• Title/Summary/Keyword: Non-systemic Risk

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Evaluation of Factors that Can Affect Protective Immune Responses Following Oral Immunization of Recombinant Helicobacter pylori Urease Apoenzyme

  • Kim, Jang-Seoung;Chang, Ji-Hoon;Park, Eun-Jeong;Chung, Soo-Il;Yum, Jung-Sun
    • Journal of Microbiology and Biotechnology
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    • v.10 no.6
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    • pp.865-872
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    • 2000
  • Helocobacter phylori is the major cause of gastritis, peptic ulcer, and a principal risk factor for gastric cancer. As the firs step towards a vaccine against H. pylori infection, Hy.pylori urease was expressed and purified as a recombinant apoenzyme (rUrease) in E. coli. In order to develop an effective immunization protocol using rUrease, the host immune responses were evaluated after the oral immunization of mice with rUrease preparations plus cholera toxin relative to various conditions, such as the physical nature of the antigen, the frequency of the booster immunization, the dose of the antigen, and the route of administration. The protective efficacy was assessed using a quantitative culture following an H. pylori SS1 challenge. It was demonstrated that rUrease, due to its particulated nature, was more superior than the UreB subunit as a vaccine antigen. The oral immunization of rUrease elicited significant systemic and secretory antibody responses, and activated predominantly Th2-type cellular responses. The bacterial colonization was significantly reduced (~100-fold) in those mice immunized with three or four weekly oran doses of rUrease plus cholera toxin (p<0.05), when compared to the non-immunized/challenged controls. The protection correlated well with the elicited secretory IgA level against rUrease, and these secretory antibody responses were highly dependent on the frequency of the booster immunization, yet unaffected by the dose of the antigen (25-200$\mu\textrm{g}$). These results demonstrate the remarkable potential of rUrease as a vaccine antigen, thereby strengthening the possibility of developing an H. pylori vaccine for humans.

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Study on the Effectiveness of image inspection Replacement of the Periodontal disease Questionnaire in the Electronic Medical Record Environment (전자의무기록 의료 환경에서 치주 자가설문지의 영상 판독 대체 효용성에 대한 연구)

  • Maeng, You-Jin
    • The Journal of the Korea institute of electronic communication sciences
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    • v.12 no.4
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    • pp.707-714
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    • 2017
  • There have recently been an increasing number of reports claiming that the periodontal disease, the most typical oral disease, is closely associated with various systemic diseases such as cardiovascular disease. Therefore, it is imperative to explore the methods that can ensure effective and cost-effective monitoring of periodontal disease in specific population groups, as well as individuals in the electronic medical record environment. However, traditional periodontal examination methods, such as periodontal probe, are considerably demanding and time-consuming for dental specialists, and furthermore, cause the risk of bacteremia as they are invasive procedures. Thus, the objective of this study was to validate the capability of new method for screening the periodontal disease using the self-reported questionnaire for periodontitis which is the non-invasive procedure to replace radiography.

Predictors of Blood and Body Fluid Exposure and Mediating Effects of Infection Prevention Behavior in Shift-Working Nurses: Application of Analysis Method for Zero-Inflated Count Data (교대근무 간호사의 혈액과 체액 노출 사고 예측 요인과 감염예방행위의 매개효과: 영과잉 가산 자료 분석방법을 적용하여)

  • Ryu, Jae Geum;Choi-Kwon, Smi
    • Journal of Korean Academy of Nursing
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    • v.50 no.5
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    • pp.658-670
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    • 2020
  • Purpose: This study aimed to identify the predictors of blood and body fluid exposure (BBFE) in multifaceted individual (sleep disturbance and fatigue), occupational (occupational stress), and organizational (hospital safety climate) factors, as well as infection prevention behavior. We also aimed to test the mediating effect of infection prevention behavior in relation to multifaceted factors and the frequency of BBFE. Methods: This study was based on a secondary data analysis, using data of 246 nurses from the Shift Work Nurses' Health and Turnover study. Based on the characteristics of zero-inflated and over-dispersed count data of frequencies of BBFE, the data were analyzed to calculate zero-inflated negative binomial regression within a generalized linear model and to test the mediating effect using SPSS 25.0, Stata 14.1, and PROCESS macro. Results: We found that the frequency of BBFE increased in subjects with disturbed sleep (IRR = 1.87, p = .049), and the probability of non-BBFE increased in subjects showing higher infection prevention behavior (IRR = 15.05, p = .006) and a hospital safety climate (IRR = 28.46, p = .018). We also found that infection prevention behavior had mediating effects on the occupational stress-BBFE and hospital safety climate-BBFE relationships. Conclusion: Sleep disturbance is an important risk factor related to frequency of BBFE, whereas preventive factors are infection prevention behavior and hospital safety climate. We suggest individual and systemic efforts to improve sleep, occupational stress, and hospital safety climate to prevent BBFE occurrence.

Clinical Practice Guidelines for Hepatocellular Carcinoma: Current and Future Perspectives (간암 진료가이드라인의 현재와 전망)

  • Bo Hyun Kim;Joong-Won Park
    • Journal of Digestive Cancer Research
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    • v.4 no.1
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    • pp.21-28
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    • 2016
  • Hepatocellular carcinoma (HCC) is rather unique. Most of HCC patients have underlying chronic liver diseases with or without cirrhosis and the prognosis of HCC depends on the liver function, as well as the tumor extent. Non-invasive diagnosis of HCC can be made with certain risk factors and specific imaging findings (e.g. hypervascularity). Patients with HCC can receive surgical resection, radiotherapy, and systemic chemotherapy as other solid malignancies. HCC has more treatment options such as liver transplantation, transarterial chemoembolization (TACE) and radiofrequency ablation (RFA). A variety of practice guidelines for HCC has been published by many academic societies. Different healthcare systems and availability of resources also affect the practice guidelines; therefore, practice guidelines have similarities and dissimilarities. Herein, we review the current status of practice guidelines for HCC and future perspectives for the improvement of guidelines are also discussed.

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Systemic Analysis on Hygiene of Food Catering in Korea (2005-2014) (Systemic analysis 방법을 활용한 국내 학교급식 위생의 주요 영향 인자 분석 연구(2005-2014))

  • Min, Ji-Hyeon;Park, Moon-Kyung;Kim, Hyun-Jung;Lee, Jong-Kyung
    • Journal of Food Hygiene and Safety
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    • v.30 no.1
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    • pp.13-27
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    • 2015
  • A systemic review on the factors affecting food catering hygiene was conducted to provide information for risk management of food catering in Korea. In total 47 keywords relating to food catering and food hygiene were searched for published journals in the DBpia for the last decade (2005-2014). As a result, 1,178 published papers were searched and 142 articles were collected by the expert review. To find the major factors affecting food catering and microbial safety, an analysis based on organization and stakeholder were conducted. School catering (64 papers) was a major target rather than industry (5 pagers) or hospitals (3 papers) in the selected articles. The factors affecting school catering were "system/facility/equipment (15 papers)", "hygiene education (12 papers)", "production/delivery company (6 papers)", food materials (4 papers)" and "any combination of the above factors (9 papers)". The major problems are follow. 1) The problems of "system/facility/equipment" were improper space division/separation, lack of mass cooking utensil, lack of hygiene control equipment, difficulty in temperature and humidity control, and lack of cooperation in the HACCP team (dietitian's position), poor hygienic classroom in the case of class dining (students'), hard workload/intensity of labor, poor condition of cook's safety (cook's) and lack of parents' monitoring activity (parents'). 2) The problem of "hygiene education' were related to formal and perfunctory hygiene education, lack of HACCP education, lack of compliance of hygiene practice (cook's), lack of personal hygiene education and little effect of education (students'). 3) The problems of "production/delivery company" were related to hygiene of delivery truck and temperature control, hygiene of employee in the supplying company and control of non-accredited HACCP company. 4) The area of "food materials" cited were distrust of safety regarding to raw materials, fresh cut produces, and pre-treated food materials. 5) In addition, job stability/the salary can affect the occupational satisfaction and job commitment. And job stress can affect the performance and the hygiene practice. It is necessary for the government to allocate budget for facility and equipment, conduct field survey, improve hygiene training program and inspection, prepare certification system, improve working condition of employees, and introducing hygiene and layout consulting by experts. The results from this study can be used to prepare education programs and develop technology for improving food catering hygiene and providing information.

Awareness and Use of Complementary and Alternative Medicine in Korean Lung Cancer Patients

  • Choi, Joon Young;Ji, Wonjun;Choi, Chang-Min;Chung, Chaeuk;Noh, Jae Myoung;Park, Cheol-Kyu;Oh, In-Jae;Yoon, Hong In;Kim, Hyeong Ryul;Kim, Ho Young;Yeo, Chang Dong;Jang, Seung Hun;Public Relation Committee of the Korean Association for Lung Cancer
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.2
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    • pp.105-114
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    • 2021
  • Background: Complementary and alternative medicine (CAM) has been used frequently, and its use continues to increase in lung cancer patients, despite insufficient scientific of its efficacy. To investigate this situation, we analyzed the current awareness and use of CAM in Korean lung-cancer patients. Methods: This prospective survey-based study was performed at seven medical centers in South Korea between August and October 2019. The survey assessed general patient characteristics and the awareness and use of CAM. We analyzed differences in the clinical parameters of patients aware and not aware of CAM and of CAM non-users and users. Results: Of the 434 patients included in this study, 68.8% responded that they were aware of CAM and 30.9% said they had experienced it. In univariate analysis, the patients aware of CAM were younger with poor performance status, had advanced-stage lung cancer, received more systemic therapy, and received concurrent chemoradiation therapy (CCRT). By multiple logistic regression, younger age, poor performance status, advanced stage, and prior CCRT were identified as independent risk factors for CAM awareness. There were no significant differences in the general characteristics and cancer-associated clinical parameters of CAM non-users and users. Conclusion: Specific clinical parameters were associated with patients' awareness of CAM, although there were no significantly different characteristics between CAM users and non-users.

Analysis of Occupational Disease Caused by Oral Health Behavior of Some Dental Hygiene Students (일부 치위생과 학생의 구강건강행위와 구강병 발생요인 간의 관계)

  • Lim, Soon-Hwan;Hwang, Ji-Min
    • The Journal of the Korea Contents Association
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    • v.18 no.3
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    • pp.256-264
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    • 2018
  • The purpose of this study was to investigate the relationship between oral health behaviors and the results of the oral dysentery test for dental hygienists and students at Gyeonggi - do and Chungcheongnam - do. Self - filling questionnaires and oral diseases. The following conclusions were obtained. The most common toothbrushing frequency was three times a day (60.2%), and the most dominant frequency of eating between meals was once or less(49.7%). The most common snack that they had was stickiness-free sweetened food(66.5%), and the type of beverage that they had the most was sweetened beverages(49.7%). The average stimulated saliva flow rate was 9.41ml, and they got a mean of 9.52 in the buffering capacity of saliva. The average glucose clearance time was a mean of 12.02. When they took a streptococcus mutans colony count test, 80.1 percent belonged to the low-risk group(<$10^5$), and 82.6 percent belonged to the low-risk group(<$10^5$) when a lactobacillus test was conducted. There was a positive correlation between the irritant saliva fraction and the non-irritating saliva and saliva buffering ability. In the fluoride application experience, the glucose retention time was 10.66 minutes and the fluoride application experience was 13.33 minutes. (P = .008). The importance of oral health, which is directly linked to general health, should be emphasized in order to improve the quality of life as well as the life expectancy. For oral health, which is directly linked to systemic health, it is necessary to provide opportunities for oral health education that can be easily accessed by the public, and to continuously develop and provide oral health care programs for a lifetime.

What Can We Apply to Manage Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Acute Respiratory Failure?

  • Kim, Deog Kyeom;Lee, Jungsil;Park, Ju-Hee;Yoo, Kwang Ha
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.2
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    • pp.99-105
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    • 2018
  • Acute exacerbation(s) of chronic obstructive pulmonary disease (AECOPD) tend to be critical and debilitating events leading to poorer outcomes in relation to chronic obstructive pulmonary disease (COPD) treatment modalities, and contribute to a higher and earlier mortality rate in COPD patients. Besides pro-active preventative measures intended to obviate acquisition of AECOPD, early recovery from severe AECOPD is an important issue in determining the long-term prognosis of patients diagnosed with COPD. Updated GOLD guidelines and recently published American Thoracic Society/European Respiratory Society clinical recommendations emphasize the importance of use of pharmacologic treatment including bronchodilators, systemic steroids and/or antibiotics. As a non-pharmacologic strategy to combat the effects of AECOPD, noninvasive ventilation (NIV) is recommended as the treatment of choice as this therapy is thought to be most effective in reducing intubation risk in patients diagnosed with AECOPD with acute respiratory failure. Recently, a few adjunctive modalities, including NIV with helmet and helium-oxygen mixture, have been tried in cases of AECOPD with respiratory failure. As yet, insufficient documentation exists to permit recommendation of this therapy without qualification. Although there are too few findings, as yet, to allow for regular andr routine application of those modalities in AECOPD, there is anecdotal evidence to indicate both mechanical and physiological benefits connected with this therapy. High-flow nasal cannula oxygen therapy is another supportive strategy which serves to improve the symptoms of hypoxic respiratory failure. The therapy also produced improvement in ventilatory variables, and it may be successfully applied in cases of hypercapnic respiratory failure. Extracorporeal carbon dioxide removal has been successfully attempted in cases of adult respiratory distress syndrome, with protective hypercapnic ventilatory strategy. Nowadays, it is reported that it was also effective in reducing intubation in AECOPD with hypercapnic respiratory failure. Despite the apparent need for more supporting evidence, efforts to improve efficacy of NIV have continued unabated. It is anticipated that these efforts will, over time, serve toprogressively decrease the risk of intubation and invasive mechanical ventilation in cases of AECOPD with acute respiratory failure.

Clinical Experiences for Cardiac Myxomas (심장 점액종의 임상적 고찰)

  • Lee, Geun-Dong;Lee, Jae-Won;Jung, Jae-Seung;Jung, Sung-Ho;Je, Hyoung-Gon;Choo, Suk-Jung;Song, Hyun;Chung, Cheol-Hyun
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.703-709
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    • 2008
  • Background: Diagnosis and treatment are often successful in the setting of cardiac myxomas. However, cardiac myxomas can lead to catastrophic complications, due to intracardiac obstruction and embolism preoperatively, and can recur postoperatively. Material and Method: We retrospectively reviewed the clinical characteristics, surgical treatment, and recurrence data of 85 patients who underwent cardiac myxoma surgery at Asan Medical Center between November 1994 and June 2007. We analyzed the morphologic characteristics of 58 patients with left atrial myxomas and determined the development of functional mitral valve stenosis and systemic embolism through reviewing the results of preoperative echo-cardiograms to find potential preoperative risk factors. Result: Twenty-seven (31.8%) patients were men, and 58 (68.2%) were women. The mean patient age was $54.5{\pm}14.3$ years. Preoperative symptoms included obstructive symptoms in 41 (48.2%) patients, signs of embolism in 19 (22.4%), constitutional symptoms in 8 (9.4%), and no symptoms in 19 (20.0%). Among the 58 patients with left atrial myxomas, the mean maximal tumor diameter was $4.3{\pm}1.8$ (range $1.1{\sim}8\;cm$)cm. Twenty-six (44.8%) patients had a prolapsing type, defined as a tumor mobile enough to move down. to the mitral. annular plane during diastole, and 32 (55.2%) had villous type, defined as a tumor consisting of multiple fine villous extensions on the surface. Twelve (20.7%) patients had severe functional mitral valve stenosis, and 15 (25.9%) had systemic embolism preoperatively. The incidence of severe functional mitral valve stenosis was significantly higher in patients with the prolapsing type than in those with the non-prolapsing type (p=0.001). The mean maximal tumor diameter in patients with severe functional mitral valve stenosis was $5.1{\pm}1.0\;cm$, significantly larger than that seen in patients without severe functional mitral valve stenosis (p=0.041). The incidence of systemic embolism was significantly higher in patients with the villous type than in those with the smooth type (p=0.006). Postoperative complications were noted in 6 (7.1%) patients, and early mortality was noted in 1 (1.2%). The mean postoperative follow-up duration was $36.2{\pm}37.5$ months, with recurrence reported in 2(2.4%) patients during the follow-up period. The disease free interval were 48, 12 months, respectively. Conclusion: Surgical treatment for cardiac myxomas was performed safely, and long-term prognosis was good. In patients with left atrial myxoma, close attention should be maintained and surgery should be performed promptly in those of prolapsing type, those with large maximal diameter in order to prevent severe functional mitral valve stenosis, and those of villous type in order to prevent systemic embolism. Echocardiography should be followed serially in order to detect recurrence.

Assessment of Prognostic Value of "Neutrophil to Lymphocyte Ratio" and "Prognostic Nutritional Index" as a Sytemic Inflammatory Marker in Non-small Cell Lung Cancer

  • Kos, Fahriye Tugba;Hocazade, Cemil;Kos, Mehmet;Uncu, Dogan;Karakas, Esra;Dogan, Mutlu;Uncu, Hikmet Gulsen;Ozdemir, Nuriye;Zengin, Nurullah
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3997-4002
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    • 2015
  • Background: Systemic inflammatory response was shown to play an important role in development and progression of many cancer types and different inflammation-based indices were used for determining prognosis. We aimed to investigate the prognostic effects of neutrophil to lymphocyte ratio (NLR) and prognostic nutritional index (PNI) in patients with non-small cell lung cancer (NSCLC). Materials and Methods: NSCLC patients diagnosed in our institution were retrospectively reviewed. Demographic and clinicopathologic characteristics were recorded. NLR and PNI was calculated before the application of any treatment. Results: A total of 138 patients were included in the study. Patients were divided into two groups according to NLR (<3.24 or ${\geq}3.24$) and PNI (<49.5 or ${\geq}49.5$). While median overall survival was 37.0 (95% CI 17.5-56.5) months in the group with low NLR, it was calculated as 10.0 (95%CI 5.0-15.0) months in the group with high NLR (p<0.0001). While median overall survival was 7.0 (95%CI 3.5-10.5) months in the group with low PNI, it was calculated as 33.0 (95% CI 15.5-50.4) months in the group with high PNI (p<0.0001). Stage, NLR and PNI levels were evaluated as independent risk factors for overall survival for all patients in multivariate analysis (p<0.0001, p=0.04 and p<0.001, respectively). Conclusions: NLR (${\geq}3.24$) and PNI (<49.5) at diagnosis is an independent marker of poor outcome in patients with NSCLC. NLR and PNI is an easily measured, reproducible prognostic tests that could be considered in NSCLC patients.