• Journal of Gastric Cancer
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• 제18권3호
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• pp.253-263
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• 2018

Purpose: With increasing life expectancy, the presence of comorbidities has become a major concern in elderly patients who require surgery. However, little is known about the impact of different comorbidities on the outcomes of laparoscopic total gastrectomy (LTG). In this study, we investigated the impact of comorbidities on postoperative complications in patients undergoing LTG for gastric carcinoma. Materials and Methods: We retrospectively reviewed the cases of 303 consecutive patients who underwent LTG for gastric carcinoma between 2005 and 2016. The associations between each comorbidity and postoperative complications were assessed using univariate and multivariate analyses. Results: A total of 189 patients (62.4%) had one or more comorbidities. Hypertension was the most common comorbidity (37.0%), followed by diabetes mellitus (17.8%), chronic viral hepatitis (2.6%), liver cirrhosis (2.6%), and pulmonary (27.1%), ischemic heart (3.3%), and cerebrovascular diseases (2.3%). The overall postoperative morbidity and mortality rates were 20.1% and 1.0%, respectively. Patients with pulmonary disease significantly showed higher complication rates than those without comorbidities (32.9% vs. 14.9%, respectively, P=0.003); patient with other comorbidities showed no significant difference in the incidence of LTG-related complications. During univariate and multivariate analyses, pulmonary disease was found to be an independent predictive factor for postoperative complications (odds ratio, 2.14; 95% confidence interval, 1.03-4.64), along with old age and intraoperative bleeding. Conclusions: Among the various comorbidities investigated, patients with pulmonary disease had a significantly higher risk of postoperative complications after LTG. Proper perioperative care for optimizing pulmonary function may be required for patients with pulmonary disease.

• The Korean Journal of Physiology and Pharmacology
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• 제9권1호
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• pp.17-22
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• 2005

We examined whether the abnormal EEG state by NMDA receptor blocker MK-801 can be reversed by typical and atypical antipsychotics differentially by comparing their spectral profiles after drug treatment in rats. The spectral profiles produced by typical antipsychotics chlorpromazine (5 mg/kg, i.p.) and haloperidol (0.5 mg/kg, i.p.) were differ from that by atypical antipsychotic clozapine (5 mg/kg, i.p.) in the rats treated with or without MK-801 treatment (0.2 mg/kg, i.p.) which produce behavioral abnormalities like hyperlocomotion and stereotypy. The dissimilarity between the states produced by antipsychotics and the control state was examined with the distance of the location of the canonical variables calculated by stepwise discriminant analysis with the relative band powers as input variables. Although clozapine produced more different state from normal state than typical antipsychotics, clozapine could reverse the abnormal schizophrenic state induced by MK-801 to the state closer to the normal state than the typical antipsychotics. The results suggest that atypical anesthetic can reverse the abnormal schizophrenic state with negative symptom to the normal state better than typical antipsychotic. The results indicate that the multivariate discriminant analysis using the spectral parameters can help differentiate the antipsychotics with different actions.

• 식품산업과 영양
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• 제11권3호
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• pp.6-11
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• 2006

바이러스성 식중독은 장염을 일으키는 원인 병원체 중 노로바이러스에 의해 흔히 발생하며 이외에도 아스트로바이러스나 로타바이러스에 의한 집단 설사 사례가 국내에서 보고된 바 있다. 노로바이러스는 식중독과 관련하여 특히 오염된 식수와 굴 등 어패류의 생식을 통한 감염 사례가 많이 보고되어 있으나 사람 간 전파도 흔히 일어나는 전염력이 매우 높은 바이러스이다. 국내에서는 1999년 이후 보고가 되고 있으며 최근 집단 급식과 관련된 대형 식중독 사례들이 보고되면서 학교급식이 사회적인 이슈로 대두되고 있다. 2000년 이후 질병관리본부는 바이러스성 설사의 국내 발생현황을 파악하기 위하여 전국의 17개 시도보건환경 연구원과 노로바이러스를 포함한 4종의 바이러스성 장염원인 병원체에 대한 전국적인 실험실 감시체계를 운영한 결과 바이러스성 병원체가 확인된 사례의 약 18%에서 노로바이러스가 검출되었고, 집단설사 사례에서는 대부분 노로바이러스가 원인병원체로 확인되었다. 또한 노로바이러스의 조기 검출을 위해 질병관리본부는 2004년 중 노로바이러스 유전자 검출 kit를 자체적으로 제작하여 이를 전국의 시도 보건환경연구원을 연계한 감시체계에서 적극 활용함으로써 노로바이러스 집단설사사례의 조기 검출이 가능하게 되었고 지역내 노로바이러스 검출율을 높이는데 기여하였다. 국립보건연구원은 2003년과 2006년에 발생한 대규모 노로바이러스 식중독 사례 이외에도 산발적으로 지속적으로 발생하는 사례들을 조기에 탐지하고 국내에서 검출되는 설사바이러스 유전형 분포양상과 새로운 유전자형이나 변이주를 조기에 검출하고자 전국적인 노로바이러스 실험실 감시망을 강화하여 운영하고 있으며, 집단설사 발생시 각 사례의 연관성을 신속하게 분석할 수 있는 실시간 분자역학적 유전자 분석체계를 단계적으로 도입하고 있다. 실험실 감시체계 운영과 함께 집단 식중독 유발 병원체의 효율적인 관리를 위해 질병관리본부는 노로바이러스를 포함한 설사 유발 병원체를 신고대상 병원체로 지정(2006.06.12)하여 병원체 검출시 보고하도록 하고 관련 지침을 마련하였다. 노로바이러스가 지정전염병 병원체로 추가로 지정됨에 따라 집단 사례 및 실험실 감시사업을 통해 검출되는 병원체에 대한 보고가 강화되고 전파 방지와 2차 감염 사례 감소에도 기여할 수 있을 것으로 사료되며 전국의 실험실 감시망을 연결하는 국가 차원의 노로바이러스 실시간 분자역학적 분석체계 도입을 통해 노로바이러스 2차 감염을 줄이고 대규모 집단발병 및 유행의 조기 차단 효과를 가져올 수 있을 것이다.

• 한국지역사회생활과학회지
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• 제23권4호
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• pp.383-397
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• 2012

The incidence of zoonoses in Korea has recently increased. But the study for high risk group such as pig farmers to zoonoses has not been conducted in Korea. Thus we reviewed the articles in order to obtain basic data for zoonoses among pig farmers, especially in rural communities. Pigs are one of the most important domestic livestock in Korea not only from economic standpoint but also from standpoint of food. Pigs also represent a potential reservoir for many novel pathogens, therefore may transmit these to humans via direct contact, vectors such as mosquitos, or contaminated meat. The zoonoses associated with pigs can be classified into bacterial pathogen, viruses and so on. Bacterial zoonoses include brucellosis, leptospirosis, listeriosis, enterohemorrhagic Escherichia coli infection, pasteurellosis, salmonellosis, yersiniosis, tuberculosis, anthrax, necrobacillosis, swine erysipelas, erysipeloid, melioidosis, Streptococcus suis infection, Clostrium difficile infection, and campylobactor infection. Viral zoonoses consist of Japanese encephalitis, swine influenza, Nipah virus, Reston ebolavirus, and hepatitis E virus infection. Other type of zoonoses include actinomycosis, toxoplasmosis and Taenia solium infection. These zoonoses were important in Korean health policy but lately they have been overlooked. For effective health policy, we need to study zoonoses associated with pigs, and clinicians and veterinarians must care deeply about these zoonoses.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권2호
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• pp.114-123
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• 2017

Purpose: The goal of this study was the early diagnosis of ABCB11 spectrum liver disorders, especially those focused on benign recurrent intrahepatic cholestasis and progressive familial intrahepatic cholestasis. Methods: Fifty patients presenting neonatal cholestasis were evaluated to identify underlying etiologies. Genetic analysis was performed on patients suspected to have syndromic diseases or ABCB11 spectrum liver disorders. Two families with proven ABCB11 spectrum liver disorders were subjected to genetic analyses to confirm the diagnosis and were provided genetic counseling. Whole exome sequencing and Sanger sequencing were performed on the patients and the family members. Results: Idiopathic or viral hepatitis was diagnosed in 34%, metabolic disease in 20%, total parenteral nutrition induced cholestasis in 16%, extrahepatic biliary atresia in 14%, genetic disease in 10%, neonatal lupus in 2%, congenital syphilis in 2%, and choledochal cyst in 2% of the patients. The patient with progressive familial intrahepatic cholestasis had novel heterozygous mutations of ABCB11 c.11C>G (p.Ser4*) and c.1543A>G (p.Asn515Asp). The patient with benign recurrent intrahepatic cholestasis had homozygous mutations of ABCB11 c.1331T>C (p.Val444Ala) and heterozygous, c.3084A>G (p.Ala1028Ala). Genetic confirmation of ABCB11 spectrum liver disorder led to early liver transplantation in the progressive familial intrahepatic cholestasis patient. In addition, the atypically severe benign recurrent intrahepatic cholestasis patient was able to avoid unnecessary liver transplantation after genetic analysis. Conclusion: ABCB11 spectrum liver disorders can be clinically indistinguishable as they share similar characteristics related to acute episodes. A comprehensive genetic analysis will facilitate optimal diagnosis and treatment.

• Safety and Health at Work
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• 제11권2호
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• pp.199-206
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• 2020

Background: In a wide range of industries, noise-induced hearing loss remains one of the most prevalent occupational problems. This study aimed to assess the noise exposure level and associated factors of hearing loss among textile workers in Yangon Region, Myanmar. Methods: A cross-sectional study was conducted at a Textile mill (Thamine), Yangon Region, from April to December 2018. In total, 226 workers who were randomly selected from 3 weaving sections participated in face-to-face interviews using a structured questionnaire. A digital sound level meter and pure-tone audiometer were used for the assessment of noise exposure level and hearing loss, respectively. Logistic regression analysis was performed to assess the associated factors of hearing loss. Results: In total workers, 66.4% were exposed to ≥85 dB(A) of noise exposure, and the prevalence of hearing loss was 25.7%. Age ≥35 years, below high school education, hearing difficulty, tinnitus, hypertension, > 9 years of service duration in a textile mill were positively associated with hearing loss. After adjusting confounding factors, age ≥35 years (adjusted odds ratio = 6.90, 95% confidence interval = 3.45-13.82) and tinnitus (adjusted odds ratio = 2.88, 95% confidence interval = 1.13-7.37) were persistently associated with hearing loss. Conclusion: Providing occupational hazard education and enforcement of occupational safety regulations should be taken to decrease the noise exposure level. The regular audiometry test should be conducted for assessment of hearing threshold shift. The employer needs to implement a hearing conservation program in workplace when noise exposure reaches or exceeds 85 dB(A) for 8 hours.

• Journal of Ginseng Research
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• 제35권1호
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• pp.69-79
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• 2011

Hepatocellular carcinoma (HCC) is the fi fth most common malignancy in the world and complicates liver cirrhosis related to hepatitis C virus (HCV) in many cases. We evaluated the therapeutic effect of Korean red ginseng extract (KGE) in patients with chronic liver diseases. Thirty male and female patients with HCC and another thirty with liver cirrhosis were included. Each category was divided into two groups; the first was used as control group, and received medical therapy only and the second group received the medical therapy supplemented with KGE capsules. The treated group with HCC received three KGE capsules/day (900 mg) while the treated group with HCV received two KGE capsules/day (600 mg) for 11 weeks along with their medical therapy. All patients were subjected to clinical examination and laboratory investigations, including liver function tests (at baseline, after 6 weeks of treatment and at the end of the study) and abdominal ultrasonography. Patients showing focal hepatic lesions were subjected to triphasic spiral abdominal computerized tomography and alpha-fetoprotein (AFP). HCV RNA was determined quantitatively by Roche for patients in the HCV group. Results showed that the medical therapy alone failed to normalize the liver enzymes or decrease the virus concentration. KGE administration induced a significant improvement in liver function tests, decreased the tumor marker (AFP) levels, and decreased the viral titers in HCV patients. Thus, KGE demonstrated powerful therapeutic effects against HCV and liver cancer.

• Archives of Pharmacal Research
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• 제28권4호
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• pp.451-457
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• 2005

Experimental studies have demonstrated that the triple combination of amantadine (A)/ ursodeoxycholic acid (UDCA, U)/ biphenyl dimethyl dicarboxylate (DDB, D) might have a preferential antiviral effect compared with that observed in interferon-induced antiviral signal pathways, such as those of $STAT1\alpha$ and the 6-16 genes. To confirm the results, this study examined whether th signal transduction for the antiviral activity in HepG2 2.2.15 was induced dependently or independently of interferon. To accomplish this, the correlation between the $STAT1\alpha$ and 6-16 genes, and nitric oxide, for the mediation of the antiviral activity was assessed. The increase in nitric oxide in the UDCA groups suggests that the inhibition of viral gene replication was enhanced by the amantadine combinations (AU and AUD), and might be more effective if incubated for longer periods. It was found that $STAT1\alpha$ was activated by the amantadine combination, although to a lesser extent than that of $interferon-\alpha$, and the primary endpoints examined for the inhibition of gene expression (HBsAg and HBcAg) were remarkably well regulated. This suggests that the amantadine triple, or at least the double, combination had better clinical benefits than those of $IFN-\alpha$ and the nucleoside analogue single treatment. This demonstrates that the amantadine combination might be a substitute for the existing HBV therapy if the results of in vivo and in vitro studies concur.

• Journal of Preventive Medicine and Public Health
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• 제16권1호
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• pp.13-18
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• 1983

성적접촉에 의한 B형간염의 전파가능성을 조사하고 그 정도를 파악할 목적으로 1982년 3월 1일부터 7월 31까지 대구시내 윤락여성 435명을 대상으로 B형간염감염율과 그들의 연령, 종사기간, 교육수준, 수혈 및 수술력을 조사하였다. B형간염 virus 보유율이 높은 한국인을 상대로 하는 중구보건소에 등록된 윤락여성의 경우 B형간염 감염율이 41.7%였고 B형간염 virus 보유율이 낮은 주한미군을 상대로 하는 동 남구보건소에 등록된 윤락여성에서는 30.2%의 감염율을 나타내어 중구보건소에 등록된 윤락여성이 통계적으로 유의하게 높은 잠염율을 보였다(p<0.025). 동 남구보건소에 등록된 윤락여성에서는 종사기간 별로 별다른 차이를 보이지 않았으나 중구보건소에 등록된 윤락여성에서는 2년 이상의 경우 B형간염 감염율이 49.3%였고 2년 미만의 경우 38.9%로 차이는 있으나 통계적 유의수준에는 미치지 못하였다. 교육수준, 수술력 및 수혈력과 B형간염, 감염율 사이에는 일정한 상관관계를 보이지 않았다. 이상의 결과로 미루어 보아 성적접촉으로 B형간염이 어느정도 전파되기는 하나 주전파 경로는 아닌 것으로 생각된다.

• 사상체질의학회지
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• 제25권3호
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• pp.195-207
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• 2013

Objectives This study aimed to examine differences in the hepatic function disorders and prevalence rates of liver diseases in accordance with the Sasang constitutional type, and to analyze whether Sasang constitution is a significant risk factor for fatty liver. Methods A total of 1211 patients who underwent health check-up at the Ilsan Hospital of Dongguk University and had their physical constitutions diagnosed by a specialist in Sasang constitutional medicine from October 31, 2011 to September 28, 2012 were used as the subjects of this study. Presence of hepatobiliary diseases was analyzed from the results of the hepatic function test, lipid test and viral hepatitis infection marker test in the biochemistry tests, and abdominal ultrasonography. Results & Conclusion Subjects of the study were composed of 691 males and 520 females and, in terms of Sasang constitution distribution, 550 Taeeumin, 343 Soeumin and 318 Soyangin. As the results of analysis of prevalence rates in accordance with Sasang constitutions, significant differences were observed in the prevalence rates of abnormal groups in the cases of AST, ALT, GGT, Triglyceride, HDL-cholesterol and LDL-cholesterol, and all of their prevalence rates were in the descending order of Taeeumin, Soyangin and Soeumin. Soeumin displayed significantly higher positive rate for HBs Ab in comparison to Taeeumin and Soyangin. In the results of abdominal ultrasonography, the prevalence rates of fatty liver displayed significant differences and were in the descending order of Taeeumin, Soyangin and Soeumin. And as the result of logistic regression analysis in order to find the risk factors of fatty liver, the Sasang constitution was found to be a significant risk factor for fatty liver. The odds ratio of Taeeumin in fatty liver was found to be 1.634 higher than Soeumin and 1.773 higher than Soyangin