Objective: The present study was conducted to evaluate invasive and noninvasive diagnostic methods for detection of Helicobacter pylori (H. pylori) in patients admitted with dyspeptic complaints and to compare sensitivities and specificities. Method: Sets of four gastric biopsy specimens were obtained from a total of 126 patients included in the study. The presence of H. pylori was determined by invasive tests including culture, rapid urease test, polymerase chain reaction (PCR) and histopathology. Among noninvasive tests, urea breath test, serological tests and enzyme-linked immunosorbent assay (ELISA) were performed. Results: H. pylori was isolated in 79 (62.7%) gastric biopsy cultures, whereas positivity was concluded for 105 (83.3%) patients by rapid urease test, for 106 (84.1%) by PCR, for 110 (87.3%) by histopathology, for 119 (94.4%) by urea breath test, and for 107 (84.9%) by ELISA. In the present study, the culture findings and histopathological examination findings were accepted as gold standard. According to the gold standard, urea breath test had the highest sensitivity (96.5%) and the lowest specificity (30%), whereas culture and histopathology had the highest specificities (100%). Conclusion: The use of PCR invasively with gastric biopsy samples yielded parallel results with the gold standard. PCR can be recommended for routine use in the diagnosis of H. pylori.
Qi, Wei-Xiang;Shen, Zan;Lin, Feng;Sun, Yuan-Jue;Min, Da-Liu;Tang, Li-Na;He, Ai-Na;Yao, Yang
Asian Pacific Journal of Cancer Prevention
/
v.13
no.10
/
pp.5177-5182
/
2012
Purpose: To compare the efficacy and safety of epidermal growth factor receptor tyrosine kinase inhibitormonotherapy (EFGR-TKIs: gefitinib or erlotinib) with standard second-line chemotherapy (single agent docetaxel or pemetrexed) in previously treated advanced non-small-cell lung cancer (NSCLC). Methods: We systematically searched for randomized clinical trials that compared EGFR-TKI monotherapy with standard second-line chemotherapy in previously treated advanced NSCLC. The end points were overall survival (OS), progression-free survival (PFS), overall response rate (ORR), 1-year survival rate (1-year SR) and grade 3 or 4 toxicities. The pooled hazard ratio (HR) or risk ratio (RR), with their corresponding 95% confidence intervals (CI) were calculated employing fixed- or random-effects models depending on the heterogeneity of the included trials. Results: Eight randomized controlled trials (totally 3218 patients) were eligible. Our meta-analysis results showed that EGFR-TKIs were comparable to standard second-line chemotherapy for advanced NSCLC in terms of overall survival (HR 1.00, 95%CI 0.92-1.10; p=0.943), progression-free survival (HR 0.90, 95%CI 0.75-1.08, P=0.258) and 1-year-survival rate (RR 0.97, 95%CI 0.87-1.08, P=0.619), and the overall response rate was higher in patients who receiving EGFR-TKIs(RR 1.50, 95%CI 1.22-1.83, P=0.000). Sub-group analysis demonstrated that EGFR-TKI monotherapy significantly improved PFS (HR 0.73, 95%CI: 0.55-0.97, p=0.03) and ORR (RR 1.96, 95%CI: 1.46-2.63, p=0.000) in East Asian patients, but it did not translate into increase in OS and 1-year SR. Furthermore, there were fewer incidences of grade 3 or 4 neutropenia, febrile neutropenia and neutrotoxicity in EGFR-TKI monotherapy group, excluding grade 3 or 4 rash. Conclusion: Both interventions had comparable efficacy as second-line treatments for patients with advanced NSCLC, and EGFR-TKI monotherapy was associated with less toxicity and better tolerability. Moreover, our data also demonstrated that EGFR-TKImonotherapy tended to be more effective in East Asian patients in terms of PFS and ORR compared with standard second-line chemotherapy. These results should help inform decisions about patient management and design of future trials.
Journal of Korean Academy of Fundamentals of Nursing
/
v.19
no.3
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pp.302-312
/
2012
Purpose: The purpose of this study was to investigate the level of knowledge, attitude and compliance with standard precautions and to identify predicting factors of compliance with standard precautions in ICU and ER nurses. Methods: The participants were 228 ICU and ER nurses working in one of three university hospitals and one general hospital. Collected data included general characteristics, features related to infection risk, and knowledge, attitude and compliance with standard precautions. For the final analysis, 218 questionnaires were used. Results: Within the previous one year, 103 (47.3%) nurses experienced pricking injury from syringe needles or other sharp materials, 111 (50.9%) nurses reported exposure to patients' blood and body fluid. In general, the scores for knowledge, attitude and compliance were all high. Compliance scores for nurses in intensive care units were significantly higher than those of nurses in emergency. There were significant correlations of knowledge, attitude, and compliance with standard precautions. Attitude and work place were significant factors predicting compliance with standard precautions. Conclusion: The results indicate that to increase nurse's compliance with standard precautions, continuous efforts to enhance positive attitudes and at the same time, improve work environments and use individualized approaches based on the work units are needed.
In bone density examinations, a change in the measured BMD occurs owing to the differences between the measured areas. To address this problem, we aimed to develop a new auxiliary device that could be rotated by $15^{\circ}$ by fixing the ankle to the distal femur neck. Dual energy X-ray absorptiometry (DXA) of BMD examinations were performed once a year, but 10 patients were examined over three sessions to analyze the area for measuring the femur neck BMD. The goal of this test was to determine the device's reliability, and the results were expressed in terms of the standard deviation of measurements. After performing bone density measurements using the new auxiliary device on 10 normal patients, with three measurements for each patient, the obtained standard deviation was 0.03. The standard deviation of the measured BMD was 0.19 when using the currently existing auxiliary device, while the standard deviation of the measured BMD was 0.03 when using the new auxiliary device. By using the new auxiliary device, the standard deviation could be reduced by ~80%. Accurate rotation of the femur neck was possible in all examinations, and the standard deviation of BMD measurements could be reduced by up to 80% compared with the measurements performed using the currently existing auxiliary device. We hope that this advantageous new design can be used as a standard auxiliary device for measuring the femur neck BMD.
Chung Se Young;Chung Hui Young;Kim Young Bum;Kwon Young Ho
The Journal of Korean Society for Radiation Therapy
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v.11
no.1
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pp.73-78
/
1999
In general, the patients of the head and neck cancer are treated with 4MV photon beam up to prescribed dose, but spinal cord should be excluded in the treatment field. When its absorbed dose is limited at the tolerance dose. In case of the patients who has the positive posterior neck nodes need a boost electron beam treatment to the prescribed dose. In that case, the anatomical structure of the neck and the physical structure of the standard electron cone interrupt to allow proper access to the disease site. Therefore, we extended treatment SSD for the remove of the those hindrances. In this study, we evaluated the dosimetric variation of the standard electron cone for the extended SSD, from 100cm to 120cm, 5 cm increment, and compare to the custom-made electron cone. As a result, the $\%$ depth dose, the point of maximum dose and the range of maximum were changed within the $2\%$. The penumbra width was increased from 1.0cm to 2.0cm. However, the dosimetric characteristics of the custom-made electron cone was very similar to that of the 100cm SSD standard electron cone and due to its characteristic of physical structure, patients didn't need re-positioning after photon beam treatment, therefore accurate treatment was possible, we conclude that the custom-made electron cone was very useful for the clinical practice.
Kim, Yong-Won;Kang, Dong-Hun;Hwang, Yang-Ha;Park, Jaechan;Kim, Yong-Sun
Journal of Korean Neurosurgical Society
/
v.59
no.4
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pp.379-384
/
2016
Objective : Mechanical thrombectomy (MT) for acute intracranial internal carotid artery (ICA) occlusion is often complicated by difficult revascularization and non-involved territory embolization possibly related with larger clot-burden. This study aims to evaluate the efficacy of proximal aspiration thrombectomy (PAT) using a balloon-tipped guide catheter for clot-burden reduction in such cases with period-to-period analysis (period 1 : standard MT without PAT; period 2 : PAT first, then standard MT for the remaining occlusion). Methods : Eighty-six patients who underwent MT for acute intracranial ICA occlusion were included in this analysis from the prospectively maintained stroke registry (33 patients in period 1 and 53 in period 2). In period 2, 'responder' was defined as a case where some amount of clot was retrieved by PAT and the following angiography showed partial or full recanalization. Results : Fifteen of fifty-three patients in period 2 (28.3%) were 'responders' to PAT. There was a significantly higher incidence of atrial fibrillation in the 'responder' subgroup. Period 2 showed a significantly shorter puncture-to-reperfusion time (94.5 minutes vs. 56.0 minutes; p=0.002), a significantly higher Thrombolysis in Cerebral Infarction of 2b-3 reperfusion (45.5% vs. 73.6%; p=0.009), but only a trend for better 3-month favorable outcome (mRS 0-2; 36.4% vs. 54.7%; p=0.097). There was no increase in the incidence of procedure-related complications or intracranial hemorrhage in period 2. Conclusion : A strategy of PAT before standard MT may result in shorter puncture-to-reperfusion time and better angiographic outcome than a strategy of standard MT for acute intracranial ICA occlusion.
Objectives: The purpose of this study was to develop a standard instrument of diagnosis and assessment for spleen qi deficiency pattern. Methods: Reports published in Korea and China related to spleen qi deficiency pattern were selected. Assessments of selected references were performed to select major symptoms of spleen qi deficiency pattern. Korean translation and review by a Korean linguist were performed to create a draft of [Standard instrument of diagnosis and assessment for spleen qi deficiency (for subject)]. The final [Standard instrument of diagnosis and assessment for spleen qi deficiency (for subject)] was completed after assessment on inclusion or exclusion, on importance of items and on validity of translation by an expert committee, consisting of professors from the National College of Korean Medicine. Results & Conclusions: 1. 14 major symptoms were selected by frequency from 45 references which were related to standard identification of spleen qi deficiency pattern, translated into Korean and reviewed by a Korean linguist. 2. 11 symptoms were selected after assessment on inclusion yes or no by the expert group. Items were listed in order of importance: tiredness of extremities (肢体倦怠), sallow complexion (面色萎黃), reduced appetite (食欲减退), abdominal distension after eating (腹胀食後尤甚), inability to eat (納少), pale tongue and white fur (舌淡苔白), lethargy (神疲), emaciation (消瘦), loose stool (大便溏薄), shortness of breath and reluctance to speak (少氣懶言), and weak pulse (脈緩弱). 3. Final [Standard instrument of diagnosis and assessment for spleen qi deficiency (for subject)] was completed after assessment of translation validity, reflection of individual opinions by the expert committee, and application of weighted value computed from assessment on importance of items.
The Journal of Churna Manual Medicine for Spine and Nerves
/
v.4
no.2
/
pp.39-45
/
2009
Objectives : The aim of this study is to compare the improvement of Low back pain (LBP) depending on male Inpatient's Brachlalankle Pulse Wave Velocity (baPWV), Method : We evaluated 35 LBP inpatients who took pulse wave velocity test during admission at Jaseng hospital from November 2008 to september 2009. We used applanation tonometry method to measure pulse wave velocity and numerical rating scale to measure patient's improvement. Result : At admission, standard deviation of normal group's NRS was $7.44{\pm}1.67$ and high risk group's was $7.57{\pm}2.09$(P=0.678). After 5 days of admission, standard deviation of normal group's NRS was $5.67{\pm}1.94$ and high risk group's was $6.00{\pm}2.17$(P=0.680). After 10 days of admission, standard deviation of normal group's NRS was $4.00{\pm}1.80$ and high risk group's was $4.95{\pm}1.96$(P=0.281). After 15 days of admission, standard deviation of normal group's NRS was $2.89{\pm}1.62$ and high risk group's was $4.10{\pm}1.92$(P=0.124). At discharge, standard deviation of normal group's NRS was $5.11{\pm}1.69$ and high risk group's was $4.86{\pm}2.08$(P=0.504). Comparison between admission and discharge, standard deviation of normal group's NRS was $5.11{\pm}1.69$ and high risk group's was $4.86{\pm}2.08$(P=0.504) Conclusion : Low back patients with high Brachialankle Pulse Wave Velocity, showed slower improvement rate compare to patients within normal rate. But statically, had no significance.
Standardized parenteral nutrition is required to improve patient's safety, clinical appropriateness and to increase uniformity between institution and institutions. We assessed the consistency with the American society for parenteral and enteral nutrition (A.S.P.E.N.) practice guideline for PN by evaluating current practice process for parenteral nutrition formulation in inpatients pharmacies in Korea. Each question in this survey was based on 2007 A.S.P.E.N. recommendations of standard parenteral nutrition formulation, the American society of health-system pharmacists (ASHP), and the United State Pharmacopoeia (USP) Chapter 797 guideline for compounding parenteral nutritions. All 90 Korean society of hospital pharmacist (KSHP) member directors of pharmacy were requested to respond to the survey in order to compare the survey results to ASHP national survey of pharmacy practice in hospital settings (2002) in compliance with A.S.P.E.N. guideline. We had final response rate of 35.6%. 25 (100%) hospitals complied with this Garb guideline (response rate was 84.4%) which was the highest compliance. Only 17.9% of hospital pharmacies were actively involved in complications monitoring. Monitoring complications and efficacy were least in compliance with the A.S.P.E.N. guideline. 69.0% of Korean pharmacists adjusted medication dosage based on disease state or monitoring laboratory data in compliance with the A.S.P.E.N. guideline. Over 50% of the hospital pharmacies failed to provide and evaluate staff training in aseptic manipulation skills periodically. Korean hospital pharmacies need to comply with the standard practice guideline for compounding sterile preparation in order to provide better quality of parenteral nutrition service for specific patient population.
Ko, Bum Ja;Yu, Mi;Kang, Jin Sun;Kim, Dong Yeon;Bog, Jeong Hee;Jang, Eun Kyung;Park, Sun Ja;Oh, Sun Ja;Choi, Yun Jin
Journal of Korean Clinical Nursing Research
/
v.18
no.2
/
pp.251-263
/
2012
Purpose: It was necessary for developing a neonatal classification system based on nursing needs and direct care time. This study was, thus, aimed at identifying nursing activities and measuring the standard nursing practice time for developing a neonatal patient classification system in Neonatal Intensive Care Unit (NICU). Methods: The study was taken place in 8 general hospitals located in Seoul and Kyungi province, South Korea from Dec, 2009 to Jan, 2010. By using 'the modified Workload Management System for critical care Nurses' (WMSN), nursing categories, activities, standard time, and task frequencies were measured with direct observation. The data were analyzed by using descriptive statistics. Results: Neonatal nursing activities were categorized into 8 areas: vital signs (manual), monitoring, activity of daily living (ADL), feeding, medication, treatment and procedure, respiratory therapy, and education-emotional support. The most frequent and time-consuming area was an ADL, unlike that of adult patients. Conclusion: The findings of the study provide a foundation for developing a neonatal patient classification system in NICU. Further research is warranted to verify the reliability and validity of the instrument.
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