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Short-term safety profile of COVID-19 vaccination in children and adolescents with underlying medical conditions: a prospective cohort study

  • Naye Choi;Seung-Ah Choe;Yo Han Ahn;Young June Choe;Ju-Young Shin;Nam-Kyong Choi;Seong Heon Kim;Hee Gyung Kang
    • Childhood Kidney Diseases
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    • v.27 no.1
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    • pp.34-39
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    • 2023
  • Purpose: This article was to collect data on the safety of coronavirus disease 2019 (COVID-19) vaccines in children with underlying medical conditions. Methods: We constructed a prospective cohort of children and adolescents aged 5 to 19 years who had received at least one dose of COVID-19 vaccine. Patients diagnosed with and treated for chronic kidney disease, autoimmune disease, or other chronic conditions at the Seoul National University Children's Hospital were recruited from June to December 2022. A mobile survey questionnaire was sent to their guardians. The presence of adverse events on the day (day 0), 3 weeks (day 21), and 6 months (day 180) after the 1st dose of COVID-19 vaccine was recorded by the guardians. Results: A total of 73 children participated. The median age was 14 years, and 64.4% of the patients were male. On the day of immunization, 65.8% of the patients reported at least one adverse event. Pain at the injection site, fatigue, headache, arthralgia, and myalgia were the most common symptoms. The prevalence of adverse events decreased over time (65.8% on day 0, 27.4% between days 0 and 21, and 24.6% between days 21 and 180). Severe acute respiratory syndrome coronavirus 2 infection after the 1st dose occurred in 17 patients (23.3%) and one of the patients (5.88%) was hospitalized due to infection. Conclusions: Adverse events after COVID-19 vaccination were generally mild in children and adolescents with underlying medical conditions. Our findings provide evidence for the safety of COVID-19 vaccination in the vulnerable pediatric population.

Leucogen Tablets at 60 mg Three Times per Day are Safe and Effective to Control Febrile Neutropenia

  • Huang, Xin-En;Cao, Jie;Qian, Zhi-Ying;Xu, Xia;Shi, Lin;Wu, Xue-Yan;Liu, Jin;Wang, Lin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8495-8497
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    • 2014
  • Purpose: To investigate whether it is safe to use leucogen tablets 60 mg three times per day (180 mg for a day) and whether this regimen could reduce the incidence of febrile neutropenia caused by chemotherapy. Methods: This prospectively designed study focused on the safety and effectiveness of leucogen tablets 60mg three times per day for a group of cancer patients during chemotherapy for mainly lung or gastric cancers. The tablets were administered from 5 days before until the termination of chemotherapy. Neutropenia and other healthcare encounters were defined as events and occurrence was estimated for comparison. Results: We identified 39 patients receiving leucogen tablets 60mg three times per day, including 11 with gastric, 12 with lung and 16 with other sites of cancer. The mean age was 65 (29-75) years and there were 27 male and 12 female patients. The mean duration of leucogen tablets intake was 59 days. Eighteen patients were treated with taxane-based, 4 with irinotecan-based and 17 with other chemotherapy. The incidence of febrile neutropenia was 0%. Twelve patients were found severe neutropenia (grade III/IV), and the duration of severe neutropenia (grade III/IV) was 5 days. Treatment-emergent adverse events were attributable to complications of myelosuppressive chemotherapy or the primary disease (i.e., alopecia, nausea, asthenia, neutropenia, and severe hepatic renal dysfunction). No chemotherapy was delayed and no treatment related death was observed. Conclusions: This study suggested that leucogen tablets 60mg three times per day (180mg for a day) are safe and could be effective for preventing febrile neutropenia in patients with chemotherapy.

Two-Day Fraction Gamma Knife Radiosurgery for Large Brain Metastasis

  • Joo-Hwan Lee;In-Young Kim;Shin Jung;Tae-Young Jung;Kyung-Sub Moon;Yeong-Jin Kim;Sue-Jee Park;Sa-Hoe Lim
    • Journal of Korean Neurosurgical Society
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    • v.67 no.5
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    • pp.560-567
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    • 2024
  • Objective : We investigated how treating large brain metastasis (LBM) using 2-day fraction Gamma Knife radiosurgery (GKRS) affects tumor control and patient survival. A prescription dose of 10.3 Gy was applied for 2 consecutive days, with a biologically effective dose equivalent to a tumor single-fraction dose of 16.05 Gy and a brain single-fraction dose of 15.12 Gy. Methods : Between November 2017 and December 2021, 42 patients (mean age, 68.3 years; range, 50-84 years; male, 29 [69.1%]; female, 13 [30.9%]) with 44 tumors underwent 2-day fraction GKRS to treat large volume brain metastasis. The main cancer types were non-small cell lung cancer (n=16), small cell lung cancer (n=7), colorectal cancer (n=7), breast cancer (n=3), gastric cancer (n=2), and other cancers (n=7). Twenty-one patients (50.0%) had a single LBM, 19 (46.3%) had a single LBM and other metastases, and two had two (4.7%) large brain metastases. At the time of the 2-day fraction GKRS, the tumors had a mean volume of 23.1 mL (range, 12.5-67.4). On each day, radiation was administered at a dose of 10.3 Gy, mainly using a 50% isodose-line. Results : We obtained clinical and magnetic resonance imaging follow-up data for 34 patients (81%) with 35 tumors, who had undergone 2-day fraction GKRS. These patients did not experience acute or late radiation-induced complications during follow-up. The median and mean progression-free survival (PFS) periods were 188 and 194 days, respectively. The local control rates at 6, 9, and 12 months were 77%, 40%, and 34%, respectively. The prognostic factors related to PFS were prior radiotherapy (p=0.019) and lung cancer origin (p=0.041). Other factors such as tumor volumes, each isodose volumes, and peri-GKRS systemic treatment were not significantly related to PFS. The overall survival period of the 44 patients following repeat stereotactic radiosurgery (SRS) ranged from 15-878 days (median, 263±38 days; mean, 174±43 days) after the 2-day fraction GKRS. Eight patients (18.2%) were still alive. Conclusion : Considering the unsatisfactory tumor control, a higher prescription dose should be needed in this procedure as a salvage management. Moreover, in the treatment for LBM with fractionated SRS, using different isodoses and prescription doses at the treatment planning for LBMs should be important. However, this report might be a basic reference with the same fraction number and prescription dose in the treatment for LBMs with frame-based SRS.

Comparison Study of the Use of Absorbable and Nonabsorbable Materials as Internal Splints after Closed Reduction for Nasal Bone Fracture

  • Yi, Chang Ryul;Kim, Young Joon;Kim, Hoon;Nam, Sang Hyun;Choi, Young Woong
    • Archives of Plastic Surgery
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    • v.41 no.4
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    • pp.350-354
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    • 2014
  • Background The authors sought to compare the use of the nonabsorbable polyvinyl alcohol sponge (PVA, Merocel) and absorbable synthetic polyurethane foam (SPF, Nasopore Forte plus) as intranasal splints after closed reduction of fractured nasal bones during the hospitalization period. Methods The medical records of 111 patients who underwent closed reduction for nasal bone fracture at Sanggye Paik Hospital, Inje University College of Medicine, from 2012 to 2013 were reviewed retrospectively. PVA (group A) or SPF (group B) was packed as an internal splint after closed reduction. The efficacy of the materials was compared and statistically analyzed. Results PVA was used in 82 patients, and SPF was used in 29 patients. The patients in group B complained significantly more of nasal pain on the first day after operation than the patients in group A. Headaches on the operation day were significantly more painful in group B than in group A. Bleeding on the fourth postoperative day was significantly reduced in group B as compared to group A. The patients in group B exhibited significantly more intensive nasal obstruction on the operation day and the following day than the patients in group A. However, on the third and fourth postoperative days, the nasal obstruction in group B was less than that in group A. The pain and bleeding related to the packing material was significantly reduced in group B as compared to group A. Conclusions The use of SPF as an absorbable packing material is a reasonable substitute for the traditional nonabsorbable material.

Masticator space abscess in a 47-day-old infant

  • Kim, Eun-Hee;Jeon, Ju-Hee;Shim, Yoon-Hee;Lee, Kyu-Seok;Kim, So-Young;Kim, Eun-Ryoung
    • Clinical and Experimental Pediatrics
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    • v.54 no.8
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    • pp.350-353
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    • 2011
  • A 47-day-old male infant presented with fever, poor oral intake, irritability, and right-sided bluish buccal swelling. Contrast-enhanced computed tomography of the neck showed a round mass lesion of about $2.0{\times}1.5cm$ that suggested abscess formation in the right masticator space. Ultrasound-guided extraoral aspiration of the abscess at the right masseter muscle was successful. Staphylococcus aureus was identified in the culture from the aspirated pus and blood. Appropriate antibiotics were given and the patient recovered. The patient underwent follow-up ultrasonography that showed an improved state of the previously observed right masseter muscle swelling at about 1 month after hospital discharge. A masticator space abscess usually originates from an odontogenic infection in adults. We report a case of masticator space abscess in a 47-day-old infant in whom septicemia without odontogenic infection was suspected.

Addition of Macromolecules to PZM-3 Culture Medium on the Development and Hatching of In vitro Porcine Embryos

  • Kim, J.Y.;Kim, S.B.;Park, M.C.;Park, H.;Park, Y.S.;Park, H.D.;Lee, J.H.;Kim, J.M.
    • Asian-Australasian Journal of Animal Sciences
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    • v.20 no.12
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    • pp.1820-1826
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    • 2007
  • In this study, we conducted various experiments in order to develop enhanced cultural conditions for in vitro-produced porcine embryos. All embryos were produced by in vitro maturation (IVM) and fertilization (IVF) of immature oocytes from abattoir-derived ovaries. In experiment 1, we cultured IVF embryos in 4 different groups, namely, 0% bovine serum albumin (BSA), 3% BSA, 0.05% Polyvinyl alcohol (PVA), and 0.5% Polyvinylpyrrolidone (PVP) added to the basal fluid cultural medium, Porcine zygote medium 3 (PZM-3). The rates of embryo development were higher in the group where the PZM-3 media had been supplemented with 3% BSA than the other groups. While not statistically significant, the percent of blastocysts and hatched blastocytes were 6.9% and 25.0% in the 3% BSA group vs. 1.2-6.4% and 0-16.7% in the other groups, respectively. In experiment 2, we added 10% fetal bovine serum (FBS) to PZM-3 on day 0 of culture and observed the development rate of blastocysts per day of culture from days 0 to 5. The development rate of blastocysts was higher at 15.6% on day 4 than on any other day, and was significantly higher than on day 0 or day 1 (p<0.05). The development rate of hatched blastocysts was 26.7% on day 4, and was higher than on any other day. In experiment 3, we cultured IVF embryos with different fluid culture media, grouped as 1) PZM-3+0.3% BSA (day0-day7); 2) PZM-3+0.3% BSA${\rightarrow}$day-4) PZM-3+10% FBS; 3) PZM-3+0.3% BSA${\rightarrow}$PZM-3+0.3% BSA+(day-4) FBS 10%; and 4) PZM-3+0.3% BSA+10% FBS (day0-day7). The development rates of blastocysts and hatched blastocysts were 21.5% and 53.1% in group 3, respectively, which was significantly higher than group 4 with respect to blastocyst development (5.2%, p<0.05) but not hatched blastocysts (14.3%). The total cell number (TCN) of blastocysts in group 3 was higher at $37.8{\pm}16.1$ than the other groups at $16.8{\pm}4.4$ - $30.1{\pm}10.9$; however, this was not significantly different. The results of this study showed that PZM-3 containing 0.3% BSA and supplemented with FBS during the later stage of culture on day 4 resulted in better TCNs and an increased rate of hatched blastocysts.

Physical Condition and Fatigue of Hemodialysis Patients on the Day of Dialysis and on Other Days (혈액투석 환자의 투석일과 비투석일의 신체증상과 피로)

  • Song, Chung-Sook;Kim, Jung-Hwa;Choi, Eun-Jin;Cho, Young-Sun;Lee, Ju-Hee
    • Journal of Home Health Care Nursing
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    • v.16 no.2
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    • pp.123-134
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    • 2009
  • Purpose: This study was designed to compare physical symptoms and fatigue of hemodialysis patients on dialysis day and non-dialysis day. Methods: Data were collected from 63 outpatients undergoing hemodialysis at a hospital in A university hospital in August and September, 2008 using structured questionnaires. The data were analyzed with SPSS WIN 12.0 program with Paired t-test and Pearson's correlation. Results: Physical symptoms in patients between dialysis day and non-dialysis day were not different statistically (t=1.76, p=.08). Fatigue on dialysis day was higher than on non-dialysis day (t=3.27, p=.00). Physical symptoms and fatigue positively correlated with dialysis day (r=.42, p=.00) and non-dialysis day (r=.52, p=.00). Conclusion: Intervention to decrease physical symptoms and fatigue in dialysis day and non-dialysis day should be developed.

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Massive Rhabdomyolysis Following Cardiopulmonary Bypass

  • Kim, Young Sam;Yoon, Yong Han;Kim, Joung Taek;Baek, Wan Ki
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.181-184
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    • 2014
  • Here, we report a case of massive rhabdomyolysis following an uncomplicated repair of a ventricular septal defect in a five-month-old baby. Postoperatively, the patient was hemodynamically stable but metabolic acidosis continued, accompanied by fever and delayed mental recovery. The next day, he became comatose and never regained consciousness thereafter. The computed tomography of the brain revealed a diffuse brain injury. The patient followed a downhill course and eventually died on postoperative day 33. An unusually high level of creatine phosphokinase was noticed, peaking (21,880 IU/L) on postoperative day 2, suggesting severe rhabdomyolysis. The relevant literature was reviewed, and the possibility of malignant hyperthermia obscured by cardiopulmonary bypass and hypothermia was addressed.

Development of evidence-based protocol to maintain high humidity of incubator in Extremely Low Birth Weight Infant (초극소 저출생체중아의 고농도 가습환경 유지를 위한 근거중심 프로토콜 개발)

  • Yu, Mi;Choi, Yun-Jin;Han, Li-La;Yun, Young-Mi;Bae, Geun-Ha;Lee, Ji-Eun;Park, Ji-Seon;Park, Ui
    • Journal of Korean Critical Care Nursing
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    • v.2 no.2
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    • pp.5-17
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    • 2009
  • Purpose: The purpose of this study was to investigate the current humidification state of incubator, the factors disturbing high humidification and to establish the evidence-based nursing protocol to maintain it. Methods: The subjects were 15 infants who were born with extremely low birth weight (ELBW) from May to October, 2007, and data were collected during the first 3 days and analyzed with SPSS WIN program. Results: The goal of humidity level in incubator was 95%, but mean humidity levels were 89.7%(1st day), 91.9%(2nd day), and 91.8%(3rd day)(p<0.001). The disturbing factors were opening frequency and duration of incubator door and window by caregivers. The handling of infants by nurses and doctors happened more frequently during the first day. Especially, nurses handled them more often than others, but the duration of opening during the invasive procedures by doctors was longer than others. The opening frequency had negative correlation with duration(r=-.779, p<.01). Conclusion: So the evidence-based protocol for maintaining high humidity in incubator for ELBW infants during the first 3 days and next 2 days was made. Furthermore we need to educate NICU nurses and doctors about minimal handling.

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Calculation of the Costs and Optimal profits per Inpatient-day of the Geriatric Hospitals (노인병원의 재원환자 1인당 일평균 원가 및 적정이윤 계산)

  • Hwang, In-Kyoung;Kim, Jai-Sun;Choi, Whang-Gyu
    • Korea Journal of Hospital Management
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    • v.8 no.4
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    • pp.149-181
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    • 2003
  • It has been asserted that per diem payment system should be introduced, in place of the current fee-for-service system, for payment of the inpatient services of the geriatric hospitals, Based on the assentation, this study aims at calculating costs and profits per inpatient-day of the geriatric hospitals, and thereby at contributing to the managerial improvement from the both sides of the Government and the hospitals. Relevant data of the three months, May to August, 2002 were collected from the five geriatric hospitals, and per inpatient-day costs and profits were calculated for the three disease groups. Major results and conclusions are as follow : Firstly, total costs per insured inpatient-day of the geriatric hospitals are 65, 389 won for dementia (including optimal profit of 3,858 won), 69,730 won for stroke (including optimal profit of 4,117 won), and 70,085 won for other diseases (including optimal profit of 4,134 won). Secondly, the amount of the non-insured costs per inpatient-day occupies 34.5% of the total costs for dementia, 30.3% for stroke, and 30.1% for other diseases. Thirdly, the total amount of the per inpatient-day costs calculated including the optimal profits is, on the average, higher by 12% than the present price level calculated for the current fee-far-service system. This implies that the present price level should rise by 12% when the current fee-far-service payment system be maintained, and Finally, introduction of a sliding-scale payment system should be considered for the inpatient medical management fees for the length of stay over six months or more that are being cut in the claim examination process by the insurance corporation.

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