• Journal of The Korea Institute of Healthcare Architecture
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• v.25 no.3
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• pp.15-23
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• 2019

Purpose: As the medical laboratories in general hospitals have made an efforts on quality management and employee health, they recognized the need of design guideline for clinical laboratory. As laboratories are prohibited to patients, their environments are becoming more congested and deteriorated as time goes by. So, this study investigates the current status of facility and equipment of laboratory medicine focusing on less than three hundred patient bed hospitals, and searches the improving matters. Methods: Questionnaires to technologist captains and field surveys to medical laboratories in korean hospitals have been conducted for the data collection. 18 answers have been analysed statistically by MS Excel program. Results: The result of this study can be summarized into followings. Clinical laboratory functions are all hematology, clinical chemistry, immunology, transfusion and urine microscopy, and except for three including microbiology for infection and bio safety level. Average man power of lab are 12.3 man including lab director and captain. Patient bed number, space area and total specimen numbers are not correlated with each other, but specimen numbers and employee number are correlated with. Work space distances are usually good, but exit distances are not adequate for escape owing to obstacles. Specimen delivery system by courier, test method by automatic analyzer, access floor for exposed plumbing and electricities are more practical. Open lab layed out in the center and lab support layed peripheral in space diagram. Lab space configuration by SD method showed that lab support area and employee support area are dissatisfied. Implications: Specialized hospital and yearly total specimen numbers are related to the space area and organization for laboratory planning and design.

• Clinical and Experimental Pediatrics
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• v.64 no.6
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• pp.293-300
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• 2021

Background: Understanding the epidemiology and prevalence of febrile urinary tract infection (fUTI) in children is important for risk stratification and selecting appropriate urine sample collection candidates to aid in its diagnosis and treatment. Purpose: This study aimed to analyze the epidemiology, etiology, and changes in antibiotic susceptibility patterns of the first fUTI in children. Methods: This retrospective observational cohort study included children younger than 19 years of age who were diagnosed and treated for their first fUTI in 2006-2016. Electronic medical records were analyzed and radiologic images were evaluated. Results: A total of 359 patients (median age, 5.1 months; interquartile range, 3.0-10.5 months) fit the inclusion criteria; of them, 78.0% (n=280) were younger than 12 months old. The male to female ratio was 5.3:1 for patients aged 0-2 months, 2.1:1 for those 3-5 months, and 1.6:1 for those 6-11 months. Beyond 12 months of age, there was a female predominance. Escherichia coli was the leading cause (83.8%), followed by Enterococcus species (6.7%), and Klebsiella pneumoniae (3.6%). Significant yearly increases in the proportions of multidrug-resistant strains (P<0.001) and extended-spectrum beta-lactamase (ESBL) producers (P<0.001) were observed. In patients with vesicoureteral reflux (VUR), the overall recurrence rate was 53.6% (n=15). A significantly higher recurrence rate was observed when the fUTI was caused by an ESBL versus non-ESBL producer (75.0% vs. 30.0%, P=0.03). Conclusion: fUTI was most prevalent in children younger than 12 months of age and showed a female predominance in patients older than 12 months of age. The proportion of ESBL producers causing fUTI is increasing. Carbapenems, rather than noncarbapenems, should be considered for treating fUTI caused by ESBL-producing enteric gram-negative rods to reduce short-term recurrence rates in children with VUR.

• Animal Bioscience
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• v.34 no.9
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• pp.1491-1498
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• 2021

Objective: This research was carried out to investigate the effects of corn particle size on the apparent total tract digestibility (ATTD) of energy and nutrients fed to pigs at four different growth stages and therefore to provide basis for better application of corn in pig feeds. Methods: Eighteen weanling piglets, 18 growing barrows, 24 gestating sows and 24 lactating sows were used in this study. Within each stage, pigs were allotted to 1 of 3 or 4 corn-soybean meal diets which were formulated with different corn particle size in a completely randomized design with 6 replicate pigs per diet. Each stage lasted for 19 days, including 7 days for cages adaptation, 7 days for adaptation to diets and followed by 5 days for total collection of feces and urine. Results: For nursery and growing stages, the results showed that digestible energy content and ATTD of gross energy (GE), dry matter (DM), neutral detergent fiber (NDF), and acid detergent fiber (ADF) was increased (p<0.05) as the corn particle size reduced. Meanwhile, the metabolizable energy content and ATTD of crude protein (CP) tended to increase. For gestating sows, no differences were found in the ATTD of nutrients among dietary treatments. As for lactating sows, there were linear and quadratic increases (p<0.05) in the ATTD of DM, GE, NDF as the corn being finer milled. Quadratic response in ATTD of ADF and CP (p<0.05) were observed as sows fed with four different diets. Conclusion: Reducing corn particle size can increase digestibility of nutrients fed to young pigs and lactating sows. No effects were observed in present experiment when gestating sows were fed with different particle sized corn.

• The Journal of Korean Academic Society of Nursing Education
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• v.29 no.4
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• pp.381-394
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• 2023

Purpose: This study aimed to develop an intentional rounding protocol to enhance the clinical competence of nursing students. Methods: An intentional rounding protocol for nursing students' clinical practice was developed following the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model. A convenient sampling method was used to select 23 junior year university nursing students during their clinical practice in adult nursing. The program evaluation included a quantitative assessment (communication and relationship efficacy, empathy, and patient safety competency) and focus group interviews. Results: The intentional rounding protocol focused on the 4Ps (pain, position, potty, and possessions) and encompassed aspects such as level of consciousness, pain management, personal care needs, intravenous injection, oxygen administration, nasogastric/nasoenteric tube care, maintenance of urine collection bags, and the identification of environmental fall risks. Nursing students performed intentional rounding at least twice a day. Following the implementation of this protocol, nursing students demonstrated a significant improvement in communication and interpersonal efficacy. The focus group interviews revealed four main themes: growth of human relationships, acquiring knowledge in and about the clinical field, becoming a nurse, and barriers in reality. Conclusion: The intentional rounding protocol has the potential to enhance nursing students' communication and interpersonal skills during clinical practice and to provide them with positive experiences in nursing clinical education. Therefore, it is recommended that this protocol be incorporated into nursing clinical practice education.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.3
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• pp.168-175
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• 2024

Purpose: The presence of alcoholic stool in biliary atresia (BA) patients is the basis of a stool color card (SCC), a screening tool that has led to more patients receiving Kasai portoenterostomy earlier. This study aimed to evaluate the color image processing of stool images captured using smartphones. We propose that measuring digital color parameters is a more objective method for identifying BA stools and may improve the sensitivity of BA screening. Methods: A prospective study was conducted in five hospitals in Thailand between October 1, 2020, and December 31, 2021. Stools from infants presenting with jaundice, acholic stool, or dark-colored urine were photographed. Digital image color analysis was performed, and software was developed based on the color on the original SCC. Sensitivity and specificity for predicting BA stools were compared between the SCC and the software. Results: Of 33 infants eligible for data collection, 19 were diagnosed with BA. Saturation and blue were two potential digital color parameters used to differentiate BA stools. The receiver operating characteristic curve was used to determine the optimum cutoff point of both values, and when saturation ≤56 or blue ≥61 was set as a threshold for detecting BA stool, high accuracy was achieved at 81.8% and 78.8%, respectively. Conclusion: Digital image processing is a promising technology. With appropriate cutoff values of saturation in hue, saturation, value and blue in red, green, blue color models, BA stools can be identified, and equivocal-colored stools of non-BA patients can be differentiated with acceptable accuracy in infants presenting with jaundice.

• The Korean Journal of Physiology
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• v.23 no.2
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• pp.253-261
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• 1989

Responses of atrial natriuretic peptide (ANP), aldosterone and renin release to acute volume expansion were compared in normotensive Wistar and spontaneously hypertensive rat (SHR) fed low or high-sodium diet (2 or 25 mmol Na/100 g diet). Experimental diets were fed for 6 weeks from 7-week-old and the growth rate was similar in all groups. In the morning of the experiment, catheters were inserted under ether anesthesia in femoral artery for pressure recording and blood collection, femoral vein for saline infusion, and bladder for urine collection. Then, the rats were placed in restraining cages. When the rats were recovered from anesthesia and the arterial pressure became stabilized, control urine and blood samples were collected. Then, 0.9% saline was infused for 30 min for volume expansion (3% BW). Arterial pressure was significantly higher in the high-sodium SHR but there was no difference between the two groups of Wistar rats. Control plasma levels of Na, K, ANP, renin activity, and hematocrit were not different among the 4 groups. However, plasma aldosterone level was significantly higher in the low-sodium groups. Wistar low-sodium rats showed approximately two times higher plasma aldosterone level than the SHR counterpart. Volume expansion produced a marked increase in plasma ANP level, especially in the high-sodium groups. The low-sodium groups of both strains showed approximately two-fold increase in plasma ANP level. Following a volume expansion plasma aldosterone level and renin activity decreased in all groups. There was a significant logarithmic positive correlation between plasma renin activity and aldosterone concentration. The low-sodium rats produced a greater increase in aldosterone release by small increase in plasma renin than did the high-sodium rats. The low- and high-sodium rats produced a similar degree of diuresis and natriuresis after volume expansion. However, SHR produced a greater natriuresis than did the Wistar rats. The above results indicate that regulatory mechanisms of ANP, aldosterone and renin release are different between the normotensive and hypertensive rats, and between the low- and high-sodium groups.

• Journal of Nutrition and Health
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• v.42 no.5
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• pp.486-495
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• 2009

The purpose of this study was to analyze the performance evaluation index for a salt reduction project. Questionnaires were developed in order to investigate salt reduction programs nationwide. The evaluation index and programs were analyzed through the case study of a salt reduction program in public health centers. The validity of the salt reduction program's evaluation index was determined based on study of the Delphi survey and on discussion with nutrition and health care professionals. The Delphi survey showed that daily salt intake was the most valid nutritional evaluation index. Stroke mortality and stomach cancer mortality were good health care evaluation indexes. The method for measuring salt intake that had the greatest validity was a 24-hour urine collection. However, 24-hour urine collection had the lowest score for ease of performance. The combined scores of validity and ease of performance showed that the survey method for dietary attitude and dietary behavior, dietary frequency analysis (DFQ 15), and a salty taste assessment, in that order, were proper methods. The high reliability of the salty taste assessment indicated that the percentage of the population that exhibits proper salt intake (2,000 mg sodium or less daily) and the percentage of the population that consumes low-salt diets as nutritional evaluation indexes also will be helpful to evaluate performance of salt reduction programs.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.7 no.2
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• pp.161-170
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• 1997

This is an effort to confirm changes biological monitoring according to changes in levels of exposure to styrene for industrial workers. This study was conducted on 108 workers, including male of 64 and female 44 who were working at factories of FRP, dipping, and coating. An improved passive monitor method(organic vapor monitor; OVM) was employed to determine levels of exposure. The biological monitoring include blood styrene concentration, urinary mandelic acid(MA), and urinary phenylglyoxylic acid(PGA). Biological monitoring were made through the Collection of blood and urine. The mean value of exposure to styrene was 21.0ppm, which is measured by organic vapor monitor, one of improved passive monitors. The highest exposure level was observed among workers in boat factories, laminating procedure workers, processing workers, respectively(p<0.01). For exposure level, 11% of subjects under study showed over 50ppm which is time weighted average(TWA). The correlation coefficient between biological specimens and the exposure level was 0.62 for blood styrene concentration, 0.58 for MA corrected by creatinine, and 0.70 for PGA corrected by creatinine, respectively(p<0.01). The regression analyses found exposure level relative importance in explaining variance in biological monitoring. In additional to that, gender was a significant factor in explaining variance of MA and MA+PGA. Almost half of variance(49%) in blood styrene concentration was explained by predictors, including exposure level, age, gender, duration, and drinking volume during the last week(p<0.01). The very high correlation(higher than 0.95 was found when a comparison was made among three types of corrected methods, including uncorrected specific gravity and creatinine. In conclusion, these findings suggest OVM to represent levels of exposure to styrene for industrial workers. A discussion was made on possible use of specific gravity sample for biological monitoring. Exposure level may be predicted on MA, PGA in urine, which could be applied to represent biological monitoring.

• Childhood Kidney Diseases
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• v.6 no.2
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• pp.169-177
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• 2002

Purpose: Hypertension accelerates the progression of chronic renal disease, whether it results from, or causes, the renal disease. Therefore, the control of hypertension is one of the important factors that retard the rate of renal deterioration. We compared the effects of different antihypertensive agents on renal function and glomerular morphology In subtotal nephrectomized rats. Materials and methods: After induction of chronic renal failure with 5/6 nephrectomy, the rats were divided into three groups; control group (Group C), enalapril group (Group E), and nicardipine group (Group N). Systolic blood pressure was measured by tail cuff method every 4 weeks until 12 weeks after nephrectomy. At 12 weeks after nephrectomy, all rats were placed in metabolic cages for 24 hour urine collections to measure urinary protein and creatinine excretion. After urine collection and blood sampling for serum creatinine, all rats were sacrificed. The renal tissue was processed for morphometric study with light microscope and electron microscope. Results: 1. The blood pressure of Group C increased progressively, but both enalapril and nicardipine prevented the development of hypertension, and the two drugs were equally effective in maintaining normal blood pressure throughout the study. 2. Twenty-four hour urinary protein excretion was lower in Group E compared to Group C and Group N 3. Mesangial expansion score in both treated groups were significantly lower than the control group. Mean glomerular volume in Group E was significantly reduced compared to Group C and Group N. There was no significant difference in mean glomerular volume between Group C and Group N. 4. There was no significant difference in podocyte structural changes, estimated by filtration slit length density, among control, enalapril and nicardipine treated groups. Conclusion: Control of hypertension with enalapril or nicardipine afforded considerable protection from mesangial expansion in the rat remnant kidney model. But protein excretion and glomerular growth were significantly reduced in Group E compared to Group N. There was no significant difference in podocyte structural changes among the 3 groups.

• Tuberculosis and Respiratory Diseases
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• v.42 no.6
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• pp.888-899
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• 1995

Background: Topical inhaled steroids, budesonide(Bu) and beclomethasone dipropionate (BOP), are now established as effective drugs in the management of chronic asthma. These drugs have high topical anti-inflammatory effect with low systemic activity. This study was performed to determine the effects of two inhaled corticosteroids, Bu and BOP, on the adrenocortical supression in 44 patients with bronchial asthma or chronic obstructive pulmonary disease. Methods: The adrenocortical function was assessed by measurement of serum cortisol concentration at 8 o'clock in morning and free cortisol in 24-hour urine collection at interval in 44 patients. No steroid was administered during the pretreatment period of 10 days and the final 6 days of the study. Each subject inhaled BOP or Bu, in daily doses of 800 or 1,600 micrograms for 12 days. The dose was delivered by metered dose inhaler (MDI) or diskhaler or large spacing device attached to MDI. Results: The levels of serum cortisol and 24-hour urinary free cortisol were decreased during the treatment period in patients inhaled Bu delivered by MDI in daily doses of 800 and 1,600 micrograms. In contrast, serum cortisol level was decreased on 6 and 12th day of treatment period in patients with BDP diskhaler in daily doses of 800 micrograms. In daily doses of 1,600 micrograms, the serum cortisol and 24hour urine free cortisol levels were decreased on 6, 9 and 12th day of treatment period in patients with BDP disk haler. The serum cortisol and 24-hour urinary free cortisol levels were not significantly decreased during the treatment period in patients inhaled Bu delivered by large spacing device attached to a MDI. Conclusion: These results showed that 1) the endogenous cortisol secretion was suppressed after inhalation of BDP and Bu in daily doses of 800 and 1,600micrograms, 2) Bu with MDI suppressed the adrenocortical function more than BDP with diskhaler, in daily doses of 1600 micrograms. and 3)large spacing device attached to a MDI might decrease the risk of suppression in the hypothalamic -pituitary- adrenal axis.