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Evaluation of HbA1c Levels Via the Latex Immunoturbidimetric Method by Using Chemistry Autoanalyzer (자동화학분석기에서의 라텍스 면역비탁법의 Autolab HbA1c 평가)

  • Jo, Yongjun;Lee, So-young;Park, Hae-il;Kim, YeongSic;Lee, Jehoon;Kim, Yonggoo;Han, Kyungja
    • Laboratory Medicine Online
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    • v.2 no.1
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    • pp.10-14
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    • 2012
  • Background: Measurement of HbA1c levels is widely used to diagnose diabetes mellitus and to evaluate and monitor plasma-glucose concentrations over 6-8 weeks. In this study, we evaluated the diagnostic performance of the newly developed latex immunoturbidimetric method by using Autolab HbA1c. Methods: We analyzed and compared the diagnostic performance of Autolab HbA1c with that of Toshiba 200FR between April 2009 and July 2009. According to guidelines (EP5-A2, EP6-P, EP9-A2) of the clinical and laboratory standards institute (CLSI), we compared linearity, precision and correlation of Autolab HbA1c with those of G7 (Tosoh Corp., Kyoto, Japan) by using high-performance liquid chromatography (HPLC) method. Results: Data obtained using Autolab HbA1c showed good linearity in mixtures of samples with low (3.1%) and high (15.1%) levels of HbA1c (r2=0.9997). In the analysis of within-run precision of the samples with HbA1c levels of 5.1% and 12.1%, the SDs were 0.04 and 0.06 and covariances of these samples were 0.8% and 0.5%, respectively. In the Deming regression model, the regression equation was as follows: Autolab HbA1c=1.0859×Tosoh HPLC-0.6957. Conclusions: In this study, Autolab HbA1c method showed better performance characteristics than Tosoh G7 did. In reference review, there was no interference of variant hemoglobin. The data acquisition time of Autolab HbA1c was lower than that of Tosoh G7. The advantages of Autolab HbA1c are that it can be used as an autoanlyzer in routine chemical analysis, it does not require pre-analytical treatment, and the samples are automatically treated with distilled water for hemolysis.

A Study on the Characteristics and Consultation Type of Inpatients Referred for Delirium and Depressive Disorder (섬망 및 우울장애로 자문 의뢰된 입원환자의 임상적 특징 및 의뢰 형태에 관한 연구)

  • Seong min Lee;Seung-Ho Ryu;Jee Hyun Ha;Hong Jun Jeon;Doo-Heum Park
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.1
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    • pp.10-18
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    • 2023
  • Objectives : The purpose of this study is to investigate the characteristics of patients referred for delirium and depressive disorder and to find direction of improvement of consultation-liason psychiatry in general hospital. Methods : We performed a retrospective computed chart review of the 4,966 inpatients hospitalized at Konkuk University Hospital who were referred to the Department of Psychiatry from August 1, 2005 to December 31, 2011. Results : Depressive disorder shows the order of frequency of consultation type Parallel-Complementary-Mending. Delirium shows the order of frequency of consultation type Mending-Parallel-Complementary. When comparing 'follow up consultation' and 'without follow up consultation' group within the depressive disorder, the proportion of men in the 'follow up consultation' group was higher. In the analysis of the consultation type, the 'follow up consultation' group showed the order of consultation type Parallel-Mending- Complementary, and type Parallel-Complementary-Mending in the 'without follow up consultation' group. When comparing 'follow up consultation' and 'without follow up consultation' group within the delirium, the proportion of the surgical field in the 'follow up consultation' group was higher. In the analysis of the consultation type, both group showed the order of consultation type Mending-Parallel- Complementary. Conclusions : Doctors in each department and psychiatrists should pay attention to delirium symptoms that may occur in surgical inpatients and preventive measures should be taken. Screening tests should be conducted in medical patients to properly evaluate coexisting psychiatric diseases. Risk factors of Delirium and Depressive disorder should be identified from the time of hospitalization, and actively discussing treatment plans and early interventions could improve the quality of medical services.

Effects of Mixed Application of Chemical Fertilizer and Liquid Swine Manure on Dry Matter Yield and Feed Value of Whole Crop Barley (화학비료와 발효 돈분 액비 혼용 시용이 총체보리의 생산성 및 영양성분에 미치는 영향)

  • Sang Moo Lee
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.43 no.4
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    • pp.225-231
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    • 2023
  • This study was carried out to investigate the growth characteristics, yield and chemical compositions of whole crop barley (Hordeum vulgare L.) according to mixing ratio of chemical fertilizer (CF) and liquid swine manure (LSM) in the paddy field cultivation. The experimental design was arranged in a randomized block design with five treatments and three replications. The manure fertilizer ratio of five treatments were CF 100% (T1), CF 70% + LSM 30% (T2), CF 50% + LSM 50% (T3), CF 30% + LSM 70% (T4), and LSM 100% (T5) of whole crop barley. At this time, the application of liquid swine manure was based solely on the nitrogen. Plant length was higher at T1 as compared to other treatments (T2, T3, T4 and T5). Fresh yield, dry matter yield and total digestive nutrients (TDN) yield were the highest in T1, whereas the lowest in T5 treatment (p<0.05). Chemical compositions (crude protein, crude fat, neutral detergent fiber, acid detergent fiber and TDN) did not show significant difference among treatments. Ca and Na contents were significantly lower at T1 as compared to other treatments (T2, T3, T4 and T5). However, Mg and P contents were significantly higher at T1 as compared to other treatments(p<0.05). There was no significant difference in total free sugar content among T2, T3, T4 and T5 treatments, but the chemical fertilizer (T1) was significantly lower than the other treatments (p<0.01). Considering the above results, liquid swine manure application showed lower dry matter yield and TDN yield than chemical fertilizer, but higher free sugar content. Therefore, in order to increase the productivity of whole crop barley, it is considered desirable to mix liquid fertilizer with chemical fertilizer, taking into account the decomposition rate and insufficient components (P, K) of the liquid swine manure.

Effect of Oil in Water Nanoemulsion Containing a Mixture of Lactic Acid and Gluconolactone for Skin Barrier Improvement (유산 및 글루코노락톤 혼합물을 함유하는 수중유형 나노에멀젼의 피부장벽개선 효과)

  • Ji-Hye Hong;Young Duck Choi;Gye Won Lee;Young Ho Cho
    • Journal of Life Science
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    • v.33 no.11
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    • pp.905-914
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    • 2023
  • To evaluate the effectiveness of the skin barrier improvement of lactic acid (LA) and gluconolactone (GL), the expression of filaggrin, loricrin, hyaluronic acid (HA), hyaluronan syhthase-2 (HAS2), and aquaporine-3 (AQP3) in keratinocytes, and the moisture content and transepidermal water loss (TEWL) by clinical trials were evaluated. The expression levels of filaggrin and locricrin, which are the main factors affecting the proper functioning of skin barrier function, and HA, HAS2, and AQP3, which are skin moisturizing-related proteins measured by quantitative real-time polymerase chain reaction (qRT-PCR) and western blotting. The results showed that the expression levels of the factors that decreased by H2O2 treatment were significantly increased by LA, GL, and a mixture of LA and GL at the mRNA and protein levels (p<0.05). The nanoemulsion containing a mixture of LA and GL was prepared using the emulsion inversion method, and the average particle size was 299.9 ± 0.287 nm. After measuring the TEWL of nanoemulsion using Vapometer, it was found that TEWL significantly decreased by 15.53% and 26.73% after two weeks and four weeks of product use, respectively, compared to TEWL before product use (p<0.001). Similarly, the skin moisture content of the nanoemulsion significantly increased by 15.40% and 26.59% after two weeks and four weeks of product use, respectively, compared to skin moisture content before product use (p<0.001). Therefore, the skin barrier function and moisturizing effect of a mixture of LA and GL are shown by increasing the moisture content and decreasing the TEWL by increasing the expression of filaggrin, loricrin, HA, HAS2, and AQP3. This suggests the possibility for the development of functional cosmetic ingredients in the future.

The effect of university students' participation in the entrepreneurship planning course on the enhancement of core competencies of entrepreneurship: Focusing on the case of S women's university (대학생의 창업계획 교육과정 참여가 창업가정신 핵심역량 증진에 미치는 효과: S여대 사례를 중심으로)

  • Kyun, Suna;Seo, Heejeon
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.17 no.5
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    • pp.81-94
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    • 2022
  • This study analyzed the effect of the entrepreneurship planning course provided by an women's university in Seoul on the enhancement of the core competencies of entrepreneurship of university students. To this end, pre- and post-test of core entrepreneurship competency were conducted on 63 female university students (32 in experimental group, 31 in control group) and then the results were analyzed. The course in which the experimental group participated was a team-based project learning course and it required a team of three people to draw an entrepreneurship plan containing social problem solving as the final result. The course was operated for a total of 8 weeks. To measure the level of entrepreneurship core competency in the pre- and post- test, the survey tool that was developed by the Ministry of Education and Korea Entrepreneurship Foundation (2020) was used. This tool composed by 'value creation', 'challenge', 'self-directed', and 'group creativity' competencies. As analyses methods, i) covariance analysis was performed using the pretest as a covariate, and then a two-way ANOVA was performed with treatment (experimental group, control group) and time point (pre test, post test) as two independent variables. Results show while there was no significant difference between the experimental group and the control group in the value creation competency, it significantly contributed to the enhancement of challenge, self-directed, and collective creativity competencies. Based on these results, implications and limitations were discussed, followed by future research direction.

Image quality and usefulness evaluaton of 3D-CBCT and Gated-CBCT according to baseline changes for SBRT of Lung Cancer (폐암 환자의 정위체부방사선치료 시 기준선 변화에 따른 3D-CBCT(Cone Beam Computed-Tomography)와 Gated-CBCT의 영상 품질 및 유용성 평가)

  • Han Kuk Hee;Shin Chung Hun;Lee Chung Hwan;Yoo Soon Mi;Park Ja Ram;Kim Jin Su;Yun In Ha
    • The Journal of Korean Society for Radiation Therapy
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    • v.35
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    • pp.41-51
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    • 2023
  • Purpose: This study compares and analyzes the image quality of 3D-CBCT(Cone Beam Computed-Tomography) and Gated CBCT according to baseline changes during SBRT(Stereotactic Body RadioTherapy) in lung cancer patients to find a useful CBCT method for correcting movement due to breathing Materials and methods : Insert a solid tumor material with a diameter of 3 cm into the QUASARTM phantom. 4-Dimentional Computed-Tomography(4DCT) images were taken with a speed of the phantom at period 3 sec and a maximum amplitude of 20 mm. Using the contouring menu of the computerized treatment planning system EclipseTM Gross Tumor Volume was outlined on solid tumor material. Set-up the same as when acquiring a 4DCT image using Truebeam STxTM, breathing patterns with baseline changes of 1 mm, 3 mm, and 5 mm were input into the phantom to obtain 3D-CBCT (Spotlight, Full) and Gated-CBCT (Spotlight, Full) images five times repeatedly. The acquired images were compared with the Signal-to-Noise Ratio(SNR), Contrast-to-Noise Ratio(CNR), Tumor Volume Length, and Motion Blurring Ratio(MBR) based on the 4DCT image. Results: The average Signal-to-Noise Ratio, Contrast-to-Noise Ratio, Tumor Volume Length and Motion Blurring Ratio of Spotlight Gated CBCT images were 13.30±0.10%, 7.78±0.16%, 3.55±0.17%, 1.18±0.06%. As a result, Spotlight Gated-CBCT images according to baseline change showed better values than Spotligtht 3D-CBCT images. Also, the average Signal-to-Noise Ratio, Contrast-to-Noise Ratio, Tumor Volume Length and Motion Blurring Ratio of Full Gated CBCT images were 12.80±0.11%, 7.60±0.11%, 3.54±0.16%, 1.18±0.05%. As a result Full GatedCBCT images according to baseline change showed better values than Full 3D-CBCT images. Conclusion : Compared to 3D-CBCT images, Gated-CBCT images had better image quality according to the baseline change, and the effect of Motion Blurring Artifacts caused by breathing was small. Therefore, it is considered useful to image guided using Gated-CBCT when a baseline change occurs due to difficulty in regular breathing during SBRT that exposes high doses in a short period of time

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The Public Health Welfare Conception of the Beveridge Report and Its Realization via the NHS (베버리지 보고서의 의료보장 구상과 NHS를 통한 구현)

  • Juneyoub Han;Jiyong Park
    • The Korean Society of Law and Medicine
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    • v.24 no.3
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    • pp.59-104
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    • 2023
  • This essay attempts to analyze the public health welfare conception within the text of the Beveridge Report and its realization via the NHS in Great Britain. Once referring to the influence of the Report to create the foundations of the 20th-century welfare system, the quest to scrutinize the original intentions of the Report and its succession to the NHS is certainly intriguing. Furthermore, when regarding the significance of public health policy for a modern state, the effort to engage in Beveridge's conception and its realization is more than timely. In light of such a premise, this paper indulges in its study by the following methods. First, the historical background of the Report - namely, the role of the spirit of the age and the experience of the Emergency Medical Service are to be analyzed to identify the origins of the welfare policies proposed by Beveridge. Furthermore, the public health welfare conception of the Report conceived from its time is reflected upon by engaging on the goal towards social welfare and public health scheme. Lastly, the aims of the NHS and its management, treatment classification, and rehabilitation program are reviewed for comparative analysis with the Report to survey the realization of Beveridge's design. In this process, this paper not only takes into account the original text of the Report - but also other essential works of law and public policy, including the NHS Constitution for England and the National Health Service Act of 1946. The intentions of this study are not bound by merely coinciding with the Report, but resonate significance via reflecting upon the Beveridgian legacy on the modern welfare state from the current perspective. The structured analysis to research the aims and policies of the Report and to compare them to the reality of the NHS may provide an opportunity to confirm the realization of Beveridge's scheme in British society. In addition, this essay is part of an academic endeavor to critically assess the past and the present of the welfare institution in the public health sector. As such, it is hopeful that the essay sheds light on further studies concerning the constructive remedies of the Korean welfare system as well.

Latest Supreme Court Decision on Proof of Causation in Medical Malpractice Cases - Focusing on Supreme Court decision 2022da219427 on August 31, 2023 and the Supreme Court decision 2021Do1833 on August 31, 2023 - (의료과오 사건에서 인과관계 증명에 관한 최신 대법원 판결 - 대법원 2023. 8. 31. 선고 2022다219427 판결 및 대법원 2023. 8. 31. 선고 2021도1833 판결을 중심으로 -)

  • HYEONHO MOON
    • The Korean Society of Law and Medicine
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    • v.24 no.4
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    • pp.3-36
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    • 2023
  • The main issue in medical malpractice civil litigation is medical negligence and the causal relationship between medical negligence and damages. Regarding the presumption of causality in cases where medical negligence is proven, there is a previous Supreme Court decision 93da52402 on February 10, 1995, but it is difficult to find a case that satisfies the textual requirements of the above decision, and yet, in practice, the above decision is cited. In many cases, causal relationships were assumed, and criticism was consistently raised that it was inconsistent with the text of the above judgment. In its ruling, the Supreme Court reorganized and presented a new legal principle regarding the presumption of causality when medical negligence is proven in a civil lawsuit. According to this, If the patient proves ① the existence of an act that is assessed as a medical negligence, that is, a violation of the duty of care required of an ordinary medical professional at the level of medical care practiced in the field of clinical medicine at the time of medical practice, and ② that the negligence is likely to cause damages to the patient, the burden of proving the causal relationship is alleviated by presuming a causal relationship between medical negligence and damage. Here, the probability of occurrence of damage does not need to be proven beyond doubt from a natural scientific or medical perspective, but if recognizing the causal relationship between the negligence and the damage does not comply with medical principles or if there is a vague possibility that the negligence will cause damage, causality cannot be considered proven. Meanwhile, even if a causal relationship between medical negligence and damage is presumed, the party that performed the medical treatment can overturn the presumption by proving that the patient's damage was not caused by medical negligence. Meanwhile, unlike civil cases, the standard is 'proof beyond reasonable doubt' in criminal cases, and the legal principle of presuming causality does not apply. Accordingly, in a criminal case of professional negligence manslaughter that was decided on the same day regarding the same medical accident, the case was overturned and remanded for not guilty due to lack of proof of a causal relationship between medical negligence and death. The above criminal ruling is a ruling that states that even if 'professional negligence' is recognized in a criminal case related to medical malpractice, the person should not be judged guilty if there is a lack of clear proof of 'causal relationship'.

Radiation Therapy and Chemotherapy after Breast Conserving Surgery for Invasive Breast Cancer: An Intermediate Result (침윤성 유방암에서 유방보존수술 후 방사선치료 및 항암화학 병용치료의 성적 및 위험인자 분석)

  • Lee, Seok-Ho;Choi, Jin-Ho;Lee, Young-Don;Park, Heoung-Kyu;Kim, Hyun-Young;Park, Se-Hoon;Lee, Kyu-Chan
    • Radiation Oncology Journal
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    • v.25 no.1
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    • pp.16-25
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    • 2007
  • [ $\underline{Purpose}$ ]: Breast conserving surgery (BCS) followed by chemotherapy (CTx.) and radiation therapy (RT) is widely performed for the treatment of early breast cancer. This retrospective study was undertaken to evaluate our interim results in terms of failure patterns, survival and relative risk factors. $\underline{Materials\;and\;Methods}$: From January 1999 through December 2003, 129 patients diagnosed with invasive breast cancer and treated with BCS followed by RT were subject to retrospective review. The median age of the patients was 45 years (age distribution, $27{\sim}76$ years). The proportions of patients according to their tumor, nodes, and metastases (TNM) stage were 65 (50.4%) in stage I, 41 (31.7%) in stage IIa, 13 (10.1%) in stage IIb, 9 (7.0%) in stage III, and 1 patient (0.8%) in stage IIIc. For 32 patients (24.8%), axillary node metastasis was found after dissection. BCS consisted of quadrantectomy in 115 patients (89.1%) and lumpectomy in 14 patients (10.6%). Axillary node dissection at axillary level I and II was performed for 120 patients (93%). For 7 patients (5.4%), only sentinel node dissection was performed with BCS. For 2 patients (1.6%) axillary dissection of any type was not performed. Postoperative RT was given with 6 MV X-rays. A tumor dose of 50.4 Gy was delivered to the entire breast area using a tangential field with a wedge compensator. An aditional dose of $9{\sim}16\;Gy$ was given to the primary tumor bed areas with electron beams. In 30 patients (23.3%), RT was delivered to the supraclavicular node. Most patients had adjuvant CTx. with $4{\sim}6$ cycles of CMF (cyclophosphamide, methotrexate, 5-fluorouracil) regimens. The median follow-up period was 50 months (range: $17{\sim}93$ months). $\underline{Results}$: The actuarial 5 year survival rate (5Y-OSR) was 96.9%, and the 5 year disease free survival rate (5Y-DFSR) was 93.7%. Local recurrences were noted in 2 patients (true: 2, regional node: 1) as the first sign of recurrence at a mean time of 29.3 months after surgery. Five patients developed distant metastases as the first sign of recurrence at $6{\sim}33$ months (mean 21 months). Sites of distant metastatic sites were bone in 3 patients, liver in 1 patient and systemic lesions in 1 patient. Among the patients with distant metastatic sites, two patients died at 17 and 25 months during the follow-up period. According to stage, the 5Y-OSR was 95.5%, 100%, 84.6%, and 100% for stage I, IIa, IIb, and III respectively. The 5Y-DFSR was 96.8%, 92.7%, 76.9%, and 100% for stage I, IIa, IIb, and III respectively. Stage was the only risk factor for local recurrence based on univariate analysis. Ten stage III patients included in this analysis had a primary tumor size of less than 3 cm and had more than 4 axillary lymph node metastases. The 10 stage III patients received not only breast RT but also received posterior axillary boost RT to the supraclavicular node. During the median 53.3 months follow-up period, no any local or distant failure was found. Complications were asymptomatic radiation pneumonitis in 10 patients, symptomatic pneumonitis in 1 patient and lymphedema in 8 patients. $\underline{Conclusion}$: Although our follow up period is short, we had excellent local control and survival results and reaffirmed that BCS followed by RT and CTx. appears to be an adequate treatment method. These results also provide evidence that distant failure occurs earlier and more frequent as compared with local failure. Further studies and a longer follow-up period are needed to assess the effectiveness of BCS followed by RT for the patients with less than a 3 cm primary tumor and more than 4 axillary node metastases.

Role, Change, Job Satisfaction and Obstacles in Carrying out the Role of Public Health Nurses in Health Center (보건소 보건간호사의 역할변화, 역할수행의 장애요인과 만족도)

  • Ahn, Kyeong-Sook;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.20 no.1
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    • pp.1-13
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    • 1995
  • Based on the questionnaires sent to 270 nurses of public health centers in kyungnam during the period of March 19 to April 11 in 1992, this study was written for the of finding out the grade of satisfaction, obstacles in carrying out duties concerned with nursing services and the change of nurses role needed according to the change of the local public health administration. The first-ranking tasks carried by nurses of public health center are believed to have been family planning activities before the 1970's, nursing services during the 1970's, mother-child health activities during the 1980's, and nursing services during the period of 1990 to 1992. As far as the priority order of all the family planning activities is concerned, the counseling of the insertion of intrauterine contraceptive device, the use of oral pill or the distribution of condom was placed emphasis on before 1970, and publicity activities of family planning after that time. The first priority order of mother-child health activities has been put on the registration of pregnant women since 1970, with prenatal examination and vaccination ranking next to it. The priority order for activities against tuberculosis was laid on finding out and registration of new T.B. patients every year, with patients' control, and medication or injection ranking next to it. As for the priority order of nursing services, traveling medical examination and treatment ranked the first-stressed activity before 1970, with medication and injection ranking next to it. The first priority order management activity of communicable diseases was put on vaccination before 1970, with medication and injection. ranking next. And consultation and education ranked second to it during 1990 to 1992. As for the health services of the aged, traveling examination and treatment ranked the order, with the assistance of medical examination ranking next to it. As far as troubles and obstacles shown in case of family planning, the rate of residents' lack understanding was 28.8%, that of lacking budget 13.6%, and the imperfection of public health administration system 11.9%. In the case of tuberculosis control, residents' lacking understanding was 32.5%, the deficiency of public health administration system 18.2%, over-duty(shortage of hands) 15.6%, and the insufficiency skill and know-how 13.0%. In the case of nursing services, the deficiency of public health administration system was 18.2%, each over-duty(the shortage of hands) and the shortage of facilities and equipment 15.6% respective, and residents' lacking understanding 13.0%. The rate of dissatisfaction with the chance or possibility of promotion for his or her career or capability was shown to be 49.2%, and 65.9% of the health nurses expressed their complaints of the deficiency of the chance of the promotion to a professional or expert. when the public health nurses were asked in the questionably whether they were satisfied or not with current state of equipment and facilities needed for public health service, 49.6% of them answered in the negative. The grade of the satisfaction with the current individual position was shown to be low as much as the status of his or her position was now. 37.6% of those asked in the research answered to have the readiness to switch jobs for the reasons of dissatisfaction and so on with lacking promotion chance as well as bad working condition. Significant correlation between the grade of job satisfaction and the current status of the po as found to be in this research, which showed that the lower the status of position was, the lower the grade of job satisfaction was. But little correlation between the grade of job satisfaction and his or her schooling and career was found. In order to carry out primary health care successfully, it can be said that more education and publicity activities to make public health nurses and residents see it in a new light are requested. In addition to it, it is suggested that the improvement of promotion system for public health nurses and the enlargement of job province should also be taken in consideration of the high dissatisfaction with and complaints of the chance of promotion and the system of position. In order words, it is important that considerations for system improvement enough to make nursing services pleasant and satisfactory should be taken into.

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