• Journal of Yeungnam Medical Science
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• v.38 no.2
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• pp.136-141
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• 2021

Background: Postoperative acute kidney injury (AKI), which increases the risk of postoperative morbidity and mortality, poses a major concern to surgeons. We conducted this study to analyze the risk factors associated with the occurrence of AKI after orthopedic surgery. Methods: This was a retrospective study that included 351 patients who underwent total hip or knee replacement surgery at Inje University Haeundae Paik Hospital between January 2012 and December 2016. Results: AKI occurred in 13 (3.7%) of the 351 patients. The patients' preoperative estimated glomerular filtration rate (eGFR) was 66.66 ±34.02 mL/min/1.73 m² in the AKI group and 78.07±21.23 mL/min/1.73 m² in the non-AKI group. The hemoglobin levels were 11.21±1.65 g/dL in the AKI group and 12.39±1.52 g/dL in the non-AKI group. Hemoglobin level was related to increased risk of AKI (odds ratio [OR], 0.13; 95% confidence interval [CI], 0.02-0.68; p=0.016). Administration of crystalloid or colloid fluid alone and the perioperative amount of fluid did not show any significant relationship with AKI. Further analysis of the changes in eGFR was performed using a cutoff value of 7.54. The changes in eGFR were significantly related to decreased risk of AKI (OR, 0.74; 95% CI, 0.61-0.89; p=0.002). Conclusion: Renal function should be monitored closely after orthopedic surgery if patients have chronic kidney disease and low hemoglobin level. Predicting the likelihood of AKI occurrence, early treatment of high-risk patients, and monitoring perioperative laboratory test results, including eGFR, will help improve patient prognosis.

• The Korean journal of internal medicine
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• v.39 no.3
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• pp.477-487
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• 2024

Background/Aims: Risk factors for progression to critical illness in hospital-acquired coronavirus disease 2019 (COVID-19) remain unknown. Here, we assessed the incidence and risk factors for progression to critical illness and determined their effects on clinical outcomes in patients with hospital-acquired COVID-19. Methods: This retrospective cohort study analyzed patients admitted to the tertiary hospital between January 2020 and June 2022 with confirmed hospital-acquired COVID-19. The primary outcome was the progression to critical illness of hospital-acquired COVID-19. Patients were stratified into high-, intermediate-, or low-risk groups by the number of risk factors for progression to critical illness. Results: In total, 204 patients were included and 37 (18.1%) progressed to critical illness. In the multivariable logistic analysis, patients with preexisting respiratory disease (OR, 3.90; 95% CI, 1.04-15.18), preexisting cardiovascular disease (OR, 3.49; 95% CI, 1.11-11.27), immunocompromised status (OR, 3.18; 95% CI, 1.11-9.16), higher sequential organ failure assessment (SOFA) score (OR, 1.56; 95% CI, 1.28-1.96), and higher clinical frailty scale (OR, 2.49; 95% CI, 1.62-4.13) showed significantly increased risk of progression to critical illness. As the risk of the groups increased, patients were significantly more likely to progress to critical illness and had higher 28-day mortality. Conclusions: Among patients with hospital-acquired COVID-19, preexisting respiratory disease, preexisting cardiovascular disease, immunocompromised status, and higher clinical frailty scale and SOFA scores at baseline were risk factors for progression to critical illness. Patients with these risk factors must be prioritized and appropriately isolated or treated in a timely manner, especially in pandemic settings.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.830-837
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• 2007

Background and purpose : Stroke is one of the most deadly diseases and a leading cause of disability. Lipids confer an increased risk for cardiovascular morbidity and mortality. In spite of many studies on the relationship between stroke and lipids, their relationship is not clear. This study was undertaken to determine whether lipids were associated with stroke. Method : We compared the components of blood lipids between stroke patients group (n=217,Cases), non-stroke control group (n=160, Controls) and healthy control group without hypertension, diabetes mellitus, ischemic heart disease, or hyperlipidemia (n=140, Normals). These data were statically analyzed by general linear models and binary logistic regression analysis to get each adjusted odds ratio. Result : The results were as follows. The blood levels of total cholesterol (T-Chol), triglyceride (TG) and low density lipoprotein cholesterol (LDL-Chol) were significantly higher in patients of ischemic stroke, while the blood levels of T-Chol and LDL-Chol were significantly lower, and the blood levels of TG significantly higher in patients of hemorrhagic stroke. The blood level of high density lipoprotein cholesterol (HDL-Chol) was significantly lower in all cases. Conclusion : These results suggest that high TG and low HDL-Chol may be risk factors of hemorrhagic stroke and ischemic stroke, high T-Chol and LDL-Chol may be risk factors of ischemic stroke, and low T-Chol and LDL-Chol may be risk factors of hemorrhagic stroke in Koreans.

• Nutrition Research and Practice
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• v.9 no.2
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• pp.165-173
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• 2015

BACKGROUND/OBJECTIVES: This study addressed the question whether the composition of supposedly 'healthy' or 'unhealthy' dietary regimes has a calorie-independent short-term effect on biomarkers of metabolic stress and vascular risk in healthy individuals. SUBJECTS/METHODS: Healthy male volunteers (age $29.5{\pm}5.9years$, n = 39) were given a standardized baseline diet for two weeks before randomization into three groups of different dietary regimes: fast food, Mediterranean and German cooking style. Importantly, the amount of calories consumed per day was identical in all three groups. Blood samples were analyzed for biomarkers of cardiovascular risk and metabolic stress after two weeks of the baseline diet and after two weeks of the assigned dietary regime. RESULTS: No dietary intervention affected the metabolic or cardiovascular risk profile when compared in-between groups or compared to baseline. Subjects applied to the Mediterranean diet showed a statistically significant increase of uric acid compared to baseline and compared to the German diet group. Plasma concentrations of urea were significantly higher in both the fast food group and the Mediterranean group, when compared to baseline and compared to the German diet group. No significant differences were detected for the levels of vitamins, trace elements or metabolic stress markers (8-hydroxy-2-deoxyguanosine, malondialdehyde and methylglyoxal, a potent glycating agent). Established parameters of vascular risk (e.g. LDL-cholesterol, lipoprotein(a), homocysteine) were not significantly changed in-between groups or compared to baseline during the intervention period. CONCLUSIONS: The calorie-controlled dietary intervention caused neither protective nor harmful short-term effects regarding established biomarkers of vascular or metabolic risk. When avoiding the noxious effects of overfeeding, healthy individuals can possess the metabolic capacity to compensate for a potentially disadvantageous composition of a certain diet.

• Journal of the Korea Institute of Building Construction
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• v.16 no.6
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• pp.519-527
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• 2016

The demand of construction risk analysis is rapidly increased to improve the competitiveness of construction companies and the sound management of the construction project. However, estimating the amount and uncertainty of the risk is difficult due to the wide range of risks in the construction industry. Moreover, most of the research on risk management of construction risk is only focused on the causes of risk without separate the internal and external risk. This study statistically analysis the internal risk and external risk based on the accidents cases which are caused at construction sites to define the difference and importances of the risk. An accident cause analysis and T-test analysis are carried out to reach the goal of study. The results of the study are expected to be used as a guideline of construction project risk analysis.

• Journal of the Korean Society of Hazard Mitigation
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• v.10 no.4
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• pp.105-117
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• 2010

The topographical depressions in urban areas, the lack in drainage capability, sewage backward flow, road drainage, etc. cause internal inundation, and the increase in rainfall resulting from recent climate change, the rapid urbanization accompanied by economic development and population growth, and the increase in an impervious area in urban areas deteriorate the risk of internal inundation in the urban areas. In this study, the vulnerability of internal inundation in urban areas is analyzed and SWMM model is applied into Oncheoncheon watershed, which represents urban river of Busan, as a target basin. Based on the results, the representative storm sewers in individual sub-catchments is selected and the risk of vulnerability to internal inundation due to rainfall in urban streams is analyzed. In order to analyze the risk and vulnerability of internal inundation, capacity is applied as an index indicating the volume of a storm sewer in the SWMM model, and the risk of internal inundation is into 4 steps. For the analysis on the risk of internal inundation, simulation results by using a SMMM model are compared with the actual inundation areas resulting from localized heavy rain on July 7, 2009 at Busan and comparison results are analyzed to prove the validity of the designed model. Accordingly, probabilistic rainfall at Busan was input to the model for each frequency (10, 20, 50, 100 years) and duration (6, 12, 18, 24hr) at Busan. In this study, it suggests that the findings can be used to preliminarily alarm the possibility of internal inundation and selecting the vulnerable zones in urban areas.

• Korean Circulation Journal
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• v.54 no.6
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• pp.354-356
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• 2024

• Industrial Engineering and Management Systems
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• v.9 no.2
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• pp.121-130
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• 2010

In today's uncertain economic environment, economic risk is inherent in making large investments on manufacturing facilities. It is, therefore, practically meaningful to divide investment over multiple periods, reducing the risk of investment. Then, the cash-flow over the entire planning horizon would comprise positive inflow and negative outflow. In this case, in general, evaluation by internal rate of return (IRR) is not feasible, because multiple IRRs are involved. This paper deals with a problem of evaluating profitability, as well as risk, of investment alternatives made in multiple times of investment over the entire horizon. Typically, an additional investment is required after the initial one, for expanding manufacturing capacity or other reasons. The paper pays attention to a unit cash-flow over two periods, decomposing the total cash-flow into a series of unit cash-flow patterns. It is easy to evaluate profitability of a unit cash-flow by using IRR. The total cash-flow can be decomposed into the series of two types of unit cash-flows: an investment type one (negative-positive) and the borrowing type one (positive-negative). This paper, therefore, proposes a method in which only the borrowing type unit cash-flow is eliminated in the series by converting total cash-flow using capital interest rate. Then, a unique IRR can be obtained and the profitability is evaluated. Thus, the paper extends the method of IRR so that it may help decision making in complicated cash-flow pattern observed in practice.

• Genomics & Informatics
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• v.8 no.4
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• pp.194-200
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• 2010

The PIK3CA gene, oncogenic gene located on human chromosome 3q26.3, is an important regulator of cell proliferation, death, motility and invasion. To evaluate the role of PIK3CA gene in the risk of Korean lung cancer, genotypes of the PIK3CA polymorphisms (rs11709323, rs2699895, rs3729679, rs17849074 and rs1356413) were determined in 423 lung cancer patients and 443 normal controls. Statistical analyses revealed that the genotypes and haplotypes in the PIK3CA gene were not significantly associated with the risk of lung cancer in the Korean population, suggesting that these PIK3CA polymorphisms do not contribute to the genetic susceptibility to lung cancer in the Korean population.

• Tuberculosis and Respiratory Diseases
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• v.74 no.3
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• pp.111-119
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• 2013

Background: Hemoptysis due to pulmonary tuberculosis (TB) frequently develops in Korea where the prevalence of TB is intermediate. The effect of bronchial artery embolization (BAE) on the control of massive hemoptysis has been well known. This study is designed to identify the risk factors contributing to rebleeding after BAE in patients with TB. Methods: We retrospectively evaluated risk factors and the time for rebleeding after BAE in 72 patients presenting with hemoptysis. Results: The overall immediate success rate of BAE was 93.1% (67 of 72 patients). Of the 29 patients (40.3%) who showed rebleeding after BAE, 13 patients experienced rebleeding within 1 month, and 14 patients between 1 month to 1 year. The existence of a shunt in angiographic finding, aspergilloma, and diabetes mellitus were risk factors of rebleeding after BAE in multivariate analysis. Conclusion: BAE was very effective for obtaining immediate bleeding control in hemoptysis associated with active TB or post-TB sequelae. It is important to observe whether or not rebleeding occurs up to 1 year of BAE especially in TB patients with aspergilloma, DM, or a shunt. Even rebleeding can be managed well by second BAE.