• Korean Journal of Clinical Laboratory Science
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• v.42 no.3
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• pp.125-128
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• 2010

HbA1c test measures the amount of glycated hemoglobin in blood. HbA1c shows the average of blood glucose levels for the past three months, this is a better indicator of how overall diabetes is doing. HbA1c gives a much better idea of how the body is breaking down the glucose. Therefore, this HbA1c is very important tool for maintaining normal glucose levels for pre-and diabetic patients. Total 408 participants were tested HbA1c voluntarily from Chosunilbo Health Expo (8th~11th, July 2010). Through this small-scaled direct HbA1c, about 54.7% (207 out of 408) was shown glucose tolerance and diabetes. However, 61 from 157 participants who were shown under 6.9% HbA1c (normal and pre-diabetic stage) are taking only antidiabetic drugs to maintain a normal blood glucose. Regular HbA1c test can bring an important management and awareness about controlling blood sugar level and prevention of diabetic complications.

• Clinical Endoscopy
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• v.55 no.3
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• pp.332-338
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• 2022

Continuous measurement of quality indicators (QIs) should be a routine part of colonoscopy, as a wide variation still exists in the performance and quality levels of colonoscopy in Korea. Among the many QIs of colonoscopy, the adenoma detection rate, average withdrawal time, bowel preparation adequacy, and cecal intubation rate should be monitored in daily clinical practice to improve the quality of the procedure. The adenoma detection rate is the best indicator of the quality of colonoscopy; however, it has many limitations for universal use in daily practice. With the development of natural language processing, the adenoma detection rate is expected to become more effective and useful. It is important that colonoscopists do not strictly and mechanically maintain an average withdrawal time of 6 minutes but instead perform careful colonoscopy to maximally expose the colonic mucosa with a withdrawal time of at least 6 minutes. To achieve adequate bowel preparation, documentation of bowel preparation with the Boston Bowel Preparation Scale (BBPS) should be a routine part of colonoscopy. When colonoscopists routinely followed the bowel preparation protocols, ≥85% of outpatient screening colonoscopies had a BBPS score of ≥6. In addition, the cecal intubation rate should be ≥95% of all screening colonoscopies. The first step in improving colonoscopy quality in Korea is to apply these key performance measurements in clinical practice.

• Asian-Australasian Journal of Animal Sciences
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• v.26 no.6
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• pp.788-794
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• 2013

Mastitis set apart as clinical and sub clinical is a disease complex of dairy cattle, with sub clinical being the most important economically. Of late, laboratories showed interest in developing biochemical markers to diagnose sub clinical mastitis (SCM) in herds. Many workers reported noteworthy alternation of acute phase proteins (APPs) and nitric oxide, (measured as nitrate+nitrite = NOx) in milk due to intra-mammary inflammation. But, the literature on validation of these parameters as indicators of SCM, particularly in riverine milch buffalo (Bubalus bubalis) milk is inadequate. Hence, the present study focused on comparing several APPs viz. ${\alpha}_1$-anti trypsin, ${\alpha}_1$-acid glycoprotein, fibrinogen and NOx as indicators of SCM in buffalo milk. These components in milk were estimated using standardized analytical protocols. Somatic cell count (SCC) was done microscopically. Microbial culture was done on 5% ovine blood agar. Of the 776 buffaloes (3,096 quarters) sampled, only 347 buffaloes comprising 496 quarters were found positive for SCM i.e. milk culture showed growth in blood agar with $SCC{\geq}2{\times}10^5$ cells/ml of milk. The cultural examination revealed Gram positive bacteria as the most prevalent etiological agent. It was observed that ${\alpha}_1$-anti trypsin and NOx had a highly significant (p<0.01) increase in SCM milk, whereas, the increase of ${\alpha}_1$-acid glycoprotein in infected milk was significant (p<0.05). Fibrinogen was below detection level in both healthy and SCM milk. The percent sensitivity, specificity and accuracy, predictive values and likelihood ratios were calculated taking bacterial culture examination and $SCC{\geq}2{\times}10^5$ cells/ml of milk as the benchmark. Udder profile correlation coefficient was also used. Allowing for statistical and epidemiological analysis, it was concluded that ${\alpha}_1$-anti trypsin indicates SCM irrespective of etiology, whereas ${\alpha}_1$-acid glycoprotein better diagnosed SCM caused by gram positive bacteria. NOx did not prove to be a good indicator of SCM. It is recommended measuring both ${\alpha}_1$-anti trypsin and ${\alpha}_1$-acid glycoprotein in milk to diagnose SCM in buffalo irrespective of etiology.

• Korean Journal of Clinical Laboratory Science
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• v.36 no.1
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• pp.27-32
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• 2004

Bone marrow transplantation(BMT) is widely used as curative means of various malignant and nonmalignant hematologic disorders, and early and accurate determination of engraftment is very important for critical management decisions. Reticulocyte counts performed by automated flow cytometric methods is a good indicator of erythropoietic activity and its evaluation has been proposed as an early predictor of bone marrow regeneration. Some reports highlighted the usefulness of the percentage of highly fluorescent reticulocytes and the sum of highly and medium fluorescent reticulocytes(immature reticulocyte fraction, IRF). In Asan Medical Center, the criteria for engraftment following BMT or PBSCT was defined as the first day of a 3-day trend of absolute neutrophil count(ANC)${\geq}500/uL$ and platelet count${\geq}30{\times}10^3/uL$. In 1999, Grotto et al proposed an indidator of bone marrow recovery as the first day on which the IRF was twice the minimum value after bone marrow transplantation. To compare the both criterias, we got consecutive datas of immature reticulocyte fraction, absolute neutrophil count(ANC), WBC count, platelet count and reticulocyte count by XE-2100 automated hematology analyzer(Sysmex Co. Japan) from 33 patients daily after BMT. When compared to standard neutrophil engraftment(10-30 days, $16.2{\pm}4.6days$), IRF engraftment (5-21 days, $11.0{\pm}3.9days$) occured significantly earlier in 87.9% of patients(P<0.05). The mean engraftment day for WBC count(11-29 days, $16.4{\pm}4.3days$) was similar to ANC, but platelet count and reticulocyte count revealed more delayed data (10-49 days, $19.1{\pm}7.4days$ vs 17-64 days, $31.4{\pm}14.1days$). In conclusion, our results confirm that an increase in the immature reticulocyte population is the earliest sign of the hematopoietic recovery after BMT and that automated reticulocyte quantification including immature fraction may be integrated into clinical protocols to evaluate bone marrow reconstitution.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3575-3581
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• 2016

Background: Cancer survival analysis is an essential indicator for effective early detection and improvements in cancer treatment. This study was undertaken to document colorectal cancer survival and associated prognostic factors in Malaysians. Materials and Methods: All data were retrieved from the National Cancer Patient Registry-Colorectal Cancer. Only cases with confirmed diagnosis through histology between the year 2008 and 2009 were included. Retrieved data include socio-demographic information, pathological features and treatment received. Survival curves were plotted using the Kaplan-Meier method. Univariate analysis of all variables was then made using the Log-rank test. All significant factors that influenced survival of patients were further analysed in a multivariate analysis using Cox' regression. Results: Total of 1,214 patients were included in the study. The overall 3- and 5-year survival rates were 59.1% and 48.7%, respectively. Patients with localized tumours had better prognosis compared to those with advanced stage cancer. In univariate analysis, staging at diagnosis (p<0.001), primary tumour size (p<0.001), involvement of lymph nodes (p<0.001) and treatment modalities (p=0.001) were found to be predictors of survival. None of the socio-demographic characteristics were found to exert any influence. In Cox regression analysis, staging at diagnosis (p<0.001), primary tumour size (p<0.001), involvement of lymph nodes (p<0.001) and treatment modalities (p<0.001) were determined as independent prognostic factors of survival after adjusted for age, gender and ethnicity. Conclusions: The overall survival rate for colorectal cancer patients in Malaysia is similar to those in other Asian countries, with staging at diagnosis, primary tumor size, involvement of lymph node and treatment modalities having significant effects. More efforts are needed to improve national survival rates in future.

• Journal of Physiology & Pathology in Korean Medicine
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• v.36 no.5
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• pp.193-208
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• 2022

In this study, we proposed a mathematical model that can explain the source of the observed variability of repeated measurement data collected in Korean medicine clinical practice, and conducted a pilot analysis to infer the source of these variability based on our model. Mathematical model was constructed by dividing the observed variations into three components: common time-dependent variations, signal shift, and measurement error. To show the applicability of our model in real data, we analyzed 20 repeated measurement data of Korean clinical indicators in graduate students of Pusan National University Graduate School of Korean Medicine. We showed how to infer each source of variations based on our model and also showed the limitation of inference given the acquired the dataset. On the basis of objective recognition of these source of the variability, we hope that quantitative investigations on these sources for each Korean medicine clinical indicator are made in the future, so that they can be used in the clinical and educational areas of Korean medicine.

• Journal of Korean Clinical Nursing Research
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• v.16 no.3
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• pp.157-174
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• 2010

Purpose: This study aims to develop, verify, and suggest outcome indicators for advanced practice nurses (APNs) in order to clarify their usefulness. Methods: To develop outcome indicators, the following methods were applied: reviewing literature intended to identify preliminary outcome indicators; surveying outcome indicators currently used for APNs and collecting the opinions from representatives of the professionals in clinical practice; verifying the content validity of preliminary outcome indicators by professionals and verifying the preliminary outcome indicators with 252 APNs. Results: Suggested outcome indicators are categorized into 84 items in total. Of these, the number of outcome indicators commonly appearing across disciplines was 18, mostly related to satisfaction and education. A majority of other outcome indictors exhibiting high relevance to individual disciplines are associated with care, including critical care (19 items), oncologic care (9 items) and emergency care (10 items). Conclusion: As the outcome indicators identified in this study are available to demonstrate the usefulness of APNs, it is recommended that future studies need to select and use appropriate outcome indicators according to characteristics and conditions of the discipline under examination. In addition, it is necessary to validate whether the suggested outcome indicators reflect adequately the practices of APNs.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.1847-1850
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• 2016

Background: It is reported that the percentage of smudge cells in the blood smear could be a prognostic indicator in chronic lymphocytic leukemia. However, the clinical significance of smudge cells in other hematological malignancies, solid tumors or non-malignant diseases is less clear. Hence, this study was conducted to survey the clinical significance of smudge cells in hematological cancers and other disorders. Materials and Methods: From January to November, 2015, the clinical data of patients who received blood examination with differential counts for clinical purpose and were found to have smudge cells in the peripheral blood film in Far Eastern Memorial Hospital were selected. The percentage of smudge cells and patient outcomes were evaluated for further univariate and survival analyses. Results: A total of 102 patients with smudge cells in their blood smears were included. Smudge cells were frequently presented in out-of-hospital cardiac arrest (OHCA; n=30), infections (n=23), hematological cancers (n=23) and solid cancers (n=10). There was no relationship between the percentage of smudge cells and the patient mortality in all diseases (OR: 1.08, 95% CI: 0.47-2.48, P=1.000) as well as the OHCA group (OR: 1.91, 95% CI: 0.38-9.60, P=0.694). It was observed that in patients with all cancers with the percentage of smudge cells less than 50% had a lower mortality rate in comparison with those who had the percentage of smudge cells of 50% or more (OR: 22.29, 95% CI: 2.38-208.80, P<0.001). Additionally, it was seemingly that patients with smudge cells of 50% or more had a lower survival rate than those with smudge cells less than 50% in all cancers with follow-up at 2-month intervals, but without statistical significance (P=0.064). Conclusions: Our survey indicated that in all cancers, those who had higher percentage of smudge cells were prone to have poor outcomes when compared with the subjects with lower percentage of smudge cells. This finding was quite different from the results of previous studies in which the race-ethnicity of most study populations was non-Asian; hence, further investigations are required. Besides, there was no apparent association of the percentage of smudge cells with patient outcomes in all diseases, including OHCA.

• Journal of the Korean Dietetic Association
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• v.18 no.1
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• pp.72-80
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• 2012

This study examined the effects of custom nutrition education on dietary intakes and clinical parameters in patients diagnosed with iron deficiency anemia. A total of 34 patients visited the anemia clinic of Yeouido St. Mary's Hospital. Among these, only 16 patients were available for follow-ups. A follow-up was conducted by a clinical dietitian 2 months from the first nutrition education session. Patients were all women. For custom nutrition education, we investigated anthropometric data, dietary assessment (24 hr-recall, FFQ), and self-recognized anemic symptoms. Weight did not show a significant difference but hemoglobin, hematocrit (P<0.01), serum iron, and serum ferritin (P<0.05) were significantly increased after the nutrition education. Serum total iron binding capacity was significantly decreased (P<0.01). Self-recognized symptoms such as dizziness, fatigue (P<0.001), shortness of breath, headache (P<0.01), brittle nails, and sore tongue (P<0.05) were significantly improved. Daily intakes of protein (P<0.05), total iron (P<0.01), and animal iron (P<0.001) were significantly increased. A significantly negative correlation was observed between current serum iron and the intake of carbohydrates, fat, or phosphorus (P<0.05). But current serum ferritin showed a significantly positive correlation with the frequency of intake of meat, poultry, and fish. It could be concluded that the custom nutrition education might be effective on quality of diet as well as iron status and it might also improve the clinical parameters in patients diagnosed with the iron deficiency anemia.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.12
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• pp.6373-6386
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• 2013

This study examined the relationship between the MBTI character types and heart rate variability. The subjects were 25 students in the department of emergency medical technology in C city, Chungnam, Korea. The heart rate variability was measured under two conditions: a stable state, and in the second week and fourth week in clinical practice. The period of the heart rate variability measurements was from Jun. 21, 2013 to Jul. 26, 2013.The changes in the HRV at the stable state and during clinical practice depending on the MBTI character types, and the HRV at the stable state and during clinical practice according to the distribution chart of four character types showed a significant difference in the nHF and standard deviation of all R-R intervals (SDNN). In the changes in the HRV at the stable state and during clinical practice depending on the preference distribution chart of each indicator, the T-F group and J-P group in the nLF, T-F group and J-P group in the nHF, S-N group in the standard deviation of all R-R intervals (SDNN) and the J-P group in the mHR showed a significant difference.