• Title/Summary/Keyword: hepatitis B

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A Study on Needle Stick Injuries in Health Professionals (의료인의 바늘자상 실태에 관한 연구)

  • 김영분
    • Journal of Korean Academy of Nursing
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    • v.26 no.3
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    • pp.605-622
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    • 1996
  • Needle stick injury, in which blood-borne pathogens including Human Immune-Deficiency virus and hepatitis B virus are transmitted, is one of the major occupational hazards that health professionals face everyday. In order to provide basic data for the development of educational programs for health professionals aimed at preventing and effectively managing needle stick injuries, a retrospective descriptive study was carried out .The subjects of the study were 630 health professionals, 499 nurses and 131 physicians, from two university hospitals in Seoul, Korea. Data on episodes of needle stick experiences over the past is months September 1994 through August 1995, were collected between September 1 and 7, 1995. A Questionaire developed by the researcher was used. The frequencies and the percentile score for episodes of needle stick injuries were calculated using the PC-SAS program. The differences and similarities in reference to the structure, career, and specialty variables were analysed by X$^2$-tests. Results are as follows : 1. Of the sample, 521(82.7%) reported a needle stick injury, 33.4% reported 3 or more episodes of needle stick injuries. 2. The needle stick injuries occured in the following processes : process of percutaneous venepuncture for intra-venous injection and infusion(55.3%), medical examination and treatment(48.9%), per-cutaneous venepuncture for blood sampling (46.3%) and intra-muscular injection(42.2%). 3. The study showed that needle stick injuries occured before(19%), during(25%), and after (56%) client treatment. The major causes of needle stick injuries were perceived to be hastiness(82.2%) and carelessness(48.3%). Of these injuries, 91.8% occured in emergency situations. 4. Follow of care for the injury consisted of : treating the injured site immediately using disinfectants(89.7%), reviewing the clinical records of the patient involved(84.2%), immunological investigation for the status of antibodies(11.1%) and self-medication of antibiotics (10.7%). Only 16.3% of the total episodes were founded to have been reported to the administrative unit. 5. The length of clinical experience of the nurses, clinical specialty and length of clinical experience in physicians were found to have influenced the episodes of needle stick injuries ; nurses with less than 1 year and with more than 6 years of clinical experiences had significantly lower levels (X$^2$=25.04, P=.00), surgeons had significantly higher levels (X$^2$=9.89, P=.02) compared to that of internists and interns, higher(X$^2$=4.54, P=.03)than residents.

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A Case of Pneumonia with Septic Shock Due to Nocardia farcinia in Liver Transplant Patient (간이식 환자에서 발생한 Nocardia farcinia 폐렴 및 패혈성 쇼크 1예)

  • Lee, Su-Hwan;Park, Byung-Hoon;Son, Ji-Young;Jung, Ji-Ye;Kim, Eun-Young;Lim, Ju-Eun;Lee, Ji-Hoon;Hyun, Shin-Young;Lee, Sang-Hoon;Lee, Sang-Kook;Kim, Song-Yee;Lee, Kyung-Jong;Kang, Young-Ae;Kim, Young-Sam;Kim, Se-Kyu;Chang, Joon;Seo, You-Kyung;Lee, Kyoung-Won;Park, Moo-Suk
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.6
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    • pp.469-473
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    • 2010
  • Nocardia farcinia, an aerobic, gram-positive bacilli actinomycetes of the genus Nocardia, is an uncommon pathogen found in humans. The most common Nocardia infection sites are the lung, central nervous system, and skin. Even though hematogenous dissemination can occur, isolation of the organism from blood cultures is very rare. We report a case of Nocardia infection that was isolated on blood cultures. A 59-year-old male with a medical history that includes a liver transplantation 6-years prior due to hepatocellular carcinoma secondary to chronic hepatitis B, developed pneumonia and was transferred to Severance Hospital. At the time of admission, the patient's initial exam showed hypothermia, tachypnea, and hypotension. His chest radiograph showed severe pneumonia and a large abscess on left upper lobe. Under the presumptive diagnosis of bacterial pneumonia or other opportunistic infection, we started broad spectrum antibiotics. However, he developed Nocardia sepsis, rapidly deteriorated, and subsequently died.

Analysis to Recognition of School Health Promotion Applied ACCESS Model (초등학교 양호교사의 학교건강증진 인식도 연구- ACCESS모델을 적용 -)

  • Kang, Mal-Soon;Kim, Jung-Nam;Ryu, Mi-Kyung
    • Research in Community and Public Health Nursing
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    • v.11 no.2
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    • pp.577-590
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    • 2000
  • This study is basic research for developing health promotion programs in elementary school and is looking at the effect factor of School nurses perception and school health promotion. This study was conducted with the ACCESS model for school health promotion from WHO. The subjects of this study were 28 elementary school nurses located in the west side of Kung-Nam from the 7th of June to the 30th of June by direct interview. The results of this study are summarized as follows: 1. the score from obesity, dental caries, health counselling, scoliosis, hepatitis B, immunization BCG items are higher in the low grade but showed significant difference in visual disturbance items. 2. the average score of school health promotion perception is 5.04. The list of school health promotion is composed of school health policies(5.39), physical environments (5.38), school health services(5.34), social environments (5.22), personal health skills (4.92), and community relationships(4.64). 3. after an analysis of the perception of school health promotion from school nurses, the relationship between the school health budget and the school health policy and school health service was shown to be significant. 4. after analysis of the effect factor of perception of school health promotion from school nurses, school health policy, school social environment, personal health skills, and school health service were shown to be significant. 5. The factors in school health promotion are the number of classes and students, school budgets, school nurses' final education and age, health education classes per week, and teaching experience. Particularly the school health budget and school nurses of the classes per week are statistically significant. The suggestions of this study are as follows: 1, as a related factor of school health promotion. the generally characteristics of schools and school nurses should be considered for improving the perception of school health promotion. 2, the period of health education for effective school health management and health education should be an on-going program. 3. the scope of school health promotion and perception should be considered for developing health promotion programs. 4. elementary school health promotion programs should be developed and applied to research. 5. computer system programs should be developed for effective school health projects.

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A Research and Application of Polyhydroxyalkanoates in Biosensor Chip (생분해성 고분자, 폴리하이드록시알카노에이트를 이용한 바이오센서 칩 연구와 그 응용)

  • Park, T.J.;Lee, S.Y.
    • KSBB Journal
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    • v.22 no.6
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    • pp.371-377
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    • 2007
  • Polyhydroxyalkanoates (PHAs) are a family of microbial polyesters that can be produced by fermentation from renewable resources. PHAs can be used as completely biodegradable plastics or elastomers. In this paper, novel applications of PHAs in biosensor are described. A general platform technology was developed by using the substrate binding domain (SBD) of PHA depolymerase as a fusion partner to immobilize proteins of interest on PHA surface. It could be shown that the proteins fused to the SBD of PHA depolymerase could be specifically immobilized onto PHA film, PHA microbead, and microcontact printed PHA surface. We review the results obtained for monitoring the specific interaction between the SBO and PHA by using enhanced green fluorescent protein, red fluorescent protein, single chain antibody against hepatitis B virus preS2 surface protein and severe acute respiratory syndrome coronavirus surface antigen as model proteins. Thus, this system can be efficiently used for studying protein-protein and possibly protein-biomolecule interactions for various biotechnological applications.

A Rare Case of Acquired Arteriovenous Malformation in Transarterial Chemoembolization for Hepatocellular Carcinoma (간세포암의 경동맥 화학색전술 중 발견된 후천성 동정맥 기형에 관한 드문 증례보고)

  • Moon, Sung-Nam;Seo, Sang-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.188-193
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    • 2019
  • Transarterial chemoembolization (TACE) is a commonly used and rapidly evolving non-invasive treatment for hepatocellular carcinoma (HCC). It is important that understanding individual anatomical variants and planning for tumor-feeding artery access to acquire adequate treatment effectiveness. In this study, we will report acquired arteriovenous malformation which interferes with TACE for HCC. A 72-year-old man with persistent abdominal pain for 2 days visited our hospital. The patient was chronic hepatitis B carrier and had a history of HCC treated with conventional TACE 10 years ago. Hypervascular nodular HCC in the liver segment 8 and aberrant right hepatic artery from the superior mesenteric artery were detected on computed tomography (CT). When first TACE was performed, the tumor-feeding artery originating from the left hepatic artery was found and embolized. There was no tumor-feeding artery from the right hepatic artery but arteriovenous malformation was found. After a month, follow up CT showed necrotic lesion and residual HCC and we performed secondary TACE. On secondary TACE, we selected the right hepatic artery and passed through arteriovenous malformation. Superselective-angiogram showed remnant tumoral staining and remnant tumor was embolized using drug-eluting bead and Adriamycin. Final angiogram showed no remnant tumoral staining and the patient was discharged without complication. We found the rare case of arteriovenous malformation adjacent to HCC, and we performed superselective TACE beyond arteriovenous malformation to treat HCC.

Diagnostic Performance of Spin-Echo Echo-Planar Imaging Magnetic Resonance Elastography in 3T System for Noninvasive Assessment of Hepatic Fibrosis

  • Se Woo Kim;Jeong Min Lee;Sungeun Park;Ijin Joo;Jeong Hee Yoon;Won Chang;Haeryoung Kim
    • Korean Journal of Radiology
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    • v.23 no.2
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    • pp.180-188
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    • 2022
  • Objective: To validate the performance of 3T spin-echo echo-planar imaging (SE-EPI) magnetic resonance elastography (MRE) for staging hepatic fibrosis in a large population, using surgical specimens as the reference standard. Materials and Methods: This retrospective study initially included 310 adults (155 undergoing hepatic resection and 155 undergoing donor hepatectomy) with histopathologic results from surgical liver specimens. They underwent 3T SE-EPI MRE ≤ 3 months prior to surgery. Demographic findings, underlying liver disease, and hepatic fibrosis pathologic stage according to METAVIR were recorded. Liver stiffness (LS) was measured by two radiologists, and inter-reader reproducibility was evaluated using the intraclass correlation coefficient (ICC). The mean LS of each fibrosis stage (F0-F4) was calculated in total and for each etiologic subgroup. Comparisons among subgroups were performed using the Kruskal-Wallis test and Conover post-hoc test. The cutoff values for fibrosis staging were estimated using receiver operating characteristic (ROC) curve analysis. Results: Inter-reader reproducibility was excellent (ICC, 0.98; 95% confidence interval, 0.97-0.99). The mean LS values were 1.91, 2.41, 3.24, and 5.41 kPa in F0-F1 (n = 171), F2 (n = 26), F3 (n = 38), and F4 (n = 72), respectively. The discriminating cutoff values for diagnosing ≥ F2, ≥ F3, and F4 were 2.18, 2.71, and 3.15 kPa, respectively, with the ROC curve areas of 0.97-0.98 (sensitivity 91.2%-95.9%, specificity 90.7%-99.0%). The mean LS was significantly higher in patients with cirrhosis (F4) of nonviral causes, such as primary biliary cirrhosis (9.56 kPa) and alcoholic liver disease (7.17 kPa) than in those with hepatitis B or C cirrhosis (4.28 and 4.92 kPa, respectively). There were no statistically significant differences in LS among the different etiologic subgroups in the F0-F3 stages. Conclusion: The 3T SE-EPI MRE demonstrated high interobserver reproducibility, and our criteria for staging hepatic fibrosis showed high diagnostic performance. LS was significantly higher in patients with non-viral cirrhosis than in those with viral cirrhosis.

Study on Vaccination State in Children : Jeonbuk Province, 2000 (전라북도 아동의 예방접종실태에 관한 조사연구)

  • Choung, Ju Mi;Kim, Jung Chul;Eun, So Hee;Hwang, Pyoung Han;Nyhambat, B.;Kilgore, P.;Kim, Jung Soo
    • Clinical and Experimental Pediatrics
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    • v.45 no.10
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    • pp.1234-1240
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    • 2002
  • Purpose : This study was carried out to obtain the vaccination rate and age appropriateness of vaccination in children under five years of age in Jeonbuk province. Methods : Eight hundred and fifty infants and children were enrolled in this study. Vaccination rate(Number of vaccinees/Number of subjects), places of vaccination, age appropriateness of vacination were examined by either vaccine record review or interview with parents or guardians. Results : The salient features of the findings were as follows : All subjects were aged under five and mostly under two years of age(68.8%). Places of vaccination were health centers or subcenters( 50.4%), private clinics(44.3%), and general hospitals(5.3%). Routine vaccinations such as BCG, hepatitis B vaccine(HBV), diphtheria, tetanus, acellular pertussis(DTaP) and Trivalent Oral Polio Vaccine(TOPV), measles, mumps, rubella(MMR), and Japaneses B encephalitis(JBE) were vaccinated mostly in health centers or subcenters, while chickenpox(CHP) and haemophilus influenzae vaccines(Hib), which are not routine in Korea, were vaccinated in private clinics. The vaccination rates of BCG(99.2%), HBV(93.5%) and DTaP(96.1%) were very high. But those of MMR(83.7%), CHP(72.5%), JBE(50.2%), and Hib(15.8%) were lower than expected. Considering the age appropriateness of vaccination, some infants and children were not appropriately vaccinated(vaccination rate/age appropriateness of vaccine; HBV, 93.5%/88.4% : DTaP, 94.6%/73.1% : JBE, 50.2%/ 18.5%). Conclusion : The vaccination rate of BCG, HBV, DTaP and TOPV was very high, but MMR, CHP, JBE, and Hib vaccination rate was not high enough to be able to protect against epidemic. We should pay more attention to vaccinating children, and there is a need for a program that will enhance coverage for vaccines.

Immunogenicity and Safety of a Haemophilus influenzae Type b Polysaccharide-Tetanus Toxoid Conjugate Vaccine (PRP-T: HiberixTM) in Korean Infants (우리나라 영아에서 PRP-T(HiberixTM)백신의 면역원성 및 안전성에 대한 연구)

  • Chung, Eun Hee;Kim, Yae Jean;Kim, Yun Kyung;Kim, Dong Ho;Seo, Jeong Wan;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.10 no.1
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    • pp.71-80
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    • 2003
  • Purpose : Four kinds of Haemophilus influenzae type b protein conjugate vaccines, PRPD, PRP-T, PRP-OMP and PRP-CRM197, have been developed, and PRP-T vaccines are currently produced by two manufacturer, $ActHib^{(R)}$ by Aventis and $Hiberix^{TM}$ by GlaxoSmith-Kline Biologicals. The purpose of this study is to evaluate the immunogenicity and safety of $Hiberix^{TM}$ in Korean infants. Methods : Seventy-three healthy infants(43 male infants) were recruited for this study after parental informed consent was obtained. Each infant was vaccinated at 2, 4 and 6 months of age with the study vaccine. At each visit, infants were also immunized with DTaP, trivalent oral polio vaccine and hepatitis B vaccine when indicated. The serum anti-PRP antibody was measured at prevaccination, 2 month later after the 2nd dose, and 1 month later after the 3rd dose by the ELISA method. The local and systemic adverse reactions of vaccination were monitored for 3 consecutive days after each immunization. Immunogenicity of vaccine was evaluated in infants who received all the scheduled immunization and the adverse reactions were evaluated for infants who received at least one dose of the study vaccine. Results : Among seventy three infants, enrolled in this study; sixty three(37 male infants) completed all the scheduled immunizations. The geometric mean titer(GMT) of anti-PRP antibodies at prevaccination was 0.17 ${\mu}g/mL$(95% confidence interval[CI]; 0.13~0.22). The GMT of anti-PRP antibodies increased to 4.14 ${\mu}g/mL$(95% CI; 2.65~6.48) at 2 month later after the 2nd dose of PRP-T and 14.65 ${\mu}g/mL$(95% CI; 10.83~19.81) at 1 month later after the 3rd dose. Anti-PRP antibody ${\geq}0.15$ ${\mu}g/mL$, was observed in 98.4%(95% CI; 91.8~100) after 2 doses and 100%(95% CI; 100~100) after 3 doses. Anti-PRP antibody ${\geq}1.0$ ${\mu}g/mL$, was obtained in 77.8%(95% CI; 67.5~88.0) after 2 doses, and 98.4%(95% CI; 95.3~100) after 3 doses. Most of the adverse reaction after vaccination were mild. Irritability, the most common systemic reaction, was observed in 45.5%, followed by drowsiness(30.5%), poor feeding(26.7%) and fever(5.6%). Among the local reactions tenderness was observed in 7.9%, redness(${\geq}5$ mm) in 2.8% and swelling(${\geq}5$ mm) in 1.8%. Conclusion : The PRP-T vaccine used in this study was highly immunogenic and safe in Korean young infants. The finding that high GMT and high frequency of infants with a protective titer achieved after 2 doses is consistent with the previous studies which were done with a PRP-T vaccine of other manufacturer. This study suggests that the immunization schedule of PRP-T vaccine for Korean infants may need re-evaluation.

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Clinical Characteristics of Pulmonary Cryptococcosis (국내 폐효모균증의 임상적 특징)

  • Moon, Doo-Seop;Yoo, Jeong-Soo;Kim, Chung-Mi;Kim, Yeon-Soo;Kim, Seung-Min;Oh, Kwang-Taek;Sohn, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Hahm, Shee-Young
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1083-1093
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    • 1997
  • Background : So far, there have been numerous reports on organ damage due to cryptococcosis, however, cases of lung localization have been infrequently reported. Recently pulmonary cryptococcosis has been reported more frequently than before due to enhanced diagnostic techniques and increased underlying diseases. Method : The author, therefore, analyzed the clinical manifestations of 5 cryptococcosis cases that we experienced at Hanyang University Hospital from 1985 to 1996 and 9 cases reported in Korea from 1984 and 1996 retrospectively. The following results were obtained. Results : Cryptococcosis occurred frequently over sixth decade and the male to female ratio was 3.6 : 1. Underlying diseases included acute rejection after kidney transplantation, rheumatoid arthritis, autoimmune hepatitis, diabetes mellitus and state of bilateral adrenalectomy. Remaining 8 cases had no evidence of an underlying disease. Because the symptoms were subacute & nonspecific, and not improved by conventional antibiotics, 6 patients of 14 pulmonary cryptococcosis patients were treated as pulmonary tuberculosis before correct diagnosis was made. There were three asymptomatic cases. According to the results of CXR, solitary alveolar consolidation was the most common finding(8 cases) followed by diffuse infiltration(5 cases). It also showed pleural effusion, hilar lymphadenopathy and cavity formation that was rarely reported in world literature. The diagnasis was made through fine needle aspiration biopsy in 10 cases, open thoracotomy in 2 cases, transbronchial lung biopsy in 1 case. and thoracentesis with pleural biopsy in 1 case. Only one case showed positive result in sputum stain and culture, serum latex agglutination test for cryptococcus neoformans. Treatment modalities were various such as fluconazole, amphotericin B, flucytosine, ketoconazole, surgery and it's combination. After 1990 year, there was a trend that fluconazole or ketoconazole are more used than other therapeutic modalities. Conclusion : Because the symptoms are subacute & nonspecific and not improved by conventional antibiotics, pulmonary cryptococcosis is likely to misdiagnosis as pulmonary tuberculosis in Korea. Because the diagnosic yield of sputum stain, culture and serologic test for pulmonary cryptococcosis is low, histologic diagnosis is need in most pulmonary cryptococcosis.

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A Study on Health Behavior of the Populations in Urban and Rural Area (도시·농촌지역 주민의 건강행태에 관한 연구)

  • Lee, Jeong-Mi;Kwon, Keun-Sang;Lee, Ju-Hyoung;Jeon, Gap-Sung
    • Journal of agricultural medicine and community health
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    • v.30 no.2
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    • pp.213-225
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    • 2005
  • Objectives: This study was carried out to evaluate the socio-demographic, style of living, and health related behaviors of community residents between urban and rural areas in Jeonbuk province. Methods: The data was obtained from 2,086 residents who lived in Jeonbuk province from July to September 2001 which included 1,238 residents in urban area and 848 residents in rural area. Results: The results were as follows; There were significant differences socio-demographic characteristics including occupation and educational level of the populations between urban and rural areas. In the urban populations, housewives, professional classes, and people who received collage graduate education were significantly higher, people who were engaged in the primary industries and lower educational classes(below middle school), in contrast, were significantly lower than in the rural populations. In the practice of health behavior, consumption of health foods and amount of exercise in urban populations were significantly higher than in the rural, whereas the state of health, prevalence of chronic disease, Body Mass Index(BMI), consumption of ethanol and cigarette, and hours of sleep were not significantly different between the urban and rural populations. In the eating habits, rate of surfeit, vaccination of hepatitis B, and screening of cancer in the urban populations were significantly higher than in the rural, rate of regular meal, taste of salted food, consumption of vegetables, in contrast. were significantly lower than in the rural. But, consumption of coffee, intake of meat, and periodic medical checkup were not significantly different between urban and rural communities. Logistic regression analysis revealed that the factors associated with subjective thought on health state were sex, age, occupation, educational level, exercise, and consumption of coffee. Logistic regression analysis to find related factor with prevalence of chronic disease was conducted. As a results, age, educational level, BMI, intake of meat, screening of cancer, and consumption of health foods were related to prevalence of chronic disease. Conclusions: The study showed that special attention to device the health plan are necessary and it suggested that consideration of regional differences are required to provide the community health projects.

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