Mugwort and ragweed pollens have been considered as important respiratory allergens in Korea. These two pollens are abundant in the air of Seoul from August through October. Many ragweed-sensitive patients have shown concurrent sensitivities to mugwort pollen. However the antigenic relationship between these two pollens has not been clarified. To observe the cross-reactivity between them, we developed polyclonal anti-mugwort and anti-ragweed antibodies by immunization on New Zealand white rabbits, and performed crossed immunoelectrophoresis(CIE) with two pollen extracts. Five precipitation lines were formed by mugwort and anti-mugwort antibody. One precipitation line was formed by ragweed and anti-ragweed antibody. There was no reaction from mugwort and anti-ragweed antibody, and from ragweed and anti-mugwort antibody. These results indicate that there is no cross-antigenicity between mugwort and ragweed pollens.
Animal ; Antibodies/immunology ; Cross Reactions ; Immunoelectrophoresis, Two-Dimensional ; Pollen/*immunology ; Rabbits

BACKGROUND: New educational objectives and evaluation methods in Korean medical schools have been suggested recently to cope with health care related environmental changes. Current status of family medicine clinical clerkships in Korean medical schools is to be known before establishing standards. METHODS: Educational Committee of Korean Academy of Family Medicine surveyed the family medicine clerkship in Korean medical school (about educational environment, subjects and evaluation methods) using structured questionnaires by e-mail and Fax from February through March in 2004. RESULTS: Family medicine clinical clerkship was run by 25 of 41 medical schools (65.9%). Educational subject areas included communication skill, observation in hospital based ambulatory office, primary care and family medicine, medical recording, diagnosis and treatment of common problems, residential out-hospital ambulatory programs, presentation of hospital based ambulatory programs, procedure skill, lifelong heath management plan, and health promotion, in descending order. Faculties of family medicine were directly in charge of educational subjects. However, educational methods were mainly composed of lectures and indirect observation. It should be noted that concrete and precise evaluation methods in the family medicine clerkship program had been lacking due to insufficient and obscure evaluation strategies. CONCLUSION: Clerkship period, educational environment, and number of class were variable among medical schools in Korea. Educational format needs to be standardized in terms of common educational subjects such as communication skill education, patient education, and ambulatory care clerkship. More valid methods are to be introduced for family medicine clerkship evaluation.
Ambulatory Care ; Clinical Clerkship* ; Delivery of Health Care ; Diagnosis ; Education ; Electronic Mail ; Health Promotion ; Humans ; Korea ; Lectures ; Medical Records ; Methods ; Patient Education as Topic ; Primary Health Care ; Schools, Medical* ; Surveys and Questionnaires

PURPOSE: Chitosan has been studied as a non-viral gene delivery vector, drug delivery carrier, metal chelater, food additive, and radiopharmaceutical, among other things. Recently, galactose-graft chitosan was studied as a non-viral gene and drug delivery vector to target hepatocytes. The aim of this study was to investigate the usefulness of nuclear imaging for in vivo evaluation of targeting the hepatocyte by galactose grafting. METHODS AND MATERIALS: Galactosyl methylated chitosan (GMC) was produced by methylation to lactobionic acid coupled chitosan. Cytotoxicity of 99mTc-GMC was determined by MTT assay. Rabbits were injected via their auricular vein with 99mTc-GMC and 99mTc-methylated chitosan (MC), the latter of which does not contain a galactose group, and images were acquired with a gamma camera equipped with a parallel hole collimator. The composition of the galactose group in galactosylated chitosan (GC), as well as the tri-, di-, or mono-methylation of GMC, was confirmed by NMR spectroscopy. RESULTS: The results of MTT assay indicated that 99mTc-GMC was non-toxic. 99mTc-GMC specifically accumulated in the liver within 10 minutes of injection and maintained high hepatic uptake. In contrast, 99mTc-MC showed faint liver uptake. 99mTc-GMC scintigraphy of rabbits showed that the galactose ligand principally targeted the liver while the chitosan functionalities led to excretion through the urinary system. CONCLUSION: Bioconjugation with a specific ligand endows some degree of targetability to an administered molecule or drug, as in the case of galactose for hepatocyte in vivo, and evaluating said targetabililty is a clear example of the great benefit proffered by nuclear imaging.
Chitosan* ; Food Additives ; Galactose ; Gamma Cameras ; Hepatocytes ; Liver ; Magnetic Resonance Spectroscopy ; Methylation ; Rabbits ; Radionuclide Imaging ; Transplants ; Veins

The lung nodule is one of the pleuropulmonary menifestations in rheumatoid arthritis. We report here a case exhibiting hydropneumothorax due to a bronchoplerual fistula resulting from a ruptured rheumatoid lung nodule complicated with a aspergilloma in it. A 39 year-old man with rheumatoid arthritis was admitted because of cough for one month. Multiple subcutaneous nodules were noted and multiple lung nodules were seen on chest X-ray, Peripheral white cells were 9,600/mm3 with 1896 of eosinophils. The percutaneous needle aspiration biopsy of the largest lung nodule of right upper lobe showed massive necrosis without acid fast bacillus, fungus, or malignant cell. Three months after discharge, air-meniscus sign was seen on the biopsied lung nodule on X-ray. Five months later, the patient was readmitted due to dyspnea and chest pain and simple chest X-ray showed hydropneumothorax on the right side. The pneumothorax was not healed after closed thoracotomy and tube drainage, and high fever developed. The pleural fluid culture revealed Pseudomonas aeroginosa and Aspergillus fumigatus. Seventy days after admission, exploratory thoracotomy was done. Aspergilloma was found in the cavitated lung nodule which was ruptured into the pleural cavity through bronchopleural fistula.
Adult ; Arthritis, Rheumatoid* ; Aspergillus fumigatus ; Bacillus ; Biopsy, Needle ; Chest Pain ; Cough ; Drainage ; Dyspnea ; Eosinophilia* ; Eosinophils ; Fever ; Fistula* ; Fungi ; Humans ; Hydropneumothorax ; Lung* ; Necrosis ; Needles ; Pleural Cavity ; Pneumothorax ; Pseudomonas ; Thoracotomy ; Thorax

PURPOSE: The purpose of this study to develop a fringed fall prevention program based on King's goal attainment theory and education. This study is applied to the personal, interpersonal, and social systems of fall high-risk patients to test its effects. METHODS: This study was a nonequivalent control group pre- and post-test design. There were 52 fall high-risk patients in the experimental group and 45 in the control group. The experimental group received six sessions, with the group sessions lasting 60 minutes and the individual sessions lasting 20~30 minutes. Data were analyzed using descriptive statistics, an χ2-test, a paired sample t-test, and a Wilcoxon signed-ranks test utilizing IBM SPSS software. RESULTS: For the 3-month intervention period, the fall prevention program was found to be particularly effective for patients in the experimental group (from 3.38 to 1.69 per 1000 patient days; p=.044), as opposed to the control group (from 1.94 to 1.49 per 1000 patient days; p=.300). For the 6-month follow up period, the fall prevention program was again found to be effective for patients in the experimental group (from 3.26 to 0.76 per 1000 patient days; p=.049) compared to the control group (from 1.98 to 1.01 per 1000 patient days; p=.368). CONCLUSION These resultsindicate that the fringed fall prevention program is very effective in reducing falls, not only during the intervention period, but also after the intervention period has ended. We can therefore recommend this program for use concerning fall high-risk patients in long-term care hospitals.

OBJECTIVE: To develop Korean version of Frenchay Aphasia Screening Test (K-FAST) and to standardize K-FAST in normal adult population in Korea. METHOD: The 'river scene' of stimulus set in original version of FAST was adapted for K-FAST. English version of the test instructions and scoring methods were translated into Korean and reverse-translation was performed by English- Korean bilinguals. The test structures and language domains (comprehension, expression, reading, and writing) were unchanged and possible maximum score was 30 points. We standardized K-FAST in 240 normal adult populations (male 102, female 138) whose ages were above 44. Basic personal information was collected through an interview and we performed Edinburgh handedness inventory (EHI), K- MMSE and K-FAST. Subjects who had history of brain disease, cognitive communicative disorders, or K-MMSE scores less than 2 percentile of same age group were excluded. K-FAST scores were analyzed according to the age and education groups. RESULTS: Mean EHI, K-MMSE, and K-FAST scores in total subjects were 9.4+/-1.2, 25.9+/-2.8, 25.4+/-3.3 points, respectively. Post-hoc analysis of K-FAST scores according to age groups classified into 3 age groups, 45~64, 65~74, and > or =74 years and education groups into 0, 1~9, > or =10 years of total education. K-FAST scores decreased significantly as increase of age (r=-0.441, p=0.000) and decrease of total years of education (r=0.580, p=0.000). CONCLUSION: Newly adapted K-FAST can be used for screening of aphasia in Korea and the standardized data according to age and education levels may provide useful reference values for interpretation of the results of K-FAST.
Adult ; Aphasia ; Brain Diseases ; Communication Disorders ; Female ; Functional Laterality ; Humans ; Korea ; Mass Screening ; Reference Values ; Research Design ; Stroke

PURPOSE: The purpose of this study to develop a fringed fall prevention program based on King's goal attainment theory and education. This study is applied to the personal, interpersonal, and social systems of fall high-risk patients to test its effects. METHODS: This study was a nonequivalent control group pre- and post-test design. There were 52 fall high-risk patients in the experimental group and 45 in the control group. The experimental group received six sessions, with the group sessions lasting 60 minutes and the individual sessions lasting 20~30 minutes. Data were analyzed using descriptive statistics, an χ2-test, a paired sample t-test, and a Wilcoxon signed-ranks test utilizing IBM SPSS software. RESULTS: For the 3-month intervention period, the fall prevention program was found to be particularly effective for patients in the experimental group (from 3.38 to 1.69 per 1000 patient days; p=.044), as opposed to the control group (from 1.94 to 1.49 per 1000 patient days; p=.300). For the 6-month follow up period, the fall prevention program was again found to be effective for patients in the experimental group (from 3.26 to 0.76 per 1000 patient days; p=.049) compared to the control group (from 1.98 to 1.01 per 1000 patient days; p=.368). CONCLUSION: These results indicate that the fringed fall prevention program is very effective in reducing falls, not only during the intervention period, but also after the intervention period has ended. We can therefore recommend this program for use concerning fall high-risk patients in long-term care hospitals.
Accidental Falls ; Aged ; Education ; Follow-Up Studies ; Humans ; Long-Term Care

Objective: The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2, is a global concern. This study aimed to examine the clinical characteristics, demographics and outcomes of COVID-19 patients in the emergency department (ED) and explore clinical predictors of in-hospital mortality. Methods: This single-center, retrospective, observational study used 1,003 adult patients with laboratory-confirmed COVID-19 who went to the ED and were admitted to the hospital between February 28 and September 30, 2020. Results: The median age of the included patients was 55 (37-68) years, and 533 were women (53.1%). Severe COVID-19 was noted in 173 patients (17.2%); seven patients (0.7%) received mechanical ventilation. The mortality rate was 2.1%. Multivariable Cox regression analysis found the risk factors associated with in-hospital death of patients (age >70 years [hazard ratio (HR), 27.411; P<0.001], albumin level <3.5 g/dL [HR, 12.273; P<0.001], CURB-65 [confusion, urea nitrogen, respiratory rate, blood pressure, 65 years of age and older] score ≥3 [HR, 10.137; P=0.002] and platelet count <100×109/L [HR, 3.281; P=0.024]) on admission. Conclusion Age>70 years, hypoalbuminemia, CURB-65≥3 and thrombocytopenia on admission were independent risk factors for mortality in patients hospitalized with COVID-19. Early detection of these predictors and application of CURB-65 score in the ED may provide guidance for appropriate risk stratification at triage and disposition of patients at increased risk of poor prognosis.

Objective: The coronavirus disease 2019 (COVID-19) outbreak is currently ravaging the world and is a major threat to public health. Healthcare workers (HCWs) are at a high risk of acquiring and transmitting COVID-19. Hence, HCWs are also experiencing emotional and behavioral changes. The purpose of this study was to compare emotional changes and stress between occupations and to investigate the impact of emotions of HCWs during the COVID-19 outbreak. Methods: An anonymous, self-administered, previously validated questionnaire was given to HCWs at a hospital dedicated to infectious diseases in Korea during the COVID-19 outbreak. The participants were asked to evaluate stress factors, depressive moods, trauma, reasons for continuing to work, things that helped them work, coping strategies to reduce stress, motivators that could help them work during future outbreaks, and what they would like to do after the outbreak was over. Results: The total number of participants was 400. The average age of participants was 34.69±9.44. Stress and depressive moods showed variations in the job-to-job comparisons. Ethical duty and the professionalism of the HCWs pushed them to continue with their jobs. The news of a decline in the number of patients was helpful to HCWs. The implementation of personal hygiene programs helped in reducing stress. The provision of adequate personal protective equipment was a factor that would encourage them to work during any future outbreak. The participants wanted to go on a trip after the outbreak was over. Conclusion Our findings indicate that the COVID-19 outbreak had a significant emotional impact on HCWs. The concerns of HCWs may affect their work efficiency in an outbreak and should be addressed by incorporating appropriate management strategies while planning to combat an outbreak.

Objective: Predictive tools such as the Glasgow Blatchford Score (GBS) and Pre-Rockall Score (PRS) have been used to foresee risks for gastrointestinal patients. This study was undertaken to determine the usefulness of the various available predictive tools in a vulnerable population. Methods: Data of patients with vulnerable upper gastrointestinal bleeding, who visited the emergency room from January 1, 2017 to December 31, 2018, were retrospectively examined. The GBS and PRS values were determined for all patients. Predictions of therapeutic endoscopy were evaluated with the area under curve (AUC) in the receiver operatory characteristic (ROC) curve. Results: A total of 152 patients were included in the study, 46 of whom required therapeutic endoscopes. In the area below the ROC curve, higher GBS values were obtained as compared to PRS in predicting therapeutic endoscopy (AUC, 0.726; 95% confidence interval [CI], 0.648-0.795 vs. 0.705; 95% CI, 0.626-0.776; P=0.689, respectively), transfusion (AUC, 0.861; 95% CI, 0.796-0.912 vs. 0.715; 95% CI, 0.637-0.786; P=0.001, respectively), and 30-day mortality (AUC, 0.698; 95% CI, 0.618-0.770 vs. 0.622; 95% CI, 0.540-0.699; P=0.351, respectively). Considering GBS 0, we determined with 100% sensitivity and 4.72% specificity that endoscopic treatment is redundant. Conclusion Compared to PRS, GBS excelled in predicting interventional treatment (endoscopy, transfusion) of vulnerable upper gastrointestinal patients, as well as the 30-day mortality. GBS is more useful in predicting low-risk patients that do not require treatment endoscopy, and is therefore a suitable procedure for outpatient care.