Purpose: This study aimed to investigate the risk factors for cardiac implantable electronic device (CIED)-related infections within the first post-procedural year after CIED insertion. Methods: This study included 509 adult patients undergoing CIED implantation procedures between January 1, 2011 and December 31, 2015. The data were analyzed by t-test, chi-square test, Fisher's exact test, and logistic regression analysis using SPSS/WIN 23.0. Results: Fifteen infections and 494 non-infections were examined. The CIED-related infection rate was 2.9%; patients with 14 pocket infections and one bacteremia were included in the CIED-related infection. The risk factors of CIED-related infections were the estimated glomerular filtration rate (eGFR) of ≤ 45 mL/min/1.73 m2 (Odds ratio [OR]= 4.03, 95% confidence interval [CI],1.15-14.10) and taking a new oral anticoagulant (NOAC) (OR = 4.50, 95% CI 1.09-18.55). Conclusion: These results identified the CIED infection rate and risk factors of CIED-related infection. It is necessary to consider these risk factors before the CIED implantation procedure and to establish the relevant nursing interventions.
The regulation of neurotoxicants has usually been based upon setting reference doses by dividing a no observed adverse effect level (NOAEL) by uncertainty factors that theoretically account for interspecies and intraspecies extraploation of experimental results in animals to humans. Recently, we have proposed a four-step alternative procedure which provides quantitative estimates of risk as a function of dose. The first step is to establish a mathematical relationship between a biological effect or biomarker and the dose of chemical administered. The second step is to determine the distribution (variability) of individual measurements of biological effects or their biomarkers about the dose response curve. The third step is to define an adverse or abnormal level of a biological effect or biomarker in an untreated population. The fourth and final step is to combine the information from the first three steps to estimate the risk (proportion of individuals exceeding on adverse or abnormal level of a biological effect or biomarker) as a function of dose. The primary purpose of this report is to enhance the certainty of the first step of this procedure by improving our understanding of the relationship between a biomarker and dose of administered chemical. Several factors which need to be considered include: 1) the pharmacokinetics of the parent chemical, 2) the target tissue concentrations of the parent chemical or its bioactivated proximate toxicant, 3) the uptake kinetics of the parent chemical or metabolite into the target cell(s) and/or membrane interactions, and 4) the interaction of the chemical or metabolite with presumed receptor site(s). Because these theoretical factors each contain a saturable step due to definitive amounts of required enzyme, reuptake or receptor site(s), a nonlinear, saturable dose-response curve would be predicted. In order to exemplify this process, effects of the neurotoxicant, methlenedioxymethamphetamine (MDMA), were reviewed and analyzed. Our results and those of others indicate that: 1) peak concentrations of MDMA and metabolites are ochieved in rat brain by 30 min and are negligible by 24 hr, 2) a metabolite of MDMA is probably responsible for its neurotoxic effects, and 3) pretreatment with monoamine uptake blockers prevents MDMA neurotoxicity. When data generated from rats administerde MDMA were plotted as bilolgical effect (decreases in hippocampal serotonin concentrations) versus dose, a saturation curve best described the observed relationship. These results support the hypothesis that at least one saturable step is involved in MDMA neurotoxicity. We conclude that the mathematical relationship between biological effect and dose of MDMA, the first step of our quantitative neurotoxicity risk assessment procedure, should reflect this biological model information generated from the whole of the dose-response curve.
The vaginal microbiota may be important for pregnancy prognosis because vaginal dysbiosis during pregnancy appears to be related to preterm birth (PTB) or pregnancy loss. Previous reports have indicated that a Lactobacillus-poor microbial flora in the vagina and intrauterine infection by diverse anaerobes ascending from the vagina are associated with undesirable delivery outcomes. However, no research has involved the use of pyrosequencing analysis to examine vaginal microbiota profiles or their potential associations with high-risk pregnancy in Korean women. Vaginal swabs were collected from 500 Korean women for the identification of community state types (CSTs). Of these, 137 samples were further analyzed using a Roche/454 GS Junior pyrosequencer. Three distinct CSTs were identified based on the dominant vaginal microbes: CST I (Lactobacillus crispatus dominated), CST III (Lactobacillus iners dominated), and CST IV (with diverse species of anaerobes). Twelve of the 67 pregnant women had undesirable pregnancy outcomes (four miscarriages and eight PTBs). The dominant microbe in the vaginal microbiota of women who gave birth at full-term was L. crispatus. In contrast, L. iners was the dominant vaginal microbe in women who miscarried. Most (n = 6/8) vaginal microbiota profiles of women who experienced PTB could be classified as CST IV, with diverse bacteria, including anaerobic vaginal species. The present study provides valuable information regarding the characteristics of the vaginal microbiota of Korean women related to high-risk pregnancy. Investigation of the vaginal microbiotic structure in pregnant Korean women is necessary to enable better prediction of adverse pregnancy outcomes.
[Purpose] Epidemiological evidence has shown that leisure-time physical activity and structured exercise before and after breast cancer diagnosis contribute to reducing the risk of breast cancer recurrence and mortality. Thus, in this review, we aimed to summarize the physical activity-dependent regulation of systemic factors to understand the biological and molecular mechanisms involved in the initiation, progression, and survival of breast cancer. [Methods] We systematically reviewed the studies on 1) the relationship between physical activity and the risk of breast cancer, and 2) various systemic factors induced by physical activity and exercise that are potentially linked to breast cancer outcomes. To perform this literature review, PubMed database was searched using the terms "Physical activity OR exercise" and "breast cancer", until August 5th, 2020; then, we reviewed those articles related to biological mechanisms after examining the resulting search list. [Results] There is strong evidence that physical activity reduces the risk of breast cancer, and the protective effect of physical activity on breast cancer has been achieved by long-term regulation of various circulatory factors, such as sex hormones, metabolic hormones, inflammatory factors, adipokines, and myokines. In addition, physical activity substantially alters wholebody homeostasis by affecting numerous other factors, including plasma metabolites, reactive oxygen species, and microRNAs as well as exosomes and gut microbiota profile, and thereby every cell and organ in the whole body might be ultimately affected by the biological perturbation induced by physical activity and exercise. [Conclusion] The understanding of integrative mechanisms will enhance how physical activity can ultimately influence the risk and prognosis of various cancers, including breast cancer. Furthermore, physical activity could be considered an efficacious non-pharmacological therapy, and the promotion of physical activity is probably an effective strategy in primary cancer prevention.
In this minireview we focus on how males may exploit female's sensitivity to predation risk in the context of mating. It has been shown in studies on guppies and jumping spiders that in response to altered female behaviors, which are adaptations to the unfavorable environment and a consequence of females' higher sensitivity to predator's presence as well as females' higher predation risk, males can adopt condition-dependent mating tactics. It appears that in such cases males do not modify their reproductive behavior directly in response to their own perception of predation risk, but indirectly in response to changes in female behavior induced by predator presence. It has also been recently shown in crabs that males can exploit female behavior by creating safer habitat spots, which increases the male mating success. Hence all the evidence suggests that males not only respond to female sensitivity to the natural variation in predation risk, but that males can also exploit female behavior by altering the environment. As a logical extension of these findings, we present a hypothesis that in certain conditions males can manipulate the environment in order to increase the predation risk and to induce female behaviors that enhance the male's mating success with the increased predation risk. We propose that such a manipulation to increase predation risk is expected to evolve in males of species with a strong sexual conflict and female-biased predation risk. Although empirical evidence has not been yet shown, initial observations in a water strider species in Korea, Gerris gracilicornis, seem to support this hypothesis.
Journal of the Korean Society of Marine Environment & Safety
/
v.24
no.6
/
pp.785-795
/
2018
The International Maritime Organization (IMO) has recognized the risk of hull fouling and announced '2011 Guidelines for the control and management of ship's biofouling to minimize the transfer of invasive aquatic species'and is planning international regulations to enforce them in the future. In this study, to effectively respond to future international regulation, we introduce the case of leading countries related to management of hull fouling and also investigate environmental risk assessment techniques for in-water cleaning. Australia and New Zealand, the leading countries in hull fouling management, have established hull fouling regulations through biological and chemical risk assessment based on in-water cleaning scenarios. Most European countries without their government regulation have been found to perform in-water cleaning in accordance with the IMO's hull fouling regulations. In the Republic of Korea, there is no domestic law for hull fouling organisms, and only approximately 17 species of marine ecological disturbance organisms, are designated and managed under the Marine Ecosystem Law. Since in-water cleaning is accompanied by diffusion of alien species and release of chemical substances into aquatic environments, results from biological as well as chemical risk assessment are performed separately, and then evaluation of in-water cleaning permission is judged by combining these two results. Biological risk assessment created 40 codes of in-water cleaning scenarios, and calculated Risk Priority Number (RPN) scores based on key factors that affect intrusion of alien species during in-water cleaning. Chemical risk assessment was performed using the MAMPEC (Marine Antifoulant Model to Predict Environmental Concentrations), to determine PEC and PNEC values based on copper concentration released during in-water cleaning. Finally, if the PEC/PNEC ratio is >1, it means that chemical risk is high. Based on the assumption that the R/V EARDO ship performs in-water cleaning at Busan's Gamcheon Port, biological risk was estimated to be low due to the RPN value was <10,000, but the PEC/PNEC ratio was higher than 1, it was evaluated as impossible for in-water cleaning. Therefore, it will be necessary for the Republic of Korea to develop the in-water cleaning technology by referring to the case of leading countries and to establish domestic law of ship's hull fouling management, suitable for domestic harbors.
Purpose: This study was undertaken to investigate bio-medical and behavioral risk factor of stroke according to the level of blood pressure among the prospective tele-health users. Method: A descriptive study was conducted using interviews with a structured questionnaire. Of the households in the village, 24 households were selected for inclusion in the study. Among all of the residents from these households, a total of 48 residents who completed all the blood tests as well as the questionnaire. Results: Among bio-medical risk factors including demographic characteristics, physiologic variables, and health history, only triglyceride(TG) was significantly different among normal, prehypertension, and hypertension groups(F=3.78, p<.05). However, regarding behavioral variables, those who were classified as prehypertension and hypertension group reported more frequent drinking, those who were in prehypertension group reported highest scores of stress and lowest frequency of exercise, and those who were in normal and hypertension group showed higher scores of interest on health and lower scores of perceived seriousness of disease and health knowledge than those who were in prehypertension group. Conclusion: Identification and implementation of modifiable risk factors of stroke according to the level of blood pressure are crucial for health care utilizing tele-medicine.
Purpose: The purpose of this study was to identify the prevalence and risk factors of colon polyps. Methods: The subjects were 180 adults enrolled from examinees who underwent colonoscopy at the health promotion center and OPD in Ulsan University Hospital. The risk factors were collected by a self-reporting standardized questionnaire and medical records. Data analysis involved chi-square test, and multiple logistic regression. Results: The prevalence of colon polyps was 41.6%. The risk factors for colon polyps were significantly increased by the cases of subjects more than 50 years old (OR, 9.213; CI, 3.291-25.789), subjects who didn't have any regular high-intensity exercise (OR, 4.762; CI, 1.387-16.351), subjects whose intake of fruits was less than once per a week (OR, 5.938; CI, 1.069-32.985) and subjects who showed irregular defecation (OR, 3.066; CI, 1.178-7.980). Conclusion: This study suggests that eating habits and proper exercise, which promote a normal habit of defecation so as to be helpful in preventing colon polyps.
Purpose: The purpose of this study was to identify the prevalence of osteoarthritis and its risk factors among a community dwelling population age 60-74 and 75 and over (young-old vs. old-old) in Korea. Methods: A total of 1,389 of age 60-74 and 397 of age 75 and over from the 2010 Korean National Health and Nutrition Examination Survey (KNHANES) were selected. The data analysis was performed using the complex sampling function of SPSS version 19.0. Results: The prevalence of osteoarthritis was greater for old-old people (35.50%) compared to young-old people (18.20%). Univariate logistic regression analysis shows that the difference of risk factors for osteoarthritis between young-old and old-old elderly people. The prevalence of osteoarthritis in young-old people was associated with lower education levels; performance of moderate intensity physical activity; higher waist circumference, whereas old-old people was most affected in females; depression and experience. Conclusion: The finding of differences in the prevalence of osteoarthritis and its' risk factors between young-old and old-old people is expected to promote the screening strategy for the aged at risk of osteoarthritis in the Korean community.
Objectives : The objective of this study is to assess the prevalence and risk factors of metabolic syndrome (MS) among inpatients with schizophrenia, and to compare with general population. Methods : Nine hundreds seventy inpatients were included to assess the prevalence of MS from two mental hospitals in Yong-in city. Assessment of MS was performed based on modified American Heart Association criteria with abdominal obesity threshold of 90cm for men, 85cm for women. Comparative analysis was performed using age- and gender matched sample from Korea Health and Nutritional Examination Survey III. For evaluating risk factors, analysis included 766 inpatients taking consistent medications at least for 30 days. Results : The prevalence of MS of inpatients with schizophrenia was 26.2%, in females it was 33.2%, compared to 20.2% in males(p < 0.001). Compared to general population, the prevalence of MS was significantly lower in male and higher in female patients. In terms of criteria prevalence, who met abdominal circumference criterion were more prevalent in patient group(p < 0.001). After multivariate analysis, female gender and old age remained as risk factors of MS. Conclusions : The prevalence of MS of inpatients with schizophrenia was 26.2% and significantly low compared to general population. Female gender and old age were risk factors of MS.
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