• Title/Summary/Keyword: Prospectively

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Analysis of procedural performance after a pilot course on endovascular training for resuscitative endovascular balloon occlusion of the aorta

  • Sung Wook Chang;Dong Hun Kim;Dae Sung Ma;Ye Rim Chang
    • Journal of Trauma and Injury
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    • v.36 no.1
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    • pp.3-7
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    • 2023
  • Purpose: As resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed in an extremely emergent situation, achieving competent clinical practice is mandatory. Although there are several educational courses that teach the REBOA procedure, there have been no reports evaluating the impact of training on clinical practice. Therefore, this study is aimed to evaluate the effects of the course on procedural performance during resuscitation and on clinical outcomes. Methods: Patients who were managed at a regional trauma center in Dankook University Hospital from August 2016 to February 2018 were included and were grouped as precourse (August 2016-August 2017, n=9) and postcourse (September 2017- February 2018, n=9). Variables regarding injury, parameters regarding REBOA procedure, morbidity, and mortality were prospectively collected and reviewed for comparison between the groups. Results: Demographics and REBOA variables did not differ between groups. The time required from arterial puncture to balloon inflation was significantly shortened from 9.0 to 5.0 minutes (P=0.003). There were no complications associated with REBOA after the course. Mortality did not show any statistical difference before and after the course. Conclusions: The endovascular training for REBOA pilot course, which uses a modified form of flipped learning, realistic simulation of ultrasound-guided catheter insertion and balloon manipulation, and competence assessment, significantly improved procedural performance during resuscitation of trauma patients.

Study for Safety of Oriental Medical Therapy and Continuous Intravenous Urokinase combined Therapy in Acute Cerebral Infarction. (급성기 뇌경색 환자에서 한방치료와 지속적 유로키나제 정주요법 병용시 안전성에 대한 임상적 고찰)

  • Kim, Sung-keun;Lim, Chang-sun;Yim, Jun-hyok;Yang, Dong-ho;Shin, Hyon-seung;Park, Joon-ha;Jeong, Seung-cheol
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.10 no.1
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    • pp.1-7
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    • 2009
  • Objectives : This Study was prepared for investigating the safety of oriental medicine and continuous intravenous urokinase combined therapy in acute cerebral infarction. Methods : We prospectively estimate safety of hemorrhagic transformation occurred in oriental medical therapy and continuous intravenous urokinase combined therapy. We estimate National Institute of Health Stroke Scale Score and Modified Barthel Index. Results : Hemorrhagic transformation was not noted. and Others are not fatal complication. Conclusions : oriental medical therapy and continuous intravenous urokinase combined therapy are safety method in treatment of acute cerebral infarction. We think this can be a good model of Oriental and western cooperative therapy.

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The Effect of Nurse Image, Satisfaction with One's Major and Career Decision-making Self-efficacy on Career Preparation Behavior of First-year Nursing Students (간호학과 신입생의 간호사 이미지, 전공만족도, 진로결정 자기효능감이 진로준비행동에 미치는 영향)

  • Kim, Seong Kyong
    • Journal of muscle and joint health
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    • v.31 no.2
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    • pp.117-125
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    • 2024
  • Purpose: This study was intended to evaluate the effect of nurse image, satisfaction with one's major and career decision-making self-efficacy on career preparation behavior of first-year nursing students. Methods: A total of 134 first-year nursing students were enrolled in this study. Data were collected from March 25 to April 5, 2024. Data collected prospectively were analyzed by t-test, ANOVA, Pearson's correlation coefficients, and multiple regression analysis. Results: Career preparation behavior showed a significantly positive correlation with nurse image (r=.28, p=.001), satisfaction with one's major (r=.41, p<.001) and career decision-making self-efficacy(r=.61, p<.001). Career decisionmaking self-efficacy showed a significantly positive correlation with nurse image (r=.59, p<.001), satisfaction with one's major (r=.70, p<.001). Satisfaction with one's major showed a significantly positive correlation with nurse image (r=.66, p<.001). Career preparation behavior was significantly affected by nurse in the family and relatives (β=-.21, p=.003) and career decision-making self-efficacy (β=.64, p<.001), which had an explanatory power of 41.0%. Conclusion: To establish career preparation behavior in first-year nursing students, it is necessary to develop a variety of systematic educational programs to enhance career decision-making self-efficacy.

The Clinical Association of Thyroid Lesions in Patients with Globus Pharyngeus (인후두부 이상감을 호소하는 환자와 갑상선 병변과의 임상적 연관성)

  • Park Kyoung-Ho;Park Young-Hak;Hwang Sung-Jae;Kang Min-Gon;Park Hong-Jin;Kim Min-Sik;Cho Seung-Ho
    • Korean Journal of Bronchoesophagology
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    • v.10 no.2
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    • pp.43-48
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    • 2004
  • Background and Objectives : Globus pharyngeus is the feeling of a lump or foreign body in the throat. Otolaryngologists are often confronted with this condition, and some author reported that it represents 3 percent of all new clinic referral. The purpose of this study is to estimate the incidence of impalpable thyroid lesion in patients with globes pharyngeus and investigate possible association between globus pharyngeus and thyroid lesions. Material and Method : 146 patients with globus pharyngeus and 30 controls were prospectively examined by high resolution ultrasound. Results: Thyroid abnormalities were present in $75/146(51\%)$ patients with globus pharyngeus and in $7/30(23\%)$ controls. Of the patients with globus, 55 patients had a nodule or nodules, 11 patients had a cyst or cysts, 9 patients had diffuse abnormalities. Solitary nodule ranged from 4mm to 20mm. Conclusion : Impalpable, ultrasound detectable thyroid abnormailities are significantly more common in patients with globus pharyngeus than in controls. The thyroid abnormalities may be the cause of globus symptoms in some patients, and high resolution ultrasound is an important modality in patients presenting with globus.

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Short-term, Multi-center Prospective Clinical Study of Short Implants Measuring Less Than 7mm

  • Kim, Young-Kyun;Yi, Yang-Jin;Kim, Su-Gwan;Cho, Yong-Seok;Yang, Choon-Mo;Liang, Po-Chin;Chen, Yu-Yal;I, Lee-Long;Sim, Christopher;Tan, Winston;Ser, Go Wee;Yue, Deng;Yi, Man;Ping, Gong
    • Journal of Korean Dental Science
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    • v.3 no.1
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    • pp.11-16
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    • 2010
  • Objective : This prospective study sought to verify the stability of three types of short implants measuring 7mm or less. Materials and methods : Implants measuring 7mm or less were placed in patients at multicenter dental clinics in Korea, China, Taiwan, and Singapore. Initial stability, intraoperative and postoperative complications, crestal bone loss, and survival rate of the implant were prospectively evaluated. Results : The primary stability of a 6-mm implant was lower than that of a 7-mm implant. The marginal bone loss of short implants measuring less than 7mm was minimal. Complications such as wound dehiscence, implant mobility, and peri-implant mucositis developed, and these were associated with initial implant failure. The short-term survival rate of 6-mm implant was 93.7%, and that of 7-mm implant, 96.6%. Conclusion : Short implant for the mandible with insufficient height for the residual ridge can be selectively used. Poor primary stability and wound dehiscence can cause osseointegration failure and alveolar bone loss.

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Status of Herbal-drug-associated Adverse Drug Reactions Voluntarily Reported by EMR (1개 대학 한방병원에서 EMR을 통해 보고된 한약에 의한 약물유해반응의 현황)

  • Kwon, Yeong-Ju;Cho, Woo-Keun;Han, Chang-Ho
    • The Journal of Internal Korean Medicine
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    • v.33 no.4
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    • pp.485-497
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    • 2012
  • Objectives : The aim of this study was to systematically investigate herbal-drug-associated adverse drug reactions (herbal ADRs) reports submitted by a single oriental hospital and to analyze the general characteristics, causative agents, clinical manifestations, severity and types of herbal medicines which caused herbal ADRs. Methods : This study proceeded with IRB approval. The data on herbal ADR were collected prospectively from January 2008 to February 2012 by EMR of Dongguk University Ilsan Oriental Hospital. The World Health Organization (WHO)-Uppsala Monitoring Center (UMC) criteria was used to determinate causality for each herbal ADR. WHO-Adverse Reaction Terminology (WHO-ART) System Organ Class (SOC) code and WHO severity category were also used in this study. Results : A total of twenty eight cases were reported. Twenty two cases were assessed to have over possible relations with herbal medication. The gender ratio of these cases were 64.6 percent female and 36.4 percent male, demonstrating no statistical significance. Patients aged over 60 were 59.1%. Gastro-intestinal system was reported to be the most frequently affected organ (38.8%), and followed by psychiatric system (22.4%), and integumentary system (22.4%). The most common clinical symptom was headache (12.2%), followed by diarrhea (10.2%), and pruritus (10.2%). The severity of most cases was assessed to be mild (89.8%). The percentage of moderate ones was 10.2%, and there were no severe cases. Conclusions : Progressive study and further analysis on herbal ADRs are warranted for safety in the clinical use of herbal medicines.

Study on patients of infectious diseases administered with vancomycin or teicoplanin - Assessment of fitness of antimicrobial administration - (감염증 환자에서 vancomycin, teicoplanin 투여례에 대한 연구 - 항균제 투여의 적응증 평가 -)

  • Chang, Chul Hun;Son, Han Chul;Hwang, Kyu Yon;Park, Kwang Ok;Yang, Ung Suk
    • Quality Improvement in Health Care
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    • v.3 no.2
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    • pp.26-35
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    • 1997
  • Background : Glycopeptide antibiotics are the only drugs for treatment of infections due to beta-lactam-resistant Gram-positive bacteria. As the incidence of infection and colonization with vancomycin-resistant enterococci(VRE) rapidly increases, the hospital infection control practices advisory committee(HICPAC) recommends prudent vancomycin use to detect, prevent and control infection and colonization with VRE. Methods : The inpatients admitted from September to December, 1996 in Pusan National University Hospital, with Gram-positive bacterial infections were evaluated retrospectively to see whether the administrations of glycopeptide antibiotics were appropriate or not, upon comparison with the recommendations for preventing the spread of vancomycin resistance by HICPAC. Results : Teicoplanin has been chosen more frequently than vancomycin of the glycopeptide antibiotics. The indications of administration of glycopeptides in patients with pneumonia, wound infections, sepsis, and in febrile or neutropenic patients with malignancies were appropriate, but the use of glycopeptides for elimination of merely colonized bacteria in the oral cavity could not be excluded. Inappropriate use of glycopeptides was 10.6%, and inappropriately long-term use without positive culture for beta-lactam-resistant Gram-positive organisms was about 40% of total days of drug use. Conclusion : It seems essential for the quality assurance committee to make a plan in teaching the HICPAC recommendations to the medical practitioners who prescribed the glycopeptides inappropriately or used for irrelevantly long to his patient, monitor and survey their use of glycopeptides prospectively and periodically, and if there are repeated inappropriate prescriptions, a certain penalty would be given to the practitioners.

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Diagnostic and Prognostic Value of miR-205 in Colorectal Cancer

  • Orang, Ayla Valinezhad;Safaralizadeh, Reza;Feizi, Mohammad Ali Hosseinpour;Somi, Mohammad Hossein
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.9
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    • pp.4033-4037
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    • 2014
  • Emerging evidence has shown associations of microRNA-205 (miR-205) with crucial cell processes such as the epithelial-mesenchymal transition (EMT) and aberrant expression with tumorigenesis in many types of human malignancy. This prospective study characterized the contribution of miR-205 to the colorectal cancer (CRC) tumorigenesis. The real-time reverse transcription-polymerase chain reaction was used to examine miR-205 levels prospectively in 36 pairs of samples of CRC tissue and adjacent noncancerous tissue (>2 cm from cancer tissue). In addition, the relationship between miR-205 levels and clinicopathological features was explored. The capability of miR-205 to function as a tumor marker was also examined. miR-205 expression levels did not show significant changes overall. However, miR-205 was significantly downregulated in a group of CRC samples compared with matched noncancerous tissue samples. Moreover, decreased miR-205 correlated significantly with lymphatic metastasis. A receiver operating characteristic (ROC) curve also showed an optimum cut off point of $1.4{\times}10^{-3}$ to distinguish lymphatic metastatic CRCs from non-metastatic CRCs. Interestingly we found lymphatic metastasis in almost 80% of the depressed samples. This study suggested that miR-205 could be reduced in the majority of metastatic CRCs and the risk of CRC metastasis may be predicted by monitoring miR-205 in patient samples collected at the time of the initial diagnosis. Therefore, targeting miR-205 and its potential environmental activators might be a promising therapeutic option to prevent malignant progression toward metastasis.

Prevalence and risk factors for vitamin D deficiency in children with iron deficiency anemia

  • Yoon, Jung Won;Kim, Sung Woo;Yoo, Eun Gyong;Kim, Moon Kyu
    • Clinical and Experimental Pediatrics
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    • v.55 no.6
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    • pp.206-211
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    • 2012
  • Purpose: The increasing prevalence of breast feeding has led to concerns about vitamin D deficiency (VDD) and iron deficiency anemia (IDA) in children. We evaluated the prevalence of VDD in a population of Korean children with IDA and assessed the risk factors for VDD in these children. Methods: A total of 79 children who were diagnosed with IDA were prospectively surveyed from April 2010 to March 2011. Data were collected by questionnaire, medical assessment, and laboratory tests, including measurement of 25-hydroxyvitamin D (25OHD), hemoglobin, and wrist radiography. Results: The median age was 22 months and 30% of the subjects were female. Over a half of subjects (58%) had subnormal vitamin D level (25OHD<30 ng/mL), and VDD (25OHD<20 ng/mL) was present in 39% of children. There was no difference in serum hemoglobin level between IDA patients with VDD and those without VDD. Most subjects (89%) were currently or had recently been breastfed and almost all subjects (97%) who had VDD received breastfeeding. Children with VDD were more likely to be younger than 2 years, to have been breastfed, and to have been tested in winter or spring. Multivariable analysis indicated seasonal variation was a significant independent risk factor for VDD in our IDA patients. Conclusion: Our results demonstrated that VDD has a high prevalence in Korean children with IDA. Primary care physicians should be aware of the possibility of VDD in children with IDA and should supplement the vitamin D as well as iron.

Comparison of Heparin Solution and 0.9% Normal Saline Solution Flushing to Secure the Patency of Non-Tunneled Central Venous Catheters (비턴넬형 중심정맥관 개방성 유지를 위한 헤파린 희석액 관류와 생리식염수 관류의 비교)

  • Kim, Ji Hye;Seo, Eun Ji;Park, Hee Jung;Kim, Si Hyeon;Min, Ja;Park, Jeong Yun;Kim, Song Cheol
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.3
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    • pp.326-336
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    • 2014
  • Purpose: The purpose of this study was to compare the effectiveness of heparin and 0.9% normal saline solution flushing for maintaining patency of non­tunneled central venous catheters in patients with surgery. Methods: A randomized controlled clinical trial was performed. Fifty­eight patients were prospectively enrolled and fifty-four patients were completed the study. The heparin group consisted of 30 patients given 100u/ml diluted heparin flushing and the normal saline group consisted of 24 patients with 0.9% sodium chloride flushing. Results: There was no significantly difference in occlusion between the heparin group and the normal saline group in non­tunneled central venous catheters' occlusion. Also there was no difference between these two groups in catheter­related infections. Conclusion: Flushing with 0.9% normal saline is as effective as flushing with heparin solution in maintaining the patency of non­tunneled central venous catheters. In this study, however, the duration of central line use was short and the infection occurrence was little. Further studies are warranted with a larger sample size at multiple centers.