• Title/Summary/Keyword: Characteristics of patients

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Clinical Use and Complications of Percutaneous Central Venous Catheterization in Very Low Birth Weight Infants (극소 저출생 체중아에서 경피 중심정맥 도관의 유용성과 합병증)

  • Kim, Hyang;Kim, Sun Hui;Byun, Hyung Suck;Choi, Young Youn
    • Clinical and Experimental Pediatrics
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    • v.48 no.9
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    • pp.953-959
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    • 2005
  • Purpose : The administration of total parenteral nutrition(TPN) has become a standard procedure in the management of nutritionally deprived and critically low birth weight neonates. Sepsis remains the most frequent serious complication during TPN, resulting in increased morbidity, mortality and health care costs. This study was performed to evaluate the clinical efficacy and complications of percutaneous central venous catheterization(PCVC) in very low birth weight infants. Methods : A total of 56 very low birth weight infants below 1,500 g during the period from January 1998 to December 2003 were enrolled and their medical records reviewed. Study group(n=32) included the babies who had undergone PCVC and a control group(n=24) included babies who had not undergone PCVC. We compared the study group with the control group for factors such as subject characteristics and catheter-related complications. Results : There was no difference in subject characteristics, such as birth weight, gestational week, respiratory distress syndrome, duration of ventilator therapy, duration from tube to complete oral feeding, days at TPN and its total duration, body weight at discontinuation of TPN and the days taken to reach to 2,000 g. However, the morbidity rate due to patent ductus arterious, chronic lung disease, necrotizing enterocolitis, osteopenia, cholestasis, and sepsis showed no difference. The study group with infants below 1,000 g showed a higher incidence of sepsis compared to the control group of the same weight group. The study group with infants between 1,000 to 1,500 g showed significantly higher incidences of intraventricular hemorrhage and took longer reach the a body weight of 2,000 g. Conclusion : Considering the high incidence of sepsis in the PCVC group, every attempt should be made to minimize the length of TPN therapy and encourage early enteral feeding. We also recommend the use of PCVC carefully in patients requiring prolonged nutritional support.

Clinical Characteristics of the Intracordal Cysts (성대낭종의 임상적 특성)

  • 홍기환;이상헌;최승철;임현실;김연우;전희석;양윤수
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.13 no.2
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    • pp.173-179
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    • 2002
  • Background and Objectives : Intracordal cysts may occur secondary to voice abuse and overuse or may be secondary to a remnant of epithelium trapped within the lamina propria. They nay occur spontaneously or may be associated with poor vocal hygiene. As the cyst enlarges it can start to significantly affect the vibratory region of the vocal fold. Recently, with the advancement of the microsurgical technique and the laryngeal stroboscopy, correct diagnosis of intracordal cyst have been increased. The aims of this study is to review the important clinical characteristics of the intracordal cyst. Materials and Method : In the present study, 121 cases of the intracordal cyst were treated by the microsurgical technique. These lesions were diagnosed before the operation with indirect laryngoscopy, laryngeal endoscopy, laryngeal stroboscopy and confirmed with the findings observed during operations and the results of the biopsies. Results : The intracordal cysts were 121 cases in the 2595 patients who underwent laryngeal micorosurgery(4.7%). Ductal cyst were 88 cases and epidermoid cyst were 33 cases. The lesions are more frequent in women and anterior third of true vocal cord is more frequently involved site. With the indirect laryngoscopic examination, the ductal cysts are more frequently misdiagnosed as other diseases of the vocal cord such as vocal polyps or nodules. The degree of postoperative voice satisfaction is similar to that of vocal polyps. Conclusion : Intracordal cysts are very similar to the other mucosal disorders of the vocal cord and it may be misdiagnosed as vocal polyps or nodules, frequently. Therefore careful preoperative examinations for the vocal cord lesions with stroboscopy and other endoscopic instruments are important part of the correct diagnosis. An ideal treatment is enucleation of the cysts without upture of the cystic wall or injury of the lamina propria.

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Genetic Characteristics and Virulence Factors of Pandemic Vibrio parahaemolyticus Isolated in South Korea and Japan (한국과 일본에서 유행하는 장염비브리오의 병원성 인자와 유전자의 특성)

  • Hong, Seuk-Won;Moon, Ji-Young;Lee, Bok-Kwon;Kim, Yung-Bu
    • Journal of Life Science
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    • v.17 no.3 s.83
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    • pp.386-395
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    • 2007
  • A total of 27 strains of Vibrio parahaemolyticus (18 strains isolated from Korea and 9 strains from Japan) were serotyped and examined for biochemical characteristics, antimicrobial susceptibility patterns, cytotoxicity assay, thermostable direct hemolysin (TDH) production and molecular epidemiology. Using polymerase chain reaction (PCR) method and DNA probe hybridization method, the strains were tested for toxR, tdh, trh and ORF 8 genes. The V. parahaemolyticus isolated from patients were belonged to 8 different serotypes : O3:K6, O1:K38, O3:K57, O4:K9, O4:Kl2, O4:K68, O5:Kl5 and O6:K46. Urease-positive strain possessed the trh gene, and conversely, urease-negative strains lacked the gene, indicating that urease production by V. parahemolyticus strains strongly correlates with the possession of the trh gene. Most strains showed multiple resistant to more than three antibiotics and the antibiogram could be classified into 6 group (I to VI). All of the O3:K6 strains isolated in South Korea and Japan producted TDH at high levels. The TDH titers ranged between 256 and 2.048, and the average titer was 1009. To distinguish the new and increasingly common V. parahaemolyticus strains from clinical isolates, ORF 8 is a useful genetic marker. After Southern hybridization, the HindIII restriction fragment patterns of the tdh gene were grouped one type, respectively. One type showed two bands one of which was 4.3kb and the other was 11.5kb in size. Variation between the O3:K6 serotype are minor when compared to the differences seen with the non O3:K6 strains. The migration patterns of Not I -digested of the total DNA of the O3:K6 strains were similar, and only slight variations were observed between the serotypes. By contrast, the O3:K6 strains and non O3:K6 had markedly different profiles. In conclusion, Random amplified polymorphic DNA (RAPD) profile using appropriate primers was an effective epidemiological marker.

An Analysis of Epidemiological Investigation Reports Regarding to Pathogenic E. coli Outbreaks in Korea from 2009 to 2010 (최근 2년간(2009-2010) 우리나라 병원성 대장균 식중독 역학조사 보고서 분석)

  • Lee, Jong-Kyung;Park, In-Hee;Yoon, Kisun;Kim, Hyun Jung;Cho, Joon-Il;Lee, Soon-Ho;Hwang, In-Gyun
    • Journal of Food Hygiene and Safety
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    • v.27 no.4
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    • pp.366-374
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    • 2012
  • Recently pathogenic E. coli is one of the main foodborne pathogens resulting in many patients in Korea. To understand the characteristics of pathogenic E. coli outbreaks in Korea, the epidemiological investigation reports of pathogenic E. coli outbreak in 2009 (41 reports) and in 2010 (27 reports) were collected in the web site of the Korea Centers for Disease Control and Prevention, reviewed and analysed in this study. The main places of the pathogenic E. coli outbreaks were food catering service area (64.8%) and restaurants (25.0%). The main type of the pathogens were EPEC (44.7%) and ETEC (34.2%). EAEC and EHEC was responsible for 10.5 and 9.2%, respectively. Eight of 68 outbreak cases were caused by more than 2 types of pathogenic E. coli which implicates the complicated contamination pathways of pathogenic E. coli. The incidence rate of pathogenic E. coli was $33.6{\pm}30.5%$ and the main symptoms were diarrhea, stomach ache, nausea, vomiting, and fever etc. The two identified food sources were identified as frozen hamburger pattie and squid-vegetable mixture. To improve the food source identification by epidemiological investigation, food poisoning notification to the agency should not be delayed, whole food items attributed the outbreak should be collected and detection method of the various pathogenic E. coli in food has to be improved. In conclusion, the characteristics between the EHEC outbreaks in the western countries and the EPEC or ETEC outbreaks in Korea needs to be distinguished to prepare food safety management plan. In addition, the development of the trace back system to find the contamination pathway with the improved detection method in food and systemic and cooperative support by the related agencies are necessary.

A Study on the Medical Application and Personal Information Protection of Generative AI (생성형 AI의 의료적 활용과 개인정보보호)

  • Lee, Sookyoung
    • The Korean Society of Law and Medicine
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    • v.24 no.4
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    • pp.67-101
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    • 2023
  • The utilization of generative AI in the medical field is also being rapidly researched. Access to vast data sets reduces the time and energy spent in selecting information. However, as the effort put into content creation decreases, there is a greater likelihood of associated issues arising. For example, with generative AI, users must discern the accuracy of results themselves, as these AIs learn from data within a set period and generate outcomes. While the answers may appear plausible, their sources are often unclear, making it challenging to determine their veracity. Additionally, the possibility of presenting results from a biased or distorted perspective cannot be discounted at present on ethical grounds. Despite these concerns, the field of generative AI is continually advancing, with an increasing number of users leveraging it in various sectors, including biomedical and life sciences. This raises important legal considerations regarding who bears responsibility and to what extent for any damages caused by these high-performance AI algorithms. A general overview of issues with generative AI includes those discussed above, but another perspective arises from its fundamental nature as a large-scale language model ('LLM') AI. There is a civil law concern regarding "the memorization of training data within artificial neural networks and its subsequent reproduction". Medical data, by nature, often reflects personal characteristics of patients, potentially leading to issues such as the regeneration of personal information. The extensive application of generative AI in scenarios beyond traditional AI brings forth the possibility of legal challenges that cannot be ignored. Upon examining the technical characteristics of generative AI and focusing on legal issues, especially concerning the protection of personal information, it's evident that current laws regarding personal information protection, particularly in the context of health and medical data utilization, are inadequate. These laws provide processes for anonymizing and de-identification, specific personal information but fall short when generative AI is applied as software in medical devices. To address the functionalities of generative AI in clinical software, a reevaluation and adjustment of existing laws for the protection of personal information are imperative.

The effect of dental hygiene students' knowledge and attitude toward the elderly on the discrimination of the elderly (치위생학과 학생들의 노인에 대한 지식 및 태도가 노인차별주의에 미치는 영향)

  • Young-Sun Kim;Jung-Hwa Lee
    • Journal of Korean Dental Hygiene Science
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    • v.6 no.2
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    • pp.129-139
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    • 2023
  • Background: The elderly population aged 65 or older in Korea is expected to continue to increase to 18.4% in 2023, and to enter a super-aged society at 20.6% in 2025. In clinical practice, the elderly discrimination of dental hygienists may experience difficulties during dental hygiene treatment due to an increase in the number of elderly patients due to aging, which can lead to maladjustment to work and turnover, so education on the understanding of the elderly is essential for students in the Department of Dentistry, who are prospective dental hygienists. Accordingly, a study was conducted to prepare for a super-aged society by studying the relationship between elderly discrimination and the knowledge and attitudes of the elderly, and to change the curriculum of universities and develop programs related to the elderly. Method: 204 students enrolled in the Department of Dentistry in D area were analyzed using the SPSS/WIN 25.0 program. The subject's geriatric discrimination, knowledge about the elderly, and attitude toward the elderly were calculated as the mean and standard deviation. T-test and one-way ANOVA were performed to verify the difference in geriatric discrimination according to the general characteristics of the subject, with a Scheffe' test applied for post-hoc analysis. Correlation analysis was conducted on the subject's geriatric discrimination, knowledge about the elderly, and attitudes toward the elderly. Results: Geriatrics scored 2.03±0.36 out of 4. Knowledge about the elderly was categorized as follows: physical domain 0.57±0.15; social domain 0.36±0.17; and psychological domain 0.35±0.20. The attitude toward the elderly was 3.86±0.27. Knowledge of the elderly averaged 11.27±3.30 points out of 25. The question with the highest percentage of correct answers to knowledge about the elderly was 'physical strength tends to decrease with age', which was 93.1%. The attitude toward the elderly according to the general characteristics of the study subjects showed significant differences in gender (p=0.040), age (p=0.026), and life experience with grandparents (p=0.001). The elderly discrimination of the study subjects showed a negative correlation in both attitude and knowledge toward the elderly, and among the elderly discrimination, there was a high positive correlation with regard to emotional avoidance (r=.892, p<0.001). Conclusion: College students are the leading players in caring for the elderly and are directly affected by aging social problems. Therefore, it is considered necessary to apply various programs in the state, society, and educational institutions to avoid negative prejudices that lead to positive thinking and discrimination against the elderly.

The Use of Pharmacogenomic Method for the Prediction of Antidepressant Responsiveness (약리 유전학적 방법을 이용한 항우울제 치료반응성의 예측)

  • Kim, Doh Kwan;Lim, Shinn-Won
    • Korean Journal of Biological Psychiatry
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    • v.9 no.1
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    • pp.25-33
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    • 2002
  • Serotonin transporter(5-HTT) is one of the major action site of antidepressants in neuronal cells. According to the recent studies, it is known that the functional polymorphism in the promoter region of the 5-HTT gene(5-HTT linked polymorphism repetitive element in promoter region, 5-HTTLPR) is associated with antidepressant responsiveness, and the distributions of 5-HTTLPR is various among the different populations. Our preliminary study suggested that it is possible to measure the endophenotype of 5-HTTLPR genotype by examining the pharmacodynamic research of the 5-HTT in platelet membranes. However, there are limitations to predicting the antidepressant responsiveness only from the endophenotypic characteristics of 5-HTT gene promoter polymorphism, and therefore we propose to use the pharmacogenomic methods for overcoming these limitations. We found that the significant correlations existed among the genetic polymorphisms of biogenic amine transporters whose structure and characteristics are similar to the 5-HTT, and the predictable odds ratio of antidepressant responsiveness are increased significantly by combining the effect with other associated polymorphisms, compared to the effect of 5-HTT promoter polymorphism only. These results support the hypothesis that antidepressant treatment has to be individualized according to the genetic and ethnic background of depressed patients. It would be possible to develope the evaluation tools to predict the antidepressant responsiveness and its side effect profile, if scientists reveal the genes related to the action mechanism as well as the metabolism of antidepressants so as to discover the interaction of those genes and contribution of endogenotypes toward antidepressant responsiveness.

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Comparison of Rotational Strength in Shoulders with Anterior Instability and Normal Shoulders Using Isokinetic Testing (등속성 검사를 통한 견관절 전방 불안정 환자와 정상인의 회전력 비교)

  • Lee, Dong-Ki;Kim, Tae-Kwon;Lee, Jin-Hyuck;Lee, Dae-Hee;Jung, Woong-Kyo
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.79-85
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    • 2012
  • Objective: It has been expected that patient with posttraumatic recurrent anterior shoulder dislocation might have limited daily life activity because of pain and apprehension of dislocation. But there have been only a small number of investigations regarding the rotator strength in this patient. The aim of this study is to find the characteristics about rotator strength of patient with posttraumatic recurrent anterior shoulder dislocation using an isokinetic testing. Method: We enrolled thirteen patients with posttraumatic recurrent anterior shoulder dislocation and fifteen sex, age-matched healthy nonathletic subjects in this controlled study. All participants were male and there were no significant differences between the two groups in age, height, weight, BMI. Isokinetic internal rotator and external rotator strength was evaluated with a Biodex Isokinetic Testing machine (Biodex Medical Systems, Shirley, NY, USA), tests were performed at 60 deg/sec and 180 deg/sec for both sides. Peak torque normalized to body weight, external rotator to internal rotator ratio, total work and fatigue were calculated for each angular velocity. The association between internal rotator and external rotator strength and shoulder instability was analyzed by comparisons with a control group. Results: Any notable differences could not be found between the two groups given all data from no symptomatic left shoulder. There were no significant differences between the two groups statistically in internal rotation strength of right shoulder. However, there has been a tendency that at all angular velocities, external rotator peak torque to body weight, total work and external rotator to internal rotator ratio were significantly lower in the anterior instability group than the control group at all angular velocities. There was no substantial difference between those groups with respect to the fatigue of external rotator and internal rotator in our study. Conclusion: The prominent characteristics of posttraumatic recurrent anterior shoulder dislocation are external rotator weakness and loss of balance with external rotator and internal rotator. Therefore selective training using this information rotator might be helpful in conservative treatment and rehabilitation.

Ecological Study on Poisonous Snake and Investigation of the Venom Characteristics, Snakebiting Frequenty in Korea (한국산 독사의 생태학적 특징 및 독성, 교상빈도에 관한 조사, 연구)

  • Shim, Jae-Han;Son, Young-Jong;Lee, Sang-Seob;Park, Kyung-Seok;Oh, Hee-Bok;Park, Young-Do
    • Korean Journal of Environment and Ecology
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    • v.12 no.1
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    • pp.58-77
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    • 1998
  • Four species(25%) of Viperidae(Agkistrodon brevicaudus, Agkistrodon ussuriensis, Agkistrodon saxatilis) and Cloubridae(Rhabdophis tigrenus tigrenus) were Korean poisonous snake. Copulation season of these species was from July to August. Reproduction mode of genus Agkistrodon species was ovoviviparous but Rhabdophis tigrinus tigrinus was the other pattern of oviparous. Optimal movement temperature range was from 20$\circ $C to 29$\circ $C(March~September). Wjen atmosphere temperature was below 10$\circ $C, at that time they hibernate at the ground, rock bottom, stone wall and embankment around the end of a field. The venom of these snakes consist mainly Hematoxin, Cytolysin, Neurotoxin and Cardiotoxin of poisonous liquids. These material injection to animal cause systemic syndrome such as Dizziness(25.7%), Vomitting(23.1%), Fever(22%), Visual trouble(18%), Headace(17.7%), Dyspnoea(17.6%) and bring about other local syndrome such as Discoloration(54.2%), Bleeding(20.2%), Bullae(10.7%) and Skin ulcer(!0.8%). The annual distribution was appeared to decrease 1972 after 1992 and average snakebiting patients was 25.6 per year, but practically total estimated snakebiting was 2,700 per year. The seasonal distribution was most frequent in August(25%), and mortality was 1.8%(26 per 1,430). The sex ratio was 2:1 and according to age distribution, it was most prevalent at one's fifties(19%). The most frequent place where the accident happened was the field(48.2%) and most predilection site of the body for victim were hand(47.8%) and foot(39.5%), Commonly bite snake were Agkistrodon ussuriensis(27.1%), Agkistrodon brevicaudus(22.6%) and Agkistrodon saxatilis(9.6%) but 40.7% of species could not be identified. Treatment of antivenin patient was 75.9% (1,068/1,407).

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Etiology and Clinical Features of Acute Bacterial Gastroenteritis in Children Mananged at a Secondary Hospital (일개 이차 병원에서 치료한 소아 급성 세균성 위장염 원인 및 특징)

  • Kim, Sung Yoon;Kim, Hyun-Jung;Shin, Eun Hye;Eun, Byung Wook;Ahn, Young Min;Song, Mi Ok
    • Pediatric Infection and Vaccine
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    • v.24 no.2
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    • pp.95-101
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    • 2017
  • Purpose: Acute bacterial gastroenteritis (ABG) can cause more severe symptoms than acute viral gastroenteritis in children. This study was aimed at determining the etiologic trends and to examine the clinical characteristics of ABG in children. Methods: We sent stool samples from the children with acute gastroenteritis who were treated at a secondary hospital located in Seoul, Korea between January 2011 and December 2014 to Seoul Metropolitan Government Research Institute of Public Health and Environment to find the causative organisms. Clinical characteristics of patient were analyzed through a medical records review. Results: Out of 664 stool samples, 183 (27.6%) yielded bacterial pathogens. Staphylococcus aureus was the most common bacterial pathogen, found in 72 cases (39.3%), even though it was only tested for since 2012. The monthly isolation rate was the highest (24.6%) in August. The isolation rate of Campylobacter spp. by patient's age group was high (16.7%) in the 12- to 18-year-age group (P=0.04). In patients with bloody stool, Campylobacter spp. was the most commonly isolated (31.0%, P=0.04). When comparing C-reactive protein, the Salmonella spp.- or Campylobacter spp.-isolated group showed higher values than the S. aureus- or pathogenic Escherichia coli-isolated group ($5.7{\pm}0.6mg/dL$ vs. $2.1{\pm}0.3mg/dL$, P<0.01). Conclusions: S. aureus, Salmonella spp., pathogenic E. coli, and Campylobacter spp. were important pathogens of ABG among children. Considering the differences in pathogens found according to age, a clinical symptom and inflammation index might be helpful in assuming the causative organism.