaks were subject to both qualitative and quantitative analyses and then classified into 8 classes. The aerosol samples collected in Seoul in summer 2013 and winter 2014 were used as the test case. It was found that some chemical classes such as furanone showed seasonal variation in the high polarity-volatile organic compounds (HP-VOC) group. Also, for some chemical classes, qualitative and quantitative analyses showed different trends. Limitations of the proposed method are discussed.

A Study on Compliance of Hypertensive Patients Registered at Community Health Practitioner Post (보건진료소에 등록된 고혈압 환자의 순응도 연구)

  • Cha, Sun-Sook;Kim, Keon-Yeop;Lee, Moo-Sik;Na, Back-Joo;Park, Jung-Hwan;Yu, Taec-Soo
    • Journal of agricultural medicine and community health
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    • v.30 no.1
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    • pp.101-111
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    • 2005
  • Objectives: This study was to evaluate the compliance of hypertensive patients and its related factors registered at Community Health Practitioner Post(CHCP). Methods: 304 patients were interviewed by trained nursing students during one month(June~July 2004). The questionnaire included general charactristics, knowledge of hypertension, health education experience, constructs of Health Belief Model, self efficacy and so on. Compliance group was defined "having regularly medication and good life style". Good life style included regular exercise, non-smoking, little alcohol, low salt diet, weight control. Results: In compliance group 90.3% of man and 93.3% of woman were regularly taking hypertensive medicine, and 45.2% of man and 56.4% of woman were having good life style (compliance group). In both man and woman, the group of higher education were more compliance group, but were statistically significant were in man(p<0.05). In woman, the compliance group have significantly higher score in knowledge of hypertension(p(0.05). The compliance group have significantly higher self-efficacy score in both man and woman (p<0.05). In Health Belief Model, susceptibility and benefit were statistically significant in man, seriousness, benefit and barrier in woman(p<0.05). In multiple logistic regression analysis, education level and self efficacy in man and knowledge of hypertension, self-efficacy and benefit in woman were significant variables (p<0.05). Conclusions: It is very important to evaluate and modify life-style adding to having regularly medication in hypertensive patients registered at CHCP. To this, health education programs about benefit to compliance and the methods to improve self-efficacy should be developed for this patients.

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A Study of The Medical Classics in the '$\bar{A}yurveda$' (아유르베다'($\bar{A}yurveda$) 의경(醫經)에 관한 연구)

  • Kim, Kj-Wook;Park, Hyun-Kuk;Seo, Ji-Young
    • The Journal of Dong Guk Oriental Medicine
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    • v.10
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    • pp.119-145
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    • 2008
  • Through a simple study of the medical classics in the '$\bar{A}yurveda$', we have summarized them as follows. 1) Traditional Indian medicine started in the Ganges river area at about 1500 B. C. E. and traces of medical science can be found in the "Rigveda" and "Atharvaveda". 2) The "Charaka(閣羅迦集)" and "$Su\acute{s}hruta$(妙聞集)", ancient texts from India, are not the work of one person, but the result of the work and errors of different doctors and philosophers. Due to the lack of historical records, the time of Charaka(閣羅迦) or $Su\acute{s}hruta$(妙聞)s' lives are not exactly known. So the completion of the "Charaka" is estimated at 1st$\sim$2nd century C. E. in northwestern India, and the "$Su\acute{s}hruta$" is estimated to have been completed in 3rd$\sim$4th century C. E. in central India. Also, the "Charaka" contains details on internal medicine, while the "$Su\acute{s}hruta$" contains more details on surgery by comparison. 3) '$V\bar{a}gbhata$', one of the revered Vriddha Trayi(triad of the ancients, 三醫聖) of the '$\bar{A}yurveda$', lived and worked in about the 7th century and wrote the "$Ast\bar{a}nga$ $Ast\bar{a}nga$ hrdaya $samhit\bar{a}$ $samhit\bar{a}$(八支集) and "$Ast\bar{a}nga$ Sangraha $samhit\bar{a}$(八心集)", where he tried to compromise and unify the "Charaka" and "$Su\acute{s}hruta$". The "$Ast\bar{a}nga$ Sangraha $samhit\bar{a}$" was translated into Tibetan and Arabic at about the 8th$\sim$9th century, and if we generalize the medicinal plants recorded in each the "Charaka", "$Su\acute{s}hruta$" and the "$Ast\bar{a}nga$ Sangraha $samhit\bar{a}$", there are 240, 370, 240 types each. 4) The 'Madhava' focused on one of the subjects of Indian medicine, '$Nid\bar{a}na$' ie meaning "the cause of diseases(病因論)", and in one of the copies found by Bower in 4th century C. E. we can see that it uses prescriptions from the "BuHaLaJi(布唅拉集)", "Charaka", "$Su\acute{s}hruta$". 5) According to the "Charaka", there were 8 branches of ancient medicine in India : treatment of the body(kayacikitsa), special surgery(salakya), removal of alien substances(salyapahartka), treatment of poison or mis-combined medicines(visagaravairodhikaprasamana), the study of ghosts(bhutavidya), pediatrics(kaumarabhrtya), perennial youth and long life(rasayana), and the strengthening of the essence of the body(vajikarana). 6) The '$\bar{A}yurveda$', which originated from ancient experience, was recorded in Sanskrit, which was a theorization of knowledge, and also was written in verses to make memorizing easy, and made medicine the exclusive possession of the Brahmin. The first annotations were 1060 for the "Charaka", 1200 for the "$Su\acute{s}hruta$", 1150 for the "$Ast\bar{a}nga$ Sangraha $samhit\bar{a}$", and 1100 for the "$Nid\bar{a}na$". The use of various mineral medicines in the "Charaka" or the use of mercury as internal medicine in the "$Ast\bar{a}nga$ Sangraha $samhit\bar{a}$", and the palpation of the pulse for diagnosing in the '$\bar{A}yurveda$' and 'XiZhang(西藏)' medicine are similar to TCM's pulse diagnostics. The coexistence with Arabian 'Unani' medicine, compromise with western medicine and the reactionism trend restored the '$\bar{A}yurveda$' today. 7) The "Charaka" is a book inclined to internal medicine that investigates the origin of human disease which used the dualism of the 'Samkhya', the natural philosophy of the 'Vaisesika' and the logic of the 'Nyaya' in medical theories, and its structure has 16 syllables per line, 2 lines per poem and is recorded in poetry and prose. Also, the "Charaka" can be summarized into the introduction, cause, judgement, body, sensory organs, treatment, pharmaceuticals, and end, and can be seen as a work that strongly reflects the moral code of Brahmin and Aryans. 8) In extracting bloody pus, the "Charaka" introduces a 'sharp tool' bloodletting treatment, while the "$Su\acute{s}hruta$" introduces many surgical methods such as the use of gourd dippers, horns, sucking the blood with leeches. Also the "$Su\acute{s}hruta$" has 19 chapters specializing in ophthalmology, and shows 76 types of eye diseases and their treatments. 9) Since anatomy did not develop in Indian medicine, the inner structure of the human body was not well known. The only exception is 'GuXiangXue(骨相學)' which developed from 'Atharvaveda' times and the "$Ast\bar{a}nga$ Sangraha $samhit\bar{a}$". In the "$Ast\bar{a}nga$ Sangraha $samhit\bar{a}$"'s 'ShenTiLun(身體論)' there is a thorough listing of the development of a child from pregnancy to birth. The '$\bar{A}yurveda$' is not just an ancient traditional medical system but is being called alternative medicine in the west because of its ability to supplement western medicine and, as its effects are being proved scientifically it is gaining attention worldwide. We would like to say that what we have researched is just a small fragment and a limited view, and would like to correct and supplement any insufficient parts through more research of new records.

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Risk Factors of Catheter-related Bloodstream Infection Due to Methicillin-resistant Staphylococcus aureus in Very Low Birth Weight Infants (극소저체중 출생아에서 메티실린 내성 포도상구균으로 인한 카테터 연관 혈류감염의 위험인자)

  • Cho, Il-Hyun;Jung, Tae-Woong;Lee, Ju-Young;Moon, Se-Na;Bin, Joong-Hyun;Lee, Hyun-Seung;Lee, Jung-Hyun;Kim, So-Young;Sung, In-Kyung
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.288-292
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    • 2011
  • Purpose: The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection has increased in children and in neonates, and is particularly associated with frequent use of central venous catheter in very low birth weight (VLBW) infants. It is known that the morbidity and mortality of MRSA infection are low in neonates, as compared with adults. The objective of this study was to examine the difference in clinical characteristics between VLBW infants that survived and those that did not, a catheter-related bloodstream infection (CRBSI) of MRSA. Methods: Thirty-four VLBW infants had laboratory-confirmed bloodstream infection with S. aureus. We examined the incidence, mortality and morbidity of CRBSI, and predictive factors associated with mortality. Results: Twenty-six infants had same pathogen (24 MRSA, 2 Methicillin-sensitive Staphylococcus aureus) in the blood and in the catheter tip. Eight infants (25.8%) died in the CRBSI and they all had MRSA blood infections. Sex ratio, gestational age, duration between blood collection and identification of pathogens, and WBC and platelet count were not significantly different between patients that died from and patients that survived CRBSI of MRSA. C-reactive protein (CRP) was significantly higher in VLBW infants that died. Mean age of onset and hospital day was earlier (9.1${\pm}$6.6 vs. 26.9${\pm}$20.2; P=0.005) and shorter for patients that died (10.1${\pm}$7.0 vs. 73.0${\pm}$32.4; P=0.000). Two survivors had complications of pyogenic arthritis of the lower extremities and soft tissue infection, respectively. Conclusion: Mortality of CRBSI was likely to be high in VLBW infants and might be anticipated by CRP and early onset of disease.

Evaluation of Usefulness on In-vivo Diode Dosimetry for Measuring the Tumor Dose of Oral Cancer Patient (구강암 환자의 종양 선량 측정을 위한 In-vivo Diode Dosimetry의 유용성 평가)

  • Na Kyung-Su;Lee Je-Hee;Park Heung-Deuk
    • The Journal of Korean Society for Radiation Therapy
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    • v.17 no.2
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    • pp.133-140
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    • 2005
  • Purpose : This test is designed to identify the validity of treatment plan by implementing real-time dosimetry by means of dose that is absorbed into PTV and OAR when preparing doses of 3D and POP plans. Materials and Methods : In treatment. error can be calculated be comparing Exp. Dose with the actual dose, which has been converted from 'the reading value obtained by placing diode detector on the area to be measured'. Same test can be repeated using Alderson-Rando phantom. Results : Errors were found: A patient(POP plan): 197.6/199=-1.2%, B patient(3D-plan): 199.9/198.7=+0.6%, C patient: 196/200=-1.5%. In addition, considering the resulted value of measuring OAR besides target-dose for C patient showed 96/200, representing does of 47%, the purpose of protection was judged to be duly accomplished. Also it was acknowledged the resulted value of -3.7% met the targeted dose within the range of ${\pm}5%$. Conclusion : Aimed for identifying the usefulness of pre-treatment dose measurement using diode detector, this test was useful to evaluate the validity of curing because it resulted in the identification of category to be protected as well as t dose. Moreover, it is thought to have great advantage in ascertaining the dose of target, dose of which is not calculated yet. Similar to L-gram before treatment, this test is thought to be very effective so that it can bring great advantages in the aspects such as validity of curing method and post-treatment plan as well.

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A Study on Migration of Ethylenediamine and Hexamethylenediamine from Polyamide Utensils (Polyamide 조리기구로부터 Ethylenediamine 및 Hexamethylenediamine의 이행에 관한 연구)

  • Eom, Mi-Ok;Kwak, In-Shin;Yoon, Hae-Jung;Jeon, Dae-Hoon;Choi, Hyun-Chul;Kim, Hyung-Il;Sung, Jun-Hyun;Park, Na-Young;Kim, So-Hee;Lee, Young-Ja
    • Journal of Food Hygiene and Safety
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    • v.25 no.1
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    • pp.36-42
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    • 2010
  • The method for the determination of ethylenediamine (EDA) and hexamethylenediamine (HMDA) in food simulants was developed, and migration amounts of these compounds was monitored for 124 polyamide (PA) utensils. The diurethane derivatives of EDA and HMDA, which produced by reaction with ethyl chloroformate, were analyzed by using gas chromatograph (GC)/flame ionization detector (FID) and GC/mass spectrometer (MS). The developed method was validated with $0.3\;{\mu}g/mL$ of limit of detection (LOD) for EDA and $0.1\;{\mu}g/mL$ of LOD for HMDA, > 0.999 of linearity($r^2$) and > 88% of recovery. The EDA was detected 1.31 and $02.06\;{\mu}g/mL$ for 2 samples in water. The HMDA was detected $0.29\;-\;0.93\;{\mu}g/mL$ for 3 samples in 20% ethanol and $0.26\;-\;0.44\;{\mu}g/mL$ for 10 samples in n-heptane. These migration levels were below the specific migration limits (SML) of $12\;{\mu}g/mL$ and $2.4\;{\mu}g/mL$ for EDA and HMDA established in EU.

Comparison between the method of the measurement 25 Vitamin D3 (25 Vitamin D3 측정에 있어서 화학발광미세입자 측정법과 화학발광면역 측정법 간의 비교 및 고찰)

  • Kim, dae-won;Lee, jung-hee;Jung, an-na;Seo, so-yoen
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.2
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    • pp.112-114
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    • 2015
  • Purpose Vitamin D to Anti- Rickets both steroid compounds showing activity, By acting on bone tissue secretary and the key to maintain serum Ca homeostasis. The blood level of vitamin D is the largest in D3 that the concentration of the metabolite is reflected in the holding state of vitamin D in vivo. Sunlight to change the 7-dehydrocholesterol in the skin and through the skin to D3, In the liver in combination with the D2 and D3 D4 changes. The Radioimmunoassay(RIA) method is measuring the D 3, the sensitivity can be measured also difficult trace substance to measure the normal test because it is very sensitive, but recently, a check is possible, for the Total D3 in Chemimicroparticle immunoassay(CMIA) or Chemiluminescent immunoassay(CLIA) measuring using microparticle RIA and CMIA(Architect i2000SR) / use the CLIA(DXI-800) method to compare and evaluate the correlation between the tests in the same test items. Materials and Methods Commissioned from January 2014 to March 2015 patients were enrolled in a total of 273 people. 29 out of 273 people conducted by RIA were compared with CMIA, 244 patients were compared with CLIA. Using reagents and equipment were used RIA(Diasource), CMIA(Architect i2000SR, Abbott Diagnostics) / CLIA( Unicel DXi-800, Beckman coulter). Results Correlation of the RIA and CLIA was a R2 = 0.1844 (y = 0.7303x + 3.9005), and the correlation of RIA CMIA is R2 = 0.2762 (y = 0.8862x + 4.56) respectively. (According to statistics, during the same period RIA is Deficiency 4.31%, Insufficiency 90.53%, Sufficiency 5.16%, was Excess 0%, CLIA / CMIA is Deficiency 17.02%, Insufficiency 75.91%, Sufficiency 7.03%, indicating the distribution of 0.03 % Excess) Conclusion Serum vitamin D and parathyroid hormone that show an inverse relationship, the level above which are not parathyroid hormone and vitamin D reduced the increase. The density is different for each study, at most 20 is reported to be the maximum between 30 ng / ml. In Korea it requires a proposed standard of vitamin D deficiency, reference to the WHO lack the case more than 10ng/ml, 20ng/ml and defined by the lack of, if not more than, the IOM, but looking at 12ng/ml or less to the normal to lack, at least 20ng/ml, the reference do not match the deficit under 20ng/ml, 21-29ng/ml relative lack between, was also defined as a sufficient condition for more than 30ng/ml. Although not statistically is between RIA and CLIA two ways to vitamin D levels change according to season match, when seasonally seen in summer as commonly known (April to September), winter (October to March) relative to the increase measured than it was found. Finally, the study on the correlation between the two methods have been expected to result in a consistent and apply the same view high reference value on the graph is difficult. However, there may be differences between the test equipment and methods, and could be especially the case of RIA method using an organic solvent is difficult to compare different methods and correlated view similar trend in vitamin D deficiency and quarterly aspect ratio.

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Microtensile bond strength of resin inlay bonded to dentin treated with various temporary filling materials (임시 가봉재가 상아질과 레진 인레이의 미세인장 결합 강도에 미치는 영향)

  • Kim, Tae-Woo;Lee, Bin-Na;Choi, Young-Jung;Yang, So-Young;Chang, Hoon-Sang;Hwang, Yun-Chan;Hwang, In-Nam;Oh, Won-Mann
    • Restorative Dentistry and Endodontics
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    • v.36 no.5
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    • pp.419-424
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    • 2011
  • Objectives: This study was aimed to determine the effects of temporary sealing materials on microtensile bond strength between resin-coated dentin and resin inlay and to compare the bonding effectiveness of delayed dentin sealing and that of immediate dentin sealing. Materials and Methods: The teeth were divided into 4 groups: group 1, specimens were prepared using delayed dentin sealing after temporary sealing with zinc oxide eugenol (ZOE); group 2, specimens were prepared using immediate dentin sealing and ZOE sealing; group 3, specimens were prepared using immediate dentin sealing and Dycal (Dentsply) sealing; group 4, specimens were prepared using immediately sealed, and then temporarily sealed with a resin-based temporary sealing material. After removing the temporary sealing material, we applied resin adhesive and light-cured. Then the resin inlays were applied and bonded to the cavity with a resin-based cement. The microtensile bond strength of the sectioned specimens were measured with a micro-tensile tester (Bisco Inc.). Significance between the specimen groups were tested by means of one-way ANOVA and multiple Duncan's test. Results: Group 1 showed the lowest bond strength, and group 4 showed the highest bond strength (p < 0.01). When temporary sealing was performed with ZOE, immediate dentin sealing showed a higher bonding strength than delayed dentin sealing (p < 0.01). Conclusions: Based on these results, immediate dentin sealing is more recommended than delayed dentin sealing in bonding a resin inlay to dentin. Also, resin-based temporary sealing materials have shown the best result.

The Clinical Effects of Surgical Treatment for Hemoptysis due to Inflammatory Lung Disease (염증성 폐질환에 의한 객혈에 대한 수술적 치료 효과)

  • Yun, Ju-Sik;Na, Kook-Joo;CheKar, Jay-Key;Jeong, In-Seok;Song, Sang-Yun;Oh, Sang-Gi
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.144-149
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    • 2010
  • Background: Many studies have demonstrated the various therapeutic options for treating hemoptysis caused by inflammatory lung disease. However, there is debate over the surgical management of the ongoing hemoptysis. Therefore, we evaluated the clinical results of pulmonary resection that was done due to hemoptysis in patients with concomitant inflammatory lung disease. Material and Method: We performed a retrospective analysis of 75 patients who received pulmonary resection for hemoptysis and concomitant inflammatory lung disease between 2001 and 2007. The mean age was $52.1{\pm}12.5$ years old, and the male; female ratio was 52:23. Result: The underlying disease was aspergilloma in 30 patients (40%), pulmonary tuberculosis in 20 patients, bronchiectasis in 18 patients and other causes in 7 patients. The surgical treatment included lobectomy in 55 patients, bilobectony in 2 patients, pneumonectomy in 17 patients and wedge resection in 1 patient. There were 3 early deaths, and the causes of death were pneumonia in 1 patient and BPF in 2 patients. The early mortality was statistically higher for such risk factors as a preoperative Hgb level <10 g/dL, COPD and an emergency operation. Conclusion: In conclusion, pulmonary resection for treating hemoptysis showed the acceptable range of mortality and it was an effective method for the management of hemoptysis in patients with inflammatory lung disease. However, relatively high rates of mortality and morbidity were noted for an emergency operation, and so meticulous care is needed in this situation.