• Tuberculosis and Respiratory Diseases
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• 제69권3호
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• pp.184-190
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• 2010

Background: The purpose of this study was to determine the prognostic significance of chest computed tomographic (CT) parameters in acute submassive pulmonary embolism (PE). Methods: Between January 2006 and December 2009, 268 consecutive patients with acute submassive PE that was confirmed by chest CT with pulmonary angiography in emergency room were studied. One experienced radiologist measured CT parameters and judged the presence of right ventricular dysfunction. CT parameters were analyzed to determine their ability to predict a major adverse event (MAE). Results: There were 220 patients included and 61 (27.7%) had MAE. Left ventricular and right ventricular maximum minor axis ($36.4{\pm}8.0$ vs. $41.7{\pm}7.4$, p<0.01; $45.7{\pm}9.4$ vs. $41.5{\pm}7.6$, p<0.01), superior vena cava diameter ($19.2{\pm}3.4$ vs. $18.0{\pm}3.4$, p=0.02), azygos vein diameter ($10.0{\pm}2.2$ vs. $9.2{\pm}2.3$, p=0.02), septal displacement (19 vs. 18, p<0.01) were significantly higher in MAE group than in no MAE group. Patients with MAE had high right ventricular/left ventricular dimension ratio (RV/LV ratio) compared to patients without MAE ($1.34{\pm}0.48$ vs. $1.03{\pm}0.28$, p<0.01). The most useful cut-off value of RV/LV ratio for MAE was 1.3 and the area under the curve was 0.71 (0.62~0.79). Conclusion: RV/LV ratio on chest CT was a significant predictor of submassive PE related shock, intubation, in-hospital mortality, thrombolysis, thrombectomy within 30 days.

• 한국동물위생학회지
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• 제40권1호
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• pp.61-66
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• 2017

Calf diarrhea is a disease experienced by almost all of calves after birth and is one of the representative causes of damage to farmers due to mass mortality and of economic losses to them by inhibiting normal growth. In this study, we conducted quick detection of etiologic agents of diarrhea by using a rapid diagnostic kit to multiply diagnose antigens of five etiologic agents of calf diarrhea (rotavirus, coronavirus, Escherichia coli, Cryptosporidium, Giardia) in Hanwoo (Korean native cattle) calves. When the positive antigen proportion of the calf diarrheal feces for each farm was analyzed, rotavirus, coronavirus, Escherichia coli, Cryptosporidium, and Giardia showed antigen positive rates of 0~67%, 0~20%, 0~60%, 0~20%, and 0~67%, respectively. With regard to the antigen positive rate by age in days after birth, 1-week-old calves showed the antigen positive rate of 20% in rotavirus and 20% in Giardia, and 2-week-old calves showed that of 50% in rotavirus. In addition, 4-week-old calves showed the antigen positive rate of 10% in rotavirus, 10% in coronavirus, 10% in Escherichia coli, and 30% in Giardia, and 8-week-old calves showed the antigen positive rate of 17% in coronavirus, 50% in Escherichia coli, 17% in Cryptosporidium, and 33% in Giardia. Based on the results of this study, the etiologic agents of diarrhea in Hanwoo calves for each farm are widely distributed. Although younger than 2-week-old calves were strongly positive for rotavirus, older than 4-week-old calves were highly positive for Giardia and Escherichia coli. In conclusion, we considered that a rapid diagnostic kit is an effective method for quick detection of etiologic agents and would be helpful for cattle farmers and veterinarians to select appropriate therapeutic method.

• 대한한방내과학회지
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• 제33권2호
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• pp.145-159
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• 2012

Objectives : The object of this study was to obtain acute toxicity information (single oral dose toxicity) of Armeniacae Semen (AS), a medicinal herb used for treating constipation and various respiratory diseases, in rats. Methods : In order to observe the $LD_{50}$ (50% lethal dose), approximate lethal dosage (ALD) and target organs, AS aqueous extracts were orally administered once to female and male Sprague Dawley rats at dose levels of 2,000, 1,000, 500 and 0 (control) mg/kg (body weight). The mortality, changes in the body weight, clinical signs and gross observation were monitored for 14 days after single oral treatment of AS extracts, and the organ weights and histopathological findings of principle organs were observed after sacrifice. Results : After single oral treatment of AS 2,000 and 1,000 mg/kg, all (5/5; 100%) female and male rats died within 30 minutes after treatment, while no mortalities were observed in the female and male rats treated with 500 mg/kg of AS extract. Therefore, $LD_{50}$ in female and male rats was calculated as 741.95 mg/kg. Seizure, loss of locomotion, salivation, increases of respiration and heart-beat were observed after AS extract treatment, which were observed in all rats including the lowest dosage group, 500 mg/kg in the present study. In addition, lung congestion was visible in all mortal rats with AS 2,000 and 1,000 mg/kg, respectively. Conclusions : The results obtained in this study suggest that AS extract ranges in Class III, because the $LD_{50}$ and ALD in both female and male rats were calculated as 741.95 mg/kg and 500~1,000 mg/kg, respectively. However, AS extract should be carefully treated at clinical applications, because salivation, increase of respiration and heart-beat were also observed in the lowest dosage group, 500 mg/kg in the present study.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7069-7077
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• 2014

Background: This retrospective study aimed to validate the safety and effectiveness of hepatectomy for huge hepatocellular carcinoma (HCC). Materials and Methods: Data of patients who underwent hepatectomy for HCC between January 2006 and December 2012 were reviewed. The patients were divided into three groups: huge HCC(${\geq}10cm$ in diameter), large HCC(${\geq}5$ but<10 cm in diameter) and small HCC(<5cm in diameter). Results: Characteristics of pre-operative patients in all three groups were homogeneously distributed except for alpha fetal protein (AFP)(p<0.001).The 30, 60, 90-day post-operative mortality rates were not different among the three groups (p=0.785, p=0.560, and p=0.549). Laboratory data at 1, 3, and 7 days after surgery also did not vary. The 5-year overall survival (OS) and 5-year disease-free survival (DFS) rates in the huge and large HCC groups were lower than that of the small HCC group (OS: 32.5% vs 36.3% vs 71.2%, p=0.000; DFS: 20.0% vs 24.8% vs 40.7%, p=0.039), but there was no difference between the huge and large HCC groups (OS: 32.5% vs 36.3%, p=0.667; DFS: 20.0% vs 24.8%, p=0.540). In multivariate analysis, five independent poor prognostic factors that affected OS were significantly associated with worse survival (p<0.05), namely, AFP level, macrovascular invasion, Edmondsone Steiner grade, surgical margin and Ishak score. AFP level, macrovascular invasion, microvascular invasion, and surgical margin influenced disease-free survival independently (p<0.05). Conclusions: The safety of hepatectomy for huge HCC is similar to that for large and small HCC; and this approach for huge HCC may achieve similar long-term survival and disease-free survival as for large HCC.

• Asian-Australasian Journal of Animal Sciences
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• 제16권8호
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• pp.1108-1117
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• 2003

In Guadeloupe small ruminants (SR) are reared for meat production under pasture conditions. Intensive rotational grazing systems (irrigated, fertilised and high stocked) allow reasonable levels of production but generate high post-grazing residues. Experiments were designed to control them. A system in which residuals were mown (RM) was tested in comparison to the control system (Residuals Remained, RR). The same design was carried out for two years with Creole goat (G) and Martinik sheep (S). An accelerated reproductive rate (3 parturitions over 2 years) was carried out. Systems were compared at three parturition seasons per year(dry, intermediate and rainy seasons). Each group was composed of 20 goats ($36.0{\pm}2.5kg$) or 20 ewes ($46.8{\pm}2.4kg$). The female body traits did not vary according to pasture management and seasons. The stocking rate averaged 1,400 kg LW/ha. The mean fertility rate for does varied significantly (p<0.05) within the kidding season, from $80.4{\pm}0.5%$ to $93.7{\pm}2.9%$ while the mean litter size was $2.30{\pm}0.07$ total kids born. No effect of pasture system was observed. Corresponding values for ewes were $83.2{\pm}12.8%$ vs. $75.6{\pm}12.5%$ (p<0.05) and $2.43{\pm}0.24$ vs. $2.03{\pm}0.29$ (p<0.01) total lambs born for SRM and SRR ewes, respectively. A seasonal effect was observed upon ewe performances. The preweaning mortality of kids and lambs averaged 16.3% and 14.4%, respectively. It was 7 and 9 percentage points more (p<0.01) for RR than for RM kids and lambs, respectively. For both species, weaning took place at an average age of $81.4{\pm}3.6days$. In Creole kids, live weight at birth and at weaning were $1.9{\pm}0.2kg$ and $8.9{\pm}0.8kg$, respectively. In the Martinik sheep, the traits averaged $2.9{\pm}0.2kg$ and $18.9{\pm}0.9kg$. For both traits in both species, significant (p<0.05) group${\times}$season interactions were recorded. The consequences of elimination of post-grazing residues varied according to the SR species, the environmental conditions and the animal physiological status. The forage characteristics were not limiting factors since forage availability in the RM systems (2,300 and 2,600 kg DM/ha, respectively) and chemical composition were at satisfactory levels (CP content averaged 12 and 10%). It is recommended to develop new grazing system which would allow the use of post-grazing residues instead of mowing the refusals.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5141-5144
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• 2013

Background: This study aimed to determine clinical outcomes of local excision for early rectal cancer from a University Hospital in Thailand. Materials and Methods: We performed a retrospective review of 22 consecutive patients undergoing local excision for early rectal cancer (clinical and radiological T1/T2) from 2005-2010 at the Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok. Data were collected from patients' medical records, including demographic and clinical characteristics, pathological report and surgical outcomes. Results: This study included 10 males and 12 females, with average age of 68 years. Nineteen patients (86%) underwent transanal excision and the others had trans-sacral excision. Median operative time was 45 minutes. Postoperative complications occurred in 2 patients (9%); 1 fecal fistula and 1 wound infection following trans-sacral excision. There was no 30-day postoperative mortality. Median hospital stay was 5 days. Pathological reports revealed T1 lesion in 12 cases (55%), T2 lesion in 8 cases (36%) and T3 lesion in 2 cases (9%). Eight patients received additional treatment; one re-do transanal excision, two proctectomies, and five adjuvant chemoradiation. During the median follow-up period of 25 months, local recurrence was detected in 4 patients (18%); two cases of T2 lesions with close or positive margins, and two cases of T3 lesions. Three patients with local recurrence underwent salvage abdominoperineal resection. No local recurrence was found in T1/T2 lesions with free surgical margins. Conclusions: Local excision is a feasible and acceptable alternative to radical resection only in early rectal cancer with free resection margins and favorable histopathology.

• 한국의료질향상학회지
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• 제10권1호
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• pp.28-41
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• 2003

Background : Because unplanned readmissions to intensive care unit(ICU)might be related with undesirable patient outcomes, we investigated the pattern of and reason for unplanned ICU readmission to provide baseline data for reducing unplanned returns to ICU. Methods : The subjects included all patients who readmitted to ICU during the same hospitalization at a tertiary referral hospital between January 1st and June 30th 2002. Quality improvement(QI) nurse collected the data through medical records and a medical director reviewed the data collected. Results : 1) The average unplanned ICU readmission rate was 5.6%(gastroenterology 14.6%, pediatrics 12.7%, pulmonology 11.9%, neurosurgery 6.3%, general surgery 5.3%, chest surgery 3.9%, and cardiology 3.3%). 2) Among the unplanned readmissions, more than 50% of cases were from patients older than 60 years, and the main categories of diagnose at hospital admission were neurologic disease(29.9%) and cardiovascular disease(27.6%). 3) Of unplanned ICU readmissions, 41.8% had recurrence of the initial problems, 44.8% had occurrence of new problems. And 9.7% required post-operative care after unplanned operations. 4) The most common cause responsible for unplanned ICU readmission were respiratory problem(38.3%) and cardiovascular problem(14.3%). 5) About 40% of unplanned ICU readmission occurred within 3 days after ICU discharge. 6) Average length of stay of the readmitted patients to ICUs were much longer than that of non-readmitted patients. 7) Hospital mortality rate was much higher for unplanned ICU readmitted patients(23.6%) than for non-readmitted patients(1.5%) (P<0.001). Conclusions : This study showed that the unplanned ICU readmitted patients had poor outcomes(high morality and increased length of stay). In addition study results suggest that more attention should be paid to patients in ICU with poor respiratory function or elderly patients, and careful clinical decisions are required at discharged from ICU to general ward.

• Tuberculosis and Respiratory Diseases
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• 제72권4호
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• pp.360-366
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• 2012

Background: Carbapenem-resistance is rapidly evolving among the pathogenic microbes in intensive care units (ICUs). This study aimed to determine annual trend of carbapenem-resistance in the ICU for 4 years, since the opening of a university-affiliated hospital in South Korea. Methods: From 2005 to 2008, microbial samples from consecutive 6,772 patients were screened in the ICU. Three hundred and ninety-seven patients (5.9%) and their first isolates of carbapenem-resistant pathogens were analyzed. Results: The percentage of patients infected with carbapenem-resistant organisms increased constantly during the initial three years (2.3% in 2005, 6.2% in 2006, 7.8% in 2007), then it declined to 6.5% in 2008. Acute Physiology and Chronic Health Evaluation (APACHE) III score at admission was $58.0{\pm}23.5$, the median length of the ICU stay was 37 days, and the mortality rate was 37.5%. The sampling sites were endotracheal suction (67%), catheterized urine (17%), wound (6%) and others (10%). Bacteria with carbapenem-resistance were Pseudomonas aeruginosa (247 isolates, 62%), Acinetobacter baumannii (117 isolates, 30%), Enterobacteriaceae (12 isolates, 3%), and others (21, 5%). Of note, peak isolation of carbapenem-resistant microorganisms in medical ICU was followed by the same epidemic at surgical ICU. Conclusion: Taken together, carbapenem-resistant pathogens are of growing concern in the ICU.

• Journal of Korean Medical Science
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• 제33권49호
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• pp.308.1-308.10
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• 2018

Background: The aim of this study was to describe the structure, organization, management, and staffing of pediatric critical care (PCC) in Korea. Methods: We directed a questionnaire survey for all Upper Grade General Hospitals (n = 43) in Korea in 2015. The first questionnaire was mainly about structure, organization, and staffing and responses were obtained from 32 hospitals. The second questionnaire was mainly about patients and management. Responses to second questionnaire were obtained from 18 hospitals. Results: Twelve from 32 Upper Grade General Hospitals had pediatric intensive care units (PICUs) and 11 of them had the PICU which was exclusive for children. Total number of PICU beds in Korea was 113. The ratio of the number of PICU beds to the number of children was 1:77,460 in Korea and this ratio is lower than that of other developed countries. The mean number of beds in the PICUs was $9.4{\pm}9.3$ (range, 2-30). There were 16 medical doctors who were assigned for PCC and only 5 of them were full time pediatric intensivists. In the 18 Upper Grade General Hospitals that responded to the second questionnaire survey, there were 97 patients in the PICUs with an average number of $5.7{\pm}7.2$ (range, 0-22) on the survey day. The mean age of the patients was $3.4{\pm}5.6$ years. The mean length of hospital stay was $82{\pm}271days$. The mean Pediatric Risk of Mortality score III was $9.4{\pm}7.8$ at the time of admission to the PICUs. Conclusion: There is a considerable shortage of PICU beds compared to those in developed countries. In addition, the proportion of PICUs with PCC specialists is much lower than those in the US and European countries.

• 한국어병학회지
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• 제35권2호
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• pp.167-176
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• 2022

We injected infectious myonecrosis virus (IMNV) to pacific whiteleg shrimp, Litopenaeus vannamei, and observed closely with using light microscope and transmission electron microscope (TEM) for 4-8 days post infection (dpi). As clinical signs, abdominal bodies had mild opaque muscles at 5 dpi. And the mortality was shown at 6 dpi. At 8 dpi, most injected shrimps had severe opaque muscles and humped back that cause of movement disorder. As results of histopathological examinations, local parts of abdominal body muscle had muscle fiber hyalinization, muscle fiber atrophy, rounded muscle fibers, myofibrillar hypertrophy in size, a decrease in number of myofibrils and phagocytosis from the sarcolemmas by multiple hemocytes at 4 dpi. Especially, myofibrillar hypertrophy appeared at the whole or random part of single muscle fiber not in specific locations like the center or edge of muscle fiber. At 6-7 dpi, multiple muscle necrosis, muscle fiber segmentation, myofibril lysis ap- peared and a few hemocytes were infiltrated at lesions. At 8 dpi, extensive muscle necrosis, multiple myofibril lysis and muscle fiber atrophy were shown, and very few hemocytes were infiltrated. In early stage of infection, local viral myositis with zenker's degeneration were shown. These lesions appeared multiply after the early stage. In late stage of infection, extensive coagulative muscle necrosis appeared with few of inflammatory response such as hemocytes infiltration. The lack of hemocytes infiltration response at the late stage might be disadvantage for Litopenaeus vannamei to defense against IMNV and to recover, because hematocytes (granulocyte, semi-granulocyte) eliminate pathogen and damaged tissues from infection sites and help recover. As results of the TEM observation, IMNVs that had nonenveloped icosahedral capsid which was 30-40 nm diameter were in myofibril and beside tubules of sarcoplasmic reticulum and moved to the certain direction. The micro-tears and micro-trau- mas in myofibrils caused muscle fiber necrosis. And semi-granulocytes engulfed IMNVs to eliminate virus.