• Title/Summary/Keyword: Risk of Infection

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"Off-pump" Coronary Artery Bypass Graft in the Chronic Renal Failure Patients -3 Cases Report- (만성 신부전증을 동반한 협심증 환자에서 심폐바이패스를 사용하지 않는 관상동맥우회술 -3예 보고-)

  • 김태헌;김기봉
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.835-839
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    • 1999
  • Since the first report of coronary artery bypass grafting (CABG) in patients with end-stage renal disease in 1974, numerous reports have documented the feasibility of CABG in patients with chronic renal diseases. Patients with chronic renal failure often have comorbid disorders such as hypertension, and diabetes mellitus, each with their own complications and associated impact on both short and long-term survivals. In addition, infection and sepsis have been identified as significant causes of morbidity and mortality in most series of patients with end-stage renal disease undergoing cardiac surgical procedure. As a result of these and other factors such as perioperative volume and electrolyte disturbances, patients with chronic renal failures are at an increased risk of complication and mortality after CABG. We report 3 cases of "Off-pump" CABG in the chronic renal failure patients. patients.

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Generating GAN-based Virtual data to Prevent the Spread of Highly Pathogenic Avian Influenza(HPAI) (고위험성 조류인플루엔자(HPAI) 확산 방지를 위한 GAN 기반 가상 데이터 생성)

  • Choi, Dae-Woo;Han, Ye-Ji;Song, Yu-Han;Kang, Tae-Hun;Lee, Won-Been
    • The Journal of Bigdata
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    • v.5 no.2
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    • pp.69-76
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    • 2020
  • This study was conducted with the support of the Information and Communication Technology Promotion Center, funded by the government (Ministry of Science and ICT) in 2019. Highly pathogenic avian influenza (HPAI) is an acute infectious disease of birds caused by highly pathogenic avian influenza virus infection, causing serious damage to poultry such as chickens and ducks. High pathogenic avian influenza (HPAI) is caused by focusing on winter rather than year-round, and sometimes does not occur at all during a certain period of time. Due to these characteristics of HPAI, there is a problem that does not accumulate enough actual data. In this paper study, GAN network was utilized to generate actual similar data containing missing values and the process is introduced. The results of this study can be used to measure risk by generating realistic simulation data for certain times when HPAI did not occur.

An exploratory study on the development plan of the medical tourism industry in the context of the COVID-19 pandemic (코로나 19팬데믹 상황에서 의료관광 산업의 발전 방안에 관한 탐색적 연구)

  • Yoon, Kyung Jae
    • The Journal of the Convergence on Culture Technology
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    • v.7 no.4
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    • pp.577-582
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    • 2021
  • This study was conducted to find ways to restore the domestic medical tourism industry, which was seriously hit by a sharp drop in foreign patients after the COVID-19 Pandemic. Kendall's W verification was used by asking expert panel for keyword advice by ranking. The conclusion of the study is that institutions attracting foreign patients need an opportunity to turn the crisis situation into an opportunity by expanding treatment for severe foreign patients. In addition, it is possible to gain familiarity and trust in hospitals in situations where it is difficult to visit overseas through virtual and augmented reality, and to prevent the risk of infection and protect patients in the untact era. In addition, the blockchain can maintain patient information supplementation, share it safely, minimize customer inconvenience by using payment means using virtual currency, and finally, smart healthcare can manage and provide information to patients regardless of location.

Outcomes of liver transplantation for hepatocellular carcinoma: Experiences from a Vietnamese center

  • Khai Viet Ninh;Dang Hai Do;Trung Duc Nguyen;Phuong Ha Tran;Tuan Hoang;Dung Thanh Le;Nghia Quang Nguyen
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.1
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    • pp.34-41
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    • 2024
  • Backgrounds/Aims: Liver transplantation (LT) provides a favorable outcome for patients with hepatocellular carcinoma (HCC) and was launched in Vietnam in 2004. In this study, we evaluated the short-term and long-term outcomes of LT and its risk factors. Methods: This retrospective study analyzed HCC patients who underwent LT at Viet Duc University hospital, Vietnam, from 01/2012-03/2022. The following data were gathered: demographics, virus infection, tumor characteristics, alpha-fetoprotein (AFP) level, Child-Pugh and MELD scores, selection criteria, type of LT, complications, 30-day mortality, and disease-free and overall survival (DFS and OS). Results: Fifty four patients were included, the mean age was 55.39 ± 8.46 years. Nearly 90% had hepatitis B virus-related HCC. The median (interquartile range) AFP level was 16.2 (88.7) ng/mL. The average MELD score was 10.57 ± 5.95; the rate of Child-Pugh A and B were 70.4% and 18.5%, respectively. Nearly 40% of the patients were within Milan criteria, brain-dead donor was 83.3%. Hepatic and portal vein thrombosis occurred in 0% and 1.9%, respectively; hepatic artery thrombosis 1.9%, biliary leakage 5.6%, and postoperative hemorrhage 3.7%. Ninety-day mortality was 5.6%. Five-year DFS and OS were 79.3% and 81.4%, respectively. MELD score and ChildPugh score were predictive factors for DFS and OS (p < 0.05). In multivariate analysis, Child-Pugh score was the only significant factor (p < 0.05). Conclusions: In Vietnam, LT is an effective therapy for HCC with an acceptable complication rate, mortality rate, and good survival outcomes, and should be further encouraged.

Recent Research Trend in Microneedle Fabrication Using 3D Printing (3D 프린팅을 이용한 마이크로니들 제작의 최신 연구 동향)

  • Choo, Sangmin;Jung, Jae Hwan
    • Applied Chemistry for Engineering
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    • v.32 no.4
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    • pp.379-384
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    • 2021
  • A microneedle is a tool that used for drug delivery and diagnosis. Unlike general injections, the microneedle is short in length, enabling effective drug delivery while minimizing pain and risk of infection. Conventionally, microneedles have been manufactured precisely at a nanometer level based on microelectro mechanical systems (MEMS) technology, requiring expensive equipments & maintenance and complicated processes. To address the issues, 3D printing research has been conducted to fabricate microneedles simply, economically, and rapidly. Since 3D printing facilitates to manufacture prototypes and apply feedbacks, it is advantageous for the development and commercialization of microneedle for pharmaceuticals and cosmetics. Therefore, this review will introduce stereolithography (SLA), two-photon polymerization (2PP), dynamic light processing (DLP), continuous liquid interface production (CLIP), and fused deposition modeling (FDM) 3D printing technologies and also highlight research trends for microneedle production using them. Furthermore, the limitation of the current microneedle technology and the direction to be solved in the future will be discussed.

Barthel's Index: A Better Predictor for COVID-19 Mortality Than Comorbidities

  • da Costa, Joao Cordeiro;Manso, Maria Conceicao;Gregorio Susana;Leite, Marcia;Pinto, Joao Moreira
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.4
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    • pp.349-357
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    • 2022
  • Background: The most consistently identified mortality determinants for the new coronavirus 2019 (COVID-19) infection are aging, male sex, cardiovascular/respiratory diseases, and cancer. They were determined from heterogeneous cohorts that included patients with different disease severity and previous conditions. The main goal of this study was to determine if activities of daily living (ADL) dependence measured by Barthel's index could be a predictor for COVID-19 mortality. Methods: A prospective cohort study was performed with a consecutive sample of 340 COVID-19 patients representing patients from all over the northern region of Portugal from October 2020 to March 2021. Mortality risk factors were determined after controlling for demographics, ADL dependence, admission time, comorbidities, clinical manifestations, and delay-time for diagnosis. Central tendency measures were used to analyze continuous variables and absolute numbers (proportions) for categorical variables. For univariable analysis, we used t test, chi-square test, or Fisher exact test as appropriate (α=0.05). Multivariable analysis was performed using logistic regression. IBM SPSS version 27 statistical software was used for data analysis. Results: The cohort included 340 patients (55.3% females) with a mean age of 80.6±11.0 years. The mortality rate was 19.7%. Univariate analysis revealed that aging, ADL dependence, pneumonia, and dementia were associated with mortality and that dyslipidemia and obesity were associated with survival. In multivariable analysis, dyslipidemia (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.17-0.71) was independently associated with survival. Age ≥86 years (pooled OR, 2.239; 95% CI, 1.100-4.559), pneumonia (pooled OR, 3.00; 95% CI, 1.362-6.606), and ADL dependence (pooled OR, 6.296; 95% CI, 1.795-22.088) were significantly related to mortality (receiver operating characteristic area under the curve, 82.1%; p<0.001). Conclusion: ADL dependence, aging, and pneumonia are three main predictors for COVID-19 mortality in an elderly population.

Lung Complications After Allogenic Bone Marrow Transplantaion (동종골수이식 후 폐합병증)

  • JeGal, Yang-Jin;Lee, Je-Hwan;Lee, Kyoo-Hyung;Kim, Woo-Kun;Shim, Tae-Sun;Lim, Chae-Man;Koh, Youn-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Won Dong;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.2
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    • pp.207-216
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    • 2000
  • Background : The occurrence of lung complications after allogenic bone marrow transplantation(BMT) has been reported as 40-60 percent. The risk factors for lung complications are whole body irradiation, high dose chemotherapy, graft versus host disease, old age and CMV infection. The prevalence of graft versus host disease is less in Korea than in Western countries, but frequency of CMV infection is higher. Therefore, the pattern of lung complications may be different in Korea from those in Western countries. Methods : A retrospective cohort study was performed on one hundred consecutive adult patients who underwent allogenic bone marrow transplantation from December, 1993 to May, 1999 at Asan Medical Center. Lung complications were divided into two groups by the time of development, within 30days (pre-engraftment) and beyond 30 days (post-engraftment), and then subdivided into infectious and non-infectious complication. Infectious complications were defined as having the organism in blood, BAL fluid, pleural fluid or sputum, or compatible clinical findings in patients, which improved with antibiotics or an anti-fungal therapy. Result: 1) Eighty three episodes of lung complications had occurred in 54 patients. 2) Within thirty days after BMT, non-infectious complications were more common than infections, but this pattern was reversed after 30 days. After one year post-BMT, there was no infectious complication except in cases of recurrence of underlying disease or development of chronic GVHD. 3) Among the non-infectious complications, pleural effusion (27 episodes) was most common, followed by pulmonary edema (8 episodes), bronchiolitis obliterans(2 episodes), diffuse alveolar hemorrhage (1 episode) and bronchiloitis obliterans with organizing pneumonia (1 episode). 4) The infectious complications were pneumonia (bacterial: 9 episodes, viral: 4 episodes, fungal : 5 episodes, pneumocystis carinii : 1 episode), pulmonary tuberculosis(3 episodes) and tuberculous pleurisy (3 episodes). 5) Lung complications were more frequent in CMV positive patients and in patients with delayed recovery of neutrophil count. 6) The mortality was higher in the patients with lung complications. Conclusion : Lung complications developed in 54% after allogenic BMT and were associated with higher mortality.

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Ceftriaxone Associated Biliary Pseudolithiasis (Ceftriaxone 사용후 발생된 Pseudolithiasis)

  • Kim, Jae-Young;Ko, Jae-Sung;Lee, Hwan-Jong;Ko, Young-Ryul;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.1 no.1
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    • pp.100-106
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    • 1998
  • Purpose: Ceftriaxone, a potent parenteral third-generation semisynthetic cephalosporin is widely used for the treatment of a variety of bacterial infections in both children and adult. Review of recent data indicates that ceftriaxone treatment has been associated with the development of reversible biliary pseudolithiasis and that is thought by many to be a benign process. Despite, several reports describe patients with ceftriaxone pseudolithiasis who required cholecystectomy for presumed acute cholecystitis. In this study we evaluated the incidence, risk factors, and prognosis of gallbladder pseudolithiasis after ceftriaxone treatment. Methods: Between march, 1997 and January, 1998, any child admitted to the Children's hospital of National University of Seoul and prescribed ceftriaxone for probable or definite bacterial infection were eligible for the study. 21 of them had ultrasound examination on the 2~12 days later after the start of ceftriaxone treatment, 8 of whom documented gallbladder precipitates or pseudolithiasis during treatment by serial abdominal ultrasound. Repeat abdominal ultrasound was performed 10~80 days later after the end of ceftriaxone treatment. The children with underlying liver disease or decreased renal function were excluded in this study. Results: 1) 21 children had ultrasound examinations of gallbladder during ceftriaxone treatment and 8 (38%) of them acquired pseudolithiasis. 2) The patients who developed gallbladder pseudolithiasis were significantly older ($6.3{\pm}2.9$ yr. vs $2.2{\pm}3.1$ yr.)(p<0.05), and older than 24 months were probably the significant risk associated with this phenomenon (p<0.05). However, no significant differences in sex, type of infection, fasting, and ceftriaxone treatment regimen (dose, duration of therapy). 3) The abnormality found on gallbladder ultrasonography was a strikingly hyperechogenic material with post-acoustic shadowing in 5 patients without post-acoustic shadowing in 3 patients 4) Follow up of gallbladder ultrasound was performed in 6 patients after cessation of ceftriaxone treatment. Sonographic abnormalities completely resolved within 14 days post cessation of therapy in 2 patients; 30 days, 1 patient; 80 days, 3 patients. Conclusions: We suggest that routine abdominal ultrasound should be considered in all children who received high dose ceftriaxone in more than 24 months of age and developed hepatobiliary symptoms during or just after ceftriaxone treatment.

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The Occurrence of Renal Scarring in Children with Unilateral Vesicoureteral Reflux (일측성 방광 요관 역류 환아에서 신반흔의 발생)

  • Lee, Tae Ho;Son, Mi Ran;Byun, Soon Ok;Moon, Jung Woong
    • Clinical and Experimental Pediatrics
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    • v.48 no.9
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    • pp.998-1003
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    • 2005
  • Purpose : We evaluated the occurrence of renal scarring in children with unilateral vesicoureteral reflux(VUR), and the relationships between renal scar formation and risk factors such as VUR, duration of fever, acute-phase reactant, age, and sex. Methods : We retrospectively analyzed the data of 35 children newly diagnosed with unilateral vesicoureteral reflux after urinary tract infection(UTI) in Wallace Memorial Baptist Hospital between January 1996 and December 2004. Ultrasonography, Erythrocyte sedimentation rate(ESR), and C-reactive protein(CRP) were performed initially. Voiding cystourethrography(VCUG) was performed 1 to 3 weeks after treatment with UTI. $^{99m}Tc$-dimercaptosuccinic acid(DMSA) scan was performed 4 to 6 months after treatment. Results : Scintigraphic renal damage was present in 29 percent of the refluxing and in 3 percent of the nonrefluxing kidneys(P<0.05). The severity of VUR was significantly correlated with renal scar formation(P<0.05). The duration of fever before treatmen($5.0{\pm}1.3$ vs $2.6{\pm}1.3$) and prolonged fever of over 5 days were significantly different between renal scar group and non-renal scar group(P<0.05). ESR($56.3{\pm}23.8$ vs $27.9{\pm}18.1mm/hr$, P<0.05) and CRP($12.8{\pm}7.3$ vs $3.9{\pm}3.8mg/dL$, P<0.05) at the diagnosis of UTI in the renal scar group were higher, compared to those of the non-renal scar group. There were no significant differences in age and sex between the two groups. Conclusion : The presence and grade of VUR, the duration of fever before treatment, prolonged fever over 5 days, ESR, and CRP were risk factors for renal scarring, irrespective of age and sex. Diagnosis and management of VUR, in children with UTI, is important to prevent renal scars.

Dental Caries Risk Can Be Predicted by Simply Measuring the pH and Buffering Capacity of Saliva (치아우식과 연관된 타액의 pH와 완충력)

  • Jeong, Soon-Jeong;Apostolska, Sonja;Jankulovska, Mira;Angelova, Dragana;Nares, Salvador;Yoon, Mi-Sook;Lim, Do-Seon;Angelov, Nikola;Jeong, Moon-Jin
    • Journal of dental hygiene science
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    • v.6 no.3
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    • pp.159-162
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    • 2006
  • This study examined the relationship between the quantity of Streptococcus mutans and Lactobacillus spp. related to dental caries and the degree of acidity in saliva. A total of 240 saliva samples were taken from 80 subjects at the faculty of dentistry in Skopje, Macedonia. The saliva samples were taken by stimulating saliva production stimulation with paraffin chewing. However, no stimulation was applied when obtaining the samples used for measuring the pH. The data showed that in the caries group, S. mutans in 1 ml of saliva formed colonies with confluent growth (CFU > $10^6$ and $10^4-10^5$) in 100% of samples, whereas the Lactobacillus spp. formed colonies with confluent growth in 78.3%. In contrast, no colonies with confluent growth (CFU > $10^6$ and $10^5$) were found in the control group (with healthy intact teeth). In the caries group, the pH of the saliva was slightly acidic (pH = 5.90 - 6.50) and the buffering capacity was very low (below 0.7 ml of saliva per min). On the other hand, the pH of the saliva in the control group was neutral (pH 7.01 - 7.7) and the buffering capacity was high (over 1 ml of saliva per min). The increased number of S. mutans and Lactobacillus spp. in 1 ml of saliva (above $10^5$ CFU or more) from the CRT (Caries Risk Test, Vivadent, Liechtenstein) bacteria test can indicate an increased caries risk as well as slightly higher acidity of the saliva. Overall, these results reveal that the caries risk can be predicted by simply measuring the pH and buffering capacity of saliva, and can be used to monitor the effect of dental hygiene practices with the aim of preventing dental caries.

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