• Journal of Chest Surgery
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• 제57권1호
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• pp.36-43
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• 2024

Background: Coronavirus disease 2019 (COVID-19) can lead to acute respiratory failure, which frequently necessitates invasive mechanical ventilation and extracorporeal membrane oxygenation (ECMO). However, the limited availability of ECMO resources poses challenges to patient selection and associated decision-making. Consequently, this retrospective single-center study was undertaken to evaluate the characteristics and clinical outcomes of patients with COVID-19 receiving ECMO. Methods: Between March 2020 and July 2022, 65 patients with COVID-19 were treated with ECMO and were subsequently reviewed. Patient demographics, laboratory data, and clinical outcomes were examined, and statistical analyses were performed to identify risk factors associated with mortality. Results: Of the patients studied, 15 (23.1%) survived and were discharged from the hospital, while 50 (76.9%) died during their hospitalization. The survival group had a significantly lower median age, at 52 years (interquartile range [IQR], 47.5-61.5 years), compared to 64 years (IQR, 60.0-68.0 years) among mortality group (p=0.016). However, no significant differences were observed in other underlying conditions or in factors related to intervention timing. Multivariable analysis revealed that the requirement of a change in ECMO mode (odds ratio [OR], 366.77; 95% confidence interval [CI], 1.92-69911.92; p=0.0275) and the initiation of continuous renal replacement therapy (CRRT) (OR, 139.15; 95% CI, 1.95-9,910.14; p=0.0233) were independent predictors of mortality. Conclusion: Changes in ECMO mode and the initiation of CRRT during management were associated with mortality in patients with COVID-19 who were supported by ECMO. Patients exhibiting these factors require careful monitoring due to the potential for adverse outcomes.

• Journal of Preventive Medicine and Public Health
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• 제45권5호
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• pp.277-282
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• 2012

Field epidemiology involves the implementation of quick and targeted public health interventions with the aid of epidemiological methods. In this article, we share our practical experiences in outbreak management and in safeguarding the population against novel diseases. Given that cities represent the financial nexuses of the global economy, global health security necessitates the safeguard of cities against epidemic diseases. Singapore's public health landscape has undergone a systemic and irreversible shift with global connectivity, rapid urbanization, ecological change, increased affluence, as well as shifting demographic patterns over the past two decades. Concomitantly, the threat of epidemics, ranging from severe acute respiratory syndrome and influenza A (H1N1) to the resurgence of vector-borne diseases as well as the rise of modern lifestyle-related outbreaks, have worsened difficulties in safeguarding public health amidst much elusiveness and unpredictability. One critical factor that has helped the country overcome these innate and man-made public health vulnerabilities is the development of a resilient field epidemiology service, which includes our enhancement of surveillance and response capacities for outbreak management, and investment in public health leadership. We offer herein the Singapore story as a case study in meeting the challenges of disease control in our modern built environment.

• Pediatric Infection and Vaccine
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• 제19권3호
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• pp.89-110
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• 2012

Meningococcal Disease, manifesting as meningitis and septicemia, is a life-threatening bacterial infection that results in significant morbidity and mortality, particularly in childhood. Its epidemic potential and limited opportunities for clinical intervention due to its rapid course present unique public health and clinical challenges. Incidence is highest in infants and young children, with a secondary peak of risk in adolescents. Approximately 10% of cases are fatal and survivors can be left with serious and permanent sequelae including amputations, hearing loss and cognitive impairment. Transmission is only from human-to-human, by infected respiratory tract secretions or saliva and therefore crowding poses a tremendously elevated risk for disease development. Military recruits and university students are at high risk due to the high carriage rate in adolescents, their behavior patterns and close contact. Menveo$^{(R)}$ (Novartis Vaccines and Diagnostics), a novel quadrivalent meningococcal conjugate vaccine directed against meningococcal serogroups A, C, W-135 and Y, has been shown to be immunogenic and well tolerated in all age groups and was recently licensed for use in Korea. Recent cases and deaths among military recruits drew public attention to their elevated risk and the Korean government has recommended vaccination of all new military recruits. Many Korean students seek to attend school, university, or language institutes in countries where routine meningococcal vaccination is required - clinicians should be aware of such requirements to ensure that students are vaccinated prior to arrival in the destination country.

• Journal of Microbiology and Biotechnology
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• 제30권8호
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• pp.1109-1115
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• 2020

The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading globally, and the WHO has declared this outbreak a pandemic. Vaccines are an effective way to prevent the rapid spread of COVID-19. Furthermore, the immune response against SARS-CoV-2 infection needs to be understood for the development of an efficient and safe vaccine. Here, we review the current understanding of vaccine targets and the status of vaccine development for COVID-19. We also describe host immune responses to highly pathogenic human coronaviruses in terms of innate and adaptive immunities.

• Tuberculosis and Respiratory Diseases
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• 제48권1호
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• pp.33-44
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• 2000

연구배경: 기관지천식은 기도의 과민성을 특징을 지닌 기도의 염증성 질환이며, 기관지천식에서의 기도 염종의 특성에 관한 연구는 기관지천식의 병인과 병태생리를 이해하는데 필수적이다. 본 연구의 목적은 백서에서 국내에서 개발된 일실 체용적 변동기록기을 이용하여 항원에 의한 반응을 관찰하여 기관지천식의 모델을 확립하고, 사람 기관지 천식과의 유사성을 알아보고자 백서의 기관지천식 모텔에서 기도의 염증을 관찰하여 항원에 의한 기도의 반응 양상에 따른 차이를 비교하고자 하였다. 대상 및 방법: 백서 30마리에 0.1mg의 난황을 피하로 주입하여 감작시키고, 감작후 14-16일 항원유발시험을 시행하여 각 10마리씩 3군으로 나누어 기도의 반응을 관찰하면서 1시간, 6-8시간, 24시간 후에 사망시켜 폐조직의 변화를 관찰하였다. 대조군 10마리는 감작군과 동일한 방법으로 항원을 흡입하고 1일 후에 사망시켰다. 기도반응은 동물용 일실 체용적 변동기록기를 사용하여 enhanced pause(Penh)를 지표로 측정하였다. 병리소견은 백서를 사망시켜 폐와 기관지를 절제한 후 Hematoxylin Eosin으로 염색하여 기관, 대기관지 및 소기관지 및 혈관주위에서 염증반응과 호산구 침윤을 관찰하였다. 결 과: 항원 유발시험을 시행한 20마리중 총 17마리(85%)에서 항원에 의한 기도의 수축반응을 보였다. 이들중 15 마리(75%)에서 조기반응을, 5 마리(25%)는 이중반응을 보였고 2마리(10%)는 후기반응만을 보였다. 항원 유발 후 기관, 대기관지, 소기관지와 혈관주 위에서의 염증반응은 1시간군, 6시간군, 1일군모두에서 대조군과 유의한 차이는 없었다(p>0.05). 항원유발시험후 호산구의 침윤은 1시간군과 대조군에서는 호산구의 침윤을 전혀 관찰할 수 없었으나, 6시간군은 5마리(50%)에서 호산구의 침윤을 관찰하였으며, 대조군과 유의한 호산구의 침윤을 관찰할 수 있었다(p<0.05). 조기반응과 후기반응을 관찰할 수 있었던 6시간군과 1일군에서 조기반응군(조기반응만을 보인 백서, n=10)과 후기반응군(이중반응과 후기반응만을 보인 백서, n=7) 에서 염증의 침윤은 모든 부위에서 유의한 차이는 없었다. 호산구의 침윤은 조기반응군에는 10마리중 4마리(40%)에서 $0.7{\pm}1.1$등급이었으며, 후기반응군은 7마리중 4 마리(57.1%)에서 $1.0{\pm}1.0$으로 높았으나, 통계적으로 유의하지는 않았다(p>0.05). 결 론: 백서의 기관지천식 모델에서 항원에 의한 기도의 수축 반응은 높고 반응률을 보였으나 기도의 염증 반응을 유발하지는 않으며, 호산구의 침윤도 미약하다고 생각된다. 그러므로 백서 기관지 천식모델은 항원에 의한 기도 반응의 연구에는 좋으나, 사랑의 만성 기관지 천식을 연구하기에는 적당치 못하다고 생각된다.

• 한국산학기술학회논문지
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• 제22권4호
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• pp.473-482
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• 2021

자동화된 운항 시스템 도입으로 항공안전은 크게 개선되었지만, 운항을 직접 담당하는 항공기 조종사에게는 새로운 도전이 생겼다. 항공운항 관점에서의 조종사의 스트레스를 Startle과 Surprise구분할 수 있다. Startle을 총소리 같이 갑작스럽거나 위협적인 자극에 대한 짧고 강한 생리적인 반응이며, Surprise는 자신의 예상을 빗나가는 예기치 못한 사건에 대한 인지-감정적 반응이다. Martin 등이 실시한 Startle 효과 실험(2012년)에서 조종사는 Startle 상태에서 반응 지연과 심박 수 증가 등 생리적인 반응을 확인하였고, Rahim의 Startle/Surprise 실험(2020년)에서 사전 계획된 비상조치훈련은 조종사의 호흡수와 맥박수의 변화가 없으나, 비계획된 상황과 항공기가 복잡할수록 호흡 수와 심박 수가 증가되었다는 사실을 확인하였다. 이 실험 결과를 바탕으로 국내 조종사 훈련에서도 기술적 능력을 전달에만 집중하는 것이 아닌 비기술적 능력에 대한 고려가 필요하며, 법령에 의한 기계획된 단순 반복적인 훈련 항목보다는 항공사의 상황을 고려한 비정형화된 다양한 비상조치 훈련의 도입이 필요하다고 하겠다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.97-101
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• 2012

Objective: With the background of aging population in China and advances in clinical medicine, the amount of operations on old patients increases correspondingly, which imposes increasing challenges to critical care medicine and geriatrics. The study was designed to describe information on the length of ICU stay from a single institution experience of old critically ill gastric cancer patients after surgery and the framework of incorporating data-mining techniques into the prediction. Methods: A retrospective design was adopted to collect the consecutive data about patients aged 60 or over with a gastric cancer diagnosis after surgery in an adult intensive care unit in a medical university hospital in Shenyang, China, from January 2010 to March 2011. Characteristics of patients and the length their ICU stay were gathered for analysis by univariate and multivariate Cox regression to examine the relationship with potential candidate factors. A regression tree was constructed to predict the length of ICU stay and explore the important indicators. Results: Multivariate Cox analysis found that shock and nutrition support need were statistically significant risk factors for prolonged length of ICU stay. Altogether, eight variables entered the regression model, including age, APACHE II score, SOFA score, shock, respiratory system dysfunction, circulation system dysfunction, diabetes and nutrition support need. The regression tree indicated comorbidity of two or more kinds of shock as the most important factor for prolonged length of ICU stay in the studied sample. Conclusions: Comorbidity of two or more kinds of shock is the most important factor of length of ICU stay in the studied sample. Since there are differences of ICU patient characteristics between wards and hospitals, consideration of the data-mining technique should be given by the intensivists as a length of ICU stay prediction tool.

• 한국식품영양학회지
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• 제27권6호
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• pp.1175-1181
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• 2014

This study was conducted to develop for the elderly food that is safe, well-shaped, and easy to chew and swallow, using gelification. Gelatin, which has low adhesiveness, thereby lowering the possibility of being swallowed wrongly into the respiratory track, was used as a viscosity agent for the gelification. Water and gelatin amounts were adjusted to facilitate breaking the food with the tongue. Various foods for the elderly with chewing and swallowing difficulties were used for sensory assessment. Sensory panel consisted of 10 dietitians (10 women) in nursing care facilities. The sensory optimal composite recipes were determined by central composite design (CCD). The sensory measurements were significantly different in appearance (p<0.05), saltiness (p<0.05), sweetness (p<0.01), and overall quality (p<0.05). The optimum formulation of the Korean barbecue beef calculated by numerical and graphical method was 3.71 g of sugar and 19.53 g of soy sauce. Moisture content, hardness and adhesiveness of the Korean barbecue beef were 78.85%, 2.40, -1.87, respectively. The result shows that food for the elderly, which is easy to chew and swallow, using gelification will have sufficient competitiveness in terms of safety, taste, and preference. The development of food for the elderly that take into account the difficulties in chewing and swallowing among the elderly, reflects their preference, and has sufficient nutrients, is important to enable the elderly to enjoy their meals. Also, as the Korean society is getting older, it remains one of the biggest social challenges.

• 한국가금학회:학술대회논문집
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• 한국가금학회 2006년도 제23차 정기총회 및 학술발표회
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• pp.7-16
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• 2006

Poultry products including meat and eggs constitute a major protein source in the American diet and disease - causing pathogens represent major challenges to the poultry industry. More than 95 % of pathogens enter the host through the mucosal surfaces of the respiratory, digestive and reproductive tracts and over the past few decades, the two main mechanisms used to control diseases have been the use of vaccines and antibiotics. However, in the poultry industry, there are mounting concerns over the ability of current vaccines to adequately protect against emerging hyper - virulent strains of pathogens and a lack of suitable, cost effective adjuvants. Thorough investigation of the immunogenetic responses involved in host-pathogen interactions will lead to the development of new and effective strategies for improving poultry health, food safety and the economic viability of the US poultry industry. In this paper, I describe the development of immunogenomic and proteomic tools to fundamentally determine and characterize the immunological mechanisms of the avian host to economically significant mucosal pathogens such as Eimeria. Recent completion of poultry genome sequencing and the development of several tissue-specific cDNA libraries in chickens are facilitating the rapid application of functional immunogenomics in the poultry disease research. Furthermore, research involving functional genomics, immunology and bioinformatics is providing novel insights into the processes of disease and immunity to microbial pathogens at mucosal surfaces. In this presentation, a new strategy of global gene expression using avian macrophage (AMM) to characterize the multiple pathways related to the variable immune responses of the host to Eimeria is described. This functional immunogenomics approach will increase current understanding of how mucosal immunity to infectious agents operates, and how it may be enhanced to enable the rational development of new and effective strategies against coccidiosis and other mucosal pathogens.

• Biomolecules & Therapeutics
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• 제26권3호
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• pp.242-254
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• 2018

Defensins are antimicrobial peptides that participate in the innate immunity of hosts. Humans constitutively and/or inducibly express ${\alpha}$- and ${\beta}$-defensins, which are known for their antiviral and antibacterial activities. This review describes the application of human defensins. We discuss the extant experimental results, limited though they are, to consider the potential applicability of human defensins as antiviral agents. Given their antiviral effects, we propose that basic research be conducted on human defensins that focuses on RNA viruses, such as human immunodeficiency virus (HIV), influenza A virus (IAV), respiratory syncytial virus (RSV), and dengue virus (DENV), which are considered serious human pathogens but have posed huge challenges for vaccine development for different reasons. Concerning the prophylactic and therapeutic applications of defensins, we then discuss the applicability of human defensins as antivirals that has been demonstrated in reports using animal models. Finally, we discuss the potential adjuvant-like activity of human defensins and propose an exploration of the 'defensin vaccine' concept to prime the body with a controlled supply of human defensins. In sum, we suggest a conceptual framework to achieve the practical application of human defensins to combat viral infections.