• Journal of Microbiology and Biotechnology
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• v.28 no.10
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• pp.1654-1663
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• 2018

Finding a safe and broad-spectrum medication is a goal of scientists, pharmacists, and physicians, but developing and fabricating the right medicine can be challenging. The current study describes the formation of silver nanoparticles (AgNPs) by Fusarium mangiferae. It involves the antibiofilm activity of the nanoparticles against Staphylococcus aureus. It also involves cytotoxic effect against mammalian cell lines. Well-dispersed nanoparticles are formed by F. mangiferae. The sizes of the nanoparticles were found to range from 25 to 52 nm, and UV-Vis scan showed absorption around 416-420 nm. SEM, TEM, and AFM results displayed spherical and oval shapes. Furthermore, the FTIR histogram detected amide I and amide II compounds responsible for the stability of AgNPs in an aqueous solution. AgNPs were observed to decrease the formation of biofilm at 75% (v/v). DNA reducing, smearing, and perhaps fragmentation were noticed after treating the bacterial cells with 50% (v/v). Additionally, cell lysis was detected releasing proteins in the supernatant. It was also observed that the AgNPs have the ability to cause 59% cervical cancer cell line (HeLa) deaths at 25% (v/v), however, they showed about 31% toxicity against rat embryo fibroblast transformed cell lines (REF). The results of this study prove the efficiency of AgNPs as an antibiofilm against S. aureus, suggesting that AgNPs could be an alternative to antibiotics. It must also be emphasized that AgNPs displayed cytotoxic behavior against mammalian cell lines. Further studies are needed for assessing risk in relation to the possible benefit of prescribing AgNPs.

• Journal of Hospice and Palliative Care
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• v.19 no.4
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• pp.283-291
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• 2016

Over the past decade, hospice and palliative care in Japan have progressed rapidly under the national policies supported by the Cancer Control Act. The numbers of palliative care units/inpatient hospices, hospital palliative care teams, and clinics with a home hospice function have been steadily increasing. The increasing numbers of physicians, nurses, and pharmacists have been certified as specialists in palliative care by national associations. Collaborative efforts have been made to standardize and disseminate educational programs and training opportunities in undergraduate, postgraduate, and continuing medical education. Research activities in Japan have markedly contributed to the growing body of evidence, especially in the fields of terminal delirium, terminal dehydration, palliative sedation, care for dying patients, prognostication, communication, psycho-oncology, and regional palliative care programs. This review focuses on major palliative care settings, specialty, national associations, education, and research in palliative care in Japan.

• Biomolecules & Therapeutics
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• v.14 no.1
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• pp.56-65
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• 2006

Adverse drug events (ADEs) are the most common type of adverse events in medical practice. Hospital admissions related to ADEs cost high and should be monitored to prevent them. While concerns about the ADEs are increasing, the frequency and characteristics of admissions related to ADEs have not been reported in Korea. The objective of the study was to assess the rate of hospital admission related to ADEs and their characteristics through ADE signal-based retrospective reviews of medical records. As results, a total of 1,420 patients had ADE signals suggesting potential ADEs from 3,494 patients who discharged from an academic medical center over one month period. Six pharmacists independently assessed the presence of ADEs after the review of patients' medical records. Among the 3,494 discharges, 62 admissions (1.8%) were found to be realted to ADEs. Of admissions with ADEs, 83.9% were moderate (category F by the NCC MERP classification), 37.2% were preventable, and 85.5% were type A reaction. The most frequent suspected drugs causing ADEs were antineoplastics (48.9%), and the most frequent ADE signal detecting hospital admissions related to ADEs was white blood cell count (24.2%). Hospital admissions related to ADEs were found through screening the ADE signals. The ADE signal-based retrospective review could be a practical approach for identifying hospital admissions related to ADEs.

• Health Policy and Management
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• v.22 no.1
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• pp.85-108
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• 2012

One of the ways to achieve the principle of equal access for equal needs, availability and geographical accessibility of health care resources regardless of resident sites is important. The purpose of this paper is to measure socioeconomic inequities in distribution of health care resources among regions in the Republic of Korea (hereafter Korea). Data were extracted from regional statistics of National Health Insurance, Community Health Survey, Korea Social Science Data Archive, and Korean Statistical Information Services at the same period of 2009. The dependent variables were the number of health workforce and health care facilities in each region. The proxy indicator of regional socioeconomic status was local tax per person. To identify whether inequalities among regions, we examined the concentration index(CI) and indirectly standardized CI by controlling each region's demographics and need factors. Total observations were 232 districts in nationwide, and we analyzed separately Seoul(25 districts) and non-Seoul areas(207 districts). The standardized CI values of health care resources were positive(favoring the rich region) across the nation in almost all kinds of resources. Especially the number of specialist, dentist, dental clinics, clinics, oriental medical clinics, pharmacists, and pharmacies were statistically significantly favoring the rich region. But the CI for the number of long-term care hospitals, public health centers were negative(favoring the poor region). The tendency of CI presenting positive values were increased in Seoul area. But in the case of non-Seoul, the CI indexes were nearly zero. The results suggest that except the Seoul area, little regional socioeconomic-related inequalities were observed in the distribution of health care resources in Korea.

• YAKHAK HOEJI
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• v.53 no.3
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• pp.107-113
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• 2009

Since 2006, the Computerized Restricted Antibiotic Control Program (CRACP) has been incorporated to facilitate a more efficient approval process of vancomycin use at the Chonbuk National University Hospital. The purposes of the study were to evaluate proper use of vancomycin and to examine if there is any improvement when administering the CRACP. The use of vancomycin was retrospectively reviewed by a medical record review based on the American Society of Hospital Pharmacists (ASHP) criteria (i.e., indication, use of critical process indicators and use of outcome measurements) and compared before (Group I) and after the CRACP (Group II). Two hundred fifty six patient records were evaluated (138 in Group I and 118 in Group II). There was a statistically significant improvement in the report of justification for vancomycin use after CRACP (42.0% vs. 62.7%, p=0.001). Out of eight critical process indicators, two indicators (appropriate cultures prior to medication [68.8% vs. 85.6%, p=0.002] and serum vancomycin level measurement [0% vs. 7.6%, p=0.001]) were significantly improved after CRACP. The total incidence of adverse effects was decreased from 14.5% to 6.8%. In addition, there was a statistically significant difference in WBC count reduction within normal range (52.8% vs. 73.1%, p=0.024). The CRACP appears to be a promising approach to improve use of vacomycin in a hospital setting. However, further evaluation for the long-term period should be performed to confirm the performance of the program.

• Quality Improvement in Health Care
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• v.22 no.1
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• pp.41-57
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• 2016

Objectives: This study aimed to investigate how many healthcare professionals experienced near misses, what types of near misses occurred most often, and healthcare professionals' opinions about near misses at one university hospital in Korea. Methods: The authors developed a questionnaire including 26 core types of near misses and 4 questions about preventability and reporting barriers. The survey was conducted from Oct. 31st to Nov. 18th 2011, about 3 weeks, using a self-administrated questionnaire that was administered to 697 healthcare professionals (registered nurses, pharmacists, technicians, and nurses aides) who worked at a university hospital. Medical doctors and employees working in the department of administration were excluded. Results: About half of hospital workers experienced at least one or more near misses during the past one year. The drug dispensing process was the most common subcategory of near misses. Among the 26 items, patient falls was highest. Over 95% of respondents reported that the near miss they experienced was preventable. Also, more than half of respondents did not report the near miss and the main reason for omission was fear of blame. Conclusion: Regarding patient safety issues, a near miss is a very significant factor because it can be a potential adverse event. Therefore, we should grasp the size of the problem through tracking and analyzing near misses and should make an effort to reduce them. To do so, we should check whether our reporting system is well designed and functioning.

• Korean Journal of Clinical Pharmacy
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• v.10 no.1
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• pp.30-37
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• 2000

Adverse drug reactions (ADR) may result in increased hospital admissions, morbidity and mortality, adding extra cost to healthcare expenditures. Thus, it is critical to activate ADR monitoring and reporting program in tertiary hospitals in developing countries such as Korea. This study was performed to identify the types of ADR being reported in a tertiary hospital, Samsung Medical Center, and to find out the ways to improve current ADR monitoring system. Of 464 ADR reports submitted to the pharmacy department during the 6-month survey period, $97.8\%$ of the reports were from out patient and $48.5\%$ were from patients aged between 50 and 60. The medical department with the highest frequency in ADR reporting was Internal Medicines $(35.6\%)$. The most common ADR manifestations were gastrointestinal complaints $(43.4\%)\;and\;75\%$ of the reported cases were mild in their severity. The most common drugs suspected of causing ADR were CNS drugs which accounted for $32.8\%$. In terms of causality assessment, $85.1\%$ of the reports were probable cases by WHO causality assessment criteria. In regards to sources of report, $75.6\%$ of ADR were reported by physicians and $24.4\%$ by nurses. There were no ADR reported by pharmacists. In conclusion, there is an urgent need to improve ADR monitoring system for inpatient and to motivate pharmacist involvement in ADR monitoring and reporting in Korea.

• Korean Journal of Clinical Pharmacy
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• v.21 no.4
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• pp.332-338
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• 2011

This study aimed to investigate the prescription of antibiotics in clinics, and evaluate their usage appropriateness after the 2000 Korean separation of dispensary from medical practice. A retrospective study was performed on the antibiotic use for 4 years from August 2000 to July 2004 in three clinics (general, internal medicine and ear-nose-and-throat (ENT) clinics). Moreover, prescription of antibiotics for acute upper respiratory infection (AURI), concomitant drugs, duplicate antibiotics and patient adherence were assessed for 260 patients experienced AURI in a pharmacy. The prescription rates of antibiotics amongst the whole prescription decreased annually during the study period, but those in ENT clinic still constituted more than 90%. The usage of penicillins declined, but that of broad spectrum antibiotics such as amoxicillin/clavulanic acid and 1st/2nd generation cephalosporins increased. Moreover, the categories of antibiotics for the same indication were different among the clinics. For patients with AURI, the more antibiotics were prescribed as its missing days and days under its therapeutic dose increased. The drug interactions with concomitant drugs decreased annually, but the use of duplicate antibiotics was similar across the period. Potential inappropriate antibiotic use was common after the Korean policy, so the observation of pharmacists needs in addition to the patients and practitioners' attention.

• Korean Journal of Clinical Pharmacy
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• v.21 no.4
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• pp.311-318
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• 2011

Misinformation and inappropriate use of medication has become one of the most pressing concerns in drug safety. The purpose of this study was to survey public perception on drug safety as well as the channels most relied upon providing such information. The survey was performed for patients or their families visiting pharmacies in a local city in Korea. Analysis was performed from 367 respondents to the survey. The contents of this survey revealed that consumers were aware of the fact that medications should not be taken at any higher dosage or more often than directed by their prescriptions. The survey revealed a general awareness that symptoms might not be relieved immediately by their medications. However, the perception that there could be adverse drug reaction (ADR) at therapeutic dose was low except among the young or highly educated members. Respondents recognized that skin rashes were the most whereas drowsiness was the least common ADR symptom. There was a high awareness of drug-food or drug-drug interactions except in the case of certain nutraceuticals. Doctors and pharmacists were ranked as the most reliable resources to the consumer for providing drug related information. However, public relations or education programs were in need since there were still not negligible numbers of consumers depending on personal experience rather than health professionals.

• Korean Journal of Clinical Pharmacy
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• v.28 no.2
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• pp.138-145
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• 2018

Background: Presently, a multidisciplinary team of doctors, pharmacists, nurses, and dietitians provides patient education to impart information on chemotherapy. However, studies on multidisciplinary education satisfaction are inadequate. In this study, we aimed to contribute to the improvement of quality of multidisciplinary education counseling for patients with cancer by developing a satisfaction questionnaire and analyzing the satisfaction survey. Methods: A questionnaire was developed by an expert group, and the responses were recorded using the 5-point Likert scale. After conducting a pre-test, factor analysis was performed to evaluate validity. The reliability of the questionnaire was measured by Cronbach's alpha coefficient. A satisfaction survey was conducted by self-administration method. Results: Based on the results of factor analysis, factors can be divided into two parts: "overall education" and "each team member's education" (total 14 questions). The construct validity and reliability of the questionnaire are sufficiently high. Fifty-one patients took the survey between January 2, 2018 and January 20, 2018. Twenty-six (51%) patients responded that they were "very satisfied" and 22 (43.1%) patients responded that they were "satisfied". Conclusion: By developing a questionnaire on multidisciplinary education counseling for patients with cancer, it is possible to perform evaluation and research of cancer patient education. This study will contribute to the management and improvement of quality of multidisciplinary education.