• Title/Summary/Keyword: INFECTION INDEX

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Chylous Ascites After Gastric Cancer Surgery: Risk Factors and Treatment Results

  • Sung Hyun Park;Ki-Yoon Kim;Minah Cho;Hyoung-Il Kim;Woo Jin Hyung;Yoo Min Kim
    • Journal of Gastric Cancer
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    • v.23 no.2
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    • pp.253-263
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    • 2023
  • Purpose: Although chylous ascites is a frequent complication of radical gastrectomy for gastric cancer, proper diagnostic criteria and optimal treatment strategies have not been established. This study aimed to identify the clinical features of chylous ascites and evaluate the treatment outcomes. Materials and Methods: We retrospectively analyzed the data of patients who underwent radical gastrectomy between 2013 and 2019. Diagnosis was made when milky fluid or elevated triglyceride levels (≥100 mg/dL) appeared in the drains without a preceding infection. The clinical features, risk factors, and treatment outcomes were assessed according to the initial treatment modalities for fasting and non-fasting groups. Results: Among the 7,388 patients who underwent radical gastrectomy for gastric cancer, 156 (2.1%) experienced chylous ascites. The median length of hospital stay was longer in patients with chylous ascites than in those without (median [interquartile range]: 8.0 [6.0-12.0] vs. 6.0 [5.0-8.0], P<0.001). Low body mass index (adjusted odds ratio [aOR]=0.9; P<0.001), advanced gastric cancer (aOR=1.51, P=0.024), open surgery (reference: laparoscopic surgery; aOR=1.87, P=0.003), and extent of surgical resection (reference: subtotal gastrectomy, total gastrectomy, aOR=1.5, P=0.029; proximal gastrectomy, aOR=2.93, P=0.002) were associated with the occurrence of chylous ascites. The fasting group (n=12) was hospitalized for a longer period than the non-fasting group (n=144) (15.0 [12.5-19.5] vs. 8.0 [6.0-10.0], P<0.001). There was no difference in grade III complication rate (16.7% vs. 4.2%, P=0.117) or readmission rate (16.7% vs. 11.1%, P=0.632) between the groups. Conclusions: A fat-controlled diet and medication without fasting provided adequate initial treatment for chylous ascites after radical gastrectomy for gastric cancer.

In Vitro Synergistic Antibacterial and Anti-Inflammatory Effects of Nisin and Lactic Acid in Yogurt against Helicobacter pylori and Human Gastric Cells

  • Seo Gu Han;Hyuk Cheol Kwon;Do Hyun Kim;Seong Joon Hong;Sung Gu Han
    • Food Science of Animal Resources
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    • v.43 no.5
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    • pp.751-766
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    • 2023
  • Helicobacter pylori is a bacterium that naturally thrives in acidic environments and has the potential to induce various gastrointestinal disorders in humans. The antibiotic therapy utilized for treating H. pylori can lead to undesired side effects, such as dysbiosis in the gut microbiota. The objective of our study was to explore the potential antibacterial effects of nisin and lactic acid (LA) in yogurt against H. pylori. Additionally, we investigated the anti-inflammatory effects of nisin and LA in human gastric (AGS) cells infected with H. pylori. Nisin and LA combination showed the strongest inhibitory activity, with confirmed synergy at 0.375 fractional inhibitory concentration index. Also, post-fermented yogurt with incorporation of nisin exhibited antibacterial effect against H. pylori. The combination of nisin and LA resulted in a significant reduction of mRNA levels of bacterial toxins of H. pylori and pro-inflammatory cytokines in AGS cells infected with H. pylori. Furthermore, this also increased bacterial membrane damage, which led to DNA and protein leakage in H. pylori. Overall, the combination of nisin and LA shows promise as an alternative therapy for H. pylori infection. Additionally, the incorporation of nisin into foods containing LA presents a potential application. Further studies, including animal research, are needed to validate these findings and explore clinical applications.

Kikuchi-Fujimoto Disease Mimicking Mesenteric Lymphadenitis in Children: A Case Report and Systematic Review

  • Gyeongseo Jeon;Si-Hwa Gwag;Young June Choe;Saelin Oh;Jun Eun Park
    • Pediatric Infection and Vaccine
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    • v.30 no.1
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    • pp.39-46
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    • 2023
  • Kikuchi-Fujimoto disease (KFD) is an acute febrile disease that mainly involves histiocytic necrotizing lymphadenitis in children and young adults. Diagnosis of KFD is even more difficult if image-guided percutaneous biopsy is technically challenging. We present a case of clinically diagnosed KFD in an 11-year-old boy who presented with fever, abdominal pain, and mesenteric lymphadenopathy, resulting in a diagnostic challenge. Additionally, we conducted a systematic review, and our goal was to describe the spectrum of disease, therapy, and outcomes. We identified 15 cases of KFD with symptoms that mimicked mesenteric lymphadenitis. Reports from the Americas, Europe, and Asia were also included. Most patients were male, exhibited leukopenia and elevated inflammatory markers, and recovered without significant sequelae or complications. A high index of suspicion of KFD should be maintained in children presenting with prolonged fever and unusual manifestations, such as mesenteric lymphadenitis.

Selection of Resistant Varieties to Aspergillus flavus by Determination of Aflatoxin B1 Content in Korean Peanut (Arachis hypogaea L.) Accessions

  • Seungah Han;Byeong-Cheol Kim;Jungmin Ha;Tae-Hwan Jun
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.68 no.3
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    • pp.175-187
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    • 2023
  • Peanuts, also known as groundnuts (Arachis hypogaea L.), are globally recognized as a vital oilseed crop. Peanuts are rich in proteins (e.g., arginine), oils (e.g., oleic acid and linoleic acid), fiber, vitamins (e.g., niacin and tocopherol), and carbohydrates and are consumed worldwide. However, the presence of aflatoxin (AF) has garnered substantial attention since its initial discovery as the causative agent of Tukey's X disease in the United Kingdom in 1960. Among the 18 aflatoxins identified, aflatoxin B1 (AFB1) has the highest toxic activity and causes hepatocellular carcinoma. It is classified as Group I by the International Agency for Research on Cancer (IARC) of the World Health Organization (WHO). The present study was conducted to evaluate aflatoxin B1 resistance of 102 peanut accessions and select putative aflatoxin B1-resistant peanut accessions to aflatoxin B1. One hundred and one Korean germplasms harvested in 2020 were inoculated with A. flavus to identify aflatoxin-resistant cultivars, and the aflatoxin B1 concentration was measured using an ultra-performance liquid chromatography-photodiode array detector. Twenty-six accessions with aflatoxin B1 concentrations lower than those of the check plant 55-437 were chosen for the development of aflatoxin-resistant varieties in Korea. As Korean aflatoxin-resistant varieties have not yet been developed, the findings of the present study are expected to provide useful information for the development of aflatoxin-resistant cultivars.

Comparison of Clinical Outcomes between Rebound Hyperthermia and Non-Rebound Hypertherma Groups in Postcardiac Arrest Syndrome Patients Undergoing Targeted Temperature Management (목표체온유지치료를 적용한 심정지 후 증후군 환자에서 반동성 고체온 발생군과 비발생군의 임상결과 비교)

  • Rhee, Ha Na;Park, Jeong Yun
    • Journal of Korean Critical Care Nursing
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    • v.16 no.3
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    • pp.99-108
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    • 2023
  • Purpose : This retrospective study aims to provide basic data for intervention to improve clinical outcomes and identify the characteristics of the rebound hyperthermia (RHG) and non-rebound hyperthermia (NRHG) groups by checking body temperature in patients with post-cardiac arrest syndrome. Method : The study involved 118 patients who completed target temperature management (TTM) in an acute-care unit. Data were analyzed for frequency, percentages, mean, standard deviation, median, and quartiles, and compared using the chi-squared test and Mann-Whitney U-test. Results : Rebound hyperthermia (RH) was observed in 74 (62.7%) patients, predominantly male (69.5%), with an average age of 64.54 ± 15.98, and a body mass index of 23.22 ± 4.75kg/m2 (overweight). Hypertension (50%) was the most common co-morbidity, followed by diabetes and heart disease (33.1%). Neuron-specific enolase levels were higher in the NRHG 24, 48, and 72 hours after recovery of spontaneous circulation (p = .037, p < .001, p = .008). The APHCHE IV was also higher in the NRHG (p < .001). RH occurred 25.49 (7.28-52.96) hours after TTM completion, lasting for 2 (1-3) hours. Temperature reduction strategies included notifying doctors, administering antipyretics, and nursing intervention, with the latter being the most common at 94.6%. Half of the subjects in the RHG and 77.3% in the NRHG fell into cerebral performance categories 3, 4, and 5 (p = .003). Conclusion : RH is more likely a body mechanism related to CPR and TTM than a result of pathogenic infection. Therefore, we require an active intervention for hyperthermia, and a patient-specific nursing intervention protocol.

Measurement of atherosclerosis markers in individuals with periodontitis

  • Angar Soronzonbold;Erkhbilguun Munkhkherlen;Khongorzul Batchuluun;Oyun-Enkh Puntsag;Uurtuya Shuumarjav;Bayarchimeg Batbayar
    • Journal of Periodontal and Implant Science
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    • v.54 no.1
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    • pp.37-43
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    • 2024
  • Purpose: The inflammatory response due to inflammatory cytokines, bacterial pathogens, and the altered lipoprotein metabolism in patients with periodontitis indicates that infection with periodontal anaerobic bacteria may influence atherogenesis in vitro and in vivo. We aimed to explore the effect of periodontitis concerning clinical and ultrasound markers of early atherosclerosis. Methods: In this case-control study, a total of 30 systemically healthy adults (15 with periodontitis and 15 without periodontitis) over 40 years of age were studied. Periodontitis was determined by measuring the clinical attachment level (CAL) and radiographic bone loss (RBL). Conventional cardiovascular risk factors, including body mass index, serum levels of total cholesterol (TCH), triglycerides (TG), and high-density and low-density lipoprotein (HDL and LDL, respectively) cholesterol were evaluated. Carotid artery intima-media thickness (IMT) was measured using ultrasonography. Results: The mean values of the CAL and carotid IMT were 5.02±0.9 mm and 0.084±0.01 cm vs. 1.6±0.61 mm and 0.072±0.02 cm in the periodontitis and healthy groups, respectively, reflecting statistically significant differences (P=0.001 and P=0.037, respectively). There were statistically significant differences in the serum levels of TCH, TG, and LDL between the 2 groups (P=0.017). The CAL and RBL were positively associated with carotid IMT and serum cholesterol levels, except for HDL, whereas tooth loss was not associated with any markers (P<0.05). Compared to the healthy group, participants with periodontitis exhibited 2.09 times higher odds (95% confidence interval, 1.22-3.59) of having subclinical atherosclerosis. Conclusions: The presence of periodontitis increased the risk of atherosclerosis.

Risk factors for anticoagulant-associated gastrointestinal hemorrhage: a systematic review and meta-analysis

  • Fuxin Ma;Shuyi Wu;Shiqi Li;Zhiwei Zeng;Jinhua Zhang
    • The Korean journal of internal medicine
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    • v.39 no.1
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    • pp.77-85
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    • 2024
  • Background/Aims: There may be many predictors of anticoagulation-related gastrointestinal bleeding (GIB), but until now, systematic reviews and assessments of the certainty of the evidence have not been published. We conducted a systematic review to identify all risk factors for anticoagulant-associated GIB to inform risk prediction in the management of anticoagulation-related GIB. Methods: A systematic review and meta-analysis were conducted to search PubMed, EMBASE, Web of Science, and Cochrane Library databases (from inception through January 21, 2022) using the following search terms: anticoagulants, heparin, warfarin, dabigatran, rivaroxaban, apixaban, DOACs, gastrointestinal hemorrhage, risk factors. According to inclusion and exclusion criteria, studies of risk factors for anticoagulation-related GIB were identified. Risk factors for anticoagulant-associated GIB were used as the outcome index of this review. Results: We included 34 studies in our analysis. For anticoagulant-associated GIB, moderate-certainty evidence showed a probable association with older age, kidney disease, concomitant use of aspirin, concomitant use of the antiplatelet agent, heart failure, myocardial infarction, hematochezia, renal failure, coronary artery disease, helicobacter pylori infection, social risk factors, alcohol use, smoking, anemia, history of sleep apnea, chronic obstructive pulmonary disease, international normalized ratio (INR), obesity et al. Some of these factors are not included in current GIB risk prediction models. such as anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction, etc. Conclusions: The study found that anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction et al. were associated with anticoagulation-related GIB, and these factors were not in the existing prediction models. This study informs risk prediction for anticoagulant-associated GIB, it also informs guidelines for GIB prevention and future research.

Effects of Amendments on Ginseng Root Rot Caused by Fusarium solani Population Changes of the Microorganisms in Soil (토양(土壤)개량(改良)이 Fusarium solani 에 의한 인삼근부병과(人蔘根腐病)과 미생물(微生物) 변동(變動)에 미치는 효과(效果))

  • Son, Suh-Gyu;Shin, Hyun-Sung;Lee, Min-Woong
    • The Korean Journal of Mycology
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    • v.13 no.1
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    • pp.41-47
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    • 1985
  • Eighteen plant residues were added to soil and the amended soil was inoculated with chlamydospores (5,000 cells/g soil) of Fusarium solani causing root rot of ginseng in soil to test the effects of amendment using pea (Pisium sativa L.) as an index plant. Distributional conditions of microogranisms in soil were compared with each other before and after dealing with soil amendment by plant debries. Infection rate by index plant's infectivity showed a higher degree in the treatment of wheat crushed than in control group, and followed by stalk of sweet potato, chinese cabbage, ginseng leaves and soybean pod. On the other hand, the de­creasing order of infection rate was root of garlic, welsh onion, cabbage leaf and stalk, green onion stalk, wheat straw and barley straw. In comparison with control group, the propagules of fungi increased in the treatment of ginseng leaves, soybean ground, wheat crushed, maize stalk, and chinese cabbage, but decreased in the root of garlic, cabbage, and barley straw. Population of total bacteria increased in the treatment of soybean ground, chinese cabbage, radish stalk, welsh onion, and wheat crushed, but decreased in barley straw, tobaco root, ginseng stalk, and wheat straw. The numbers of actinomycetes increased only in the treatment of soybean ground in a comparison with control and also decreased in the garlic stalk and tobaco root. The propagules of Fusarium spp increased in the treatment of chinese cabbage, welsh onion, radish stalk, wheat crushed, and sweet potato stalk, wheat crushed, and sweet potato stalk, but decreased in the treat­ment of wheat straw, ginseng leaves, and cabbage than control.

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The Clinical Usefulness of a Repeat Urine Culture 48 Hours after Antimicrobial treatment in Anatomically Normal and Abnormal Urinary Tract Infection (소아 요로 감염증 환아의 항생제 치료 48시간 후 반복적 요 배양 검사의 임상적 유용성)

  • Park, Kyung-Hee;Yeom, Jung-Suk;Park, Ji-Suk;Park, Eun-Sil;Seo, Ji-Hyun;Lim, Jae-Young;Park, Chan-Hoo;Youn, Hee-Shang
    • Childhood Kidney Diseases
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    • v.13 no.1
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    • pp.49-55
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    • 2009
  • Purpose : We aimed to compare the frequency of positive repeat urine cultures 48 hours after antimicrobial treatment between anatomically normal and abnormal urinary tract Infection (UTI) groups to determine the potential clinical usefulness of the tests. Methods : We reviewed medical records of 930 patients under age 14, who had been admitted for UTI at Gyeongsang National University Hospital from January 1, 1998 to August 1, 2008. The eligible patients were divided into two groups the anatomically normal UTI group and the anatomically abnormal UTI group. Statistical analyses were performed with variables consisting of the sex ratio, age distribution and the frequency of positive repeat urine cultures of each group. Results : The sex ratio of the anatomically normal UTI group was M:F=1.9:1, whereas that of the anatomically abnormal UTI group was M:F=3.5:1 (P=0.019). For age distribution, it was found that the mean age of the anatomically normal UTI group was $0.82{\pm}1.83$ years, whereas that of the anatomically abnormal UTI group was $1.18{\pm}2.57$ years (P=0.113). The frequency of positive repeat urine cultures in the anatomically normal UTI group was 3/279 (1.1%), whereas that of the anatomically abnormal UTI group was 1/90 (1.1%) (P=0.675). Conclusion : We conclude that performing a repeat urine culture is not justified in terms of clinical usefulness, and it is unreasonable to use the results as an index of therapeutic success. A follow-up urine culture is unnecessary in patients with both the anatomically normal and abnormal UTI group.

An Epidemiological Investigation on an Outbreak of Shigellosis in a Special School for Handicapped in Yeongcheon-si and in a Rehabilitation Facility in Gyeongsan-si, Korea, 2008 (2008년 영천시 지적장애인 학교와 경산시 재활원에서 발생한 세균성이질에 관한 역학조사)

  • Lee, Hyun-Dong;Lee, Soon-Ok;Lim, Hyun-Sul
    • Journal of agricultural medicine and community health
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    • v.34 no.1
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    • pp.24-33
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    • 2009
  • Objectives: In September 2008, an outbreak of diarrhea occurred among students attending Y school in Yeongcheon-si. Shigella sonnei was cultured from some of the rectal swabs. An epidemiological investigation was carried out to determine the source of the infection and the mode of transmission of the shigellosis outbreak. Methods: The index case lived in the D rehabilitation facility in Gyeongsan-si and an additional epidemiological investigation was carried out there. The cases could not be questioned due to their mental handicaps. The teachers were interviewed instead. A patient case was defined as a resident with diarrhea more than one time a day from September 18 to September 26, 2008 or a resident with confirmed Shigella sonnei at the Y school or the D rehabilitation facility. Results: The attack rate was 1.2% (8 persons) among 659 persons in the Y school and D rehabilitation facility. Five persons were microbiologically confirmed to have the infection and three persons were diagnosed on the basis of symptoms. Shigella sonnei was cultured from five of the 659 rectal swabs. However, 80 environmental specimens including drinking water, preserved foods, and cooking utensils were negative. All eight patients were Y school students and had been living in group boarding and lodging. Six of them lived in the D rehabilitation facility and two lived in the dormitory at the Y school. Five cases showed pulsed-field gel electrophoresis patterns that were identical for Shigella sonnei. Conclusions: The results of this study showed that the infection source of the shigellosis outbreak, in the two places, were identical. It is likely that the infections initially spread from a teacher or volunteer and then among the students.