• Korean Journal of Clinical Pharmacy
• /
• v.27 no.2
• /
• pp.83-91
• /
• 2017

Background: Piperacillin/tazobactam (TZP) is an antibiotic against a broad spectrum of gram-positive, gram-negative, and aerobic and anaerobic strains of bacteria. Due to changes in its pharmacokinetic and pharmacodynamic parameters by TZP-treated patients' renal functions and obesity, it is important to administrate and monitor TZP based on their renal functions and Body Mass Index (BMI) levels. The purpose of this study was to determine the appropriateness of administration doses of TZP based on renal functions of obese cancer patients in a tertiary hospital. Methods: This study was retrospectively conducted with obese cancer patients with $BMI{\geq}30kg/m^2$ in a tertiary hospital, Korea from September 2004 to August 2014. Data were collected through Electronic Medical Record (EMR) which contained laboratory data and TZP dosing of each patient. Results: Among 7,058 patients during the study period, 102 prescriptions were selected based on inclusion and exclusion criteria and classified by their renal functions. Although TZP should be used based on patients' renal functions to adjust its dose, its initial dose and dosing interval were consistently used without considering patients' renal functions on a regular basis. Especially, in the comparison with FDA dosing standard of TZP, approximately twice patients with $20mL/min{\leq}CrCl{\leq}40mL/min$ received domestically 4.5 g instead of 2.25 g as the TZP starting dose. Conclusion: The appropriate doses of TZP were administered to almost all of obese cancer patients; however, the recommended TZP dose was different between Korea and other countries by twice the amount. Further related studies are necessary to clearly determine the results, to optimize TZP treatment for obese patients with cancer in clinical practice, and to design and develop new TZP formulations for them in pharmaceutical industry.

• Journal of Ginseng Research
• /
• v.39 no.4
• /
• pp.392-397
• /
• 2015

Background: Red ginseng (RG) is processed from Panax ginseng via several methods including heat treatment, mild acid hydrolysis, and microbial conversion to transform the major ginsenosides into minor ginsenosides, which have greater pharmaceutical activities. During the fermentation process using microbial strains in a machine for making red ginseng, a change of composition occurs after heating. Therefore, we confirmed that fermentation had occurred using only microbial strains and evaluated the changes in the ginsenosides and their chemical composition. Methods: To confirm the fermentation by microbial strains, the fermented red ginseng was made with microbial strains (w-FRG) or without microbial strains (n-FRG), and the fermentation process was performed to tertiary fermentation. The changes in the ginsenoside composition of the self-manufactured FRG using the machine were evaluated using HPLC, and the 20 ginsenosides were analyzed. Additionally, we investigated changes of the reducing sugar and polyphenol contents during fermentation process. Results: In the fermentation process, ginsenosides Re, Rg1, and Rb1 decreased but ginsenosides Rh1, F2, Rg3, and Compound Y (C.Y) increased in primary FRG more than in the raw ginseng and RG. The content of phenolic compounds was high in FRG and the highest in the tertiary w-FRG. Moreover, the reducing sugar content was approximately three times higher in the tertiary w-FRG than in the other n-FRG. Conclusion: As the results indicate, we confirmed the changes in the ginsenoside content and the role of microbial strains in the fermentation process.

• Textile Coloration and Finishing
• /
• v.16 no.5
• /
• pp.35-41
• /
• 2004

Poly(ethylene terephthalate), polyimide(Kapton), and polypropylene surfaces were modified with argon low temperature plasma by RF glow discharge at 240m Torr, 40W to investigate the surface morphological changes due to the plasma treatment using atomic force microscopy(AFM). Analysis of the AFM images and Ra(average roughness) revealed that the plasma treatment resulted in significant ablation on the surfaces. The morphological changes and surface roughness, however, were different depending on material characteristics such as heat stability, presence of amorphous region, swelling phenomenon, and molecular structure of repeating unit. It was assumed that polypropylene due to its tertiary hydrogen was ablated easily compared to poly(ethylene terephthalate), and that polyimide was more resistant to the ablation than PET due to rigid skeleton of imide and stable phenyl ring structure.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.7
• /
• pp.2685-2691
• /
• 2015

To evaluate the clinical impact of preoperative serum CEA and CA19-9 on resectable gastric cancer (GC), a total of 1,075 consecutive cases with gastric adenocarcinoma were obtained retrospectively from January 2012 and December 2013 in a single tertiary hospital, and the relationships between serum CEA, CA19-9 and clinicopathologic features were investigated. Positive preoperative serum rates of CEA and CA19-9 were 22.4% and 12.3% respectively, levels significantly correlating with each other and depth of invasion, lymph node involvement, pTNM and stage. The CEA level also presented a remarkable association with lymphovascular invasion. Both CEA and CA19-9 positivity significantly and positively correlated with depth of invasion, nodal involvement, pTNM stage, lymphovascular invasion, tumor size and tumor location. Stratified analyses according to gender or tumor location showed preoperative CEA or CA19-9 had different associations with clinicopathologic features in different gender subgroups or location subgroups. Preoperative serum CA19-9 positivity may be more meaningful for tumor size rather than CEA. In conclusion, preoperative serum CEA and CA19-9 correlate with disease progression of GC, and may have applications in aiding more accurate estimation of tumor stage, decision of treatment choice and prognosis evaluation.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.21 no.4
• /
• pp.264-270
• /
• 2018

Purpose: The aim of this study was to describe functional gastrointestinal disorders (FGID) presented in a tertiary medical center, characteristics of patients and results of the diagnostic work-up together with an outcome during the follow up. Methods: This was a retrospective, single center, observational study including all patients who were diagnosed with FGID based on Rome III criteria from January to December 2015 in tertiary medical center. Results: Overall 294 children were included (mean age, 8.9 years [range, 1-18 years]; 165 females). Majority had functional constipation (35.4%), followed by functional abdominal pain (30.6%), irritable bowel syndrome (17.0%), functional dyspepsia (12.6%), functional nausea (3.4%) and abdominal migraine (1.0%). Regression model found that only significant factor associated with improvement of symptoms is the establishment of the functional diagnosis at the first visit (hazard ratio, 2.163; 95% confidence inverval, 1.029-4.544). There was no association between improvement of symptoms and presence of alarm signs/symptoms (weight loss, nocturnal symptoms and severe vomiting) at diagnosis. Furthermore, in pain symptoms (functional abdominal pain, irritable bowel syndrome, dyspepsia) no treatment positively correlated with pain improvement. Conclusion: Regardless of the initial diagnosis of FGID, positive diagnosis at the first visit increases a chance for resolution of symptoms.

• Journal of muscle and joint health
• /
• v.28 no.3
• /
• pp.263-274
• /
• 2021

Purpose: This descriptive research study investigated the effects of temperament and character, emotional intelligence on self-leadership of clinical nurses. Methods: This study recruited clinical nurses at a tertiary general hospital located in S city through convenience sampling. A survey was conducted from April 10 to May 5, 2020, using offline questionnaires. A total of 343 answers were analyzed using descriptive statistics and a three-step hierarchical regression analysis with the SPSS 22.0 program. Results: Factors influencing self-leadership of clinical nurses at a tertiary general hospital in S city were persistent among temperament (β=.331, p<.001), personal maturity (β=.408, p<.001), and total emotional intelligence (β=1.062, p<.001). These factors contributed 58% of self-leadership (F=29.20, p<.001). Conclusion: It was confirmed that persistent among temperament and personal maturity among character, emotional intelligence were factors affecting self-leadership of clinical nurses. Therefore, it is necessary to develop and provide programs to control the factors affecting self-leadership of clinical nurses to increase self-leadership.

• Health Policy and Management
• /
• v.29 no.2
• /
• pp.105-111
• /
• 2019

On December 31, 2018, an incident occurred where a doctor was attacked and killed by a patient carrying a lethal weapon in the outpatients' clinic of the psychiatric department of a tertiary general hospital. The suspect was diagnosed with bipolar affective disorder (manic depressive disorder) and has been hospitalized and cared for in the psychiatric ward of this hospital. This incident illustrates the necessity of more active cures and therapeutic intervention for mental patients with intellectual developmental disorders who require treatment considering the fact that a radical outcome has been caused by such a patient. However, on the other hand, there is also a need for an approach and analysis from the perspective of crime prevention for all medical departments. The reason for this is that even a tertiary general hospital equipped with the largest human resources, medical devices, facilities, and so forth, is susceptible to violence. As for illegal actions perpetrated against health and medical service personnel in medical institutions, such as verbal abuse, assault, injury, etc. there have neither been understanding shown for the current extent of damage in detail, nor discussions of active institutional improvement related to the seriousness of the act. It can be said that violence in the field of medical treatment is a realm requiring serious discussion and appropriate remedial actions. This is because when such incidents take place, if a patient who is supposed to get treatment from the damaged health care provider is in an urgent situation or on the waiting list of serious cases, he or she could suffer serious damage caused by deprivation of treatment opportunity, or secondary damage might be caused to the patient and/or a guardian who can hardly have an opportunity to take action. Accordingly, in this review, we would like to help create the necessary conditions for both health and medical service personnel and patients/guardians, respectively, to provide and receive medical treatment in a more secure environment. Therefore, objective assessment of the institution and issues relating to this aforementioned incident and general cases of violence occurring in medical institutions, and by suggesting legal and institutional improvements and solutions.

• Journal of Korean Society of Water and Wastewater
• /
• v.32 no.3
• /
• pp.279-289
• /
• 2018

N-nitrosodimethylamine (NDMA) is a class of disinfection byproducts and a frequently detected nitrosamine with carcinogenic potentials. This review summarizes NDMA precursors, their formation mechanisms in chloraminated water, and mitigation strategies. Understanding the formation mechanism and characteristics of precursors is essential for developing a mitigation strategy. Dimethylamine (DMA), the most widely studied NDMA precursor, has an NDMA molar yield up to 3%. In comparison, a subset of tertiary amines, e.g., pharmaceuticals, generate up to 90% upon chloramination. Potent NDMA precursors, are characterized by their negative partial charge, low planarity values and molecular weight, and high bond length and $pK_a$ values. A nucleophilic substitution of tertiary amine on chloramine is a key reason for the high NDMA yield from the most potent NDMA precursors. The distribution and fate of NDMA in surface water, aquifers, and its formation in the distribution system can be mitigated through two strategies: (1) degrading or/removing NDMA after its formation and (2) pre-treatment of its precursor's prior chloramination.

• Journal of Korean society of Dental Hygiene
• /
• v.15 no.5
• /
• pp.899-905
• /
• 2015

Objectives: This study aimed to investigate the regional difference of chronic periodontal care services in Korea by the analysis of 2010 raw data from Health Insurance Review and Assessment Service. Methods: The subjects were the chronic periodontitis patients over 35 years old from dental care facilities in Korea. The study population was 278,319 including 264,994 claims made by dental clinics, 8,084 by dental hospitals, 3,509 by general hospitals, and 1,732 by tertiary hospitals. Results: There was a significant difference in medical care cost benefit between the provinces(p<0.0001). The age groups showed a clear difference in the patient charge, cost of insurance, and medical care cost benefit(p<0.0001). In consideration of the first visit or revisit, there were differences in the rate of prescription, dental examination, and surgical procedures of the chronic periodontal patients from dental facilities. The radiographic use rate in the tertiary hospitals was 2.6 times higher than that of the dental clinic in the treatment of the new chronic periodontal patients. Conclusions: The use of dental services in the periodontitis is influenced by the types of medical services facility, cost of medical insurance, and patient charge. In consideration of cost benefit analysis, prevention is the most important care for the periodontitis. Regional difference in peridontitis is cause by the use of medical services and quality of treatment.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.4
• /
• pp.2165-2170
• /
• 2016

Background: The survival of hepatocellular carcinoma (HCC) patients is usually low due to late diagnosis. Cipto Mangunkusumo Hospital as the largest tertiary referral hospital in Indonesia, has recently improved its modalities for advanced HCC management, but there has not been any evaluation on any improvement in HCC patient survival. Materials and Methods: A retrospective analysis on 114 HCC patients in 2013-2014 were conducted and compared with the database for 77 HCC patients in 1998-1999. Clinical characteristics and treatment received were recorded and the survival of both groups was analyzed using the Kaplan-Meier method and compared using the log-rank test. Results: The percentage of HBV positive patients had increased after fifteen years from 32.5% to 67.5%. Only two patients (1.8%) in 2013-2014 were diagnosed with HCC during surveillance program. Proportions of Barcelona Clinic Liver Cancer A, B, C, and D in 2013-2014 were 1.8%, 42%, 28.1%, and 28.1%, respectively. There was an increase in the use of potentially curative treatment, such as surgical resection or combination of loco-regional therapies. The one-year survival rate increased from 24.1% in 1998-1999 to 29.4% in 2013-2014, while the median survival decreased from 146 days to 138 days, but the difference was not statistically significant (p=0.913). Conclusions: There was no improvement in the median survival of HCC patients after fifteen years because most continued to present at late stages. There is an urgent need for a nationwide implementation of a hepatitis screening program and HCC surveillance education.