• 제목/요약/키워드: high risk cases

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Chordae Tendineae Approximation Technique for Severe Tricuspid Regurgitation with Severe Leaflet Tethering Using a Totally Endoscopic Beating-Heart Strategy: A Case Report

  • Dong Hee Jang;Jae Suk Yoo
    • Journal of Chest Surgery
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    • v.56 no.1
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    • pp.56-58
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    • 2023
  • Untreated severe tricuspid regurgitation (TR) is associated with poor outcomes. Functional TR occurs secondary to dilatation of the annulus and tethering of the leaflets. Ring annuloplasty alone can correct most cases, but is insufficient in cases of severe annular dilatation due to severe leaflet tethering. In such cases, a tricuspid edge-to-edge technique may be an option. However, stitching of the leaflet tips alone is likely to result in tearing of the leaflets. Approximation of the durable chordae tendineae is considered helpful for this problem. Herein, we present the case of a 39-year-old man who had undergone open-heart surgery for acute type A aortic dissection 13 months earlier. A right mini-thoracotomy approach with a beating-heart strategy was used, which did not require unnecessary pericardial adhesiolysis and dissection. This technique had the advantage of reducing the operation time and the risk of bleeding. To summarize, we present a case of tricuspid valve repair in a high-risk patient with severe leaflet tethering that was successfully managed using these methods.

Predicting of Ignition Time and Critical Distance for Ignition of Douglas fir by Radiant Heat of Incandescent Lamp (백열전구 복사열에 의한 미송판의 발화 임계거리 및 발화시간 예측)

  • Lee, Heung-Su;Kim, Doo-Hyun
    • Journal of the Korean Society of Safety
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    • v.31 no.2
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    • pp.18-25
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    • 2016
  • The incandescent lamp is an electric light fixture with a tungsten filament heated to a high temperature, by passing an electric current through it, until it glows with visible light. The hot filament is protected from oxidation with a glass bulb that is filled with inert gas. The incandescent lamp has fire risk when combustible materials are close to its glass bulb. Because its lamp has the property which converts 90~95 percents of the electric power to heat energy. 2015 national fire statistics show that fires caused by lighting fixtures were 652 cases, and incandescent lamps(44 cases) and halogen lamps(53 cases) accounted for 15 percents in those of high heating light fixtures. Since incandescent lamp fires account for about 45 percents in the high heating light fixture, we could not overlook the fire risks by the incandescent lamp. Although many studies related with those have been conducted, incandescent lamp fires are continuously occurred. This study was carried out to study the fire risk of ignition of wood due to radiant heat of incandescent lamp. Radiant heat flux of the incandescent lamp was predicted by applying point source model, and critical distance for ignition of wood was calculated by applying integral model. The results from this study could applied to fire prevention activities related to light bulb, and it could be used in fire cause investigations related to radiant heat of incandescent lamp.

Characteristics of Active Tuberculosis Patients Requiring Intensive Care Monitoring and Factors Affecting Mortality

  • Filiz, Kosar A.;Levent, Dalar;Emel, Eryuksel;Pelin, Uysal;Turkay, Akbas;Aybuke, Kekecoglu
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.3
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    • pp.158-164
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    • 2016
  • Background: One to three percent of cases of acute tuberculosis (TB) require monitoring in the intensive care unit (ICU). The purpose of this study is to establish and determine the mortality rate and discuss the causes of high mortality in these cases, and to evaluate the clinical and laboratory findings of TB patients admitted to the pulmonary ICU. Methods: The data of patients admitted to the ICU of Yedikule Chest Diseases and Chest Surgery Education and Research Hospital due to active TB were retrospectively evaluated. Demographic characteristics, medical history, and clinical and laboratory findings were evaluated. Results: Thirty-five TB patients (27 males) with a median age of 47 years were included, of whom 20 died within 30 days (57%). The Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were significantly higher, and albumin and $PaO_2/FIO_2$ levels were significantly lower, and shock, multiple organ failure, the need for invasive mechanical ventilation and drug resistance were more common in the patients who died. The mortality risk was 7.58 times higher in the patients requiring invasive mechanical ventilation. The SOFA score alone was a significant risk factor affecting survival. Conclusion: The survival rate is low in cases of tuberculosis treated in an ICU. The predictors of mortality include the requirement of invasive mechanical ventilation and multiple organ failure. Another factor specific to TB patients is the presence of drug resistance, which should be taken seriously in countries where there is a high incidence of the disease. Finding new variables that can be established with new prospective studies may help to decrease the high mortality rate.

Association of milk and dairy product consumption with the incidence of cardio-cerebrovascular disease incidence in middle-aged and older Korean adults: a 16-year follow-up of the Korean Genome and Epidemiology Study

  • Yeseung Jeong;Kyung Won Lee;Hyekyeong Kim;Yuri Kim
    • Nutrition Research and Practice
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    • v.17 no.6
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    • pp.1225-1237
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    • 2023
  • BACKGROUND/OBJECTIVES: Unhealthy dietary behaviors constitute one of risk the factors for chronic and cardiovascular diseases, which are prevalent in middle-aged and older populations. Milk and dairy products are high-quality foods and important sources of calcium. Calcium protects against osteoporosis and cardiovascular disease. Therefore, this study investigated the association of milk and dairy product consumption with cardio-cerebrovascular disease incidence in middle-aged and older Korean adults. SUBJECTS/METHODS: Data were derived from the Ansan-Anseong cohort study, and a total of 8,009 individuals aged 40-69 years were selected and followed up biennially. Cox proportional hazard models were used to examine the association of milk and dairy product consumption with cardio-cerebrovascular disease incidence. RESULTS: During a mean follow-up period of 96.5 person-months, 552 new cases of cardio-cerebrovascular disease were documented. Milk consumers (< 1 serving/day) exhibited a 23% lower risk of cardio-cerebrovascular disease incidence than non-milk consumers (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.61-0.97; P for trend = 0.842). High yogurt consumption was associated with a 29% lower incidence risk (≥ 0.5 servings/day vs. none: HR, 0.71; 95% CI, 0.53-0.96; P for trend = 0.049), whereas high ice cream consumption was associated with a 70% higher risk of cardio-cerebrovascular disease incidence (≥ 0.5 servings/day vs. none: HR, 1.70; 95% CI, 1.01-2.88; P for trend = 0.070). CONCLUSIONS: This study indicates that less than one serving of milk and high yogurt consumption are associated with a lower cardio-cerebrovascular disease risk in the middle-aged and older populations.

Physical Activity and Risk of Lung Cancer: A Meta-Analysis of Prospective Cohort Studies

  • Sun, Jia-Yang;Shi, Lei;Gao, Xu-Dong;Xu, Shao-Fa
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3143-3147
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    • 2012
  • Background: Previous studies investigating the association of physical activity with risk of lung cancer reported conflicting results. In order to update and improve available evidence on any link, a meta-analysis was performed. Method: We searched the PubMed database for prospective cohort studies investigating the relation of physical activity with risk of lung cancer. The pooled relative risk (RR) with its 95% confidence intervals (95%CI) was used to assess the association. Results: We included 14 prospective studies with a total of 1,644,305 participants, with 14,074 incident lung cancer cases documented during follow-up. Meta-analysis of all 14 studies suggested both high and medium levels of physical activity to be associated with decreased risk of lung cancer compared to the reference group with low level of physical activity (for high level, RR = 0.77, 95%CI 0.73-0.81, P < 0.001; for medium level, RR = 0.87, 95%CI 0.83-0.90, P < 0.001). Subgroup analyses by gender found obvious associations in both men and women. No publication bias was observed. Conclusion: Our findings suggest that high and medium levels of physical activity have a beneficial effect on lung cancer by reducing the overall risk of tumour development among both men and women.

Cost-Effectiveness of Voluntary HIV Testing Strategies in a Very Low-Prevalence Country, the Republic of Korea

  • Lee, Young Hwa;Bang, Ji Hwan;Park, Sang Min;Kang, Cho Ryok;Cho, Sung-Il;Oh, Myoung-don;Lee, Jong-Koo
    • Journal of Korean Medical Science
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    • v.33 no.46
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    • pp.304.1-304.7
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    • 2018
  • Background: The Republic of Korea has a very low prevalence of human immunodeficiency virus (HIV) infection, but the number of new HIV diagnoses has steadily risen, strongly indicating a large number of undetected HIV infections. Thus, it is important for Korean public health authorities to adopt and encourage cost-effective HIV detection tools, such as rapid HIV screening tests. In this study, we aimed to evaluate the cost-effectiveness of enzyme-linked immunosorbent assays (ELISA) and rapid tests in a public health center (PHC) setting. Methods: We developed a decision analytic model to assess the per-examinee cost and the cost-effectiveness of identifying HIV patients in a PHC setting using two HIV testing strategies: conventional HIV screening by ELISA versus rapid HIV testing. Analysis was performed in two scenarios: HIV testing in an average-risk population and in a high-risk population. Results: Compared to the ELISA, the rapid test was cost-saving and cost-effective. The per-examinee cost was USD 1.61 with rapid testing versus USD 3.38 with ELISA in an average-risk population, and USD 4.77 with rapid testing versus USD 7.62 with ELISA in a high-risk population. The cost of identifying a previously undiagnosed HIV case was USD 26,974 with rapid testing versus USD 42,237 with ELISA in an average-risk population, and USD 153 with rapid testing versus USD 183 with ELISA in a high-risk population. Conclusion: Rapid testing would be more cost-effective than using conventional ELISA testing for identifying previously undiagnosed HIV-infected cases in Korea, a country with extremely low HIV prevalence.

Prevention of Venous Thromboembolism in Patients Undergoing Hip Fracture Surgery: A Survey of the Korean Hip Society

  • Chang Hyun Kim;Je-Hyun Yoo;Young-Kyun Lee;Ye-Yeon Won;Jong-Seok Park
    • Hip & pelvis
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    • v.35 no.3
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    • pp.200-205
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    • 2023
  • Purpose: The aim of this study was to assess the current status of venous thromboembolism (VTE) prevention in Korean patients with hip fractures. Materials and Methods: A survey using a questionnaire on the experiences and protocols of VTE prevention was conducted among 570 members of the Korean Hip Society. Results: A total of 97 surgeons responded, with a response rate of 17.0%. Of the 97 participants, 61.9% answered that they had encountered one or more cases of symptomatic VTE in the past year. Mechanical prophylaxis was applied most often (30.9%) until the point of ambulation in standard-risk patients and most often (34.0%) extended until discharge in high-risk patients. Chemical prophylaxis was most often prescribed for a particular period of time rather than for recovery of walking ability (24.7% in standard-risk patients and 26.8% in high-risk patients). Dual prophylaxis was administered in the standard-risk group by 58.8% of the participants and in the high-risk group by 83.5%. Among the participants, 73.2% answered that they had been attentive to wound complications during chemical prophylaxis. More than half of the participants (59.8%) reported that they did not perform routine screening for VTE after surgery. Conclusion: The results of our survey provided information regarding the current status of VTE prevention for patients undergoing surgery for treatment of hip fractures in Korea as well as a baseline for establishment of educational programs and guidelines in the future.

A review of the features, events, and processes and scenario development for Korean risk assessment of a deep geological repository for high-level radioactive waste

  • Kibeom Son;Karyoung Choi;Jaehyeon Yang;Haeram Jeong;Hyungdae Kim;Kunok Chang;Gyunyoung Heo
    • Nuclear Engineering and Technology
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    • v.55 no.11
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    • pp.4083-4095
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    • 2023
  • Currently, various research institutes in Korea are conducting research to develop a safety case for deep geological repository for high-level radioactive waste (HLW). In the past, low and intermediate-level waste (LILW) was approved by a regulatory body by performing a post-closure safety assessment, but HLW has different disposal characteristics and safety objectives are different. Therefore, in the case of HLW, safety assessment should be performed based on these changed conditions, and specific procedures are also under development. In this paper, the regulatory status of prior research institutes, feature, event and process (FEP) and scenario development cases were investigated for well-organized FEP and scenario development methodologies. In addition, through the results of these surveys, the requirements and procedures necessary for the FEP and scenario development stage during the safety assessment of repository for HLW were presented. These review results are expected to be used to identify the overall status of previous studies in conducting post-closure risk assessment for HLW repository, starting with identifying regulatory requirements, the most basic element.

Relationship between Exposure to Pesticides and Occurrence of Acute Leukemia in Iran

  • Maryam, Zakerinia;Sajad, Amirghofran;Maral, Namdari;Zahra, Lesan;Sima, Pooralimohamad;Zeinab, Attabac;Zahra, Mehravar;Fariba, Ebrahimi;Sezaneh, Haghpanah;Davood, Mehrabani
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.239-244
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    • 2015
  • Background: One of the causes of acute leukemia can be exposure to certain chemicals such as pesticides. This study determined the relationship between exposure to pesticides and the occurrence of acute leukemia in Fars province, south of Iran. Materials and Methods: Between April 2011 and April 2013 in a case-control study conducted in Nemazee Hospital in Shiraz, Southern Iran; 314 subjects diagnosed with acute leukemia (94 pediatric cases and 220 adults) were enrolled to determine any correlation between exposure to pesticides and the occurrence. Controls (n=314) were matched by sex and age. Results: There was a history of exposure to pesticides among 85% of pediatric cases and 69% of their controls and 83% of adult cases and 75% of their controls while 87.5% of pediatric cases and 90% of adult cases reported exposure to intermediate and high doses of pesticides and among the controls, the exposure to low doses of pesticides was 70.5% and 65%, respectively. Exposure to indoor pesticides was seen among most of cases and controls. Being a farmer was at a significantly more increased risk of developing acute leukemia in comparison to other jobs, especially for their children. Conclusions: Exposure to pesticides was shown to be one of the most important causes of acute leukemia. It seems that there is a need to educate the people on public health importance of exposure to pesticides especially during school time to reduce the risk of malignancies during childhood.

Value of PAX1 Methylation Analysis by MS-HRM in the Triage of Atypical Squamous Cells of Undetermined Significance

  • Li, Shi-Rong;Wang, Zhen-Ming;Wang, Yu-Hui;Wang, Xi-Bo;Zhao, Jian-Qiang;Xue, Hai-Bin;Jiang, Fu-Guo
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5843-5846
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    • 2015
  • Background: Detection of cervical high grade lesions in patients with atypical squamous cells of undetermined significance (ASCUS) is still a challenge. Our study tested the efficacy of the paired boxed gene 1 (PAX1) methylation analysis by methylation-sensitive high-resolution melting (MS-HRM) in the detection of high grade lesions in ASCUS and compared performance with the hybrid capture 2 (HC2) human papillomavirus (HPV) test. Materials and Methods: A total of 463 consecutive ASCUS women from primary screening were selected. Their cervical scrapings were collected and assessed by PAX1 methylation analysis (MS-HRM) and high-risk HPV-DNA test (HC2). All patients with ASCUS were admitted to colposcopy and cervical biopsies. The Chisquare test was used to test the differences of PAX1 methylation or HPV infection between groups. Results: The specificity, sensitivity, and accuracy for detecting CIN2 + lesions were: 95.6%, 82.4%, and 94.6%, respectively, for the PAX1 MS-HRM test; and 59.7%, 64.7%, and 60.0% for the HC2 HPV test. Conclusions: The PAX1 methylation analysis by MS-HRM demonstrated a better performance than the high-risk HPV-DNA test for the detection of high grade lesions (CIN2 +) in ASCUS cases. This approach could screen out the majority of low grade cases of ASCUS, and thus reduce the referral rate to colposcopy.