Background: Nurses play a central role in the process of blood transfusion because they have the closest interactions with patients. Providing nurses with the appropriate knowledge and competency through education can help ensure transfusion safety. This study investigated the effectiveness of the first nationwide transfusion-related education for nurses by analyzing questionnaires for a self-assessment of competency on transfusion-related knowledge before and after the education and general evaluation for the educational program. Methods: The education program was composed of four lectures and was conducted in seven regions in South Korea. One hundred and ninety-two nurses participated, and the questionnaires for 170 nurses were analyzed. Results: The participants consisted of 90 nurses (53.0%) from tertiary hospitals, 23 (13.5%) from general hospitals, and 57 (33.5%) from other hospitals. The majority of the participants (103/170, 60.6%) were from hospitals with ≥500 beds, and 69.4% had a work period of ≥10 years. The scores for pre-/post-education self-assessment of competency were as follows: blood components, 3.03/3.73; pretransfusion testing, 2.86/3.64; management of transfusion, 3.18/3.84; and transfusion reactions, 3.11/3.78. In all categories, there was a significant increase in the score after the education program. The majority of participants (99.4%) provided a positive response regarding the necessity of a transfusion-related education program. Conclusion South Korea’s first attempt at transfusion-related education for nurses showed a strong positive effect by improving participants’ transfusion-related competency. Considering the important role of nurses in blood transfusion, the educational program should continue and be expanded in the future.

Background: Nurses play a central role in the process of blood transfusion because they have the closest interactions with patients. Providing nurses with the appropriate knowledge and competency through education can help ensure transfusion safety. This study investigated the effectiveness of the first nationwide transfusion-related education for nurses by analyzing questionnaires for a self-assessment of competency on transfusion-related knowledge before and after the education and general evaluation for the educational program. Methods: The education program was composed of four lectures and was conducted in seven regions in South Korea. One hundred and ninety-two nurses participated, and the questionnaires for 170 nurses were analyzed. Results: The participants consisted of 90 nurses (53.0%) from tertiary hospitals, 23 (13.5%) from general hospitals, and 57 (33.5%) from other hospitals. The majority of the participants (103/170, 60.6%) were from hospitals with ≥500 beds, and 69.4% had a work period of ≥10 years. The scores for pre-/post-education self-assessment of competency were as follows: blood components, 3.03/3.73; pretransfusion testing, 2.86/3.64; management of transfusion, 3.18/3.84; and transfusion reactions, 3.11/3.78. In all categories, there was a significant increase in the score after the education program. The majority of participants (99.4%) provided a positive response regarding the necessity of a transfusion-related education program. Conclusion South Korea’s first attempt at transfusion-related education for nurses showed a strong positive effect by improving participants’ transfusion-related competency. Considering the important role of nurses in blood transfusion, the educational program should continue and be expanded in the future.

OBJECTIVES: Previous studies have been limited to the use of cross sectional data to identify the relationships between nicotine dependence and smoking. Therefore, it is difficult to determine a causal direction between the two variables. The purposes of this study were to 1) test whether nicotine dependence or average smoking was a more influential factor in smoking cessation; and 2) propose effective ways to quit smoking as determined by the causal relations identified. METHODS: This study used a panel dataset from the central computerized management systems of community-based smoking cessation programs in Korea. Data were stored from July 16, 2005 to July 15, 2008. 711,862 smokers were registered and re-registered for the programs during the period. 860 of those who were retained in the programs for three years were finally included in the dataset. To measure nicotine dependence, this study used a revised Fagerstrom Test for Nicotine Dependence. To examine the relationship between nicotine dependence and average smoking, an autoregressive cross-lagged model was explored in the study. RESULTS: The results indicate that 1) nicotine dependence and average smoking were stable over time; 2) the impact of nicotine dependence on average smoking was significant and vice versa; and 3) the impact of average smoking on nicotine dependence is greater than the impact of nicotine dependence on average smoking. CONCLUSIONS: These results support the existing data obtained from previous research. Collectively, reducing the amount of smoking in order to decrease nicotine dependence is important for evidence-based policy making for smoking cessation.
Community Health Centers ; Health Policy ; Korea ; Nicotine ; Policy Making ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Use Disorder

OBJECTIVES: Previous studies have been limited to the use of cross sectional data to identify the relationships between nicotine dependence and smoking. Therefore, it is difficult to determine a causal direction between the two variables. The purposes of this study were to 1) test whether nicotine dependence or average smoking was a more influential factor in smoking cessation; and 2) propose effective ways to quit smoking as determined by the causal relations identified. METHODS: This study used a panel dataset from the central computerized management systems of community-based smoking cessation programs in Korea. Data were stored from July 16, 2005 to July 15, 2008. 711,862 smokers were registered and re-registered for the programs during the period. 860 of those who were retained in the programs for three years were finally included in the dataset. To measure nicotine dependence, this study used a revised Fagerstrom Test for Nicotine Dependence. To examine the relationship between nicotine dependence and average smoking, an autoregressive cross-lagged model was explored in the study. RESULTS: The results indicate that 1) nicotine dependence and average smoking were stable over time; 2) the impact of nicotine dependence on average smoking was significant and vice versa; and 3) the impact of average smoking on nicotine dependence is greater than the impact of nicotine dependence on average smoking. CONCLUSIONS: These results support the existing data obtained from previous research. Collectively, reducing the amount of smoking in order to decrease nicotine dependence is important for evidence-based policy making for smoking cessation.
Community Health Centers ; Health Policy ; Korea ; Nicotine ; Policy Making ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Use Disorder

Four trials of external quality assessment in diagnostic hematology were performed in 2009 with average 946 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, hematocrit, red blood cell count, platelet count, blood cell morphology, prothrombin time and activated partial thromboplastin time. The response rate was more than 98.2%. The coefficients of variation in hemoglobin, hematocrit and RBC count were stable but variable in platelet count and WBC count according to measuring cell counters. Test results of blood cell morphology showed variation among various cell morphologies.
Blood Cells ; Cell Count ; Erythrocyte Count ; Hematocrit ; Hematology ; Hemoglobins ; Korea ; Leukocyte Count ; Partial Thromboplastin Time ; Platelet Count ; Prothrombin Time

Totally implanted central venous access devices for chemotherapy (chemoport) are being used increasingly in lung cancer patients. Vascular catheters are associated with various complications including infection, thrombosis as well as spontaneous fractures and embolization of the catheter, which is known as 'pinch-off syndrome'. 'Pinch-off syndrome' refers to the compression of a subclavian central venous catheter between the clavicle and first rib resulting in an intermittent or permanent obstruction, which can lead to tears, transection, or embolization. We report two cases of fractured and embolized implanted subclavian venous catheters in which the fragments were removed percutaneously. A 62-year-old man presented with back pain with a duration of a few weeks. The chest radiograph revealed complete transsection and embolization of the catheter into the right atrium. In addition, a 47-year-old woman with a chemoport had a grade 3 pinch-off sign in a chest radiograph demonstrating complete transsection and embolization of the catheter into the pulmonary artery. Both cases were managed by retrieving the embolized distal fragment percutaneously and removing the proximal section of the catheter.
Back Pain ; Catheters ; Central Venous Catheters ; Clavicle ; Drug Therapy ; Female ; Fractures, Spontaneous ; Heart Atria ; Humans ; Lung Neoplasms* ; Lung* ; Middle Aged ; Pulmonary Artery ; Radiography, Thoracic ; Ribs ; Thrombosis ; Vascular Access Devices

PURPOSE: Paclitaxel and cisplatin, active drugs in the treatment of non-small-cell lung cancer (NSCLC), have been found to be synergistic and less myelotoxic in combination when the paclitaxel is given 24 hr prior to the cisplatin. Their antitumor activity and toxicity in patients with advanced NSCLC has been evaluated herein. MATERIALS AND METHODS: Seventy-four chemonaive patients, with advanced NSCLC, were enrolled. Paclitaxel, 175 mg/m2, was administered on day 1, followed 24 hr later by cisplatin, 75 mg/m2, on day 2. RESULTS: The overall response rate, median time to progression and median survival time were 51%, 7.1 months (95% confidence interval (CI), 5.5~8.7 months) and 13.7 months (95% CI, 11.3~16.1 months), respectively. There were significant differences in the overall survival rates in relation to stage and the ECOG performance status(PS). The toxicity was mainly nonhematological. Grade > or =3 neuropathy occurred in 2 (3%) patients, myalgia in 3 (4%), and bone pain in 3 (4%). The hematological toxicity was mild, and no grade 3 or 4 neutropenia was observed. CONCLUSION: The combination of paclitaxel and cisplatin is an effective and tolerable treatment regimen for advanced NSCLC during first line chemotherapy. The main toxicity was nonhematological, such as peripheral neuropathy, myalgia and bone pain, whereas the hematological toxicity itself was mild.
Cisplatin* ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Lung Neoplasms* ; Lung* ; Myalgia ; Neutropenia ; Paclitaxel* ; Peripheral Nervous System Diseases ; Survival Rate

Three trials of external quality assessment for Therapeutic Drug Monitoring (TDM) subcommittee of Korean Association of Quality Assurance for Clinical Pathology (KAQACP) were performed in 2002. Participating laboratories were 79 similar to the previous year. Response rates were 96.3% for 1st, 2nd, and third trials. In the first trial, 20 test items among 27 ones were responded from as least from one laboratory as follows: acetaminophen, amikacin, amitriptyline, carbamazepine, cyclosporine, digoxin, free phenytoin, gentamicin, lithium, methotrexate, phenobarbital, phenytoin, primidone, quinidine, salicylate, tacrolimus (FK-506), theophylline, tobramycin, valproic acid and vancomycin. In the second and third trial, the test items were same with those of 1st trial except the exclusion of quinidine. We included tacrolimus with a whole blood control material in addition to cyclosporine from the first trial. The most common test items were valproic acid, digoxin, phenytoin, carbamazepine, theophylline, and phenobarbital which were peformed in more than 77% of participating laboratories. The most widely used TDM analyzer was Abbott TDx/TDxFLx (56%), but its proportion were decreased slightly comparing with the previous years. In conclusion, we added tacrolimus from the year of TDM proficiency testing in 2002 and found grossly similar pattern comparing with those of previous years.
Acetaminophen ; Amikacin ; Amitriptyline ; Carbamazepine ; Cyclosporine ; Digoxin ; Drug Monitoring* ; Gentamicins ; Korea* ; Lithium ; Methotrexate ; Pathology, Clinical ; Phenobarbital ; Phenytoin ; Primidone ; Quinidine ; Tacrolimus ; Theophylline ; Tobramycin ; Valproic Acid ; Vancomycin

PURPOSE: Rheumatoid arthritis is a chronic multisystemic disease involving joints. It has been difficult to explain why the inflammatory responses of the rheumatoid arthritis (RA) are mostly limited to the joints. To explain this localizing phenomenon, we hypothetized that the cartilage, which exists in the joints, maintaines the activated status of synovial membrane and provides local specific environment for the maintenance of inflammatory response of arthritis. MATERIALS AND METHODS: Synovial fibroblast were proliferated with and without the addition of cartilage tissues, chondrocytes, type II collagens to the growth media respectively. MTS assay (CellTiter 96(R) AQ One Solution Cell Proliferation Assay) was done at 1st, 3rd, 4th, 5th, 6th, 7th, 9th and 11th days to evaluate the proliferation of the cells. The data were assessed with one-way ANOVA and unpaired t-test. Results : In a group where 0.1 g/ml of cartilage tissues were added to the growth media, the synovial fibroblasts from the normal people and rhematoid arthritic patients showed higher amount of proliferation from the 3rd day compared to the control group. When 0.02 g/ml of cartilage tissues were added, the synovial fibroblasts from the normal people showed higher amount of proliferation from the 4th day and those from RA patients from the 3rd day compared to the control group (p< 0.05). There was no significant statistical difference according to the concentration of the cartilage tissues.In a group where chondrocyte extract was added to the growth media, the synovial fibroblasts from the normal people showed higher amount of proliferation from the 4th day and those from RA patients from the 3rd day compared to the control group (p< 0.05). In a group where type II collagens were added to the growth media, the synovial fibroblasts from normal people and RA patients showed no significant statistical differences compared to the control group. CONCLUSION: The cartilage tissue is important in maintenance of synovial fibroblast proliferation. Of the cartilage tissue, chondrocyte, not extracellular type II collagen, played a major role. But further study is needed about what component of the chondrocyte extract maintaines the proliferation of synovial fibroblast.
Arthritis ; Arthritis, Rheumatoid ; Cartilage* ; Cell Proliferation ; Chondrocytes ; Collagen ; Collagen Type II ; Fibroblasts ; Humans ; Joints ; Synovial Membrane

Multiple primary colorectal carcinomas are not rare and occur more often than what can be ascribed to chance, but the frequencies on record vary. The tumors are usually classified as synchronous if they are present at the same time. It is often difficult to detect all these multiple lesions preoperatively:a correct diagnosis is frequently obtained only upon examination of the resected specimen. Triple synchronous primary colon cancer is an exceedingly rare disease. Despite of its rarity, multiple colon cancers should be investigated in the patients in whom clinical or laboratory evidence of colon cancer is suspected. Recently, we experienced one case of triple synchronous primary colon cancer diagnosed by colonoscopy before operation and report here with the review of the literature.
Colon* ; Colonic Neoplasms* ; Colonoscopy* ; Colorectal Neoplasms ; Diagnosis ; Humans ; Rare Diseases