항암화학요법 관련 오심과 구토 완화를 위한 비약물요법에 관한 연구동향

소향숙,최자윤,조인숙,김영재,김지영,김애숙,김옥미,김춘심,김현오,설영애,안정옥,이애리,이영자 성인간호학회 2003 성인간호학회지 Vol.15 No.3

Purpose: Purposes of this study were to understand the current trends on complementary therapy in relieving chemotherapy-induced nausea and vomiting and to suggest the future research direction. Method: Subjects were selected on CINAHL, MEDLINE, Korean Academy Data Base from 1980 to 2001 which used nausea, vomiting, chemotherapy and complementary therapy as key words in experimental studies. Eight korean articles and twenty-one international articles were analyzed in terms of general characteristics, research methods, and types of complementary therapy. Data were analyzed by using descriptive statistical methods. Result: Since 2000, researchers have more actively used complementary therapy. In subject characteristics, mean age was 35.5 years old, 45% of the researchers were performed with high level of incidence of chemotherapy induced vomiting, 14% of them set limit of consecutive cycle during research, and 65% of them did not comment the selecting criteria of sample. About 60% of them were designed post-test only control group: 35% used INV by Rhodes, 31% used Likert scale, and 24% used VAS for dependent variable. Muscle relaxation therapy was mostly applied for relief of nausea and vomiting. Conclusion: Further studies will be needed to control extrinsic variables affecting nausea and vomiting in research design and to accumulate evidence with studies applying various complementary therapies.

Vacuum Non-Vacuum Hybrid Process for Cu(In,Ga)Se₂ Thin Film Solar Cell

Yun-Ae Cho,SeJin Ahn,Ara Cho,Jihye Gwak,Seung Kyu Ahn,Jun Sik Cho,Joo Hyung Park,Jin Soo Yoo,Kihwan Kim,Donghyeop Shin,In-Young Jeong,Jae Ho Yun,Soomin Song,Sang-Min Lee,Ahreum Lee,Young-Joo Eo 한국신재생에너지학회 2019 AFORE Vol.2019 No.11

Nurse staffing, quality of nursing care and nurse job outcomes in intensive care units

Cho, Sung-Hyun,June, Kyung Ja,Kim, Yun Mi,Cho, Yong Ae,Yoo, Cheong Suk,Yun, Sung-Cheol,Sung, Young Hee Blackwell Publishing Ltd 2009 Journal of clinical nursing Vol.18 No.12

<P>Aim. </P><P>To examine the relationship between nurse staffing and nurse-rated quality of nursing care and job outcomes.</P><P>Background. </P><P>Nurse staffing has been reported to influence patient and nurse outcomes.</P><P>Design. </P><P>A cross-sectional study with a survey conducted August–October 2007.</P><P>Methods. </P><P>The survey included 1365 nurses from 65 intensive care units in 22 hospitals in Korea. Staffing was measured using two indicators: the number of patients per nurse measured at the unit level and perception of staffing adequacy at the nurse level. Quality of care and job dissatisfaction were measured with a four-point scale and burnout measured by the Maslach Burnout Inventory. Multilevel logistic regression models were used to determine the relationships between staffing and quality of care and job outcomes.</P><P>Results. </P><P>The average patient-to-nurse ratio was 2·8 patients per nurse. A fifth of nurses perceived that there were enough nurses to provide quality care, one third were dissatisfied, half were highly burnt out and a quarter planned to leave in the next year. Nurses were more likely to rate quality of care as high when they cared for two or fewer patients (odds ratio, 3·26; 95% confidence interval, 1·14–9·31) or 2·0–2·5 patients (odds ratio, 2·44; 95% confidence interval, 1·32–4·52), compared with having more than three patients. Perceived adequate staffing was related to a threefold increase (odds ratio, 2·97; 95% confidence interval, 2·22–3·97) in the odds of nurses’ rating high quality and decreases in the odds of dissatisfaction (odds ratio, 0·30; 95% confidence interval, 0·23–0·40), burnout (odds ratio, 0·50; 95% confidence interval, 0·34–0·73) and plan to leave (odds ratio, 0·40; 95% confidence interval, 0·28–0·56).</P><P>Conclusions. </P><P>Nurse staffing was associated with quality of care and job outcomes in the context of Korean intensive care units.</P><P>Relevance to clinical practice. </P><P>Adequate staffing must be assured to achieve better quality of care and job outcomes.</P>

Discrimination between Active and Latent Tuberculosis Based on Ratio of Antigen-Specific to Mitogen-Induced IP-10 Production

Jeong, Yun Hee,Hur, Yun-Gyoung,Lee, Hyejon,Kim, Sunghyun,Cho, Jang-Eun,Chang, Jun,Shin, Sung Jae,Lee, Hyeyoung,Kang, Young Ae,Cho, Sang-Nae,Ha, Sang-Jun American Society for Microbiology 2015 Journal of clinical microbiology Vol.53 No.2

<P><I>Mycobacterium tuberculosis</I> is the major causative agent of tuberculosis (TB). The gamma interferon (IFN-γ) release assay (IGRA) has been widely used to diagnose TB by testing cell-mediated immune responses but has no capacity for distinguishing between active TB and latent TB infection (LTBI). This study aims to identify a parameter that will help to discriminate active TB and LTBI. Whole-blood samples from 33 active TB patients, 20 individuals with LTBI, and 26 non-TB controls were applied to the commercial IFN-γ release assay, QuantiFERON-TB Gold In-Tube, and plasma samples were analyzed for interleukin-2 (IL-2), IL-6, IL-8, IL-10, IL-13, tumor necrosis factor-alpha (TNF-α), IFN-γ, monokine induced by IFN-γ (MIG), interferon gamma inducible protein 10 (IP-10), interferon-inducible T cell alpha chemoattractant (I-TAC), and monocyte chemoattractant protein 1 (MCP-1) by using a commercial cytometric bead array. The <I>Mycobacterium tuberculosis</I> antigen-specific production of most of the assayed cytokines and chemokines was higher in the active TB than in the LTBI group. The mitogen-induced responses were lower in the active TB than in the LTBI group. When the ratio of TB-specific to mitogen-induced responses was calculated, IL-2, IL-6, IL-10, IL-13, TNF-α, IFN-γ, MIG, and IP-10 were more useful in discriminating active TB from LTBI. In particular, most patients showed higher IP-10 production to <I>Mycobacterium tuberculosis</I> antigens than to mitogen at the individual level, and the ratio for IP-10 was the strongest indicator of active infection versus LTBI with 93.9% sensitivity and 90% specificity. In conclusion, the ratio of the TB-specific to the mitogen-induced IP-10 responses showed the most promising accuracy for discriminating active TB versus LTBI and should be further studied to determine whether it can serve as a biomarker that might help clinicians administer appropriate treatments.</P>

Prewarming for Prevention of Hypothermia in Older Patients Undergoing Hand Surgery Under Brachial Plexus Block

Sung-Ae Cho,Minhye Chang,Seok-Jin Lee,Tae-Yun Sung,Choon-Kyu Cho 대한노인병학회 2022 Annals of geriatric medicine and research Vol.26 No.2

Background: Older patients are more vulnerable to inadvertent perioperative hypothermia. Prewarming contributes to the prevention of inadvertent perioperative hypothermia in patients under general or neuraxial anesthesia. However, the effects of brachial plexus block (BPB) on thermoregulation and the efficacy of prewarming in the prevention of hypothermia in older patients undergoing surgery with BPB remain unclear. This study evaluated the effects of BPB on thermoregulation and the efficacy of prewarming during BPB in older patients. Methods: Patients aged ≥65 years were randomly allocated to receive either standard preoperative insulation (control group, n=20) or preanesthetic forced-air warming for 20 minutes before BPB (prewarming group, n=20). During the perioperative period, tympanic temperatures were measured. Thermal comfort scores and shivering grades were also obtained. Results: The tympanic temperatures at the end of surgery did not differ between the groups (36.9°C±0.5°C and 37.0°C±0.4°C in the control and prewarming groups, respectively; p=0.252). The maximum temperature change was significantly lower in the prewarming group compared to the control group (0.36°C±0.4°C and 0.65°C±0.3°C, respectively; p=0.013). The hypothermia incidence and severity, thermal comfort scores, and shivering grades did not differ between the groups. Conclusion: Regardless of the application of prewarming, BPB did not cause a clinically significant impairment of thermoregulation. Moreover, the efficacy of prewarming appeared to be low; thus, it may not be routinely required in patients undergoing orthopedic hand surgery under BPB.

Comparative Analysis of Anesthetic Legal Disputes between Older and Younger Patients Referred to the Korean Society of Anesthesiologists in 2009–2018

Sung-Ae Cho,Seok-Jin Lee,Tae-Yun Sung,Duk-Kyung Kim,Choon-Kyu Cho 대한노인병학회 2019 Annals of geriatric medicine and research Vol.23 No.4

Background: Although the average age of patients undergoing surgical procedures or anesthesia is increasing, differences in anesthesia-related injuries among different age groups have been not reported. This study compared older and non-older patients on the basis of disputes regarding anesthesia-related injuries referred to the Korean Society of Anesthesiologists (KSA). Methods: We retrospectively analyzed disputes regarding anesthesia-related injuries referred to the KSA between 2009 and 2018. After excluding duplicates, incomplete data, local anesthesia cases, and patients aged ≤18 or 55–64 years, the subjects were divided into older (65 years) and non-older (19–54 years) age groups. The parameters included in the KSA database were compared between these two groups. Results: The 115 cases included in the study included 28 and 87 cases from the older and non-older groups, respectively. The proportions of preventable cases of anesthesia-related adverse events differed significantly between the older (25%) and non-older groups (48.3%). The most common medical disputes in the older group were related to general anesthesia, orthopedic surgery, local hospitals, and anesthesiologist, whereas those in the non-older group were related to sedation, plastic surgery, local clinics, and non-anesthesiologists. Conclusion: In addition to understanding the differences in anesthesia characteristics according to age group, it is also necessary to develop means for reducing preventable anesthesia-related adverse events. Furthermore, we must continue to register anesthesia-related disputes, and a voluntary reporting system should be established to prevent anesthesia-related accidents.

Ticagrelor Monotherapy After 3-Month Dual Antiplatelet Therapy in Acute Coronary Syndrome by High Bleeding Risk: The Subanalysis From the TICO Trial

Yong-Joon Lee,Yongsung Suh,Jung-Sun Kim,Yun-Hyeong Cho,Kyeong Ho Yun,Yong Hoon Kim,Jae Young Cho,Ae-Young Her,Sungsoo Cho,Dong Woon Jeon,Sang-Yong Yoo,Deok-Kyu Cho,Bum-Kee Hong,Hyuckmoon Kwon,Sung-Jin 대한심장학회 2022 Korean Circulation Journal Vol.52 No.4

Background and Objectives: Identifying patients with high bleeding risk (HBR) is important when making decisions for antiplatelet therapy strategy. This study evaluated the impact of ticagrelor monotherapy after 3-month dual antiplatelet therapy (DAPT) according to HBR in acute coronary syndrome (ACS) patients treated with drug eluting stents (DESs). Methods: In this post-hoc analysis of the TICO trial, HBR was defined by 2 approaches: meeting Academic Research Consortium for HBR (ARC-HBR) criteria or Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent DAPT (PRECISE-DAPT) score ≥25. The primary outcome was a 3–12 months net adverse clinical event (composite of major bleeding and adverse cardiac and cerebrovascular events). Results: Of the 2,980 patients without adverse events during the first 3 months after DES implantation, 453 (15.2%) were HBR by ARC-HBR criteria and 504 (16.9%) were HBR by PRECISE-DAPT score. The primary outcome rate was higher in HBR versus non-HBR patients (by ARC-HBR criteria: hazard ratio [HR], 2.87; 95% confidence interval [CI], 1.76–4.69; p<0.001; by PRECISE-DAPT score: HR, 3.09; 95% CI, 1.92–4.98; p<0.001). Ticagrelor monotherapy after 3-month DAPT was associated with lower primary outcome rate than ticagrelor-based 12-month DAPT regardless of HBR by ARC-HBR criteria, with similar magnitudes of therapy effect for HBR and non-HBR patients (p-interaction=0.400). Results were consistent by PRECISE-DAPT score (p-interaction=0.178). Conclusions: In ACS patients treated with DESs, ticagrelor monotherapy after 3-month DAPT was associated with lower rate of adverse clinical outcomes regardless of HBR, with similar magnitudes of therapy effect between HBR and non-HBR.

Comparison of SARS-CoV-2 Antibody Responses and Seroconversion in COVID-19 Patients Using Twelve Commercial Immunoassays

Yun Sojeong,Ryu Ji Hyeong,Jang Joo Hee,Bae Hyunjoo,Yoo Seung-Hyo,Choi Ae-Ran,Jo Sung Jin,Lim Jihyang,Lee Jehoon,Ryu Hyejin,Cho Sung-Yeon,Lee Dong-Gun,Lee Jongmin,Kim Seok Chan,Park Yeon-Joon,Lee Hyeyo 대한진단검사의학회 2021 Annals of Laboratory Medicine Vol.41 No.6

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody assays have high clinical utility in managing the pandemic. We compared antibody responses and seroconversion of coronavirus disease 2019 (COVID-19) patients using different immunoassays. Methods: We evaluated 12 commercial immunoassays, including three automated chemiluminescent immunoassays (Abbott, Roche, and Siemens), three enzyme immunoassays (Bio-Rad, Euroimmun, and Vircell), five lateral flow immunoassays (Boditech Med, SD biosensor, PCL, Sugentech, and Rapigen), and one surrogate neutralizing antibody assay (GenScript) in sequential samples from 49 COVID-19 patients and 10 seroconversion panels. Results: The positive percent agreement (PPA) of assays for a COVID-19 diagnosis ranged from 84.0% to 98.5% for all samples (>14 days after symptom onset), with IgM or IgA assays showing higher PPAs. Seroconversion responses varied across the assay type and disease severity. Assays targeting the spike or receptor-binding domain protein showed a tendency for early seroconversion detection and higher index values in patients with severe disease. Index values from SARS-CoV-2 binding antibody assays (three automated assays, one LFIA, and three EIAs) showed moderate to strong correlations with the neutralizing antibody percentage (r=0.517–0.874), and stronger correlations in patients with severe disease and in assays targeting spike protein. Agreement among the 12 assays was good (74.3%–96.4%) for detecting IgG or total antibodies. Conclusions: Positivity rates and seroconversion of SARS-CoV-2 antibodies vary depending on the assay kits, disease severity, and antigen target. This study contributes to a better understanding of antibody response in symptomatic COVID-19 patients using currently available assays.

ENSO Teleconnection to the Isopycnal Depth Fluctuations of the East/Japan Sea Intermediate Water in the Ulleung Basin during 1968—2002

Yun, Jae-Yul,Chang, Kyung-Il,Kim, Kwang-Yul,Cho, Yang-Ki,Park, Kyung-Ae,Magaard, Lorenz AMERICAN METEOROLOGICAL SOCIETY 2016 Journal of physical oceanography Vol.46 No.9

<P>This study first detects the decadal variability in the depths of the East/Japan Sea (EJS) Intermediate Water (ESIW) using in situ observations and relates it to strong El Nino-Southern Oscillations (ENSOs). Using multitaper cross-spectrum and cyclostationary empirical orthogonal function analysis, this study found significant coherences at the 99% confidence level and opposite phases between Nino-3 and the ESIW isopycnal depths in the Ulleung Basin (UB) at a period of 14.1 yr during 1968-2002. This suggests a teleconnection between strong ENSOs and the ESIW, the cause of which is explored. When a strong El Nino (EN) develops, the Pacific-North American pattern is intensified by the EN-related Rossby wave interfering constructively with the climatological stationary wave. The amplified wave propagates upward into the stratosphere and breaks, weakening the polar vortex. The EN-related geopotential height increases over the pole with poleward converging air and decreases over the Yakutsk Basin (YB), indicating a negative northern annular mode with the south-to-north gradient balancing the easterly anomaly that responds to vortex weakening. The converged air at the pole warms adiabatically and raises the height as it sinks. This height distribution, including the east-to-west gradient balancing the southward flow, induces the polar vortex split into two with the colder one in the YB where the EJS is closer than from the pole. The EN-related northwesterly wind directing toward the EJS is also strong. Thus, the coldest air with negative wind stress curls reaches the EJS quickly and forms more ESIW, which converges into the UB, causing the observed decadal isopycnal fluctuations.</P>

Effects of dexamethasone on catheter-related bladder discomfort and emergence agitation: a prospective, randomized, controlled trial

Cho Sung-Ae,Huh Inho,Lee Seok-Jin,Sung Tae-Yun,구관우,조춘규,지영석 대한마취통증의학회 2022 Korean Journal of Anesthesiology Vol.75 No.1

Background: Catheter-related bladder discomfort (CRBD) is common in patients with a urinary catheter and is a risk factor for emergence agitation (EA). The mainstay of CRBD management is anticholinergics. Dexamethasone inhibits acetylcholine release. This study aimed to evaluate the effects of dexamethasone on postoperative CRBD and EA.Methods: In this prospective study, 90 patients undergoing urological surgery requiring urinary catheterization were allocated randomly to one of two groups (each n = 45). Before induction of anesthesia, the dexamethasone group received 10 mg (2 ml) of dexamethasone intravenously, while the control group received 2 ml of saline in the same manner. The incidence and severity of CRBD were assessed 0, 1, 2, and 6 h after the patient arrived in the post-anesthesia care unit (PACU) as the primary outcomes. The incidence and severity of EA were also compared during emergence and recovery from anesthesia as secondary outcomes.Results: The incidences of CRBD in the control group and dexamethasone group at 0, 1, 2, and 6 h postoperatively were 28.9% and 15.6%, 55.6% and 55.6%, 57.8% and 46.7%, and 53.3% and 51.1%, respectively. The incidence and severity of CRBD assessed at 0, 1, 2, and 6 h postoperatively did not show intergroup differences. The incidence and severity of EA in the operating room and PACU also showed no difference between the groups.Conclusions: Dexamethasone (10 mg) administered before induction of anesthesia did not further reduce the incidence or severity of CRBD or EA in patients undergoing urological surgery.