• Title/Summary/Keyword: Care efficacy

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Clinical application of a new hemostatic material using mussel-inspired catecholamine hemostat: A pilot study

  • Young-Mok Park;Hyung-Il Seo;Jae-Hoon Kim;Sung Pil Yoon;Haeshin Lee;Moon Sue Lee
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.1
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    • pp.98-103
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    • 2022
  • Backgrounds/Aims: This study aimed to evaluate clinical application of InnoSEAL Plus (a mussel-inspired catecholamine hemostat) as a new hemostatic material for humans. Methods: Patients treated with topical hemostatic patches after liver resection were enrolled. They were divided into an experimental group (InnoSEAL Plus group) and two control groups (TachoSil® group and Surgicel Fibrillar® group) for efficacy evaluation. Results: A total of 15 patients were enrolled. Each group had five patients. The 3-minute hemostasis success rate was 80.0% (4/5 patients) in the InnoSEAL Plus group, 80.0% (4/5 patients) in the TachoSil® group, and 40.0% (2/5 patients) in the Surgicel Fibrillar® group, showing no significant difference in the success rate among these groups (p > 0.05). All three groups exhibited 100% success rate for 10-minute hemostasis. Both InnoSEAL Plus and TachoSil® groups had one patient developing adverse events, which were treated easily with drug administrations. Conclusions: InnoSEAL Plus is expected to be functionally not inferior to other conventional hemostatic agents. However, it is necessary to confirm this through multicenter prospective studies in the future.

Initial United Kingdom experience of endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography

  • Puneet Chhabra;Wei On;Bharat Paranandi;Matthew T. Huggett;Naomi Robson;Mark Wright;Ben Maher;Nadeem Tehami
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.4
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    • pp.318-324
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    • 2022
  • Backgrounds/Aims: Gallstone disease is a recognized complication of bariatric surgery. Subsequent management of choledocholithiasis may be challenging due to altered anatomy which may include Roux-en-Y gastric bypass (RYGB). We conducted a retrospective service evaluation study to assess the safety and efficacy of endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography (EDGE) in patients with RYGB anatomy. Methods: All the patients who underwent EDGE for endoscopic retrograde cholangiopancreatography after RYGB at two tertiary care centers in the United Kingdom between January 2020 and October 2021 were included in the study. Clinical and demographic details were recorded for all patients. The primary outcome measures were technical and clinical success. Adverse events were recorded. Hot Axios lumen apposing metal stents measuring 20 mm in diameter and 10 mm in length were used in all the patients for creation of a gastro-gastric or gastro-jejunal fistula. Results: A total of 14 patients underwent EDGE during the study period. The majority of the patients were female (85.7%) and the mean age of patients was 65.8 ± 9.8 years. Technical success was achieved in all but one patient at the first attempt (92.8%) and clinical success was achieved in 100% of the patients. Complications arose in 3 patients with 1 patient experiencing persistent fistula and weight gain. Conclusions: In patients with RYGB anatomy, EDGE facilitated biliary access has a high rate of clinical success with an acceptable safety profile. Adverse events are uncommon and can be managed endoscopically.

Immune Checkpoint Inhibitor Score Predicts Survival Benefit of Immunotherapy in Patients with Non-small Cell Lung Cancer

  • Da Hyun Kang;Chang-Min Choi;Cheol-Kyu Park;In-Jae Oh;Young-Chul Kim;Seong Hoon Yoon;Yoonjoo Kim;Jeong Eun Lee
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.4
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    • pp.483-493
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    • 2024
  • Background: The use of immune checkpoint inhibitors (ICIs) in patients with advanced lung cancer is increasing. Despite ongoing studies to predict the efficacy of ICIs, its use in clinical practice remains difficult. Thus, we aimed to discover a predictive marker by analyzing blood cell characteristics and developing a scoring system for patients treated with ICIs. Methods: This was a prospective multicenter study in patients with advanced non-small cell lung cancer (NSCLC) who received ICIs as second-line treatment from June 2021 to November 2022. Blood cell parameters in routine blood samples were evaluated using an automated hematology analyzer. Immune checkpoint inhibitor score (IChIS) was calculated as the sum of neutrophil count score and immature granulocyte score. Results: A total of 143 patients from four institutions were included. The treatment response was as follows: partial response, 8.4%; stable disease, 37.1%; and progressive disease, 44.8%. Median progression-free survival and overall survival after ICI treatment was 3.0 and 8.3 months, respectively. Median progression-free survival in patients with an IChIS of 0 was 4.0 months, which was significantly longer than 1.9 months in patients with an IChIS of 1 and 1.0 month in those with an IChIS of 2 (p=0.001). The median overall survival in patients with an IChIS of 0 was 10.2 months, which was significantly longer than 6.8 and 1.8 months in patients with an IChIS of 1 and 2, respectively (p<0.001). Conclusion: Baseline IChIS could be a potential biomarker for predicting survival benefit of immunotherapy in NSCLC.

The efficacy and efficiency of percutaneous lidocaine injection for minimizing the carotid reflex in carotid artery stenting: A single-center retrospective study

  • Hyung Kyu Lee;Tae Joon Park;Sang Pyung Lee;Jin Wook Baek;Seong Hwan Kim;Aiden Ryou
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.26 no.2
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    • pp.130-140
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    • 2024
  • Objective: To assess whether local anesthetic infiltration could minimize the carotid baroreceptor reflex (CBR) which has an incidence after carotid artery stenting (CAS) that varies from 29% to 51%. Methods: This retrospective single-center study included 51 patients (mean age, 70.47 years) who underwent CAS for carotid stenosis. The groups included patients who underwent CAS for asymptomatic ischemic stroke (n=41) or symptomatic disease (n=10). Preprocedural percutaneous lidocaine injections (PPLIs) were administered to 70.6% and 5.9% of patients who underwent elective CAS and emergency CAS, respectively. Results: Among patients who received PPLIs, the mean degree of stenosis was 80.5% (95% confidence interval [CI]: ±10.74, 51-98%). The mean distance from the common carotid artery bifurcation to the most stenotic lesion (CSD) was 8.3 mm (95% CI: ±0.97, 6.3-10.2 mm); the mean angle between the internal carotid artery and common carotid artery (CCA) trunk (IAG) was 65.6° (95% CI: ±2.39, 61-70°). Among patients who did not receive PPLIs, the mean degree of stenosis was 84.0% (95% CI: ±8.96, 70-99%). The mean CSD was 5.9 mm (95% CI: ±1.83, 1.9-9.9 mm); the mean IAG was 60.4° (95% CI: ±4.41, 51-70°). The procedure time was longer in the PPLI group than in the no PPLI group (28.19 [n=39] vs. 18.88 [n=12] days) (P=0.057); the length of intensive care unit stay was shorter in the PPLI group (20.01 [n=36] vs. 28.10 [n=5] days) (P=0.132). Conclusions: Targeted PPLI administration to the carotid bulb decreased aberrant heart rates and blood pressure changes induced by carotid stent deployment and balloon inflation. As CBR sensitivity increases with decreasing distance to the stenotic lesion from the CCA bifurcation, PPLIs may help stabilize patients during procedures for stenotic lesions closer to the CCA.

Comparative study of ambulatory versus inpatient laparoscopic cholecystectomy in Thailand: Assessing effectiveness and safety with a propensity score matched analysis

  • Nattawut Keeratibharat;Sirada Patcharanarumol;Sarinya Puranapanya;Supat Phupaibul;Nattaporn Khomweerawong;Jirapa Chansangrat
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.3
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    • pp.381-387
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    • 2024
  • Backgrounds/Aims: Ambulatory laparoscopic cholecystectomy (LC) is increasingly recognized for its advantages over the inpatient approach, which advantages include cost-effectiveness and faster recovery. However, its acceptance is limited by patient concerns regarding safety, and the potential for postoperative complications. The study aims to compare the operative and postoperative outcomes of ambulatory LC versus inpatient LC, specifically addressing patient hesitations related to early discharge. Methods: In a retrospective analysis, patients who underwent LC were divided into ambulatory or inpatient groups based on American Society of Anesthesiologists (ASA) classification, age, and the availability of postoperative care. Propensity score matching was utilized to ensure comparability between the groups. Data collection focused on demographic information, perioperative data, and postoperative follow-up results to identify the safety of both approaches. Results: The study included a cohort of 220 patients undergoing LC, of which 48 in each group matched post-propensity score matching. The matched analysis indicated that ambulatory LC patients seem to experience shorter operative times and reduced blood loss, but these differences were not statistically significant (35 minutes vs. 46 minutes, p-value = 0.18; and 8.5 mL vs. 23 mL, p-value = 0.14, respectively). There were no significant differences in complication rates or readmission frequencies, compared to the inpatient cohort. Conclusions: Ambulatory LC does not compromise safety or efficacy, compared to traditional inpatient procedures. The findings suggest that ambulatory LC could be more widely adopted, with appropriate patient education and selection criteria, to alleviate concerns and increase patient acceptance.

A Study on the Job Burnout and Turnover Intention due to Work Overload: Focusing on IT workers (업무과부하에 따른 직무소진 및 이직의도에 관한 연구: IT 종사자들을 중심으로)

  • Jung-Min Lee;Min-Hee Hong
    • Advanced Industrial SCIence
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    • v.3 no.3
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    • pp.20-28
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    • 2024
  • This study aimed to verify the mediating effect of job burnout on the relationship between work overload and turnover intention among IT workers. For this study, a sample of 499 IT workers completed the online questionnaires: job demand scale, job burnout(emotional exhaustion, cynicism, professional efficacy) scale, turnover intention scale. The collected data were statistically analyzed using SPSS 25.0, and the Sobel test was conducted to verify the mediating effect. The results showed that work overload had a significant positive correlation with emotional exhaustion, cynicism, and turnover intention. Work overload had significant positive effects on emotional exhaustion and turnover intention. The full mediating effect of emotional exhaustion on the relationship between work overload and turnover intention was verified. Based on the findings, we discussed the necessity of addressing emotional exhaustion to prevent issues related to work overload and turnover intention among IT workers. Finally, we proposed human resource management strategies to address job burnout in IT workers and suggested directions for future research.

Efficacy of Endotracheal Intubation Using a Modified Laryngoscope Equipped with an Aspirator (흡입기가 장착된 변형 후두경을 이용한 기관내 삽관의 유효성)

  • Jong-Geun Yun
    • Journal of the Health Care and Life Science
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    • v.11 no.2
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    • pp.375-380
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    • 2023
  • This study aims to develop a laryngoscope that can more quickly remove foreign substances in the mouth and perform endotracheal intubation and confirm its usefulness. A laryngoscope suitable for the purpose was manufactured and conducted on 30 fourth-year students at H University. The experimental method was to perform oral suction and endotracheal intubation after inserting a laryngoscope when there was no foreign material, and when there was a foreign material, endotracheal intubation was performed using a laryngoscope with an aspirator attached. When a foreign body was present, suction was performed using the existing method and the developed integrated laryngoscope. The suction time was shorter when the integrated laryngoscope was used than the existing method, and a statistically significant difference was found (p< .000). In the case of the time required for endotracheal intubation, the time required for endotracheal intubation was shorter when the integrated laryngoscope was used than the conventional method, and a statistically significant difference was found (p< .000). The development of an integrated laryngoscope with an aspirator is a useful device that can more effectively remove foreign substances and perform endotracheal intubation when there are foreign substances in the mouth.

Study on the Efficacies of Anti-acne Cosmetic Containing Lactonic Hydroxy Acid for Improving Acne Skin Care (락톤형 하이드록시애씨드를 적용한 여드름 피부 개선 화장품 효능 연구)

  • Moonki Baek;Bum-Ho Bin
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.50 no.3
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    • pp.279-288
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    • 2024
  • This study investigates the efficacy of anti-acne cosmetics containing lactonic hydroxy acid, specifically gluconodeltalactone (GDL), in improving acne skin treatment. In sebaceous cells induced by linoleic acid, GDL at concentrations of 1.0 mg/mL or higher demonstrated a concentration-dependent inhibition of lipid synthesis. Antibacterial activity of GDL against Cutibacterium acnes (C. acnes) was confirmed through minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) assays. Based on these in vitro results, a clinical test was conducted involving 65 participants to evaluate the effects of a anti-acne cosmetic formulation containing 3% GDL over an eight-week period. The results indicated a statistically significant improvement (p < 0.05) in both inflammatory acne lesions (papules, pustules, and nodules) and non-inflammatory lesions (comedones) from as early as two weeks of application, without any reported skin irritation. The results confirm that cosmetics with GDL can be used effectively and safely without long-term skin irritation, even for consumers with sensitive acne-prone skin.

Antiemetic Effect of Dolasetron Mesylate in the Prevention of Acute and Delayed Nausea and Vomiting due to Moderately Emetogenic Chemotherapy (악성종양환자에서 중등도 이상의 오심, 구토를 유발하는 항암화학요법 시급성 및 지연성 오심, 구토의 예방에 대한 Dolasetron의 효과)

  • Kim, D.S.;Sung, H.Y.;Choi, K.M.;Paik, J.Y.;Roh, S.Y.;Moon, H.;Kim, C.C.;Hong, Y.S.
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.248-257
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    • 2004
  • Purpose: To evaluate the efficacy of dolasetron mesylate in controlling nausea and vomiting in the first 24 hours and to extend these comparisons over the next 4 days in patients receiving moderately emetogenic chemotherapy. Methods: This was a single center, open-labeled study with single arm. Dolasetron (1.8 mg/kg) was given intravenously (I.V.) prechemotherapy with 10 mg of dexamethasone IV, followed 24 hours later by oral dolasetron (200 mg once daily) for the subsequent 4 days. The frequency of vomiting, severity of nausea and the presence of rescue antiemetics were assessed daily. Results: Of 30 patients enrolled, 28 were eligible and evaluable for the efficacy. Four out of 28 patients had complete control of nausea and vomiting without any rescue antiemetics through 5 days. The complete control got better as time went by with the rates of 17.9/46.4/42.9/53.6/60.7% on days 1 to 5. Vomiting was better controlled than nausea in both cisplatin-containing and non-containing chemotherapy. The adverse events were mild to moderate degrees of headache, diarrhea and fever, but were recovered spontaneously. Conclusion: Dolasetron was effective and safe for the control of nausea and vomiting in the patients with moderately emetogenic chemotherapeutic agents.

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The factors associated with the efficacy of indomethacin treatment in premature infants with patent ductus arteriosus (인도메타신 투여 시 미숙아 동맥관개존 치료효과에 영향을 미치는 인자)

  • Yoon, Min Jeong;Yoon, Hye Sun;Chung, Sung Hoon;Han, Mi Young;Bae, Chong Woo
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.531-535
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    • 2007
  • Purpose : Indomethacin treatment is successful in about 90% of patent ductus arteriosus (PDA) in premature infants, but in some, repeated administration or surgical closure is required. The object of the present study is to determine the factors affecting the efficacy of indomethacin treatment and to predict the treatment result. Method : The 29 preterm neonates, admitted to neonatal intensive care unit of Kyunghee university medical center and Eulji university hospital between September 2002 and April 2006 were diagnosed of PDA and treated with indomethacin. The risk factors that might affect the efficacy of treatment were studied retrospectively. Results : The single-administered group was 19 patients out of 29 (65.5%) and among the repeated-administered group, 5 patients (17.2%) had repeated indomethacin administration and the other 5 patients (17.2%) underwent surgery due to reopening of the duct after repeated medical treatment. In repeated-administered group, the diameter of PDA was significantly larger ($3.66{\pm}0.8mm$ vs $2.55{\pm}0.8mm$, P<0.01), especially when larger than 3.5 mm (sensitivity: 70%, specificity: 89%). Also, the mean postnatal age of the first indomethacin administration was significantly delayed in repeated-administered group (19.7 days vs 12.5 days, P<0.05). There were no significant differences in gestational age (32 wk 5 days vs 30 wk 8 days) and in birth weight (1598.9 g vs 1750.5 g). There were no significant differences in associated morbidities. Conclusion : In patients with larger diameter of PDA (>3.5 mm) and older postnatal age (>7 days), the effect of indomethacin was decreased. Therefore in such cases, repeated dose of indomethacin or surgical ligation should be considered earlier.