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Intrawound Vancomycin Powder Application for Preventing Surgical Site Infection Following Cranioplasty

  • Seong Bin Youn;Gyojun Hwang;Hyun-Gon Kim;Jae Seong Kang;Hyung Cheol Kim;Sung Han Oh;Mi-Kyung Kim;Bong Sub Chung;Jong Kook Rhim;Seung Hun Sheen
    • Journal of Korean Neurosurgical Society
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    • v.66 no.5
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    • pp.536-542
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    • 2023
  • Objective : Surgical site infection is the most detrimental complication following cranioplasty. In other surgical fields, intrawound vancomycin powder application has been introduced to prevent surgical site infection and is widely used based on results in multiple studies. This study evaluated the effect of intrawound vancomycin powder in cranioplasty compared with the conventional method without topical antibiotics. Methods : This retrospective study included 580 patients with skull defects who underwent cranioplasty between August 1, 1998 and December 31, 2021. The conventional method was used in 475 (81.9%; conventional group) and vancomycin powder (1 g) was applied on the dura mater and bone flap in 105 patients (18.1%; vancomycin powder group). Surgical site infection was defined as infection of the incision, organ, or space that occurred after cranioplasty. Surgical site infection within 1-year surveillance period was compared between the conventional and vancomycin powder groups with logistic regression analysis. Penalized likelihood estimation method was used in logistic regression to deal with zero events. All local and systemic adverse events associated with topical vancomycin application were also evaluated. Results : Surgical site infection occurred in 31 patients (5.3%) and all were observed in the conventional group. The median time between cranioplasty and detection of surgical site infection was 13 days (range, 4-333). Staphylococci were the most common organisms and identified in 25 (80.6%) of 31 cases with surgical site infections. The surgical site infection rate in the vancomycin powder group (0/105, 0.0%) was significantly lower than that in the conventional group (31/475, 6.5%; crude odds ratio [OR], 0.067; 95% confidence interval [CI], 0.006-0.762; adjusted OR, 0.068; 95% CI, 0.006-0.731; p=0.026). No adverse events associated with intrawound vancomycin powder were observed during the follow-up. Conclusion : Intrawound vancomycin powder effectively prevented surgical site infections following cranioplasty without local or systemic adverse events. Our results suggest that intrawound vancomycin powder is an effective and safe strategy for patients undergoing cranioplasty.

Studies on Rice Varietal Resistance to Rice Stem Maggot, Chlorops oryzae Matsumura (벼줄기굴파리에 대한 수도(水稻)의 품종저항성(品種抵抗性))

  • LEE, Y.B.;HWANG, C.Y.;LEE, M.H.;Choi, K.M.;AHN, J.H.
    • Korean journal of applied entomology
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    • v.25 no.1 s.66
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    • pp.27-32
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    • 1986
  • To establish a method for measuring varietal resistance against rice stem maggot in field and pot, 20 varieties were used in $1981{\sim}1983$. The degree of injured stems by the 1st generation larvae was significantly correlated with that of injured panicles by the 2nd ($r=0.864^{**}$). There was no ovipositional preference in rice stem maggot. The larval mortality after artificial infestation varied widly from 5.6 to 100% in varieties and that of the resistant varieties was high after boring. There was a negative correlation between number of injured leaves and larval mortality after artificial infestation ($'81:r=-0.833^{**},\;'82:r=-0.918^{**}$). It is considered that larval mortality mainly caused by antibiosis and larval mortality 20 days after infestation on rice seedlings is ideal for evaluating the varietal resistance to rice stem maggot. Resistant varieties are Nagdongbyeo, Jinjubyeo and Chucheongbyeo susceptible varieties, Keumgangbyeo, Milyang 23, Baigyangbyeo and Milyang 30.

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Comparative Quality Traits, Flavor Compounds, and Metabolite Profile of Korean Native Black Goat Meat

  • Shine Htet Aung;Edirisinghe Dewage Nalaka Sandun Abeyrathne;Md. Altaf Hossain;Doo Yeon Jung;Hyun Cheol Kim;Cheorun Jo;Ki-Chang Nam
    • Food Science of Animal Resources
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    • v.43 no.4
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    • pp.639-658
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    • 2023
  • Although goat meat has several health benefits than other red meats but comsumers reluctant it due to its unpleasant flavor. This study aimed to investigate the odorant of goat meat as well as compare the quality traits of meat regarding sex status. The loin meats [non-castrated male (NCM), castrated male (CM), and female (FM)] were collected and stored at 4℃ in a laboratory refrigerator and analyzed on the 1st, 5th, and 8th consecutive days. The moisture content was the lowest and the protein content was highest in FM (p<0.05). Fat and ash content in NCM and FM were similar while lowest in CM. The CIE L* was significantly higher in NCM, but there were no significant differences of CIE a* and CIE b* within groups at initial day. The color intensity increased on the 5th storage day and decreased again after the 8th storage day, except in NCM. NCM displayed the highest thiobarbituric acid reactive substances value (p<0.05), whereas CM displayed a higher pH value than other groups throughout the storage period. Indole levels were the highest in NCM (0.031 mg/kg); however, skatole levels were not significant differences across all treatments (p>0.05). No significant difference was observed in the fatty acid composition between NCM and CM (p>0.05), whereas a significant difference was observed in FM (p<0.05). Most of the water-soluble metabolites showed significant differences between sexes. Overall, sex status effects on quality properties of meat and castration can improve the overall sensory acceptance by reducing goaty flavor of Korean native black goat meat.

The Study on the Development of the 'Successful Aging' Scale for Korean Elderly (한국 노인의 '성공적 노후 척도' 개발에 관한 연구)

  • Kim, Mee Hye;Shin, Kyung Rim
    • 한국노년학
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    • v.25 no.2
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    • pp.35-52
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    • 2005
  • This study attempts to develop the scale of 'Successful Aging' for Korean elderly. It follows fives: (1)developing 105 items based on the literature reviews, (2)performing the 1st survey to confirm and reduce items, (3)verifying the content validity through the professional group and the elderly focused group, (4)performing the 2nd survey to explore the factors of 'Successful Aging' and (5)performing the 3rd survey to identify the construct validity and concurrent validity. The scale constructs four factors with 30 items. The four factors are confirmed : (1)self efficacy, (2)satisfaction with adult children's success, (3)couple life like companion, (4)self control. The reliability of this scale is 0.94 and the relationship between the items and each factor are statistically significant by the confirmatory factor analysis. Thus, the content validity is verified. Also the correlation with the successful aging and the life satisfaction is 0.69 and then the concurrent validity is verified. This 'Successful Aging Scale' for Korean elderly will contribute to use as the socio-metrics at the welfare practice for aging.

A Case of Cold Hypersensitivity of Hands and Feet Treated with Korean Medicine Including Gyejifabuja-tang-gmibang and Acupuncture in a Patient with Lumbar Spinal Herniated Intervertebral Disc - A Case Report (한방병원에 입원한 수족냉증을 동반한 추간판탈출증 환자에 대한 한방 치료 1례)

  • Sang-hun Yun;Sang-yoon Kim;Yen-min Wang;Gil-geun Baek;Yu-jin Lee;Hyung-chul Lee;Man-ho Kang;Sung-hwan Park
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.1071-1082
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    • 2023
  • Objective: The purpose of this study is to report the efficacy of using Korean medicine treatment with cold hypersensitivity of the hands and feet with lumbar spinal herniated intervertebral disc. Case presentation: We used Korean medicine treatment (Gyejigabuja-tang, acupuncture) to treat a hospitalized patient with cold hypersensitivity of the hands and feet with lumbar spinal herniated intervertebral disc. To evaluate the treatment, we used the Numerical Rating Scale (NRS). The degree of cold hypersensitivity of the hands and feet was also evaluated using evaluation paper. The generic health status was measured using the European Quality of Life-5 Dimensions (EQ-5D) scale. The 31-year-old female underwent 13 days of inpatient treatment. Her pattern identification was that both hands and feet are cold (BiYangHeo) types. The treatments were herbal medicine and acupuncture. She took Gyejigabuja-tang for 13 days. She also received acupuncture for 20 minutes twice a day at LI11 (曲池), L14 (合谷), TE5 (外關) on her hands, LR3 (太衝), SP6 (三陰交), SP9 (陰陵泉) ST36 (足三里), GB41 (足臨泣) on Feet, GV4 (命門), GV3 (腰陽關), BL23 (腎兪), BL24 (氣海兪), BL25 (大腸兪), and BL26 (關元兪) on the low back. After 2 weeks of treatment, the NRS scale of her cold hypersensitivity of hands and feet symptoms dropped from NRS 7 to NRS 3, and her low back pain dropped from NRS 6 to NRS 3. Her cold hypersensitivity of hands and feet evaluation paper score decreased from 64 to 32, and her EQ-5D increased from 0.487 to 0.681. After the end of treatment, continued symptom improvements and no significant side effects were confirmed. Results: These findings suggest that Korean medical treatment (Gyejigabuja-tang, acupuncture) may be effective for treating cold hypersensitivity of hands and feet with lumbar spinal herniated intervertebral disc. The NRS, evaluation paper, and EQ-5D scores improved after treatment, with no side effects.

Diagnostic Performance of the Modified Korean Thyroid Imaging Reporting and Data System for Thyroid Malignancy: A Multicenter Validation Study

  • Sae Rom Chung;Hye Shin Ahn;Young Jun Choi;Ji Ye Lee;Roh-Eul Yoo;Yoo Jin Lee;Jee Young Kim;Jin Yong Sung;Ji-hoon Kim;Jung Hwan Baek
    • Korean Journal of Radiology
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    • v.22 no.9
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    • pp.1579-1586
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    • 2021
  • Objective: To evaluate the diagnostic performance of the modified Korean Thyroid Imaging Reporting and Data System (K-TIRADS), and compare it with the 2016 version of K-TIRADS using the Thyroid Imaging Network of Korea. Materials and Methods: Between June and September 2015, 5708 thyroid nodules (≥ 1.0 cm) from 5081 consecutive patients who had undergone thyroid ultrasonography at 26 institutions were retrospectively evaluated. We used a biopsy size threshold of 2 cm for K-TIRADS 3 and 1 cm for K-TIRADS 4 (modified K-TIRADS 1) or 1.5 cm for K-TIRADS 4 (modified K-TIRADS 3). The modified K-TIRADS 2 subcategorized the K-TIRADS 4 into 4A and 4B, and the cutoff sizes for the biopsies were defined as 1 cm for K-TIRADS 4B and 1.5 cm for K-TIRADS 4A. The diagnostic performance and the rate of unnecessary biopsies of the modified K-TIRADS for detecting malignancy were compared with those of the 2016 K-TIRAD, which were stratified by nodule size (with a threshold of 2 cm). Results: A total of 1111 malignant nodules and 4597 benign nodules were included. The sensitivity, specificity, and unnecessary biopsy rate of the benign nodules were 94.9%, 24.4%, and 60.9% for the 2016 K-TIRADS; 91.0%, 39.7%, and 48.6% for the modified K-TIRADS 1; 84.9%, 45.9%, and 43.5% for the modified K-TIRADS 2; and 76.1%, 50.2%, and 40.1% for the modified K-TIRADS 3. For small nodules (1-2 cm), the diagnostic sensitivity of the modified K-TIRADS decreased by 5.2-25.6% and the rate of unnecessary biopsies reduced by 19.2-32.8% compared with those of the 2016 K-TIRADS (p < 0.001). For large nodules (> 2 cm), the modified K-TIRADSs maintained a very high sensitivity for detecting malignancy (98%). Conclusion: The modified K-TIRADSs significantly reduced the rate of unnecessary biopsies for small (1-2 cm) nodules while maintaining a very high sensitivity for malignancy for large (> 2 cm) nodules.

Feasibility of the Threshold-Based Quantification of Myocardial Fibrosis on Cardiac CT as a Prognostic Marker in Nonischemic Dilated Cardiomyopathy

  • Na Young Kim;Dong Jin Im;Yoo Jin Hong;Byoung Wook Choi;Seok-Min Kang;Jong-Chan Youn;Hye-Jeong Lee
    • Korean Journal of Radiology
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    • v.25 no.6
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    • pp.540-549
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    • 2024
  • Objective: This study investigated the feasibility and prognostic relevance of threshold-based quantification of myocardial delayed enhancement (MDE) on CT in patients with nonischemic dilated cardiomyopathy (NIDCM). Materials and Methods: Forty-three patients with NIDCM (59.3 ± 17.1 years; 21 male) were included in the study and underwent cardiac CT and MRI. MDE was quantified manually and with a threshold-based quantification method using cutoffs of 2, 3, and 4 standard deviations (SDs) on three sets of CT images (100 kVp, 120 kVp, and 70 keV). Interobserver agreement in MDE quantification was assessed using the intraclass correlation coefficient (ICC). Agreement between CT and MRI was evaluated using the Bland-Altman method and the concordance correlation coefficient (CCC). Patients were followed up for the subsequent occurrence of the primary composite outcome, including cardiac death, heart transplantation, heart failure hospitalization, or appropriate use of an implantable cardioverter-defibrillator. The Kaplan-Meier method was used to estimate event-free survival according to MDE levels. Results: Late gadolinium enhancement (LGE) was observed in 29 patients (67%, 29/43), and the mean LGE found with the 5-SD threshold was 4.1% ± 3.6%. The 4-SD threshold on 70-keV CT showed excellent interobserver agreement (ICC = 0.810) and the highest concordance with MRI (CCC = 0.803). This method also yielded the smallest bias with the narrowest range of 95% limits of agreement compared to MRI (bias, -0.119%; 95% limits of agreement, -4.216% to 3.978%). During a median follow-up of 1625 days (interquartile range, 712-1430 days), 10 patients (23%, 10/43) experienced the primary composite outcome. Event-free survival significantly differed between risk subgroups divided by the optimal MDE cutoff of 4.3% (log-rank P = 0.005). Conclusion: The 4-SD threshold on 70-keV monochromatic CT yielded results comparable to those of MRI for quantifying MDE as a marker of myocardial fibrosis, which showed prognostic value in patients with NIDCM.

Automated Versus Handheld Breast Ultrasound for Evaluating Axillary Lymph Nodes in Patients With Breast Cancer

  • Sun Mi Kim;Mijung Jang;Bo La Yun;Sung Ui Shin;Jiwon Rim;Eunyoung Kang;Eun-Kyu Kim;Hee-Chul Shin;So Yeon Park;Bohyoung Kim
    • Korean Journal of Radiology
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    • v.25 no.2
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    • pp.146-156
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    • 2024
  • Objective: Automated breast ultrasound (ABUS) is a relevant imaging technique for early breast cancer diagnosis and is increasingly being used as a supplementary tool for mammography. This study compared the performance of ABUS and handheld ultrasound (HHUS) in detecting and characterizing the axillary lymph nodes (LNs) in patients with breast cancer. Materials and Methods: We retrospectively reviewed the medical records of women with recently diagnosed early breast cancer (≤ T2) who underwent both ABUS and HHUS examinations for axilla (September 2017-May 2018). ABUS and HHUS findings were compared using pathological outcomes as reference standards. Diagnostic performance in predicting any axillary LN metastasis and heavy nodal-burden metastases (i.e., ≥ 3 LNs) was evaluated. The ABUS-HHUS agreement for visibility and US findings was calculated. Results: The study included 377 women (53.1 ± 11.1 years). Among 385 breast cancers in 377 patients, 101 had axillary LN metastases and 30 had heavy nodal burden metastases. ABUS identified benign-looking or suspicious axillary LNs (average, 1.4 ± 0.8) in 246 axillae (63.9%, 246/385). According to the per-breast analysis, the sensitivity, specificity, positive and negative predictive values, and accuracy of ABUS in predicting axillary LN metastases were 43.6% (44/101), 95.1% (270/284), 75.9% (44/58), 82.6% (270/327), and 81.6% (314/385), respectively. The corresponding results for HHUS were 41.6% (42/101), 95.1% (270/284), 75.0% (42/56), 82.1% (270/329), and 81.0% (312/385), respectively, which were not significantly different from those of ABUS (P ≥ 0.53). The performance results for heavy nodal-burden metastases were 70.0% (21/30), 89.6% (318/355), 36.2% (21/58), 97.3% (318/327), and 88.1% (339/385), respectively, for ABUS and 66.7% (20/30), 89.9% (319/355), 35.7% (20/56), 97.0% (319/329), and 88.1% (339/385), respectively, for HHUS, also not showing significant difference (P ≥ 0.57). The ABUS-HHUS agreement was 95.9% (236/246; Cohen's kappa = 0.883). Conclusion: Although ABUS showed limited sensitivity in diagnosing axillary LN metastasis in early breast cancer, it was still useful as the performance was comparable to that of HHUS.

The Relationship Between Subjective Health Perception and Health Behavior of Korean Adolescents According to Gender: Using the 8th National Health and Nutrition Examination Survey (한국 청소년의 성별에 따른 주관적 건강 인식과 건강행위의 관계: 국민건강영양조사 제8기 조사를 이용하여)

  • Sug Young Lee
    • The Journal of Korean Society for School & Community Health Education
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    • v.25 no.1
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    • pp.17-28
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    • 2024
  • Background & Objectives: This study aimed to examine the relationship between subjective health perception and health behaviors among adolescents, utilizing raw data from the 8th Korea National Health and Nutrition Examination Survey (2019-2021) while distinguishing between genders. Methods: The study employed data from the 8th Korea National Health and Nutrition Examination Survey (2019-2020), recruiting students from 1st to 3rd grades in middle and high schools nationwide. Through population stratification, sample distribution, and sampling stages, a final sample of 1,065 adolescents aged 12 to 18 years was selected. The collected data were analyzed using SPSS 28.0 (IBM Corp., Armonk, NY, USA) at a significance level of .05. Results: Regarding the general characteristics of the subjects, no statistically significant differences were observed among male students based on school, family structure, and income. However, among female students, a significant difference in subjective health perception was noted, with higher perception among high school students compared to middle school students (p=.001). Significant differences in health behaviors were identified based on family structure for male adolescents, where those living with both parents exhibited more health-promoting behaviors than single-parent adolescents (p=.011). However, no significant difference was observed among female adolescents. In terms of health behaviors related to gender, regular exercise was found to significantly impact subjective health perception in male adolescents (p=.013), while breakfast habits were identified as significant influencers for female adolescents (p<.001). Conclusions: This study revealed gender differences in subjective health perception and health behaviors among adolescents. Based on these findings, there is a perceived need for the development of health promotion programs tailored to the unique needs of male and female adolescents.

Effect of Cooling Timing in the Root Zone on Substrate Temperature and Physiological Response of Sweet Pepper in Summer Cultivation (여름 파프리카 수경재배에서 근권 냉방 시간이 근권 온도와 생리적 반응에 미치는 영향)

  • Choi, Ki Young;Ko, Ji Yeon;Yoo, Hyung Joo;Choi, Eun Young;Rhee, Han Cheol;Lee, Yong-Beom
    • Horticultural Science & Technology
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    • v.32 no.1
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    • pp.53-59
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    • 2014
  • This study aimed to determine an appropriate cooling timing in the root zone for lowering substrate temperature and its effect on physiological response of sweet pepper (Capsicum annum L. 'Orange glory') grown on coir substrate in summer, from the July 16 to October 15, 2012. Daily temperature of substrate, root activity, leaf water potential, first flowering date, and the number of fruits were measured by circulating cool water through a XL pipe in the root zone during either all day (all-day) or only night time (5 p.m. to 3 a.m.; night) from the July 23 to September 23, 2012. For comparison, no cooling (control) was also applied. Between the $23^{rd}$ of July and $31^{st}$ of August (hot temperature period), daily average temperatures in substrates were $25.6^{\circ}C$, $26.1^{\circ}C$, and $29.1^{\circ}C$ for the all-day and night treatment, and control respectively. About 1.8 to $5^{\circ}C$ lower substrate temperature was observed in both treatments compared to that of control. In sunny day ($600-700 W{\cdot}m^{-2}{\cdot}s^{-1}$), the highest temperature of substrate was measured between 4 p.m. and 5 p.m. under both the all-day and night treatments, whereas it was measured between 7 p.m. and 8 p.m. under the control. Substrate temperatures during the day (6 a.m. to 8 p.m.) and night (8 p.m. to 6 a.m.) differed depending on the treatments. During the day and night, averaged substrate temperature was lower about $3.3^{\circ}C$ and $4.0^{\circ}C$ for the all-day, and $2.1^{\circ}C$ and $3.4^{\circ}C$ for the night treatment, compared to that of control. In the all-day and night treatment, the TD [TD = temperature of (control)] was greater in bottom than that of other regions of the substrate. Between the day and night, no different TD values were observed under the all-day treatment, whereas under the night treatment there was difference with the greatest degree in the bottom of the substrate. During the hot temperature period, total numbers of days when substrate temperature was over $25^{\circ}C$ were 40, 23 and 27 days for the control, all-day, and night treatment, respectively, and the effect of lowering substrate temperature was therefore 42.5% and 32.5% for the all-day and night treatment, respectively, compared to that for the control. Root activity and leaf water potential of plants grown under the all-day treatment were significantly higher than those under the night treatment. The first flowering date in the all-day treatment was similar to that in the night treatment, but 4-5 day faster than in the control. Also, the number of fruits in both treatments was significantly higher than that in the control. However, there was no effect of root zone cooling on eliminating delay in fruiting caused by excessively higher air temperature (> $30^{\circ}C$), although the substrate temperature was reduced $18^{\circ}C$ to $5^{\circ}C$. These results suggest that the method of cooling root zone temperature need to be incorporated into the lowering growing temperature for growth and fruit set of health paprika.