Effect of Alcohol Prevention Program on Subject Well-being Scale, Alcohol Abstinence Self-Efficacy Scale and Alcohol Decisional Balance Scale of Alcohol Related Prisoners in Correctional Institutions in Korea

@#Introduction: This research intends to determine the intervening effect of alcohol prevention education programs on subjective well-being, alcohol abstinence self-efficacy, and alcohol decisional balance of alcohol-related prisoners. Methods: The subjects of the research were 25 alcohol-related prisoners who were detained in S district prisons in South Korea. The program was organized into less than 10 subjects for each session and carried out in three rounds from June 1 to July 2, 2019. A total of eight sessions programs were provided for four weeks, two times a week for each session. The collected data were analyzed with frequency, percentage, and paired t-test using the SPSS/WIN 21.0 program. Results: After the alcohol prevention training program, there was significant difference in subjective well-being scores (t=3.05, p= .005) and alcohol decisional balance score (t=2.16, p=.041). However, there was no significant difference in the abstinence self-efficacy score (t=-1.17, p=.254). Conclusion: Implementing the program will not only enriches the quality of life of alcohol-related prisoners by improving inherent positive emotions but also contribute to re-socialization and reduction of recidivism by making them aware of shortcomings rather than the benefits of alcohol.

A Structural Model on the Post-Traumatic Growth of Police Officers

Purpose@#The purpose of this study is to construct and test a structural model for the Post-traumatic Growth (PTG) of police officers. The conceptual model is based on Calhoun and Tedeschi’s PTG theory. @*Methods@#Data were collected from 269 police officers working at 10 police stations in Seoul from September 26 to October 9, 2017. The exogenous variable was traumatic experiences, and endogenous variables were pain perception, self disclosure, social support, deliberate rumination, and PTG. The collected data were analyzed in order to calculate the direct and indirect effects of factors affecting PTG using SPSS/WIN 23.0 and AMOS 21.0. @*Results@#The hypothetical model showed a good fit to the data: x2 /df=2.57, GFI=.90, CFI=.95, TLI=.91, RMSEA=.07, SRMR=.07. The hypothetical model showed a similar result with the data, and out of 10 paths, 7 were statistically significant. The model explained 36% of the variance in the PTG of police officers. The model confirmed that social support and deliberate rumination had a direct effect, and that self-disclosure had an indirect effect on police officers’ PTG. Conclusion: Nursing intervention programs to increase PTG of police officers should focus on deliberate rumination, social support, and self-disclosure. In addition, they should be accompanied by various crisis managements and consultations that can promote PTG.

A Structural Model on the Post-Traumatic Growth of Police Officers

Purpose@#The purpose of this study is to construct and test a structural model for the Post-traumatic Growth (PTG) of police officers. The conceptual model is based on Calhoun and Tedeschi’s PTG theory. @*Methods@#Data were collected from 269 police officers working at 10 police stations in Seoul from September 26 to October 9, 2017. The exogenous variable was traumatic experiences, and endogenous variables were pain perception, self disclosure, social support, deliberate rumination, and PTG. The collected data were analyzed in order to calculate the direct and indirect effects of factors affecting PTG using SPSS/WIN 23.0 and AMOS 21.0. @*Results@#The hypothetical model showed a good fit to the data: x2 /df=2.57, GFI=.90, CFI=.95, TLI=.91, RMSEA=.07, SRMR=.07. The hypothetical model showed a similar result with the data, and out of 10 paths, 7 were statistically significant. The model explained 36% of the variance in the PTG of police officers. The model confirmed that social support and deliberate rumination had a direct effect, and that self-disclosure had an indirect effect on police officers’ PTG. Conclusion: Nursing intervention programs to increase PTG of police officers should focus on deliberate rumination, social support, and self-disclosure. In addition, they should be accompanied by various crisis managements and consultations that can promote PTG.

Case of Renal Microaneurysms and Multiple Renal Infarctions in a Patient with Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is a chronic inflammatory, heterogeneous autoimmune disease characterized by autoantibody production and the potential involvement of almost every organ system. Although vasculitis usually confined to small vessels is a fairly common feature of SLE, ischemic vasculitis with an aneurysm is an uncommon feature. In particular, renal arterial microaneurysms and multiple renal infarctions are very rarely reported in patients with SLE. Furthermore, to the best of the authors' knowledge, there is no report on renal arterial microaneurysms associated with SLE in Korea. Here, this paper presents a case of renal microaneurysms and multiple renal infarctions in a 41-year-old woman with SLE.

The Use of Normal Stem Cells and Cancer Stem Cells for Potential Anti-Cancer Therapeutic Strategy

BACKGROUND: Despite recent advance in conventional cancer therapies including surgery, radiotherapy, chemotherapy, and immunotherapy to reduce tumor size, unfortunately cancer mortality and metastatic cancer incidence remain high. Along with a deeper understanding of stem cell biology, cancer stem cell (CSC) is important in targeted cancer therapy. Herein, we review representative patents using not only normal stem cells as therapeutics themselves or delivery vehicles, but also CSCs as targets for anti-cancer strategy. METHODS: Relevant patent literatures published between 2005 and 2017 are discussed to present developmental status and experimental results on using normal stem cells and CSCs for cancer therapy and explore potential future directions in this field. RESULTS: Stem cells have been considered as important element of regenerative therapy by promoting tissue regeneration. Particularly, there is a growing trend to use stem cells as a target drug-delivery system to reduce undesirable side effects in non-target tissues. Noteworthy, studies on CSC-specific markers for distinguishing CSCs from normal stem cells and mature cancer cells have been conducted as a selective anti-cancer therapy with few side effects. Many researchers have also reported the development of various substances with anticancer effects by targeting CSCs from cancer tissues. CONCLUSION: There has been a continuing increase in the number of studies on therapeutic stem cells and CSC-specific markers for selective diagnosis and therapy of cancer. This review focuses on the current status in the use of normal stem cells and CSCs for targeted cancer therapy. Future direction is also proposed.

The Effects of Self-esteem and Problem Focused Coping on Post-traumatic Growth among Police Officers / 한국직업건강간호학회지

PURPOSE: The objective of this study is to identify the effects of self-esteem and problem focused coping on post-traumatic growth among police officers. METHODS: The data were collected from the 137 police officers in ten police offices of G city in July 2014. The collected data were analyzed for descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and hierarchical regression using the SPSS/WIN 18.0 program. RESULTS: Post-traumatic growth was positively correlated with self-esteem and problem focused coping. Self-esteem and problem focused coping had a significant effects on post-traumatic growth. The explained variance for post-traumatic growth was 19.0%. CONCLUSION: To improve post-traumatic growth of police officers, strategies to increase self-esteem and problem focused coping are needed.

Diagnosis and Treatment of Discoid Meniscus

There is a greater incidence of discoid meniscus in Asian countries than in Western countries, and bilateral discoid menisci are also common. The discoid meniscus may be a congenital anomaly, and genetics or family history may play a role in the development of discoid menisci. Because the histology of discoid meniscus is different from that of normal meniscus, it is prone to tearing. Individuals with a discoid meniscus can be asymptomatic or symptomatic. Asymptomatic discoid menisci do not require treatment. However, operative treatment is necessary if there are symptoms. Total meniscectomy leads to an increased risk of osteoarthritis. Therefore, total meniscectomy is generally reserved for rare unsalvageable cases. Partial meniscectomy (saucerization) with preservation of a stable peripheral rim combined with or without peripheral repair is effective, and good short-, mid-, and long-term clinical results have been reported.

Psoriatic Onycho-pachydermo-periostitis of the Fingertips: A Report of Two Cases

Psoriatic onycho-pachydermo-periostitis (POPP) causes severe nail dystrophy, painful soft tissue swelling, and marked periosteal reaction of the involved distal phalanx. There are few reports of POPP involving the great toe. We report on 2 cases of POPP involving the fingertips. A 60-year-old woman presented with fusiform swelling of her right 4th fingertip with severe tenderness, and her fingernails and toenails had varying degrees of onycholysis. She had mixed multiple erosions and meta-epiphyseal periostitis at the distal phalanx of the right 4th finger but was treated successfully with methotrexate and cyclosporine. A 39-year-old woman presented with painful swelling of the left 2nd and 5th fingertip, psoriatic lesions on the knees and soles of the feet, and onycholysis without reactive periostitis of the left 2nd and 5th fingers. She was treated successfully with cyclosporine. Despite its rarity, POPP should be considered when diagnosing arthritic or infectious conditions affecting the distal interphalangeal joint.

DICAM-mediated Inhibition of Type 1 Interferon System during Macrophage Differentiation of THP-1 Cells

OBJECTIVE: We have previously shown that DICAM inhibits LPS-mediated macrophage differentiation. However, less is known about the exact action mechanisms of DICAM on the macrophage function and differentiation. METHODS: To induce differentiation into a resting M0 macrophage, THP-1 cells were cultured with 100 nM PMA for 24 h, and then rested for 3 days. THP-1 cells were infected with 50 moi of control LacZ- or DICAM-containing adenovirus. The RNA expression profile associated with DICAM during THP-1 differentiation was analyzed with a microarray chip and in silico analysis with Ingenuity Pathway Analysis (IPA) program. RESULTS: A disease and function analysis of the microarray data in DICAM-overexpressed THP-1 cells revealed a suppression in the expression of multiple genes involved in the response of myeloid cells and phagocytes, and an increase of genes associated with apoptosis of fibroblast cell-line, and viral infection and replication. The canonical pathway analysis also showed the most prominent changes of signaling pathways that involve inflammation responses. An upstream regulator analysis identifyingmolecules upstream of the genes that potentially explain the observed expression changes revealed that IRF7 and the genes in type 1 interferon system, such as IFNA2 and IFNAR,was significantly attenuated by DICAM. A mechanistic network analysis confirmed a direct causal association between IRF7 and type 1 interferon system. A real-time RT-PCR analysis validating the microarray data verified the significant suppression of IRFs, IFNA2, and IFNB1. CONCLUSION: These results suggest that DICAM can be a critical regulator of type 1 interferon system, which is an essential mediator in the process of intracellular infection and systemic lupus erythematosus.

Third-generation cephalosporin resistance of community-onset Escherichia coli and Klebsiella pneumoniae bacteremia in a secondary hospital

BACKGROUND/AIMS: To enable appropriate antimicrobial treatment for community-onset infections in emergency departments (EDs), data are needed on the resistance profiles of Escherichia coli and Klebsiella pneumoniae, which are the main pathogens of community-onset bacteremia. METHODS: Records were reviewed of 734 patients with E. coli and K. pneumoniae bacteremia who visited the Daegu Fatima Hospital ED, Daegu, Korea between 2003 and 2009. We investigated the demographic data, clinical findings, and antimicrobial susceptibility patterns of the organisms. RESULTS: Of 1,208 cases of community-onset bacteremia, 62.8% were caused by E. coli or K. pneumoniae in an ED of a secondary care hospital. Five hundred and forty-eight cases of E. coli (75%) and 183 cases of K. pneumoniae (25%) were analyzed. Urinary tract infection (43.1%) was most common, followed by intra-abdominal infection (39%) and pneumonia (7.2%). Trimethoprim/sulfamethoxazole, fluoroquinolone, third-generation cephalosporin (3GC) and amikacin resistance rates among E. coli and K. pneumoniae were 22.8%, 19.6%, 6.2%, and 1.3%, respectively. In 2009, the rate of 3GC resistance (10.6%) was significantly higher, compared to the annual averages of 2003 to 2008 (6.1%; p = 0.03). Previous exposure to antibiotics was an independent risk factor for 3GC resistance in multivariate logistic regression analysis. CONCLUSIONS: The rate of 3GC resistance increased in community-onset infections, and previous exposure to antibiotics was an independent risk factor. Despite the increased 3GC resistance in community-onset infections, an amikacin combination therapy could provide an option for treatment of bacteremic patients with previous antibiotic exposure in an ED.

Therapeutic Effect of a Recombinant betaig-h3 Fragment-RGD Peptide for Chronic Inflammatory Arthritis

OBJECTIVE: betaig-h3 is a 68kDa extracellular matrix protein which is overexpressed in synovial tissues of rheumatoid arthritis (RA). Previous results proved that betaig-h3 fragments are relevant to adhesion and migration of synovial fibroblast and angiogenesis through interaction with alphavbeta 3 integrin. We designed a recombinant betaig-h3 protein consisting of a fas-1 domain and RGD motif and evaluated the therapeutic efficacy in RA. METHODS: Inhibitory effect of adhesion and migration of NIH3T3 cell line was evaluated in 96 well microtiter and transwell plates coated with betaig-h3. Clinical arthritis index was evaluated after treating CIA mice with MFK12. Immunohistochemical staining in synovial tissues were performed. Expression of transcripts and proteins of inflammatory mediators were analyzed by semi-quantitative RT-PCR and immunoblotting. RESULTS: Recombinant protein consisted of 4th fas-1 domain truncated for H1 and H2 sequences and RGD peptide (MFK12), had M.W. of 10.4kDa. betaig-h3 mediated adhesion and migration of NIH3T3 cell line were significantly inhibited in a dose-dependent manner. Arthritis severity and incidence were efficiently reduced when CIA mice were treated with MFK12 at 30 mg/kg/day compared with the control. Immunohistochemical staining of joint tissues in MFK12 treated mice exhibited reduced angiogenesis. In treated mice, expression of transcripts regarding inflammatory mediators was markedly suppressed and immunoblotting of ICAM-1 and RANKL from whole extract of hind paws also showed a significant reduction. CONCLUSION: This study shows that MFK12 is effective in treating RA, although further study is warranted to improve the therapeutic efficacy.

Primary Cryptococcal Tenosynovitis in a Patient with Rheumatoid Arthritis / 감염과화학요법

Here, we report a case of primary cryptococcal tenosynovitis and arthritis caused by worsened cellulitis in a patient with rheumatoid arthritis (RA) who had been taking methotrexate and leflunomide. The patient, injured during the soybean harvest, failed to respond to empirical antibiotic therapy for presumed bacterial cellulitis on the dorsum of the right hand. An operative procedure was performed. Cryptococcocal tenosynovitis was diagnosed upon histopathological examination of the lesion. Treatment with 400 mg of fluconazole daily for 3 months led to the complete disappearance of skin lesions, with slight limitation of finger extension. The patient was examined continuously for 2 years, and there was no evidence of relapse or dissemination to other organs. This case indicates that primary cryptococcal skin and soft tissue infections must be included in the differential diagnoses of antibiotics-refractory soft tissue infections, especially in immunocompromised patients.

DICAM Inhibits Activation of Macrophage by Lipopolysaccharide

OBJECTIVE: DICAM, a dual Ig domain containing adhesion molecule, is involved in cell-cell adhesion through direct interaction with alphavbeta3 integrin. In our previous study showing the inhibitory role of DICAM in osteoclast differentiation, we found that DICAM also has a suppressive role in macrophage, the precursor cell of osteoclast. The role of DICAM in macrophage activation at the inflammatory milieu, however, remains obscure. METHODS: Expression pattern of DICAM by inflammatory cytokines and lipopolysaccharide (LPS) was studied with RAW264.7, a murine macrophage cell line. To study the role of DICAM on macrophage activation, we stably transduced DICAM, or empty vector, into RAW264.7, and then compared the LPS-mediated activation such as spreading and TNF-alpha production. RESULTS: DICAM was abundantly expressed in the synovial tissue of collagen-induced arthritis. When we assessed the expression of DICAM in RAW264.7 cells by mediators of inflammation, inflammatory cytokines, such as TNF-alpha, IL-1beta, and IFN-gamma, and M-CSF increased the expression of DICAM; however, LPS decreased. Functionally, DICAM that stably transduced-RAW264.7 cells showed attenuation of LPS-mediated macrophage activation including spreading and TNF-alpha production. DICAM decreased the phosphorylation of JNK MAP kinase by M-CSF and LPS stimulation, which was corroborated by a decrease in the expression of ITAM-associated receptors including Trem2, Pira1, and Oscar. Finally, a recombinant ectodomain of DICAM suppressed LPS-induced activation of RAW264.7 cells. CONCLUSION: These results indicate that DICAM acts as a negative regulator of LPS-mediated macrophage activation.

Determining Clinical Risk Factors for Radiographical Severity in Patients with Ankylosing Spondylitis in Daegu and Kyungpook Territories / 대한류마티스학회지

OBJECTIVE: This study was designed to identify prognostic determinants of radiographical severity in patients with ankylosing spondylitis (AS) living in Daegu and Kyungpook territories. METHODS: One hundred-nineteen patients with AS were consecutively enrolled from four regional general hospitals. Clinical data including smoking habits, alcohol intake, disease duration, HLA-B27 positivity, involvement of peripheral joints, occupational activity, and regular exercise were investigated. Radiographical severity was assessed by the Modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Statistical analyses were performed using the independent Student's t-test, Pearson's correlation coefficient analysis, and multivariate regression analysis. RESULTS: Radiographical severity, as evaluated with the mSASSS, was associated with age of disease onset (p=0.011) and disease duration (p<0.001). Additionally, mSASSS was significantly higher in males than females (p=0.039) and in patients without involvement of ankle arthritis than those with involvement of ankle arthritis (p=0.026). Patients with hip arthritis had significantly higher mSASSS scores than those without hip arthritis. A multivariate regression analysis showed that older age of disease onset, male gender, and disease duration were independent predictors of AS radiographical severity (p<0.001, p=0.013, and p<0.001, respectively). Hip arthritis was an independent predictor of C-spine radiographical severity in AS (p=0.031). CONCLUSION: Radiographical severity of the prognosis was determined by age of disease onset, gender, and disease duration in patients with AS living in Daegu and Kyungpook territories.

IgA Multiple Myeloma Presenting with Pathologic Fracture at Clavicle in a Patient with Ankylosing Spondylitis / 대한류마티스학회지

Multiple myeloma (MM) is a malignant monoclonal proliferation of plasma cells that commonly causes pathologic fractures in the vertebrae, femur, humerus and rib. Although the association of MM and ankylosing spondylitis (AS) has rarely been reported, most of MM patients with AS share the characteristic of IgA type paraproteinemia, which suggests the presence of mechanisms that possibly connect the two conditions. In this report, we describe a 47-year-old man with a 25-year history of AS, and he was diagnosed as having IgA kappa type MM with a pathologic fracture at the left clavicle. To the best of our knowledge, this is the first case of IgA myeloma presenting with a pathologic fracture in a patient with AS. We report here on this case along conducting a review of the relevant medical literature.

A Case of Chylopericardium Secondary to the Superior Vena Cava Syndrome in Behcet's Disease / 대한류마티스학회지

Behcet's disease (BD) is a chronic inflammatory disorder associated with oral aphthous ulcer, genital ulcer and uveitis. Vascular lesions in BD can affect all types and sizes of vessels. The venous thrombosis, which is uncommon feature of other vasculitis, is relatively common clinical manifestation of BD. Sometimes the cardiovascular involvement in BD results in serious complications as the leading cause of morbidity and mortality. We report a 41-year-old male patient who suffered BD and presented massive chylopericardium due to the superior vena cava (SVC) syndrome. After thrombectomy of SVC, the highly productive left-sided chylothorax and restenosis of anastomosis site at SVC had occurred, which were successfully treated by the ligation of the thoracic duct and balloon-stent angioplasty. We discussed the mechanism and treatment of chylopericardium in SVC syndrome, and the possible complications after the surgical management.

A Case of Hypothenar Hammer Syndrome Presented as Digital Ulcerations / 대한류마티스학회지

Hypothenar hammer syndrome (HHS) is a non-atherosclerotic, non-inflammatory vascular disease that causes a digital ischemia as a result of the occlusion of distal ulnar artery adjacent to the hook of hamate. This syndrome is usually observed in men who use the hypothenar eminence of the hand to grip devices such as a hammer. As a consequence of repeated blunt trauma, the ulnar artery beneath hypothenar eminence may lead to pathologic changes, such as intima-medial hyperplasia and reactive inflammatory infiltrates, which lead to the digital ischemia. We experienced a case of HHS with digital ulcerations which occurred after intensive work with nail remover for 10 days. Selective angiography of right forearm showed complete occlusion of the ulnar artery at the level of hook of hamate with deficient superficial palmar arch. After treatment with intravenous prostaglandin E1 and heparin, the ulcerative lesions of fingers improved without surgical intervention, which implicates that medical management of HHS should be considered prior to the surgical treatment.

Regulation of betaig-h3 Production in Rheumatoid Synovitis by Inflammatory Mediators / 대한류마티스학회지

OBJECTIVE: To investigate the expression pattern of transforming growth factor-beta-inducible gene-h3 (betaig-h3) within rheumatoid synovial tissue and the regulation of betaig-h3 synthesis in fibroblast-like synoviocyte (FLS). METHODS: Synovial tissues obtained from patients with rheumatoid arthritis and osteoarthritis were obtained during joint replacement surgery. betaig-h3 expression was evaluated with immunohistochemical stain. FLS was isolated from synovial tissues and stimulated with cytokines including TGF-beta, TNF-alpha, IL-1beta, IFN-gamma, IL-6, IL-4, and IL-10. betaig-h3 synthesis was measured using semiquantitative RT-PCR, ELISA, immunofluorescence stain, and flow cytometry. RESULTS: Expression of betaig-h3 was diffuse and abundant in both lining and sublining layers of rheumatoid synovium, which was more prominent than those of osteoarthritis. Production of betaig-h3 in FLS was regulated by TGF-beta1 in a dose-dependent manner and was highest at 5 ng/mL of TGF-beta1. TNF-alpha and IL-1beta upregulated the production of betaig-h3 from FLS synergistically with TGF-beta1 but other cytokines such as IL-4, IL-6, IL-10 did not affect. betaig-h3 synthesis was efficiently inhibited by dexamethasone at higher dose (100 nM) but not by cyclosporine-A. CONCLUSION: Production of betaig-h3, which is highly upregulated in rheumatoid synovitis, is differentially regulated by inflammatory cytokines.

Hemorrhagic gastroenteritis with Henoch-Sch?nlein purpura in adult / 대한내과학회지

BACKGROUND: To evaluate clinical manifestations, endoscopic findings and response to treatment in adult Henoch-Sch?nlein purpura (HSP) patients with hemorrhagic gastroenteritis. METHODS: Twenty patients who were admitted to Kyungpook National University Hospital between 1996 and 2003 were included, based on the following criteria: 1) diagnosed as HSP according to the criteria proposed by Michel et al., 2) older than 15 years old and 3) had evidences of gastrointestinal (GI) bleeding. Thirteen HSP patients who were older than 15 years old and had no evidences of GI bleeding were recruited as controls. We evaluated the clinical features and findings of upper GI endoscopy and colonoscopy. RESULTS: Mean age and male to female ratio were not significantly different between patients with and without hemorrhagic gastroenteritis (age: 29.5 +/- 15.1 vs. 30.5 +/- 13.5; M:F=14:6 vs. 9:4, respectively). Patients with hemorrhagic gastroenteritis had a significantly higher frequency of petechiae on the upper extremities (p=0.015). In the multivariate analysis, petechial lesion on the upper extremities was a significant risk factor for hemorrhagic gastroenteritis (p=0.041). Mucosal lesions were found in 94.7% and 83.3% of patients on upper GI endoscopy and colonoscopy, showing that most patients (82.3%) had both upper and lower GI bleeding. Most patients with hemorrhagic gastroenteritis showed good response to high dose glucocorticoid therapy. Mortality and relapse rate were 10% and 5%, respectively. CONCLUSION: In adult HSP patients, presence of petechiae on upper extremities may be a risk factor for hemorrhagic gastroenteritis. The present data suggest that both upper and lower GI examinations are necessary for proper evaluation of HSP patients with hemorrhagic gastroenteritis.

The Effect of Aminoglycoside Restriction on the Resistance Pattern and Mortality of Nosocomial Bacteremia Caused by Gram-Negative Bacilli / 감염과화학요법

OBJECTIVE:To evaluate the effects of an aminoglycoside restriction policy on expenditures for aminoglycosides, antimicrobial resistance rates and clinical outcome of nosocomial bacteremia caused by Gram-negative bacilli (GNB). METHODS: Starting in February, 2002, a prior consultation with an infectious disease specialist for using aminoglycoside antibiotics over 5 days was required in a 930-bed university hospital. In retrospective analysis of medical records 7 months after initiation of the aminoglycoside restriction policy, sixty cases of clinically relevant nosocomial bacteremia caused by GNB were found. These bacteremic patients were compared with sixty, species-matched, control patients with nosocomial Gram- negative bacteremia before the policy for total expenditures for aminoglycosides, susceptibility to antibiotics and clinical outcomes of bacteremia. RESULTS: During the same period of 7 months before and after the restriction policy, total expenditures for aminoglycosides decreased by 44% in cost (from 465,030,841 Won to 259,618,337 Won) and the antimicrobial utilization density of aminoglycosides decreased by 42% (from 225.2 to 130.3). On the other hand, the patterns of antibiotic susceptibility and bacteremia-related in-hospital mortality rates after the policy did not show a significant change, compared with those before the policy. CONCLUSION: Antibiotic restrictions are among the most popular methods to diminish the practice of antibiotic overuse in hospitals. In this study, requirement for prior approval of aminoglycoside use over 5 days led to a significant decrease in the amount and cost of total aminoglycosides without a significant change in susceptibility patterns and bacteremia-related mortality rates.