• Title/Summary/Keyword: Clinical review

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The Incidence and risk factors of delirium in elderly surgical patients (외과계 병동 노인 수술 환자의 섬망 발생률과 위험요인)

  • Lee, Eun Ju;Jang, Mi;Kim, Myung Hwa;Yun, Hye Jun;Kim, Eun Mi;Chung, Young In;Kim, Bo Kyung;Im, Eun Su;Hong, Kyoung Soon
    • Journal of Korean Clinical Nursing Research
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    • v.28 no.2
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    • pp.137-145
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    • 2022
  • Purpose: This retrospective chart review study was conducted to examine the frequency of delirium and to identify the risk factors of delirium in elderly surgical patients. Methods: The subjects of this study were 394 patients aged 65 years or older who underwent surgery. The diagnosis of delirium was based on the nursing assessment records with scores from the day of surgery to the 4th day after surgery. The collected data were analyzed by binary logistic regression analysis. Results: The incidence of delirium was 4.3%, and delirium occurred most frequently on the first day of surgery and lasted for 2.16 days on average. Of delirium patients, 76.5% underwent gastrointestinal surgery, and the most common delirium pattern was disorientation. In terms of the characteristics of the subjects, the occurrence of delirium was statistically different by age (𝝌2=10.79, p=.005), systemic-specific disease (𝝌2=9.63, p=.047), use of delirium-inducing drug(benzodiazepine) before surgery (𝝌2=15.90, p<.001), walking ability before surgery (𝝌2=7.65, p=.006), history of delirium (𝝌2=35.92, p<.001), and emergency surgery (𝝌2=16.40, p<.001). As risk factors of delirium, gastrointestinal surgery was found to increase the risk of delirium by 12.57 times (95% CI=2.45~64.46, p=.002), and the use of benzodiazepines before surgery was shown to increase delirium by 10.07 times (95% CI=2.21~45.87, p=.003). Conclusion: It is necessary for nurses to actively evaluate delirium using screening tools for early detection and prevention of delirium in elderly surgical patients with delirium risk factors.

Current Status and Prospects for Standards, Regulations, and Detection of Probiotic Yogurt: Review (프로바이오틱 요구르트의 기준, 규정, 검출에 관한 현황 및 전망: 총설)

  • Jung-Whan Chon;Kun-Ho Seo;Tae-Jin Kim;Hye-Young Youn;Seok-Hyeong Kang;Won-Uk Hwang;Hajeong Jeong;Dongkwan Jeong;Kwang-Young Song
    • Journal of Dairy Science and Biotechnology
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    • v.41 no.1
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    • pp.9-25
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    • 2023
  • Yogurt fermentation is known to be beneficial because it provides a low pH and harsh environment for foodborne pathogens and improves organoleptic properties. Additionally, organic acids produced through fermentation have a good effect on the viscosity and gelling properties of yogurt. Several potential health benefits of probiotic and generally recognized as safe strains have been suggested. Yogurt is the preferred vehicle for delivering probiotics to health-conscious consumers. Therefore, manufacturers of probiotic beverages must comply with the relevant regulations. The development of probiotic yogurt begins with the selection of strains with safety and functional properties of probiotics. The selected probiotic strain should be technically suitable for viability and improve organoleptic quality while maintaining the number of bacteria above the standard value during processing and storage conditions. In addition, the efficacy of probiotic strains contained in yogurt should be investigated, confirmed, and approved according to well-designed clinical trials. Although various methods are used to detect probiotic strains, the recently widely used next generation sequencing method can be actively utilized. In the future, more research should be conducted with the latest methods to identify probiotic functions and accurately detect probiotic strains.

A Systematic Review of Cognitive Orientation to Daily Occupational Performance for Children with Developmental Coordination Disorder (발달성협응장애 아동의 인지기반 작업수행(Cognitive Orientation to daily Occupational Performance; CO-OP) 중재에 대한 체계적 고찰 )

  • Choi, Yeon-Woo;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.20 no.3
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    • pp.72-85
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    • 2022
  • Objective : This study was conducted to examine self-selected goals and the outcome measures used in the Cognitive Orientation to daily Occupational Performance (CO-OP) approach for Developmental Coordination Disorder. Methods : Studies published from January 2012 to October 2022 in the PubMed, Embase, ScienceDirect, Cochrance Library databases were searched. Keywords used for search were ('developmental coordination disorder' OR 'DCD') AND ('Cognitive Orientation to daily Occupational Performance' OR 'Cognitive Orientation to Occupational Performance' OR 'CO-OP'). Among 211 searched studies, 7 selected studies that match the thesis of this study were analyzed. Results : The selected studies showed a relatively high level of evidence overall, including two randomized experimental studies, one non-random two-group study, three non-random one-group studies, one single-subject study. The self-selected goals preference of the children was high in the order of play, education, and daily life activities. Most of applicable sessions were conducted 10 times during a 1-h period, and intervention effects showed positive outcomes on the occupation performance motor domain. To measure the effectiveness of CO-OP, the improvement of occupational performance was evaluated using Canadian Occupational Performance Measure (COPM) and Performance Quality Rating Scale (PQRS), and the improvement of motor skills was evaluated using Movement Assessment Battery for Children (M-ABC). Conclusion : This study is expected to be used as basic clinical data when applying the CO-OP approach to Developmental Coordination Disorder.

A Content Validity Study of the Korean Translation Version of the Sensory Processing and Self-Regulation Checklist (SPSRC) (감각처리 및 자기조절 체크리스트(SPSRC)의 국내적용을 위한 번안 및 내용타당도 연구)

  • Kim, Ye-Eun;Lee, Hye-Rim;Lee, Sun-Min
    • The Journal of Korean Academy of Sensory Integration
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    • v.20 no.3
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    • pp.27-37
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    • 2022
  • Objective : This study was adapted into Korean for domestic use of the Sensory Processing and Self-Regulation Checklist (here in after referred to as SPSRC) and verified its content validity. Methods : The Korean version of the SPSRC, which was completed via a translation, content suitability, reverse translation, expert committee review, and content understanding process, was presented to three professors of the Department of Occupational Therapy and seven occupational therapists to confirm the content validity. Results : The content validity index (CVI) of the Korean version of the SPSRC was 0.9 or higher in all 130 items. Additionally, the CVI of all items was also 0.99, showing a high level of content validity result. Conclusion : The Korean version of the SPSRC was confirmed to have high content validity as a tool that can measure children's sensory processing ability and self-regulation ability together. The Korean version of the SPSRC facilitates the understanding and evaluation of children's sensory processing and self-regulation abilities in the clinical field, and is thought to be used to establish an intervention plan.

Parabiosis and Blood Exchange Techniques in Aging Research (개체병렬결합(parabiosis)실험모델과 혈액교환을 이용한 노화(aging)연구 분석)

  • Kyung Tae Chung
    • Journal of Life Science
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    • v.33 no.2
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    • pp.208-215
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    • 2023
  • In recent decades, the field of aging research has progressed from the genetic and cellular levels to in vivo models of blood exchange. Since genes capable of extending the lifespan in C. elegance have been reported, various potential target molecules have been discovered through genomics, proteomics, metabolomics, and transcriptomics. Accordingly, research on the interactions between target molecules has also been increasing. The parabiosis method, in which two experimental animals are surgically combined, was introduced, and a factor that could reverse the aging phenomenon was discovered using this method. The parabiosis method is used to find more accurate and effective aging-reversal factors that could exist in young blood. As more new evidence has been revealed, the parabiosis method has established a new paradigm for aging research. Moreover, a device capable of exchanging blood elaborately in laboratory animals was published in 2022 and presented new results necessary for aging reversal. Since GDF11, was reported, many other anti-aging candidates that are soluble factors in blood, such as β2m, TIMP2, VCAM1, Gpld1, and clusterin, have been discovered. In addition, mcicroglia cells and neuroinflammation have been directly proven to be aging factors. These latest research results were obtained by parabiosis, the newly designed device for plasmapheresis, and injecting young blood or conditioned blood methods. In this review, we discuss the latest research results using the device and young blood administration in old mice.

Characteristics of Patients with Surgical Closure of an Atrial Septal Defect during Infancy

  • Byeong A Yoo;Su Jin Kwon;Yu-Mi Im;Dong-Hee Kim;Eun Seok Choi;Bo Sang Kwon;Chun Soo Park;Tae-Jin Yun
    • Journal of Chest Surgery
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    • v.56 no.3
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    • pp.155-161
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    • 2023
  • Background: Surgical closure of an atrial septal defect (ASD) is infrequently indicated during infancy. We evaluated the clinical characteristics and outcomes of patients who underwent surgical ASD closure during infancy. Methods: A single-center retrospective review was performed for 39 patients (19 males) who underwent surgical ASD closure during infancy between 1993 and 2020. The median body weight percentile at the time of operation was 9.3. Results: During a median follow-up of 60.9 months, 4 late deaths occurred due to chronic respiratory failure. A preoperative history of bronchopulmonary dysplasia (BPD) was the only risk factor for late mortality identified in Cox regression (hazard ratio, 3.54; 95% confidence interval [CI], 1.75-163.04; p=0.015). The 5-year survival rate was significantly lower in patients with preoperative history of BPD (97.0% vs. 50.0%, p<0.001) and preoperative ventilatory support (97.1% vs. 40.4%, p<0.001). There were significant postoperative increases in left ventricular end-diastolic (p=0.017), end-systolic (p=0.014), and stroke volume (p=0.013) indices. A generalized estimated equation model showed significantly better postoperative improvement in body weight percentiles in patients with lower weight percentiles at the time of operation (<10th percentile, p=0.01) and larger indexed ASD diameter (≥45 mm/m2, p=0.025). Conclusion: Patients with ASD necessitating surgical closure during infancy are extremely small preoperatively and remain small even after surgical closure. However, postoperative somatic growth was more prominent in smaller patients with larger defects, which may be attributable to an increase in postoperative cardiac output due to changes in ventricular septal configuration. The benefits of ASD closure in patients with BPD are undetermined.

Application of Exosome for Diagnosis and Treatment of Diseases in the Central Nervous System (중추신경계 질환의 진단과 치료를 위한 엑소좀의 활용)

  • Jia Bak;Yun-Sik Choi
    • Journal of Life Science
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    • v.33 no.9
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    • pp.754-765
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    • 2023
  • Exosomes are a type of extracellular vesicle containing proteins and messenger and microRNAs; they are secreted by all cell types. Once released, exosomes are selectively taken up by other cells adjacent or at a distance, releasing their contents and reprogramming the target cells. Since exosomes are natural vesicles produced by cells as small sizes, it is generally accepted that exosomes have a non-toxic nature and non-immunogenic behaviors. Recently, exosomes have elicited scientific attention as drug delivery vehicles to the central nervous system. The central nervous system has a blood-brain barrier that makes it difficult for drugs to penetrate. Thus, the blood-brain barrier has been a major obstacle to the development of drugs for treating neurodegenerative diseases. However, accumulating evidence suggests that exosomes can cross the blood-brain barrier primarily through transcytosis. Consequently, exosomes are expected to become a new delivery vehicle that can cross the blood-brain barrier and deliver drugs into the brain parenchyma. In addition, since different types of exosomes are secreted depending on the cell type and disease state, exosomes can also be utilized as biomarkers for the diagnosis of diseases in the central nervous system. In this review, we summarized recent research trends on exosomes, including clinical trials as biomarkers and treatment options for diseases in the central nervous system.

Trends in Saliva Research and Biomedical Clinical Applications (타액 연구의 최신 지견과 임상 응용)

  • Soyoung Park;Eungyung Lee;Jonghyun Shin;Taesung Jeong
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.1
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    • pp.1-12
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    • 2023
  • Function of salivary gland and saliva composition can be an indicator of individual's health status. Recently, saliva has been thought to have a high potential for usage in the biomedical field to diagnose, evaluate, and prevent systemic health due to the technological advances in analyzing and detecting small elements such as immunological and metabolic products, viruses, microorganisms, hormones in saliva. As a diagnostic specimen, saliva has some useful advantages compared to serum. Because of simple non-invasive method, saliva sampling is quite comfort for the patient, and it doesn't require specialists to collect samples. The possibility of infection during the collection process is also low. For this reason, proteins, genetic materials, and various biomarkers in saliva are actively being utilized on studying stress, microbiomics, genetics, and epigenetics. For the research on collecting big data related to systemic health, the needs on biobank has been focused. Regeneration of salivary gland based on tissue engineering has been also on advancement. However, there are still many issues to be solved, such as the standardization of sample collection, storage, and usage. This review focuses on the recent trends in the field of saliva research and highlight the future perspectives in biomedical and other applications.

Analysis of Research Trends in New Drug Development with Artificial Intelligence Using Text Mining (텍스트 마이닝을 이용한 인공지능 활용 신약 개발 연구 동향 분석)

  • Jae Woo Nam;Young Jun Kim
    • Journal of Life Science
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    • v.33 no.8
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    • pp.663-679
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    • 2023
  • This review analyzes research trends related to new drug development using artificial intelligence from 2010 to 2022. This analysis organized the abstracts of 2,421 studies into a corpus, and words with high frequency and high connection centrality were extracted through preprocessing. The analysis revealed a similar word frequency trend between 2010 and 2019 to that between 2020 and 2022. In terms of the research method, many studies using machine learning were conducted from 2010 to 2020, and since 2021, research using deep learning has been increasing. Through these studies, we investigated the trends in research on artificial intelligence utilization by field and the strengths, problems, and challenges of related research. We found that since 2021, the application of artificial intelligence has been expanding, such as research using artificial intelligence for drug rearrangement, using computers to develop anticancer drugs, and applying artificial intelligence to clinical trials. This article briefly presents the prospects of new drug development research using artificial intelligence. If the reliability and safety of bio and medical data are ensured, and the development of the above artificial intelligence technology continues, it is judged that the direction of new drug development using artificial intelligence will proceed to personalized medicine and precision medicine, so we encourage efforts in that field.

Development and Validation of AI Image Segmentation Model for CT Image-Based Sarcopenia Diagnosis (CT 영상 기반 근감소증 진단을 위한 AI 영상분할 모델 개발 및 검증)

  • Lee Chung-Sub;Lim Dong-Wook;Noh Si-Hyeong;Kim Tae-Hoon;Ko Yousun;Kim Kyung Won;Jeong Chang-Won
    • KIPS Transactions on Computer and Communication Systems
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    • v.12 no.3
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    • pp.119-126
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    • 2023
  • Sarcopenia is not well known enough to be classified as a disease in 2021 in Korea, but it is recognized as a social problem in developed countries that have entered an aging society. The diagnosis of sarcopenia follows the international standard guidelines presented by the European Working Group for Sarcopenia in Older People (EWGSOP) and the d Asian Working Group for Sarcopenia (AWGS). Recently, it is recommended to evaluate muscle function by using physical performance evaluation, walking speed measurement, and standing test in addition to absolute muscle mass as a diagnostic method. As a representative method for measuring muscle mass, the body composition analysis method using DEXA has been formally implemented in clinical practice. In addition, various studies for measuring muscle mass using abdominal images of MRI or CT are being actively conducted. In this paper, we develop an AI image segmentation model based on abdominal images of CT with a relatively short imaging time for the diagnosis of sarcopenia and describe the multicenter validation. We developed an artificial intelligence model using U-Net that can automatically segment muscle, subcutaneous fat, and visceral fat by selecting the L3 region from the CT image. Also, to evaluate the performance of the model, internal verification was performed by calculating the intersection over union (IOU) of the partitioned area, and the results of external verification using data from other hospitals are shown. Based on the verification results, we tried to review and supplement the problems and solutions.