• YAKHAK HOEJI
• /
• v.58 no.4
• /
• pp.229-244
• /
• 2014

Background: Antibiotic skin test(AST) is very useful for the diagnosis of drug allergies to prevent immediate allergic reactions. Although it is a safe and widespread method, it is performed very diversely by doctors and nurses without consistency and it also differs from countries and hospitals. This study aims to evaluate the current practice of AST by nurses in Korea and to compare it to the general guidelines. Methods: During January 1, 2013 to May 20, 2013, the study was conducted as questionnaires and case-based survey. The questionnaires were given to the nurses who were randomly selected in various University Hospitals (University Hospitals N=276, and Medical center N=19). The case-based surveys were given to the nurses who were conducting AST at various wards of a University Hospital (N=130). The analysis and evaluations of the responses were carried out. Results: The response rate for the questionnaires was 97.6% and 130 cases of the actual case-based surveys were collected. There were clear differences between the survey results and the general guidelines, such as the method of skin test (skin prick test was not conducted), the method of patient selection for AST, test drugs, concentration, volume and interpretation of AST. AST conducted by nurses was highly variable and inconsistent, even among nurses who worked in the same wards and hospitals. Manufactured standard concentration antibiotic solution of AST showed consistency of concentration to a certain degree. Conclusion: Although the general guidelines have been published by several countries including Korea, these are not a great help to nurses as they lack details for conducting AST, practical consideration for nurses in the clinical setting, propagation and education. Standardized guideline for nurses should be published and it should be a safe, clear, comfortable and easily accessible protocol. Futhermore, additional antibiotic solutions to standardize skin test should be developed and manufactured. Lastly, it would be the pharmacists role to compare their hospitals antibiotic skin test methods with the standard guidelines and develop a protocol within the hospital for patients' safety, and to strive to consistently implement it.

• Korean Journal of Clinical Pharmacy
• /
• v.25 no.2
• /
• pp.74-79
• /
• 2015

Objective: Treatment with sulfonylureas in combination with metformin improves glycemic control in type 2 diabetes mellitus (T2DM), but is associated with hypoglycemia and weight gain. This retrospective study aims to compare the effectiveness of dipeptidylpeptidase-4 (DPP-4) inhibitors and sulfonylureas as an add-on therapy to metformin in patients with T2DM. Methods: Data from medical records of 355 T2DM patients received therapy either DPP-4 inhibitors (DPP-4 inhibitor group) or sulfonylurea (SU group) in combination with metformin from 1 March 2009 to 30 September 2011 were retrospectively reviewed. Of total 355 patients, 231 patients were in DPP-4 inhibitor group and 124 patients were in SU group. Baseline Hemoglobin $A_{1c}$ ($HbA_{1c}$) level in SU group was higher than DPP-4 inhibitor group with a statistically significant difference (8.6% vs. 7.8%). Comparative analysis between DPP-4 inhibitor group and SU group was performed for $HbA_{1c}$ values, amounts of $HbA_{1c}$ changes, and rates of $HbA_{1c}$ changes from baseline at 6-month intervals and incidence rates of major cardiocerebral events. Results: SU group showed larger $HbA_{1c}$ changes in both amounts and rates compared to DPP-4 inhibitor group, although statistical significance was not found in all study periods. Proportions of patients with stable $HbA_{1c}$ <6.5% or 7% were significantly higher in DPP-4 inhibitor group than SU group (<6.5%: 30.4% vs. 13.4%, <7%: 72.3% vs. 41.2%). Time to achieve stable $HbA_{1c}$ <6.5% was not significantly different, but time to achieve stable $HbA_{1c}$ <7% was shorter in DPP4 inhibitor group than SU group with a significant difference. The incidence rate of cardiocerebral events in group of patients with or without previous events was 1.7%, not significantly lower than that in DPP-4 inhibitor group (4.0%). For newly encountered cardiocerebral events during the treatment, incidence rates of two groups did not differ significantly. Conclusion: DPP-4 inhibitors were as effective as sulfonylureas in achieving the $HbA_{1c}$ goal of less than 6.5% or 7% and cardiocerebral event rates did not differ between the two drugs.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.13 no.2
• /
• pp.606-614
• /
• 2012

With rising concerns on downturn of global economy, college graduates are experiencing a serious unemployment crisis. In this reality, undergraduates preparing for employment face much stress from worries and conflicts. Accordingly, the purpose of this study is to examine the influence of university student's belief of destiny on sub factors of employment stress such as environmental, physical, psychological and keen behaviors according to internal and external locus of control. 550 surveys were distributed to four-year university students in Seoul, capital area and rural area for 15 days from October 5 until October 20, 2011. 480 surveys were returned, among which 430 were effective as study subjects. As a result of this study, first, environmental influence on employment stress was high at 49% while physical influence was 7%. Second, as a result of performing correlation analysis on employment stress and locus of control, external locus of control showed positive influence in environmental, physical, psychological and keen behaviors. Internal locus of control showed negative influence in all behaviors, suggesting that more diverse career information must be provided. Since increase in career efficacy and reduction of employment stress in university students are directly linked to unemployment rate of youths, diverse and active methods are deemed necessary.

• Korean journal of applied entomology
• /
• v.36 no.1
• /
• pp.111-117
• /
• 1997

Occurrence status of Tetranychus viennensis Zacher was investigated in Kyonghuk province. Its ecological studies were carried out and chemical control efficacy against females and eggs was examined. And the results ohtained are as follows. T. viennensis occurred from mid April through mid November with the peak time in June on cherry tree. Population level of T. viennensis was varied from 0 to 160 individuals per 100 peach leaves in different peach orchards, and its occurrence rate was 35% out of 20 ochards. However no T. viennensis was observed from 25 apple orchards in 5 districts of Kyongbuk province. Overwintering stage of T. viennensis females appeared in mid October, and most of them moved into under the rough hark in early November. The overwintered adult females moved out from the rough bark to leaves in early April. Mortality during overwintering was about 55%. Under four constant temperatures of 16, 19, 22, 25$^{\circ}$C. egg periods were 14. 3, 9.2, 6.8, and 4.0 days ; larva -nymph periods were 20.2, 13.9, 8.7, and 6.6 days. Female longevity was 67. 7, 60.7, 46.4, and 34.0 days : mean tota: fecundities per female were 21.2, 44.3, 54.4, and 64.7 eggs. Some acaricides, azocyclotin, pyridaben, propargite, tehufenpyrad and fenpyroximate were highly effective against females, while hexythiazox and clofentezine showed very low control effect from 3.6 to 14.4%. Whereas, all of 7 acaricides tested highly effective against the eggs.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.16
• /
• pp.7061-7069
• /
• 2015

Background: During the past decades, the incidence and mortality rate of stomach cancer has demonstrated a great decrease in the world, but it is still one of the most common and fatal cancers especially among men worldwide, including Iran. The MYC proto-oncogene, which is located at 8q24.1, regulates 15% of genes and is activated in 20% of all human tumors. MYC amplification and overexpression of its protein product has been reported in 15-30% of gastric neoplasias. The aim of this investigation was to find the relative efficacy of CISH (chromogenic in situ hybridization) or IHC (immunohistochemistry) in diagnosis and prognosis of gastric cancer, as well as the relationship of amplification and expression of C-MYC gene with patient survival. Materials and Methods: In this cross-sectional study, 102 samples of gastric cancer were collected from patients who had undergone primary surgical resection at the Cancer Institute Hospital, Tehran University of Medical Sciences, from July 2009 to March 2014. All samples were randomly selected from those who were diagnosed with gastric adenocarcinomas. CISH and IHC methods were performed on all of them. Results: Patients were classified into two groups. The first consisted of stage I and II cases, and the second of stage III and IV. Survival tests for both groups was carried out with referrnce to CISH test reults. Group II (stage III & IV) with CISH+ featured lower survival than those with CISH- (p=0.233), but group I (stage I & II) patients demonstrated no significant variation with CISH+ or CISH- (p=0.630). Kaplan-Meier for both groups was carried out with IHC test findings and showed similar results. This data revealed that both diffuse and intestinal types of gastric cancer occurred significantly more in men than women. Our data also showed that CISH+ patients (43%) were more frequent in comparison with IHC+ patients (14.7%). Conclusions: For planning treatment of gastric cancer patients, by focusing on expanding tumors, which is the greatest concern of the surgeons and patients, CISH is a better and more feasible test than IHC, in regard to sensitivity and specificity. Therefore, CISH can be used as a feasible test for tumor growth and prognosis in stage III and IV lesions. This study also indicated that C-MYC amplification in gastric cancer is correlated with survival in advanced stages.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.9
• /
• pp.4357-4361
• /
• 2012

Objective: The guidelines on indications for prophylactic use of Bacille Calmette-Gu$\acute{e}$rin (BCG) against non-muscle-invasive bladder cancer (NMIBC) have changed over the years. In order to assess the impact on outcome, the present retrospective comparison of BCG efficacy by time period with Japanese patients was conducted. Patients and Methods: A total of 146 cases of NMIBC treated with BCG since February 1985 were retrospectively evaluated. All patients received 80 mg of BCG (Tokyo 172 strain) six to eight times a week for prophylactic use. Comparison was made among three historical groups (Group A: 1980's, 39 cases; Group B: 1990's, 61 cases; Group C: 2000's, 46 cases). Results: In total, recurrence was seen in 55 of the 146 cases (37.7%), and progression in 14 (9.6%), 1 patient dying of cancer. These overall results were similar to those outlined in previous reports. However, the outcomes of this time-period-based analysis indicated a tendency for a shorter time to recurrence in patients after 2000, although a log-rank test showed no significance (P=0.229). Seven of the cases featuring progression (i.e., half of all such cases) were among the 46 Group C patients (15.2%). Excluding these progressive cases, there was no significant difference among the remaining 132 patients in the three groups. Conclusion: This study results revealed a tendency for a lower non-recurrence rate after 2000 in our series. This could stem from a number of factors, including changes in BCG indication criteria and the evolution of histopathological diagnostic criteria.

• Radiation Oncology Journal
• /
• v.33 no.3
• /
• pp.207-216
• /
• 2015

Purpose: Stereotactic radiosurgery (SRS) has been introduced for small-sized single and oligo-metastases in the brain. The aim of this study is to assess treatment outcome, efficacy, and prognostic variables associated with survival and intracranial recurrence. Materials and Methods: This study retrospectively reviewed 123 targets in 64 patients with non-small cell lung cancer (NSCLC) treated with SRS between January 2006 and December 2012. Treatment responses were evaluated using magnetic resonance imaging. Overall survival (OS) and intracranial progression-free survival (IPFS) were determined. Results: The median follow-up was 13.9 months. The median OS and IPFS were 14.1 and 8.9 months, respectively. Fifty-seven patients died during the follow-up period. The 5-year local control rate was achieved in 85% of 108 evaluated targets. The 1- and 2-year OS rates were 55% and 28%, respectively. On univariate analysis, primary disease control (p < 0.001), the Eastern Cooperative Oncology Group (ECOG) performance status (0-1 vs. 2; p = 0.002), recursive partitioning analysis class (1 vs. 2; p = 0.001), and age (<65 vs. ${\geq}65$ years; p = 0.036) were significant predictive factors for OS. Primary disease control (p = 0.041) and ECOG status (p = 0.017) were the significant prognostic factors for IPFS. Four patients experienced radiation necrosis. Conclusion: SRS is a safe and effective local treatment for brain metastases in patients with NSCLC. Uncontrolled primary lung disease and ECOG status were significant predictors of OS and intracranial failure. SRS might be a tailored treatment option along with careful follow-up of the intracranial and primary lung disease status.

• Radiation Oncology Journal
• /
• v.33 no.4
• /
• pp.276-283
• /
• 2015

Purpose: We evaluated the efficacy and toxicity of repeated high dose 3-dimensional conformal radiation therapy (3D-CRT) for patients with unresectable hepatocellular carcinoma. Materials and Methods: Between 1998 and 2011, 45 patients received hepatic re-irradiation with high dose 3D-CRT in Samsung Medical Center. After excluding two ineligible patients, 43 patients were retrospectively reviewed. RT was delivered with palliative or salvage intent, and equivalent dose of 2 Gy fractions for ${\alpha}/{\beta}=10Gy$ ranged from $31.25Gy_{10}$ to $93.75Gy_{10}$ (median, $44Gy_{10}$). Tumor response and toxicity were evaluated based on the modified Response Evaluation Criteria in Solid Tumors criteria and the Common Terminology Criteria for Adverse Events (CTCAE) ver. 4.0. Results: The median follow-up duration was 11.2 months (range, 4.1 to 58.3 months). An objective tumor response rate was 62.8%. The tumor response rates were 81.0% and 45.5% in patients receiving ${\geq}45Gy_{10}$ and $<45Gy_{10}$, respectively (p = 0.016). The median overall survival (OS) of all patients was 11.2 months. The OS was significantly affected by the Child-Pugh class as 14.2 months vs. 6.1 months (Child-Pugh A vs. B, p < 0.001), and modified Union for International Cancer Control (UICC) T stage as 15.6 months vs. 8.3 months (T1-3 vs. T4, p = 0.004), respectively. Grade III toxicities were developed in two patients, both of whom received ${\geq}50Gy_{10}$. Conclusion: Hepatic re-irradiation may be an effective and tolerable treatment for patients who are not eligible for further local treatment modalities, especially in patients with Child-Pugh A and T1-3.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.6
• /
• pp.511-520
• /
• 2010

Purpose: This study was conducted in order to compare the efficacy of osseointegration of three different calcium metaphosphate (CMP) coated implants in the rabbit's femur. Materials and Methods: Twenty four rabbits and three different type of CMP coated implants and RBM implants were used in this study. The animals were divided into 4 groups on the basis of implant surface characteristics. Two implants were installed into the condyle of femur of each rabbits. The animals were sacrificed at 2 and 4 weeks after installation. The undecalcified specimens were prepared for histological, radiological examination and histomorphometric analysis of implant-bone contact ratios (BIC) and bone area ratio (BA). Results: Two implants were failed to osseointegrate and implant success rate was 95.2%. There were not any significant inflammatory response in all groups. Fluorescent image at 4 weeks shows that remodeling is slower in RBM group than CMP group. CMP III showed more active remodeling than CMP I, II. In histomorphologic analysis, BIC ratio at 2 weeks was lower than 4 weeks. Conclusion: The results suggest that the ratios of CMP coated implants were higher than that of RBM control group but there is no significantly difference between RBM group and CMP group. In conclusion, CMP coated implant had more clinical availability than RBM implants.

• The Journal of Korean Academy of Prosthodontics
• /
• v.36 no.3
• /
• pp.468-482
• /
• 1998

Since the concept of osseointegration was introduced by Branemark of Sweden, dental implants have been used for various dental prosthetic treatments. The survival rate of dental implant is likely to be closely related to the total biomechanical role of each component of implant system. The use of interchangeable component is very attractive for dental practitioners because such an approach would save treatment cost, flexibility of prosthetic treatment options as well as conveniences. Therefore, the use of interchangeable implant system has been increasing without scientific assessment of safety and efficacy of various interchangeable implant system. The purpose of this study, therefore, were to compare the geometric characteristic of four interchangeable dental implant screws and the loosening torque of these screws. Four types of dental implant screws tested in this study were Nobelpharma, 3i, Impla-med, Restore. Four screws each of the test specimens were subjected for scanning electron microscopic examinations under the same condition and a 35x magnified standard SEM picture was objected from each test specimen using JSM-5200 scanning microscope. From each of the SEM pictures, eight parameters. i.e., diameter of screw head. screw length, thread pitch, major diameter. neck diameter, neck length, crest width and root width were determined using a caliper. The measurement for each parameters were then corrected for their magnification factor. The loosening torque were also determined by using a torque gauge. All of the measurements were statistically analyzed by ANOVA test and multiple range test. Statistical significance was set in advance at the probability level of less than 0.05. All analyses were done with SPSS software for the personal computer. The conclusion obtained from this studies were summarized as the following; 1. No statistically significances were noted in the thread pitch. and crest width in the four screws, and in the case of major diameter, the Impla-med screw was significantly smaller than the other three screws (p<0.05). Therefore, four implant bolts could be physically inserted in a abutment nuts. 2. The diameter of screw head was decreased in the order of Restore, 3i, Nobelpharma, Impla-med screws and the length of screws were decreased in the order of 3i, Restore, Nobelpharma and Impla-med. The diameter of neck was decreased in the order of Impla-med, Restore. Nobelpharma, 3i screws. The differences of each of these parameters were statistically significant (p<0.05). The width of root of screws were decreased in the order of Nobelpharma, Impla-med, Restore and 3i. The differences among Nobelpharma and Impla-med. Restore and 3i were statistically significant (p<0.05). 3. When the screws were loosening 1, 3, 4 and 5 times, the loosening torque for Impla-med and 3i screws were significantly higher than that of Nobelpharma or Restore screws (p<0.05). However, when statistically smaller than that of 3i, Restore or Nobelpharma screws(p<0.05).