• Journal of Hospice and Palliative Care
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• v.25 no.3
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• pp.133-137
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• 2022

A 72-year-old woman with metastatic lung cancer to bone and brain and with left external iliac vein thrombosis was under the care of a community palliative care provider. She experienced an acute pain crisis due to acute limb ischemia of the left lower limb. Goals-of-care discussions were held with the patient and her family; she prioritized symptom control and end-of-life care at home. The family and patient were aware of her short prognosis. Her complex pain was managed by the community palliative team, and her family was empowered to give subcutaneous injections. We illustrate a case showing the importance of community health services with palliative care support in providing symptom management and support to patient and family caregivers throughout the course of a life-limiting illness. It also highlights family caregivers' potential psychological distress in delivering subcutaneous injections in terminal care for a patient at home.

• Journal of Korean Academy of Nursing
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• v.40 no.2
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• pp.247-254
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• 2010

Purpose: To study the thickness of gluteal subcutaneous fat (SCF) and propose an adequate length for needle for gluteal intramuscular injections based on computed tomography (CT) measurements. Methods: The thickness of gluteal SCF were measured and studied for 568 patients who visited a tertiary hospital in Seoul, Korea between January 2007 and February 2009 for routine health screening and who had abdominopelvic CT. Results: The average thickness of gluteal SCF was $15.92{\pm}4.08mm$ in males and $24.90{\pm}5.47mm$ in females. The thickness of gluteal SCF differed significantly according to gender. The gluteal SCF thickness was greater than 20.4 mm for 54 (12.3%) of the 440 male patients and 99 (77.3%) of the 128 female patients. Conclusion: The most common syringe needle used for gluteal intramuscular injections in Korea is a 23 G, 25.4 mm-needle. The SCF thickness must be less than 20.4 mm in order to reach the dorsogluteal muscles to a depth of at least 5 mm if this 25.4 mm needle is used. In many patients, especially in female patients, the 25.4 mm needles will result in improper intramuscular injections with the injection being into the SCF. Therefore an appropriate needle should be selected by considering the gender and SCF thickness of patients receiving gluteal intramuscular injections.

• Korean Journal of Veterinary Pathology
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• v.3 no.2
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• pp.83-85
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• 1999

Weekly subcutaneous injection of7 ,12-dimethylbenz[a]anthracene(DMBA) at a dose level of 0.25kg/mg body weight induced proliferative lesions in the spleen of syrian golden of syrian In addition, subcutaneous tumors at injection sites were observed. The splenic lesions included stromal hyperplasia and hacmangioma-like lesion.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.3
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• pp.262-267
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• 2021

Objective: Progesterone application for luteal phase support is a well-established concept in in vitro fertilization (IVF) treatment. Water-soluble subcutaneous progesterone injections have shown pregnancy rates equivalent to those observed in patients receiving vaginal administration in randomized controlled trials. Our study aimed to investigate whether the results from those pivotal trials could be reproduced in daily clinical practice in an unselected patient population. Methods: In this retrospective cohort study in non-standardized daily clinical practice, we compared 273 IVF cycles from 195 women undergoing IVF at our center for luteal phase support with vaginal administration of 200 mg of micronized progesterone three times daily or subcutaneous injection of 25 mg of progesterone per day. Results: Various patient characteristics including age, weight, height, number of oocytes, and body mass index were similar between both groups. We observed no significant differences in the clinical pregnancy rate (CPR) per treatment cycle between the subcutaneous (39.9%) and vaginal group (36.5%) (p=0.630). Covariate analysis showed significant correlations of the number of transferred embryos and the total dosage of stimulation medication with the CPR. However, after adjustment of the CPR for these covariates using a regression model, no significant difference was observed between the two groups (odds ratio, 0.956; 95% confidence interval, 0.512-1.786; p=0.888). Conclusion: In agreement with randomized controlled trials in study populations with strict selection criteria, our study determined that subcutaneous progesterone was equally effective as vaginally applied progesterone in daily clinical practice in an unselected patient population.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.2
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• pp.94-100
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• 2022

Objectives: This study aimed to compare the effects of systemic administration of levofloxacin or cephalexin on fracture healing in rats. Materials and Methods: In this animal study, tibial fractures not requiring fixation were artificially induced in 30 male Wistar albino rats using a 1.1 mm surgical bur. The rats were randomly divided into 6 groups (n=5). Groups 1 and 2 received daily subcutaneous saline injections. Groups 3 and 4 received subcutaneous injections of 25 mg/kg levofloxacin twice daily. Groups 5 and 6 received daily subcutaneous injections of 20 mg/kg cephalexin. The rats in Groups 1, 3, and 5 were sacrificed after 1 week, while the rats in Groups 2, 4, and 6 were sacrificed after 4 weeks. The score of fracture healing was determined through histological assessment of sections from the fracture site according to Perry and colleagues. Data were analyzed by Kruskal-Wallis and Mann-Whitney tests. Results: The mean score of fracture healing at 4 weeks was significantly higher than that at 1 week in the saline, levofloxacin, and cephalexin groups (P<0.001). At 1 week, no significant difference was noted among the three groups of saline, levofloxacin, and cephalexin in the mean score of fracture healing (P=0.360). However, this difference was significant at 4 weeks (P=0.018), and the mean score in the saline group was significantly higher compared to that in the levofloxacin group (P=0.015). Conclusion: It is recommended not to prescribe levofloxacin for more than 1 week after surgical management of bone fractures due to its possible adverse effects on fracture healing.

• Advances in pediatric surgery
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• v.4 no.2
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• pp.137-143
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• 1998

Intramuscular injection(IM) into the gluteal muscles is a common route of medication, but may lead to complications. A retrospective review of 32 patients who required surgical treatment for local complications of buttock injections in children was made at the Taegu Fatima Hospital during a seven-year nine-month period (March 1990 to December 1997). Local complications included acute inflammation, cellulitis and abscess(71.9 %), and fat necrosis(21.9 %), and injection granuloma(6.2 %). Over the half of injections were on the upper and outer quadrant of the buttock, but the other 43.7 % were in the upper and inner or lower and outer quadrant which are considered unsuitable sites for intramuscular injection. The majority of complications developed within fat tissue(90.6 %) rather than within muscle(9.4 %). Two-thirds of the patients were under 2 years of age, this suggests that it is technically difficult to accurately administer IM injections in small children because muscle mass is smaller compared to subcutaneous. In addition subcutaneous fat is more susceptible to chemical irritation. Staph. aureus was the predominant organism, isolated in 84.6 % of the patients with abscesses. Treatment consisted of needle aspiration, incision and drainage, curettage, or surgical excision. In conclusion, the major factor that contributes to complications following IM of the buttock appears to be the inadvertent intrafat rather than of IM injection. Accurate injection into the muscles based on a knowledge of pelvic anatomy as well as the potential complications is necessary to prevent complications.

• The Journal of Korean Academic Society of Nursing Education
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• v.28 no.4
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• pp.378-388
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• 2022

Purpose: The purpose of this study was to evaluate the effects of Metaverse-based core nursing skill contents (CNSC) developed for undergraduate nursing students. Methods: A nonequivalent control group was sampled with a non-synchronized design. Seventy-two participants (experimental group 34, control group 38) were recruited from May to June 2022 in Gwangju metropolitan city. The CNSC consisted of scenarios of vital sign measurements, and subcutaneous injections (including blood sugar tests). The data were analyzed using SPSS version 25 for Windows. Results: At the completion of the CNSC, statistically differences were found between groups in knowledge of core nursing skills (t=6.20, p<.001), confidence in core nursing skills performance (t=5.71, p<.001), and clinical competency (t=3.32, p=.001). Conclusion: These results indicate that the CNSC developed for undergraduate nursing students is effective in improving knowledge of core nursing skills, confidence in core nursing skills performance, and clinical competency for nursing students.

• Journal of Pharmacopuncture
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• v.25 no.3
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• pp.250-257
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• 2022

Objectives: Bee venom (BV) therapy is performed by a bee sting or subcutaneous injection of BV. However, there is not much information on the effect of BV on blood parameters after entering the body. This project aimed to assess the side effects of subcutaneous BV injections in healthy rats by measuring the hematological and biochemical parameters. Methods: Various amounts of BV, including 100, 200, and 500 (㎍/day), were subcutaneously injected into rats for 30 days. The results showed that BV affected the metabolism of the liver, kidney, and glands. Results: An increase in blood sugar and a decrease in other biochemical parameters, including cholesterol, triglyceride, urea, creatinine AST, ALT, ALP, and phosphorous, were observed. Results also showed increased counts of white blood cells, neutrophils (%), and platelets and decreased levels of red cells, hemoglobin, and hematocrit. Conclusion: This study demonstrates that BV therapy in medical clinics requires routine care and testing to prevent eventual metabolic and anemia side effects.

• Korean Journal of Clinical Pharmacy
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• v.26 no.1
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• pp.59-69
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• 2016

Background: The subcutaneous formulation of biologic disease-modifying antirheumatic drugs (DMARDs) was preferred due to favored self-administration and would be an economical treatment option for patients with rheumatoid arthritis. This study was to compare the economic impact of biologic DMARDs administered by subcutaneous injection in patients with rheumatoid arthritis who had inadequate response to conventional DMARDs. Methods: The cost-minimization analysis was conducted to estimate the lifetime health care costs of treatment sequences with subcutaneous biologic DMARDs as first-line therapy from a health care system perspective. The Markov model was developed to represent the transitions through treatment sequences based on American College of Rheumatology response rate and discontinuation rate. The health care costs comprised the cost of medications, administration, dispensing, outpatient visits, test/diagnostic examination, palliative therapy and treatment of serious infection. All costs were expressed in 2016 Korean Won (KRW) and discounted at 5%. Results: The mean lifetime health care cost per patient was lowest in the etanercept sequence, which was estimated at KRW 63,441,679. The incremental costs of the treatment sequence started with adalimumab, golimumab, abatacept, and tocilizumab were KRW 7,985,730, KRW 4,064,669, KRW 2,869,947, and KRW 4,282,833, respectively, relative to etanercept sequence. These differences in costs mainly were attributable to medication costs. One-way and probabilistic sensitivity analyses confirmed that etanercept represented the option with the lowest cost compared with comparators. Conclusion: This study found that etanercept is likely a cost-saving treatment option among subcutaneous biologic DMARDs in patients with rheumatoid arthritis.

• Women's Health Nursing
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• v.27 no.4
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• pp.318-325
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• 2021

Purpose: Although insulin is usually injected into the abdominal subcutaneous fat, in pregnancy women tend to avoid abdominal injections due to concern about fetal damage. Prior studies have been limited to only measuring skin-subcutaneous fat thickness (S-ScFT) at one site at specific pregnancy points. This study aimed to measure S-ScFT across several abdominal sites and over the gestational period in Korean pregnant women. This can identify which site would be relatively safe for subcutaneous injection during pregnancy. Methods: Healthy women over 24 weeks of pregnancy in Korea were invited to voluntarily participate in this descriptive study. For the 142 women, S-ScFT of 12 sites in the abdomen were measured by ultrasound, several times over the pregnancy. Each incidence was treated as a case and a total of 262 cases were analyzed. Results: The mean S-ScFT during pregnancy was 1.14±0.47 cm (1.25±0.54 cm at 24⁺⁰-27⁺⁶ weeks; 1.17±0.48 cm at 28⁺⁰-31⁺⁶ weeks; 1.09+0.40 cm at 32⁺⁰-35⁺⁶ weeks; and 1.06±0.47 cm at 36⁺⁰-40 weeks of pregnancy). Most S-ScFT were thicker than 10 mm. But S-ScFTs in the lateral abdomen and some sites were suboptimal (<6 mm), especially in the pre-pregnancy underweight body mass index group, who had a high rate of suboptimal thickness (27.1% overall and 33.9% in the lateral side). Conclusion: The whole abdomen seems to be appropriate for subcutaneous injection in most Korean women during pregnancy, with a 4 to 5-mm short needle. However, for the lateral abdomen, making the skin fold might be needed for fetal safety.