• Title/Summary/Keyword: Aggravation factors

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Clinicopathological Characteristics and Prognosis of Remnant Gastric Cancer

  • Lee, Sang-Bong;Kim, Jae-Hun;Kim, Dae-wan;Jeon, Tae-Yong;Kim, Dong-Heon;Kim, Gwang-Ha;Park, Do-Youn
    • Journal of Gastric Cancer
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    • v.10 no.4
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    • pp.219-225
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    • 2010
  • Purpose: The long-term survival rate of gastric cancer patients after surgery has recently increased as a result of making an early diagnosis of gastric cancer. Therefore, the incidence of remnant gastric cancer is increasing. This study was performed to evaluate the clinicopathological characteristics and prognosis of patients with remnant gastric cancer. Materials and Methods: From January 2005 to December 2009, twenty-nine patients with remnant gastric cancer and who underwent surgery at Pusan National University Hospital were enrolled in this study. We retrospectively reviewed and analyzed their medical records. We also divided them into two groups: the remnant gastric cancer (RGC)-B group (first operation for benign disease) and the RGC-M group (first operation for malignant disease). Results: The RGC-B group included ten patients and the RGC-M group included nineteen patients. The mean interval between the first and second operations was 17 years. The curative resection rate was 93.1% (27/29). The postoperative complication rate was 20.7% (6/29) and there was no perioperative mortality. Ten (37%) of twenty-seven patients experienced recurrence after curative resection and eight patients (27.6%) expired due to aggravation of remnant stomach cancer. An advanced TNM stage and non-curative resection were the negative prognostic factors for survival for patients with remnant stomach cancer (P=0.0453 and P<0.001). The RGC-M group showed a shorter interval (P<0.001) and the RGC-B group had more advanced TNM stage (P=0.003). Conclusions: Long-term follow-up should be considered not only for patients who undergo an operation for malignant disease, but also for the patients who underwent an operation for benign disease. When remnant gastric cancer is diagnosed, curative resection is essential to improve the survival.

Balloon-Occluded Retrograde Transvenous Obliteration versus Transjugular Intrahepatic Portosystemic Shunt for the Management of Gastric Variceal Bleeding

  • Gimm, Geunwu;Chang, Young;Kim, Hyo-Cheol;Shin, Aesun;Cho, Eun Ju;Lee, Jeong-Hoon;Yu, Su Jong;Yoon, Jung-Hwan;Kim, Yoon Jun
    • Gut and Liver
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    • v.12 no.6
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    • pp.704-713
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    • 2018
  • Background/Aims: Gastric varices (GVs) are a major cause of upper gastrointestinal bleeding in patients with liver cirrhosis. The current treatments of choice are balloon-occluded retrograde transvenous obliteration (BRTO) and the placement of a transjugular intrahepatic portosystemic shunt (TIPS). We aimed to compare the efficacy and outcomes of these two methods for the management of GV bleeding. Methods: This retrospective study included consecutive patients who received BRTO (n=157) or TIPS (n=19) to control GV bleeding from January 2005 to December 2014 at a single tertiary hospital in Korea. The overall survival (OS), immediate bleeding control rate, rebleeding rate and complication rate were compared between patients in the BRTO and TIPS groups. Results: Patients in the BRTO group showed higher immediate bleeding control rates (p=0.059, odds ratio [OR]=4.72) and lower cumulative rebleeding rates (logrank p=0.060) than those in the TIPS group, although the difference failed to reach statistical significance. There were no significant differences in the rates of complications, including pleural effusion, aggravation of esophageal varices, portal hypertensive gastropathy, and portosystemic encephalopathy, although the rate of the progression of ascites was significantly higher in the BRTO group (p=0.02, OR=7.93). After adjusting for several confounding factors using a multivariate Cox analysis, the BRTO group had a significantly longer OS (adjusted hazard ratio [aHR]=0.44, p=0.01) and a longer rebleeding-free survival (aHR=0.34, p=0.001) than the TIPS group. Conclusions: BRTO provides better bleeding control, rebleeding-free survival, and OS than TIPS for patients with GV bleeding.

Digital Marketing in the Condition of Wartime Posture in Ukraine

  • Dubovyk, Tetiana;Buchatska, Iryna;Diachuk, Iryna;Zerkal, Anastasiia
    • International Journal of Computer Science & Network Security
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    • v.22 no.7
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    • pp.206-212
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    • 2022
  • Strengthening global geopolitical instability in the world leads to an aggravation of international conflicts; it destabilizes the domestic political situation in countries, violates the rights and freedoms of man and citizen, and also activates economic crime. The full-scale invasion of the Russian Federation on the territory of Ukraine and the deployment of military operations in a large territory of a sovereign country have created a number of destabilizing factors in the development of digital technologies and negatively affect the state and trends of digital marketing, which allows establishing interaction with a wide audience and facilitating the search for new customers in various places. The purpose of the research lies in substantiating the theoretical and applied principles for studying the features of digital marketing in the conditions of wartime posture in Ukraine. In the course of the research, general and special methods of economic analysis have been used and applied, namely: analysis and synthesis; analogies and comparisons; generalization and systematization; graphic and tabular methods. Regarding the results of the research of digital marketing in the conditions of wartime posture in Ukraine, it has been established that the intensification of the development of digital marketing is caused by the crisis phenomena of social-economic, social-political and military nature, as well as exacerbated by the challenges of the COVID-19 pandemic. It has been proven that highly developed countries use innovative digital technologies more effectively in the field of marketing, which indicates the importance of the Multidimensional Index of Digitization (the USA - MID: 0,92-0,92; the UK - MID: 0,80-0,97; Japan - MID: 0,80-0,88; Canada - MID: 0,78-0,81; Germany - MID: 0,78-0,88; France - MID: 0,72-0,76), however, the developing countries record much lower values (Ukraine - MID: 0,22-0,48). Accordingly, the level of cybersecurity in highly developed countries is also significantly higher than in transitive countries, in particular, in the United States (GCI: 0,919-0,999); Great Britain (GCI: 0,783-0,995); Canada (GCI: 0,818-0,978) and in Ukraine (GCI: 0,501-0,661).

A Study on the Visualization of Geospatial Big Data using Sentiment Analysis of Collective Civil Complaints (집단민원의 감성분석을 이용한 공간빅데이터 시각화 방안)

  • Yong-Jin JOO
    • Journal of the Korean Association of Geographic Information Studies
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    • v.26 no.1
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    • pp.11-20
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    • 2023
  • Traditionally, surveys or interview studies have been used to measure satisfaction factors for public services. This method focuses on the simple frequency of civil complaints and does not consider the aggravation of emotions implied in civil complaints. As a result, it is difficult to judge the urgency of civil complaints and the severity of grievances experienced by civil petitioners. This study aims to calculate the negative emotional value of collective complaints by using the happiness score for each word on the Hedonometer. The Anti-Corruption and Civil Rights Commission applied a Hedonometer to the top civil complaint topics and related keyword data by region in 2021 to calculate negative sentiment values by subject of civil complaints, and visualize the distribution by region. Using the negative emotional values derived from the results of this study, the severity of emotions contained in civil complaints can be considered. It is also expected to be helpful in determining the urgency of civil complaints and the severity of grievances experienced by civil petitioners.

Evaluation on Toxicity of Habitual dose of Extract of Rheum Palmatum through Single Blinded Pilot Study (단일맹검시험을 통한 대황(大黃) 상용량(常用量)의 독성작용 평가)

  • Kwon, Hyork;Chi, Gyoo-Yong;Eom, Hyun-Sup
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.3
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    • pp.390-400
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    • 2010
  • This study is aimed to test physiological and hematological actions of Rheum palmatum through clinical pilot study optimized for usual oriental medicine prescription. Thirty-one cases were finally collected and the sample extract 100 $m{\ell}$ of Rheum palmatum (ERP) was administered two times in a day during 3 days and checked with blood CBC test, urinalysis, liver function test, abdominal X-ray as well as general diagnostic process of oriental medicine; pattern identification, assessment of shapes and constitution. The total toxic effective rate of ERP was 9.68% in 3 cases of the whole in case of consistent uneasy state in the subjective symptomatic assessment and aggravation of blood and urine examination. The relevant diagnostic factors were so-eum constitution and essence type subject, carapaces species, lung type in the aspect of Jisan shape theory. On the other hand, the positive effective rate of ERP was 29.03% manifesting improvement of vital signs or present illness and no abnormal changes of blood chemistry and urinalysis and simple abdomen radiology. The relevant diagnostic factors were tae-eum constitution, energy type subject, aves species, heart and liver type in Jisan's shape theory. And the other cases were manifesting no specific change through the administration of ERP. The ratio of the numbers of decrease and increase was 44:5 in the tenderness and hardness of abdominal palpation. But if the pattern identification doesn't comply with the aim of rhubarb application despite of constipation and abdominal pain, the tendeness and biochemical report was shown in abnormal change. The mean number of diarrhea by ERP was $16.77{\pm}6.95$ during 3 days after administration, and the frequent areas of abdominal pain were lower>middle>upper in order, and it meant the target site of ERP too. Besides, the toxic reaction against ERP was expressed highly in case of decrease in blood cell count and hemoglobin, hematocrit having blood deficiency syndrome. Likewise, the toxicity of ERP was influenced by pattern identification manifesting present disease condition and diagnostic factors of four constitutions, Jisan's shape theory collaterally. In conclusion, evaluation of herbal toxicity in order for using as a clinical guideline, various diagnostic pattern information and shape features like the above should be studied together with other pharmacologic toxicology test for the future.

The effect of Combination Therapy of Inhaled Corticosteroids and Long-acting Beta2-agonists on Acute Exacerbation in Moderate to Severe COPD Patients (중등증 이상의 COPD 환자에서 흡입용 스테로이드와 지속성 β2-항진제 복합제제사용시 용량의 차이가 급성악화에 미치는 영향)

  • Jeong, Hye Cheol;Ha, Eun Sil;Jung, Jin Yong;Lee, Kyung Ju;Lee, Seung Hyeun;Kim, Se Joong;Lee, Eun Joo;Hur, Gyu Young;Lee, Sung Yong;Kim, Je Hyeong;Lee, Sang Yeub;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.2
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    • pp.164-169
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    • 2005
  • Background : The role of combination therapy of inhaled corticosteroid (ICS) plus long-acting ${\beta}_2-agonist$ (LABA) in asthma is well established, but nor much is known about this treatment in COPD. Recent studies have revealed that combining therapy is associated with fewer acute exacerbations in COPD, but in most of the studies, high-dose combination therapies have been employed. The current study assessed the effect of moderate or high-dose combination therapy of ICS plus LABA on the frequency of acute exacerbations in COPD. Methods : Between January 1, 2001 and August 31, 2004, 46 patients with COPD (moderate, severe, very severe) were enrolled who received either fluticasone/salmeterol (flu/sal) $250{\mu}g/50{\mu}g$ twice a day (group A) or flu/sal $500{\mu}g/50{\mu}g$ twice a day (group B) for more than a year. We divided them into two groups depending on the dosage of ICS plus LABA. Effect of drugs was compared based on the factors such as symptom aggravation, number of admission, and time to first exacerbation during a year after use. Results : Eleven of twenty-six patients in group A (42.3%) experienced acute exacerbation and eleven of twenty patients in group B (55%) experienced acute exacerbation during 1 year. Mean exacerbation rate of Group A was 0.96 and Group B was 1.05. Mean admission rate was 0.15 and 0.30, respectively. There was no statistically significant difference of aggravation rate, number of administration and time to first exacerbation between the two treatment groups. Conclusion : There was no significant difference between moderate and high dose combined inhaler therapy to reduce acute exacerbation in COPD patients (moderate, severe, very severe). Hence, the effective dose of combination therapy needs further study in patients with COPD.

MRI Follow-up Study After Arthroscopic Repair of Multiple Rotator Cuff Tendons (다발성 회전근 개 파열에서 시행한 관절경적 회전근 개 복원술 후 MRI 추적 검사)

  • Tae, Suk-Kee;Kim, Jin-Young;Park, Jae-Sik
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.96-103
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    • 2008
  • Purpose: This study investigated the rate of retear and related factors after arthroscopic repair of rotator cuff tears involving more than one tendon. Materials & Methods: Arthroscopic repair of 22 rotator cuff tears (average size 3.2cm: average age 58 years old) involving the supraspinatus and part or all of the infraspinatus were investigated using MRI on average 10 months after repair. The status of the repaired cuff was investigated using Sugaya's classification, and the change in muscle was evaluated with Goutallier's classification. Results: Retear (Sugaya grade IV, V) was found in 7cases(32%). Tears larger than 3cm had a higher retear rate(67%) than smaller tears(8%). Retear cases had Goutallier grade II or higher muscle changes preoperatively and showed aggravation of muscle atrophy postoperatively. Even without retear, reversal of muscle change was not seen Conclusion: Rotator cuff tears not confined to the supraspinatus had a 32% retear rate after arthroscopic repair. The size of the tear was the most crucial factor influencing retear. Retear was frequent in tear over 3cm. Atrophy of the cuff muscle worsened when the repair failed but did not improve even without retear.

Restoration planning of the Seoul Metropolitan area, Korea toward eco-city

  • Lee, Chang Seok
    • Proceedings of the Korea Society of Environmental Biology Conference
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    • 2003.06a
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    • pp.1-5
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    • 2003
  • In order to prepare a basis for ecological restoration of the Seoul Metropolitan area, ecological diagnoses on soil physico-chemical properties and vegetation structure were carried out. Land use patterns, actual vegetation, and biotope patterns were also investigated based on aerial photograph interpretation and field checks. I formulated landscape elements overlaying those data and evaluated the ecological value of each element. Soil pollution was evaluated by analyzing soil samples collected in each grid on the mesh map, divided by 2km $\times$ 2km intervals. Soil samples were collected in forests or grasslands escaped from direct human interference. Soil pollution evaluated from pH, and SO$_4$, Ca, Mg, and Al contents of soil was more severe in the urban outskirts than in the urban center. Those soil environmental factors showed significant correlation with each other. Vegetation in the urban area was different in species composition from that in suburban areas and showed lower diversity compared with that in the suburban areas. Successional process investigated by population structure of major species also showed a difference. That is, successional trend was normal in suburban areas, but that in urban areas showed a retrogressive pattern. The landscape ecological map of Seoul indicates that the urban center lacks vegetation and greenery space is restricted in urban outskirts. Such an uneven distribution of vegetation has caused a specific urban climate and thereby contributed to aggravation of air and soil pollution, furthermore causing vegetation decline. From this result, it was estimated that such uneven distribution of vegetation functioned as a trigger factor to deteriorate the urban environment. I suggested, therefore, a restoration plan based on landscape ecological principles, which emphasizes connectivity and even distribution of green areas throughout the whole area of the Seoul to solve this complex environmental problem. In this restoration plan, first of all, I decided the priority order for connection of the fragmented greenery spaces based on the distances from the core reserves comprised of green belt and rivers, which play roles as habitats of wildlife as well as for improvement of urban environment. Next, I prepared methods to restore each landscape element included in the paths of green network to be constructed in the future on the bases of such preferential order. Rivers and roads, which hold good connectivity, were chosen as elements to play important roles in constructing green network by linking the fragmented greenery spaces.

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Cavernous Angioma : Natural History and Management Strategies (해면상 혈관종의 자연 경과와 치료 전략)

  • Lim, Hyo Joo;Kwon, Yang;Ahn, Jae Sung;Kim, Jeong Hoon;Kim, Chang Jin;Lee, Jung Kyo;Kwun, Byung Duk
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1001-1007
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    • 2000
  • Objective : We analysed diverse clinical features of the cavernous angioma. Also, we report the experience in differ-ent methods of the management and their results. Method : Data from 80 patients who were confirmed pathologically or diagnosed radiologically between Jan. 1990 and Sept. 1998 at our hospital were analysed. Variable factors that were examined were : clinical features, effects of treatment, and complications. Results : There were 47 male and 33 female patients. The age at the first presentation was from 3 to 57(mean 34.1) years old. Clinical features were seizure in 28 cases(38%), bleeding in 24 cases(32%), neurologic deficits in 12 cases(16%), headache in 10 cases(14%), and six incidental cases. The locations of lesion were cerebral and cerebellar hemisphere in 45 cases(56.2%), brainstem, basal ganglia, and thalamus in 32 cases(40%), multiple in 3 cases (3.8%). Seizure was common at the third decade and occurred frequently with the cavernous angioma in temporal (43%) or frontal lobe(39%). Bleeding was frequent after the third decade with peak at the fourth decade and had high incidence in brainstem or thalamus. The gamma-knife radiosurgery was done in 47 cases. Rebleeding occurred in 3 cases, but it was within postradiosurgery 1 year. Symptomatic radiation change occurred in 2 cases of 8 radiation change on MRI. On follow-up MRI, no evidence of rebleeding was found in 30 cases. Also, The lesion size was decreased in 3 cases. Resection was performed in 23 cases ; total 20, subtotal 2, partial 1. Postoperative complication occurred in 6 cases(26.1%). After surgery, 7(63.6%) of 11 seizure patients had outcome of seizure-free. Subclinical rebleeding occurred in one of two subtotal resected cases. In 11 patients, conservative management was done. There was neither rebleeding nor symptom aggravation during follow-up period of mean 17.2 months. Conclusion : The solution for prevention of rebleeding is complete removal of the lesion located at noneloquent area or accessible region, especially for the patients who presented symptoms or intractable seizure. However, the Gamma knife radiosurgery is considered when the lesions are located at eloquent area or when severe postoperative morbidity is expected.

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Clinical Analysis of 89 Patients with Severe Acute Ischemic Stroke from 3rd Intensive Care Unit(East-West Integrated Intensive Care Uint) of Kyung Hee Medical Center (경희의료원 제3 중환자실(동서협진중환자실)에 입원한 89명의 중증 급성기 뇌경색 환자에 대한 임상적 고찰)

  • Heo, Hong;So, Hyung-Jin;Im, Ju-Hyuk;Cho, In-Young;Lee, Hae-Yong;Min, Kyoung-Yoon;Ryu, Jae-Hwan;Lee, Beom-Jun
    • The Journal of Internal Korean Medicine
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    • v.28 no.4
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    • pp.863-871
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    • 2007
  • Objects : To gain better insights of East-west integrated treatment of ischemic stroke. We analyzed 89 patients with severe acute ischemic stroke who were admitted to the East-west integrated intensive care unit. Methods : Subjects enrollment was from the East-west integrated intensive care unit of Kyung Hee Medical Center from March 2006 to February 2007. Patients were admitted within 14 days after the onset of ischemic stroke. We assessed the subjects' general characteristics, risk factors, admitting routes and periods, diagnostic imaging, process of western treatment and Korean traditional treatment, complication and consequence. Results : The proportion of males was 50.6%, of females 49.4%, average age was male 66.0$\pm$10.3 and female 71.1$\pm$10.5. Average length of hospital stays was 19.5 days. Monthly admissions were highest in November and December. The admission route was through emergency room (61.8%) or ward (34.8%). Mean Glasgow coma scale score was 10.0$\pm$2.5, average time from symptom of onset to hospital admission was 2.3$\pm$2.2 days. Dominant ischemic vascular territory was middle cerebral artery (66.3%). Initial western treatment was argatroban (22.5%), urokinase (28.1%), and heparinization (38.2%). Distribution of Sasang constitution of So-yang to Tae-eum to So-eum was equal to 5.4 to 2.9 to 1.5. Major complications were observed in 40 (42.7%) patients. In hospital mortality was 12.4% (11 deaths), all of them caused by aggravation of neurological deficit and only 3 of them with major complications. There appears to be a significant positive relationship between length of hospital stay and occurrence of complications (P<0.05). After discharge from the ICU, 64 (71.9%) patients were improved, 11 (12.4%) patients had expired, and 14 (15.8%) patients were transferred. Conclusions : From this study, we suggest that patients with severe acute ischemic stroke should be treated with East-west integrated therapy for more favorable consequences and decreased mortality.

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