• Title/Summary/Keyword: Risk Severity

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Evaluation of Toxicological Data on Food Additives and Guideline for ADI establishment - Polydimethylsiloxane as emulsifier - (식품첨가물의 독성자료 고찰과 ADI 평가지침 - 소포제 Polydimethylsiloxane를 사례로 -)

  • Choi, Chan-Woong;Jeong, Ji-Yoon;Park, Hyoung-Su;Moon, Jin-Hyun;Lee, Kwang-Ho;Lee, Hyo-Min
    • Journal of Food Hygiene and Safety
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    • v.24 no.4
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    • pp.352-356
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    • 2009
  • The purpose of this study was to introduce the toxicological study review to evaluate the safety of PDMS on the 69th JECFA meeting. Polydimethylsiloxane is a polymer and its ADI was established at 23rd JECFA meeting in 1979. The ADI was maintained although the specification was expanded at its 26th, 29 th, 37 th meetings. Recently, it was reported that PDMS with low molecular weight and viscosity has high absorption rate and different toxicity, so it was submitted at 69th meeting. Toxicological studies of PDMS were submitted from the sponsor and additional information is collected from a document searching. The toxicological studies were reviewed in accordance with the 'Guidelines for the preparation of toxicological working papers for the Joint FAO/WHO Expert Committee on Food Additives'. In the available acute, sub-chronic and chronic toxicity studies on PDMS, dose-related increases in incidence and severity of ocular lesions(corneal crystal, inflammation of the corneal epithelium etc.) were consistently observed after oral dosing. It seems to be a local irritant effect, but the mechanism by which the ocular lesions arose is unclear, although the lack of absorption of PDMS indicates that it is unlikely to be a direct systemic effect. Consequently, the relevance of the ocular lesions for food use of PDMS could not be determined. The ADI of PDMS was re-established from 0-1.5 mg/kg bw/day to 0-0.8 mg/kg bw/day by applying additional safety factor 2 based on its ocular toxicity. The result of 0-0.8 mg/kg bw/day is a temporary ADI until further data are provided to 2010.

Risk Factors of Neurologic Complications After Coronary Artery Bypass Grafting (관상동맥 우회수술후 신경계 합병증의 위험인자)

  • Park, Kay-Hyun;Chae, Hurn;Park, Choong-Kyu;Jun, Tae-Gook;Park, Pyo-Won
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.790-798
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    • 1999
  • Background: As the early outcome after coronary artery bypass grafting(CABG) has been stabilized, neurologic complication has now become one of the most important morbidity. The aim of this study was to find out the risk factors associated with the neurologic complications after CABG. Material and Method: In 351 patients who underwent CABG, the incidence and features of neurologic complications, with associated perioperative risk factors, were retrospectively reviewed. Neurologic complication was defined as a new cerebral infarction confirmed by postoperative neurologic examination and radiologic studies, or delayed recovery of consciousness and orientation for more than 24 hours after the operation. Result: Neurologic complications occurred in 18 patients(5.1%), of these nine(2.6%) were diagnosed as having new cerebral infarctions(stroke). Stroke was manifested as motor paralysis in four patients, mental retardation or orientation abnormality in four, and brain death in one. Statistical analysis revealed the following variables as significant risk factors for neurologic complications by both univariate and multivariate analyses: cardiopulmonary bypass longer than 180 minutes, atheroma of the ascending aorta, carotid artery stenosis detected by Duplex sonography, and past history of cerebrovascular accident or transient ischemic attack. Age over 65 years, aortic calcification detected by simple X-ray, and intraoperative myocardial infarction were significant risk factors by univariate analysis only. Neither the severity of carotid artery stenosis nor technical modifications such as cannulation of the aortic arch or single clamp technique, which were expected to affect the inciden e of neurologic complications, had significant relationship with the incidence. Conclusion: This study confirmed the strong association between neurologic complications after CABG and atherosclerosis of the arterial system. Therefore, to minimize the incidence of neurologic complications, systematic evaluation focused on atherosclerotic lesions of the arterial system followed by adequate alteration of operative strategy is needed.

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Analysis of Complications Associated with the Nuss Procedure: Risk Factors and Preventive Measures (너스수술의 합병증에 대한 고찰: 위험인자 분석과 예방책의 제시)

  • Park, Hyung-Joo;Chang, Won-Ho;Jeon, Cheol-Woo;Park, Han-Gyu;Lee, Seock-Yeol;Lee, Cheol-Sae;Youm, Wook;Lee, Kihl-Roh
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.524-529
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    • 2004
  • Background: Since the Nuss procedure for the correction of pectus excavatum is in its early stage, there have been problems that need to be solved. We examined complications in a single-institute experience of the Nuss technique in order to develop possible solutions to prevent them. Material and Method: 335 consecutive patients, who underwent the modified Nuss procedure between August 1999 and October 2002, were studied retrospectively. Median age was 8 years (range 1 to 46). 264 patients (78.8%) were in pediatric group (age$\leq$15) and 71 patients (21.2%) were in adult group (age> 15). 193 patients (57.6%) had symmetric and 142 patients (42.4%) had asymmetric pectus configurations. Risk factors predicting postoperative complications were analyzed using multi-variate logistic regression. Result: Postoperative complication rates were 18.9% (61/335) in total patients. Frequent complications were pneumothorax 24 (7.5%), bar displacement 11 (3.4%), and wound seroma 10 (3.1%) in order. Early complications (within a month, 49 cases, 15.2%) were pneumothorax (n=23, 6.9%), wound seroma (n=12, 3.6%), and bar displacement (n=8, 2.4%). Late complications (after a month, 12 cases, 3.7%) were pericarditis and pericardial effusion (n=5, 1.5%), bar displacement (n=4, 1.2%), and hemothorax (n=3, 0.9%). Techniques were modified to prevent complications especially in bar shaping and fixation, which led to decrease complication rate in later experience (Operation Date 1: 15/51 (29.4%) vs Operation Date 2: 34/284 (12.0%), p=0.004). Grand Canyon type (eccentric long canal type) showed higher complication rate than other types (GC type: 12/30(40%) vs Others: 37/305 (12.1%), p<0.001). Major risk factors are severity of pectus (OR=2.88, p=0.038), Grand Canyon type (OR=2.82, p=0.044), and Op. Date 1 (OR=4.05, p=0.001). Conclusion: Major complications were related to severe eccentric type of pectus configuration (Grand Canyon type) and lack of surgeon's experience (Op. Date 1). Com-plication rate was reduced with accumulation of experience and advancement of surgical techniques. The Nuss procedure can be performed at a low risk of complications with our current technique.

Anti-inflammatory Effects of UDCA on Splenocytes Exposed to PMA/Ionomycin

  • Park, So-Young;Woo, Jong-Shick;Jung, Yu-Jin;Won, Tae-Joon;Hih, Yun-Ju;Lee, Chan-Woo;Kim, Hyo-Shin;Joo, Seong-Soo;Lee, Do-Ik;Hwang, Kwang-Woo
    • Biomolecules & Therapeutics
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    • v.16 no.2
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    • pp.126-131
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    • 2008
  • Immunosuppressive therapy after organ transplantation is routinely used to prevent rejection of the organ, because this decreases the risk of adverse events, infection, and malignancies. Recently, ursodeoxycholic acid (UDCA), which is isolated from the dried bile of adult Chinese bears, has been shown to reduce the incidence and severity of acute rejection of liver allograft during early phase of liver transplantation. Therefore, in this study, we investigated the effect of UDCA on the proliferation of splenocytes exposed to PMA plus ionomycin. Our results demonstrated that UDCA decreased the splenocytes' proliferation in a dose-dependent manner. The decreased cell proliferation was accompanied with the decreased secretion of cytokines such as IL-2, IFN-${\gamma}$ and TNF-${\alpha}$. In addition, the pretreatment of UDCA on splenocytes stimulated with PMA plus ionomycin decreased the mRNA levels of cytokines (IL-2, IFN-${\gamma}$ and TNF-${\alpha}$) and costimulatory molecules (B7.2 and PD-L1). These results suggest the beneficial effect of UDCA on organ transplantation by decreasing lymphocyte proliferation.

A Study on Non-smoking Policy and Factors Related to Smoking in General Hospitals (종합병원의 금연방침과 직원의 흡연관련 요인 분석)

  • Nam, Eun-Woo;Ryu, Hwang-Gun
    • Korea Journal of Hospital Management
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    • v.6 no.1
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    • pp.85-106
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    • 2001
  • Since physical damages caused by passive smoking had been widely recognized, the Korea parliament enacted the National Health Promotion Law on September, 1995. The law specified nonsmoking areas in all public facilities, including hospitals. But this law is not strictly enforced. The benefits of a nonsmoking policy can not be expected by the public. Even though hospitals should preserve a smoke-free-environment, most of hospitals are not under full controls against smoking. The purpose of this study is to identify factors related to smoking in general hospitals. Field study and surveys were simultaneously performed at study hospitals in Busan. 9 of 24 general hospitals were selected and survey was performed for 10 days by investigators during January of 2000. Nine hospitals had nonsmoking regulations, but only 8 hospitals had designated nonsmoking areas. Two hospitals among those hospitals had a nonsmoking committee. Patients' smoking rate was 35.0%, while hospital employees' smoking rate was 22.5%. The smoking rates of physicians, nurses, administrators and medical technicians were 45.38%, 0.85%, 31.73% and 40.70%, respectively. In the question of the severity of damages caused by passive smoke, only 29.2% of the smoking group considered smoking as a serious health risk, while 69.4% of non-smoking group did. Christian employee showed lower smoking rate compared to other employee did. Even though physicians should educate patients and other professions about smoking, physicians' smoking rate (45.4%) was higher than other professions. As a consequence, this study insists that general hospitals should enhance their nonsmoking policy and implement any practical policy for smoking free hospital environment.

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Outcomes of Primary Unilateral Cheiloplasty in Same-Day Surgical Settings

  • Khan, Mansoor;Ullah, Hidayat;Aziz, Asif;Tahir, Muhammad
    • Archives of Plastic Surgery
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    • v.43 no.3
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    • pp.248-253
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    • 2016
  • Background Financial, clinical, and psychological considerations have made same-day surgery an attractive option for a variety of procedures. This article aimed to analyse the postoperative results of same-day primary unilateral cleft nasolabial repair. Methods This study was performed from 2011 to 2014. Unilateral cleft lip patients fulfilling the inclusion criteria were preoperatively classified as mild, moderate, and severe. All patients underwent same-day surgery and were discharged after satisfying the appropriate clinical criteria, receiving thorough counselling, and the establishment of a means of communication by phone. Postoperative outcomes were assessed and stratified according to preoperative severity and the type of repair. Results A total of 423 primary unilateral cleft lip patients were included. Fisher's anatomical subunit approximation technique was the most common procedure, followed by Noordhoff's technique. The postoperative outcome was good in 89.8% of cases, fair in 9.9% of cases, and poor in 0.2% of cases. The complication rate was 1.18% (n=5), and no instances of mortality were observed. The average hospital stay was 7.5 hours, leading to a cost reduction of 19% in comparison with patients who stayed overnight for observation. Conclusions Mild unilateral cleft lip was the most common deformity for which Fisher's anatomical subunit approximation technique was performed in most of the cases, with satisfactory postoperative outcomes. Refinements in the cleft rhinoplasty techniques over the course of the study improved the results regarding cleft nasal symmetry. Single-day primary unilateral cleft cheiloplasty was found to be a cost-effective procedure that did not pose an additional risk of complications.

Development of Crown Fire Propagation Probability Equation Using Logistic Regression Model (로지스틱 회귀모형을 이용한 수관화확산확률식의 개발)

  • Ryu, Gye-Sun;Lee, Byung-Doo;Won, Myoung-Soo;Kim, Kyong-Ha
    • Journal of the Korean Association of Geographic Information Studies
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    • v.17 no.1
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    • pp.1-12
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    • 2014
  • Crown fire, the main propagation type of large forest fire, has caused extreme damage with the fast spread rate and the high flame intensity. In this paper, we developed the probability equation to predict the crown fires using the spatial features of topography, fuel and weather in damaged area by crown fire. Eighteen variables were collected and then classified by burn severity utilizing geographic information system and remote sensing. Crown fire ratio and logistic regression model were used to select related variables and to estimate the weights for the classes of each variables. As a results, elevation, forest type, elevation relief ratio, folded aspect, plan curvature and solar insolation were related to the crown fire propagation. The crown fire propagation probability equation may can be applied to the priority setting of fuel treatment and suppression resources allocation for forest fire.

Status of Nosocomial Urinary Tract Infections in the ICU: Molecular Epidemiology of Imipenem Resistant P. aeruginosa (중환자실내 병원성 요로감염 실태와 전파경로: Imipenem Resistant P. aeruginosa[IRPA]의 분자역학적 특성을 중심으로)

  • Yu, Seong-Mi;Jeon, Seong-Sook;Kang, In-Soon;An, Hye-Gyung
    • Journal of Korean Academy of Nursing
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    • v.36 no.7
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    • pp.1204-1214
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    • 2006
  • Purpose: This retrospective study was done to evaluate the status of nosocomial urinary tract infections and to determine the risk factors and transmission route of causal IRPA through molecular epidemiology. Method: Two hundred ninety-nine of 423 patients admitted to the internal medicine and surgery ICU at a university hospital incity B had a positiveurine culture. Twelve of the 299 patients who had a urinary tract infection had IRPA strains. The data was collected from November 1, 2004 to January 31, 2005. The following results were obtained after the data was analyzed using percentile and UPGMA. Result: The rate of nosocomial urinary tract infections in the ICU was 10.8%. Therewere 16.8 cases of infection based on the period of hospitalization. There were 16.9 cases of infection based on the use of a foley catheter. The rate of nosocomial urinary tract infection in the ICU and urinary tract infections related to IRPA were higher in patients with the following characteristics: men, old age, admission through the emergency room, longer than seven days admission, severity of admitting causes, disturbance of consciousness, hydration less than 300cc in 24hours, a long course of antibiotics, a long period of foley catheterization and perineal care. Most of the microorganisms that caused the urinary tract infection were gram negative bacilli, among which P. aeruginosa was found in 70 patients (18.5%) and IRPA in 12 (4.0%). Among the 12 IRPA strains that were tested with PFGE, eight showed a dice coefficient higher than 80%, suggesting a genetic relationship. They were related with the period of hospitalization in the same ICU. These patients all received direct care for a urinary tract infection. Conclusion: Through these results, IRPA can be consideredas a contributing factors to urinary tract infections thus, active preventative measures are needed by the medical staff.

Satellite-based Hybrid Drought Assessment using Vegetation Drought Response Index in South Korea (VegDRI-SKorea) (식생가뭄반응지수 (VegDRI)를 활용한 위성영상 기반 가뭄 평가)

  • Nam, Won-Ho;Tadesse, Tsegaye;Wardlow, Brian D.;Jang, Min-Won;Hong, Suk-Young
    • Journal of The Korean Society of Agricultural Engineers
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    • v.57 no.4
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    • pp.1-9
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    • 2015
  • The development of drought index that provides detailed-spatial-resolution drought information is essential for improving drought planning and preparedness. The objective of this study was to develop the concept of using satellite-based hybrid drought index called the Vegetation Drought Response Index in South Korea (VegDRI-SKorea) that could improve spatial resolution for monitoring local and regional drought. The VegDRI-SKorea was developed using the Classification And Regression Trees (CART) algorithm based on remote sensing data such as Normalized Difference Vegetation Index (NDVI) from MODIS satellite images, climate drought indices such as Self Calibrating Palmer Drought Severity Index (SC-PDSI) and Standardized Precipitation Index (SPI), and the biophysical data such as land cover, eco region, and soil available water capacity. A case study has been done for the 2012 drought to evaluate the VegDRI-SKorea model for South Korea. The VegDRI-SKorea represented the drought areas from the end of May and to the severe drought at the end of June. Results show that the integration of satellite imageries and various associated data allows us to get improved both spatially and temporally drought information using a data mining technique and get better understanding of drought condition. In addition, VegDRI-SKorea is expected to contribute to monitor the current drought condition for evaluating local and regional drought risk assessment and assisting drought-related decision making.

Claimed Adverse Events of Korean Medicine in South Korea: Analysis of Cases in the Korea Medical Dispute Mediation and Arbitration Agency Databases (한의 의료와 연관된 조정 요청 이상반응: 한국의료분쟁조정중재원 접수사례 분석)

  • Hwang, Hye-Won;Lee, Ji-Sun;Kim, Kun Hyung
    • Korean Journal of Acupuncture
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    • v.34 no.3
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    • pp.126-135
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    • 2017
  • Objectives : The purpose of this study was to describe the type of claimed adverse events related to Korean Medicine practices in South Korea. Methods : Claims with regard to the Korean Medicine practice submitted to the Korea Medical Dispute Mediation and Arbitration Agency from April 2012 to December 2016 were collected. We analyzed claims that explicitly reported the type of Korean medicine intervention and were deemed as being adverse events as defined by the Korea Good Clinical Practice. Claims that did not mention the Korean medicine practice explicitly or those related to the patient's dissatisfaction to the service rather than adverse health outcomes were excluded. Types, related interventions and the suspected severity of claimed adverse events were summarized. Results : Of 197 claims obtained, 140 claim cases were eligible and 144 claimed events were deemed as possible adverse events of the Korean medicine practice. Pain(16%), local infection/inflammation(12%) and neurological symptoms(11%) were the most frequently reported types of claimed adverse events. Thirty-nine claimed serious adverse events(SAE) were identified, including pneumothorax(28.2%) and death(17.9%). Conclusions : A wide range of claimed adverse events were identified. Routine monitoring of claims data may provide undetected safety information with regard to the Korean medicine practice. High risk of misclassification of the intervention and claimed adverse events due to insufficient information is the main caveat of this study.