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Association between the Pattern of Prophylactic Antibiotic Use and Surgical Site Infection Rate for Major Surgeries in Korea (예방적 항생제 사용 양상과 수술부위감염률의 관련성)

  • SaKong, Pil-Yong;Lee, Jin-Seok;Lee, Eun-Jung;Ko, Kwang-Pil;Kim, Cheol-Hwan;Kim, Yoon;Kim, Yong-Ik
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.1
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    • pp.12-20
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    • 2009
  • Objectives : The purpose of this study was to analyze the association between the pattern of prophylactic antibiotic use(PAU) and the surgical site infection(SSI) rate for major surgeries in Korea. Methods : We retrospectively reviewed the medical records of patients who underwent cardiac, colon and gastric surgery, hysterectomies and hip/knee replacements at 20 hospitals, and inclusive of over 500 beds. We randomly sampled 60 cases per surgery type for patients discharged between September and November, 2006. A total fo 2,924 cases were included in our analysis. Cox's proportional hazard analysis was conducted to evaluate the association between the pattern of PAU and SSI rate. Results : The proportion of patients who received their first prophylactic antibiotics(PA) 1 hour before incision was 65.5%, who received inappropriate PAs was 80.8%, and the proportion of patients whose PA was discontinued within 24 hours of surgery was 0.5%. The average duration of PAU after surgery was 9 days. The relative risk(RR) of SSI in patients who received their first PA more than 1 hour before incision was significantly higher than for those who received it within 1 hour prior to incision(RR=8.20, 95% CI=4.81-13.99). Inappropriate PA selection increased SSI rate, albeit with marginal significance(RR=1.97, 95% CI=0.96-4.03). Also, prolonged PAU following surgery had no effect on SSI rate. Conclusions : These results suggest that the pattern of PAU in the surgeries examined was not appropriate. Errors in the timing of PAU and of PA selection increase SSI rate. SSI rate remained unaltered following prolonged PAU after surgery.

Relationships Between Job Stress and Psychosocial Stress Among Nurses in a University Hospital (대학병원 간호사의 직무스트레스와 사회심리적 스트레스의 관련성)

  • Park, Sung-Kyeong;Kim, Jong-Oh;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.9
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    • pp.3887-3896
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    • 2011
  • This study was intended to measure the level of psychosocial stress among nurses working for a university hospital and to reveal its related factors. The self-administered questionnaires were given to 450 nurses during the period from October 1st to 31st, 2010. As a results, the level of psychosocial stress was 10.2% in normal group, 64.0% in potential stresses group, and 25.8% in high risk stress group. In correlation, psychosocial stress was positively correlated with job demand, but it was negatively correlated with job autonomy, supervisor and colleague support. For the results of hierarchial multiple regression analysis, the level of psychosocial stress was influenced by the variables of regular exercise, quality of sleep, subjective status of health, shift work, fit to the job, job demand, job autonomy and supervisor support. Especially, the psychosocial stress was higher related with the contents of job stress increased with explanatory powers of 18.1% on the psychosocial stress.

Fasting Blood Sugars and Their Association with Serum Lipids, and Obesity Indices in Manufacturing Workers (제조업 근로자의 공복 시 혈당과 혈청지질 및 비만지표와의 관련성)

  • Park, Sung-Kyeong;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.4
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    • pp.285-292
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    • 2017
  • The purpose of this study was to investigate the relationship between the fasting blood sugar and serum lipid levels (TC, TG, HDL-C, LDL-C) and obesity indices (BMI, body fat rates, waist circumference, waist to hip ratio). The study sample consists of 1,473 manufacturing workers aged from 30 to 59 years, who underwent a health check-up at a university hospital during the period from Jan. to Dec. 2015. A data analysis was conducted to classify the subjects into the normal and abnormal groups according to their fasting blood sugar levels depending on the average values of the serum lipids and obesity indices. Multiple regression analyzes adjusted for sex and age were conducted for the factors affecting the fasting blood sugar level. As a result, the Serum TC, TG, LDL-C, BMI and waist circumference were found to be significantly higher in the abnormal fasting blood sugar level group than in the normal one, but the HDL-C was significantly lower in the abnormal group than in the normal one The fasting blood sugar level had a significant positive correlation with the TC, TG, LDL-C, BMI and waist circumference. The TC, TG, BMI and body fat were the significant factors affecting the fasting blood sugar. The above results suggest that the fasting blood sugar and serum lipid levels (TC, TG, HDL-C, LDL-C), obesity indices (BMI, body fat rates, waist circumference, waist to hip ratio) of manufacturing workers are significantly associated with each other.

Risk associated with Adverse Events of Folk Medicine Reported in the Internet News Articles (인터넷 신문기사로 본 민간요법 유해사례의 위험성)

  • Park, Jeong Hwan;Mun, Sujeong;Kim, Sungha;Bae, Eun Kyung;Lee, Sanghun
    • The Journal of the Korea Contents Association
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    • v.15 no.1
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    • pp.357-365
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    • 2015
  • Folk medicine is traditionally passed down to cure disease, and adverse events (AEs) of folk medicine are any unfavorable and unintended discomforts temporally associated with the use of folk medicine. The aim of this study was to analyze AEs types and risks of folk medicine through the internet news articles. Included in this analysis are all articles on the topic of folk medicine and AE reported in the top 3 online news websites (NAVER, DAUM and NATE) determined by InternetTrend$^{TM}$(www.internettrend.co.kr). It was searched in the last five years (between 1 January 2009 and 28 February 2014). In total, 18 AEs articles of 973 news articles met our inclusion criteria. A total of 27 people were experienced AEs associated with use of folk medicine. Age was from 4 months to 76 years old, and it was occurred in both men and women. Folk medicine that caused AEs in twice or more was therapy that patient taking the dictamnus or aconitum of toxic herbal medicines, vinegar therapy of external use to topical skin, and cupping or bee sting therapy by practitioners. Death as a kind of serious AEs was 11 people, and 10 people were died after treatment by unqualified practitioner. Folk medicine that is popular and widely used in Korea is actively interacted with information on the internet, so it apt to misuse and abuse without guidance of health professionals. Aspects of health care system, we point out that the need for government and medical society establish not only correct health information plan and promotion of risk but also system as reporting and monitoring of AEs by folk medicine.

High Prevalence of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B Infection in Thailand

  • Wanich, Nattawat;Vilaichone, Ratha-Korn;Chotivitayatarakorn, Peranart;Siramolpiwat, Sith
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2857-2860
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    • 2016
  • Background: Chronic hepatitis B (CHB) infection is one of the important causes of hepatocellular carcinoma (HCC) in Thailand, involved in the pathogenesis and leading to a development of HCC with or without cirrhotic changes of the liver. This study was aimed to investigate the predictive factors for HCC among CHB patients in a tertiary care center in Thailand. Materials and Methods: We conducted a retrospective study of CHB patients with or without HCC during the period of January 2009 and December 2014 at Thammasat University Hospital, Pathumthani, Thailand. Data on clinical characteristics, biochemical tests and radiologic findings were collected from review of medical records. Results: A total of 266 patients were diagnosed with CHB in Thammasat university hospital during the study period. However, clinical information of only 164/266 CHB patients (98 males, 66 females with mean age of 49.4 years) could be completely retrieved in this study. The prevalence of HCC in CHB infection in this study was 38/164 (23.2%). CHB patients with HCC had a mean age older than those without HCC (59.5 vs 47 years, P-value = 0.01). Furthermore, history of upper GI bleeding, tattooing, blood transfusion, and chronic alcoholism were significantly more common in CHB patients with HCC than patients without HCC (13.2% vs 3.2% P-value 0.03, OR = 4.6, 95%CI = 1.2-18.1, 20% vs 3.9%, P-value = 0.01, OR= 6.1, 95% CI= 1.6-23.6, 20% vs 6.3%, P-value = 0.03, OR = 3.8, 95%CI =1.1-12.7, 62.2% vs 30.3%, P-value <0.0001, OR = 3.7, 95%CI= 1.7-8.1 respectively). Interestingly, more CHB patients with HCC had evidence of cirrhosis than those without HCC (78.9% vs 20.4%, P-value <0.0001, OR = 14.6, 95%CI = 5.8-36.7). In CHB patients with HCC, surgical therapy provided longer survival than radiofrequency ablation (RFA) (72 vs 46.5 months, P-value= 0.04). The mean survival time after HCC diagnosis was 17.2 months. Conclusions: HCC remains a major problem among patients with CHB infection in Thailand. Possible risk factors are male gender, history of upper GI bleeding, chronic alcoholism, tattooing, blood transfusion and evidence of cirrhosis. For early stage HCC patients, surgical treatment provided longer survival time than RFA. Most HCC patients presented with advanced disease and had a grave prognosis. Appropriate screening of CHB patients at risk for HCC might be an appropriate approach for early detection and improvement of long-term outcomes.

The Knowledge and Learning Needs about Gestational Diabetes in Pregnant Women (임부의 임신성 당뇨병관련 지식정도와 교육요구도)

  • Choi, Euy-Soon;Oh, Jeong-Ah;Hur, Myung-Haeng;Lee, In-Sook;Choi, Soon-Young
    • Women's Health Nursing
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    • v.6 no.1
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    • pp.96-108
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    • 2000
  • The purpose of this study was to provide the basic data for developing a program for effective education about GDM(Gestational Diabetes Mellitus) by investigating the knowledge and learning needs of pregnant women about GDM. The subjects were 192 pregnant women who visited obstetrical clinics for prenatal care. The data were collected from October, 1998 to December, 1999, using a 50-item questionnaire(knowledge ; 30 items, learning needs ; 20 items), and analyzed by SAS program for t-test, ANOVA, Ducan test, and Pearson correlation coefficients. The results were as follows. 1. The knowledge level about GDM 1) Pregnant women had very little knowledge(total means ; 15.1 of 30.0) about GDM. 2) Pregnant women more than 30 years old, pregnant women from Seoul, and pregnant women who had more than a bachelor's degree were more knowledgeable about GDM. 3) Pregnant women who didn't experience spontaneous abortions, pregnant women who had DM(Diabetes Mellitus) patients in their families, and pregnant women who received education about DM were more knowledgeable about GDM. 4) Pregnant women knew very well that GDM women have more maternal and fetal complications than normal pregnant women. Although they were knowledgeable about the importance and ways of controlling blood glucose level, they knew very little about the causes, symptoms, or management of hypoglycemia. 2. The learning needs about GDM 1) Pregnant women had high learning needs (total means ; 85.0 of 100.0) about GDM. 2) The learning needs of pregnant women who had more than a bachelor's degree and pregnant women who earned less than two million won in monthly income were higher than that of other groups. 3) Pregnant women had high learning needs about the health of their baby and themselves, but their learning needs related to weight control and exercise-things that play important roles in controlling blood glucose level-were relatively low. As a result of the above findings, a systemic and individualized program is required for pregnant women and GDM patients, In addition to that, further studies that investigate the effects of education and retention of learning obtained by education are required in the near future.

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Obesity-Associated Metabolic Signatures Correlate to Clinical and Inflammatory Profiles of Asthma: A Pilot Study

  • Liu, Ying;Zheng, Jing;Zhang, Hong Ping;Zhang, Xin;Wang, Lei;Wood, Lisa;Wang, Gang
    • Allergy, Asthma & Immunology Research
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    • v.10 no.6
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    • pp.628-647
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    • 2018
  • Purpose: Obesity is associated with metabolic dysregulation, but the underlying metabolic signatures involving clinical and inflammatory profiles of obese asthma are largely unexplored. We aimed at identifying the metabolic signatures of obese asthma. Methods: Eligible subjects with obese (n = 11) and lean (n = 22) asthma underwent body composition and clinical assessment, sputum induction, and blood sampling. Sputum supernatant was assessed for interleukin $(IL)-1{\beta}$, -4, -5, -6, -13, and tumor necrosis factor $(TNF)-{\alpha}$, and serum was detected for leptin, adiponectin and C-reactive protein. Untargeted gas chromatography time-of-flight mass spectrometry (GC-TOF-MS)-based metabolic profiles in sputum, serum and peripheral blood monocular cells (PBMCs) were analyzed by orthogonal projections to latent structures-discriminate analysis (OPLS-DA) and pathway topology enrichment analysis. The differential metabolites were further validated by correlation analysis with body composition, and clinical and inflammatory profiles. Results: Body composition, asthma control, and the levels of $IL-1{\beta}$, -4, -13, leptin and adiponectin in obese asthmatics were significantly different from those in lean asthmatics. OPLS-DA analysis revealed 28 differential metabolites that distinguished obese from lean asthmatic subjects. The validation analysis identified 18 potential metabolic signatures (11 in sputum, 4 in serum and 2 in PBMCs) of obese asthmatics. Pathway topology enrichment analysis revealed that cyanoamino acid metabolism, caffeine metabolism, alanine, aspartate and glutamate metabolism, phenylalanine, tyrosine and tryptophan biosynthesis, pentose phosphate pathway in sputum, and glyoxylate and dicarboxylate metabolism, glycerolipid metabolism and pentose phosphate pathway in serum are suggested to be significant pathways related to obese asthma. Conclusions: GC-TOF-MS-based metabolomics indicates obese asthma is characterized by a metabolic profile different from lean asthma. The potential metabolic signatures indicated novel immune-metabolic mechanisms in obese asthma with providing more phenotypic and therapeutic implications, which needs further replication and validation.

A Case of Klinefelter Syndrome with Refractory Seizure in Infant (난치성 경련이 동반된 클라인펠터 증후군 영아)

  • Kim, Sun;Kim, Jong Seok;Kim, Dong Hyun;Lee, Ji Eun;Kwon, Young Se
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.276-279
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    • 2018
  • Klinefelter syndrome a genetic disorder with various clinical manifestations. Neurological symptoms, such as seizures, are rarely reported with Klinefelter syndrome, and it response well to anti-epileptic drugs. A 5-month-old boy visited the Inha university hospital due to jerking movements and hiccups. The patient had been diagnosed with Klinefelter syndrome at birth and had a medical history of admission to the neonatal intensive care unit due to opisthotonus and ocular deviation at 26 days of age. The patient's serum testosterone level was decreased and his anti-$M{\ddot{u}}llerian$ hormone level was increased. The brain image examination was normal and the electoencephalography and other blood test results showed no specific findings. However, after admission, the patient recurred generalized tonic-clonic-seizures recurred intermittently even after the administration of antiepileptic drugs. This paper reports a case of non-febrile seizures in a child with Klinefelter syndrome who presented with a refractory course.

A Comparative Analysis of Disaster-Related Curriculum between Emergency Department and Nursing Department

  • Jung, Ji-Yeon
    • Journal of the Korea Society of Computer and Information
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    • v.24 no.10
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    • pp.183-188
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    • 2019
  • This study is a descriptive research to compare and analyze the current status of disaster-related curriculum between emergency department and nursing department Research and analysis targets were 41 universities which include the emergency department in South Korean by using the universities' internet homepage, finally 30 universities were researched by removing the universities which doesn't upload the curriculum on their homepage, have emergency department or have nursing department. The research data were collected and analyzed by using the universities' internet homepage. The Keyword is 'Disaster', 'Catastrophe', and 'Emergency' to search the name of the subjects. The curriculum calculated as a percentage of frequency by using the status of disaster-related subjects opening, classification of major education, grade, credit, number of class, practical hours, and the total number of subjects. According to the study, 29 universities (96.7%) of emergency department and 19 universities (63.3%) of nursing department has the disaster-related subjects in their curriculum. The current status of the class opening is emergency department at second grade and nursing department as fourth grade. As a subject of major, two credits are the common class credits. Based on the results of the study, knowledge and skills and training courses are necessary to develop the ability to cope with disasters in the disaster field. The curriculum that matches the role of health care resources will be required.

A Prospective Observational Study on Symptoms of the High Risk Group and Normal Group Used Postpartum Care Center during Six Weeks after Childbirth in Korean Medicine Hospital (고위험산모와 일반산모의 산후 6주간 증상에 대한 전향적 관찰 연구 - 일개 한방병원 산후조리원을 이용한 산모를 중심으로)

  • Jung, Jong-Kwan;Jeong, Seo-Yoon;Kim, An-Na;Jang, Hyun-Chul;Kim, Pyung-Wha;Lee, Eun-Hee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.32 no.4
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    • pp.116-131
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    • 2019
  • Objectives: The aim of this study was to observe the changes of women's postpartum symptoms, the quality of life and depression scale over the first six weeks after childbirth. Methods: Twenty seven mothers who received Korean medical treatment in the outpatient department treatment (from September 27th, 2017 to January 5th, 2018) were evaluated for Verbal numerical rating scale (VNRS), edema index, EuroQol Visual Analogue Scale (EQ-VAS), and Edinburgh Postnatal Depression Scale (EPDS). Results: There were 17 high risk participants (63.0%) and 10 normal participants (37.0%). The VNRS of edema is the highest in the first week, and the VNRS of joint pain is the highest from the second week to the sixth week in all patients. The Extra Cellular Water/Total Body Water (ECW/TBW) of high risk group significantly decreased from $0.403{\pm}0.011$ to $0.387{\pm}0.006$(p<0.05) in the first 2 weeks. The ECW/TBW of normal group significantly decreased from $0.393{\pm}0.070$ to $0.383{\pm}0.011$ (p<0.05) in the first 2 weeks. The EQ-VAS of high risk group increased from $64.12{\pm}13.941$ to $69.35{\pm}18.155$ (p<0.05) in the first 2 weeks. But this difference was not significant statistically (p=0.234). The EQ-VAS of normal group significantly increased from $62.50{\pm}21.763$ to $74.00{\pm}9.661$ (p<0.05) in the first 2 weeks. The difference of EPDS was not statistically significant between the first week and the sixth week in every participants. Conclusions: VNRS was the highest in edema in the first week, joint pain was the highest from the second week to six week. The edema index of high risk groups was higher than that of the normal group in the first week (p<0.05). The EQ-VAS of normal group significantly increased (p<0.05) in the first 2 weeks but high risk group didn't. In the EPDS, the ratio of nine or more points of high risk group was more than twice than normal group in the first 2 weeks.