• Urogenital Tract Infection
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• 제13권3호
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• pp.66-71
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• 2018

Purpose: To determine the appropriate regimen of antibiotic prophylaxis for the prevention of bacterial infections in patients receiving percutaneous nephrolithotomy (PCNL). Materials and Methods: Forty patients, who planned to undergo PCNL from October 2015 to August 2017, were assigned randomly into two groups. Patients in the single-dose group (n=20) were administered an intravenous single dose of 2 g ceftriaxone 30 minutes before PCNL, whereas those in the three-days regimen group (n=20) were administered a preoperative intravenous single dose of 2 g ceftriaxone and an additional postoperative oral cefpodoxime proxetil (100 mg twice a day) for three days. The incidences of infectious complications in the two groups, such as pyrexia, systemic inflammatory response syndrome (SIRS), and sepsis, were compared. Results: Fever (axillary temperature >$38.0^{\circ}C$) did not develop in any of the patients in the single-dose group but developed in one patient (5.0%) in the three-day regimen group due to pneumonia (p=0.3). SIRS developed in a total of eight patients (20.0%), four patients from each group. None of the patients in either group developed sepsis after PCNL. Conclusions: The three-day prophylactic antibiotic regimen did not demonstrate better efficacy for the prevention of bacterial infections in patients with PCNL compared to the single-dose prophylactic antibiotic regimen.

• Journal of Interdisciplinary Genomics
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• 제4권1호
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• pp.1-6
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• 2022

Purpose: Mastectomy is performed as a surgical treatment for patients with breast cancer who have the BRCA 1/2 mutation. In this study, we have reported the trends in Korea for both immediate breast reconstruction and prophylactic mastectomy. Methods: This retrospective study was conducted from 2019 to 2021. Both skin-sparing mastectomy and immediate implant-based breast reconstruction with prepectoral and/or subpectoral techniques were performed in five patients with BRCA 1/2 mutations. Data on age; body mass index; cancer stage; BRCA 1/2 mutation; estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expression; diagnosis; and complications were collected. Results: The average (±standard deviation [SD]) age was 44.0±6.48 years old; BMI 24.5±2.25 kg/m²; and breast volumes were 365.8±70.34 and 382.4±96.33 cc for right and left ones, respectively. The BRCA 1 and 2 were diagnosed in four and one patients, respectively. The estrogen and progesterone receptors and human epidermal growth factor receptor 2 were detected in one (20%), one (20%), and three (60%) patients, respectively. The applied implant-based breast reconstruction techniques for ten breasts were subpectoral technique (n=7, 70%) and prepectoral technique (n=3, 30%). For the cancer stage, those with I, II, and III stages were one (20%), two (40%), and one (20%), respectively. There were no major complications such as Infection, seroma. Conclusion: When mastectomy is performed as surgical treatment in BRCA 1/2 mutation positive breast cancer patients, it is possible to obtain a better outcome with both implant-based breast reconstruction and different circumstances between breast cancer and contralateral breast.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9635-9641
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• 2014

Background: This retrospective study was aimed to investigate the efficacy of prophylactic agents in hepatocellular carcinoma (HCC) patients receiving TACE and compare the difference between lamivudine and entecavir. Materials and Methods: A consecutive series of 203 HBV-related HCC patients receiving TACE were analyzed including 91 patients given prophylactic agents. Virologic events, defined as an increase in serum HBV DNA level to more than 1 log10 IU/ml higher than the nadir level, hepatitis flares due to HBV reactivation and progression free survival (PFS) were the main endpoints. Results: Some 48 (69.6%) reached virologic response. Prophylaxis significantly reduced virologic events (8.8% vs 58.0%, p=0.000) and hepatitis flares (1.1% vs 13.4%, p=0.001). Patients presenting undetectable HBV DNA levels displayed a significantly improved PFS as compared to those who never achieved undetectable HBV DNA. Prophylaxis and e-antigen positivity were the only significant variables associated with virologic events. In addition, prophylaxis was the only independent protective factor for hepatitis flares. Liver cirrhosis, more cycles of TACE, HBV DNA negativity, a lower Cancer of the Liver Italian Program score, non-metastasis and no hepatitis flares were protective factors for PFS. Prophylactic lamivudine demonstrated similar efficacy as entecavir. Conclusions: Prophylactic agents are efficacious for prevention of HBV reactivation in HCC patients receiving TACE. Achievement of undetectable HBV DNA levels displayed a significant capability in improving PFS. Moreover, persistent tumor residual lesions, positive HBV DNA and hepatitis B flares might be causes of tumor progression in these patients.

• Nutrition Research and Practice
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• 제8권1호
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• pp.54-58
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• 2014

The liver is vulnerable to alcohol-related injury because it is the primary site of alcohol metabolism. Additionally, a number of potentially dangerous by-products are generated as alcohol is broken down in the liver. However, dietary supplements may prevent or relieve some of alcohol's deleterious effects. Therefore, this study was conducted to evaluate the prophylactic effect of aqueous extract of Sesamum indicum (SI) on ethanol induced toxicity in rats. Male Wistar albino rats were divided into control, ethanol, pre-treatment, simultaneous and post-treatment groups. In the prophylactic experiment, Sesamum indicum, (200 mg/kg body weight) was administered by oral gavage for 28 days; two hours before, simultaneously with or two hours after ethanol exposure. Toxicity was induced by administering 45% ethanol (4.8 g/kg bw) by oral gavage. Lipid peroxidation (TBARS) and reduced glutathione (GSH) levels and catalase (CAT), glutathione peroxidase (GPx), superoxide dismutase (SOD) and gluthathione-S-transferase (GST) activities were then determined in the liver, serum triglyceride (TG) levels, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities were monitored and histological examination was carried out. The results revealed that ethanol administration led to significant elevation of TBARS level while depleting in the level of GSH as well as CAT, GPx, SOD and GST activities. Similarly, TG level and ALT and AST activities were elevated. The SI pre-treated group significantly inhibited TBARS, restored GSH level, enhanced CAT, GPx, SOD and GST activities and significantly decreased the elevated level of serum TG, ALT and AST activities. SI treatment (simultaneously with ethanol) exhibited similar effects to those of the SI pre-treated groups, while the SI post-treated group did not show the same protection as the Pre-treated group. S. indicum possesses antioxidant and hepatoprotective properties, that eliminate the deleterious effects of toxic metabolites of ethanol.

• 대한방사선기술학회지:방사선기술과학
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• 제39권3호
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• pp.313-321
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• 2016

유착태반환자는 분만 시 발생하는 대량의 출혈로 모성 사망률이 높아 수술 중 출혈량 감소를 목적으로 수술 전 예방적 내장골동맥 풍선카테터 설치술(Prophylactic placement of Internal Iliac Artery Balloon Occlusion Catheters;PIIABOCs)을 시행하는데, 시술 중 발생하는 산모와 태아의 방사선 피폭에 대한 연구가 미흡한 실정이다. 본 연구는 PIIABOCs 시술 시 태아가 받는 선량을 측정하여 피폭의 정확한 정보를 제공하고자 본 연구를 시행하였다. MRI영상을 이용하여 선량측정 위치를 설정하고 팬텀과 선량계를 이용하여 실제 시술 시와 같은 환경으로 흡수선량을 측정하였다. 태아의 장기별 평균 흡수선량은 2.38~8.83 mGy로, 중심선속-수정체-위-방광 순으로 높게 측정되었고, 투시시간이 길어질수록, 장기의 위치가 선속의 중심에서 가까울수록, 산모의 복부두께가 두꺼울수록 태아선량이 증가하였다. 조사면적를 각각 25%, 50% 감소시켰을 때 각각 19.0%, 39.4%의 선량 감소, 조사야 전체에 차폐체를 사용하였을 때 약 56.3%의 선량 감소를 보였다. 시술테이블의 높이가 75 cm에서 가장 높게 나타났고 85, 95 cm 순으로 선량 감소를 보였다. 의료행위로 인한 방사선이 태아에게 미치는 영향으로 확률적 영향보다 결정적 영향이 우선 관심사이며 유의한 결정적 영향의 문턱선량은 대략 100 mGy로 알려져 있어, 실험결과 시술 시 태아 장기의 흡수선량은 0.49~18.27 mGy로 문턱선량의 10% 수준임을 확인하였다.

• Parasites, Hosts and Diseases
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• 제31권4호
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• pp.363-370
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• 1993

Toxoprqsmagonnii의 강독주(RH주) 혹은 약독주(Beverley주)를 마우스에 감염시킴과 동시에 trimethoprim-sulfamethoxazole(TMP-SMZ)을 투여하여 Toxoplasma 감염 마우스에 있어 서 TMP-SMZ의 감염 예방효과를 마우스의 생존기간과 생존율. 면역혈청학적 반응 및 뇌조직내 씨스트의 수로 평가한 후 감염대조군 및 spiramycin 투여군과 비교하였다. T. gondii의 RH주를 감염시킨 마우스(마우스당 $1{\;}{\times}{\;}10^5$개의 tachyzoite를 감염)에 TMP-SMZ을 투여시 마우스의 생존기간은 감염대조군이나 spiramycin 투여군보다 유의하게 증가하였으며(p < 0.01), TMP-SMZ의 투여량을 증가시킴에 따라 생존기간 및 생존율이 증가하였고 마우스당 24 mg/day 이상 15일간 투여시 100% 생존하였다. T. gondii의 Beverley주를 감염시킨 마우스(마우스당 10개의 씨스트를 감염)의 혈청내 IgG 및 IgM 항체가는 TMP-SMZ 투여시 유의하게 감소하였으며(p < 0.05) TMP-SMZ을 마우스당 24 mg/day 이상 투여시 뇌조직내에서 씨스트를 발견할 수 없었다. 그러나 spiramycin 투여군은 감염대조군과 유사한 항체가를 보였으며 감염 후 20일부터 씨스트가 발견되었다 이상의 성적으로 보아 TMP-SMZ은 T. gondii의 강독주나 약독주 감염 마우스에 투여시 감염 예방효과가 있었다.

• Journal of Preventive Medicine and Public Health
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• 제42권1호
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• pp.12-20
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• 2009

Objectives : The purpose of this study was to analyze the association between the pattern of prophylactic antibiotic use(PAU) and the surgical site infection(SSI) rate for major surgeries in Korea. Methods : We retrospectively reviewed the medical records of patients who underwent cardiac, colon and gastric surgery, hysterectomies and hip/knee replacements at 20 hospitals, and inclusive of over 500 beds. We randomly sampled 60 cases per surgery type for patients discharged between September and November, 2006. A total fo 2,924 cases were included in our analysis. Cox's proportional hazard analysis was conducted to evaluate the association between the pattern of PAU and SSI rate. Results : The proportion of patients who received their first prophylactic antibiotics(PA) 1 hour before incision was 65.5%, who received inappropriate PAs was 80.8%, and the proportion of patients whose PA was discontinued within 24 hours of surgery was 0.5%. The average duration of PAU after surgery was 9 days. The relative risk(RR) of SSI in patients who received their first PA more than 1 hour before incision was significantly higher than for those who received it within 1 hour prior to incision(RR=8.20, 95% CI=4.81-13.99). Inappropriate PA selection increased SSI rate, albeit with marginal significance(RR=1.97, 95% CI=0.96-4.03). Also, prolonged PAU following surgery had no effect on SSI rate. Conclusions : These results suggest that the pattern of PAU in the surgeries examined was not appropriate. Errors in the timing of PAU and of PA selection increase SSI rate. SSI rate remained unaltered following prolonged PAU after surgery.

• 대한간호학회지
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• 제42권3호
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• pp.396-404
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• 2012

Purpose: The purpose of this study was to identify the features, risk scores and risk factors for deep vein thrombosis in critically ill patients who developed deep vein thrombosis in their lower extremities. Methods: The participants in this prospective descriptive study were 175 adult patients who did not receive any prophylactic medication or mechanical therapy during their admission in the intensive care unit. Results: The mean age was 62.24 (${\pm}17.28$) years. Men made up 54.9% of the participating patients. There were significant differences in age, body mass index, and leg swelling between patients who developed deep vein thrombosis and those who did not have deep vein thrombosis. The mean risk score was 6.71(${\pm}2.94$) and they had on average 4.01(${\pm}1.35$) risk factors. In the multiple logistic regression, body mass index (odds ratio=1.14) and leg swelling (odds ratio=6.05) were significant predictors of deep vein thrombosis. Conclusion: Most critically ill patients are in the potentially high risk group for deep vein thrombosis. However, patients who are elderly, obese or have leg edema should be closely assessed and more than one type of active prophylactic intervention should be provided.

• Childhood Kidney Diseases
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• 제19권1호
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• pp.8-13
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• 2015

Antenatal hydronephrosis (ANH) is one of the most common abnormal findings detected on prenatal ultrasound (US), and it has been reported in 1-5% of all pregnancies. The likelihood of significant postnatal pathologic abnormality in the urinary tract correlates with the degree of anterior-posterior diameter (APD) according to the gestational age. Detection of urologic anomalies prenatally permits fetal interventions that avoid complications in rare cases of bladder outlet obstruction with oligohydramnios even though their final benefits still remain controversial. There is no clear consensus on the extent and mode of postnatal imaging after a diagnosis of ANH. US is the mainstay of the postnatal evaluation and helps guide further testing with voiding cystourethrography (VCUG) and diuretic renography. Although most algorithms continue to recommend generous VCUG for identification of lower urinary tract anomalies, VCUG may be safely reserved for high grade ANH cases or any grade of ANH with dilated distal ureter without increasing the risk of urinary tract infection (UTI). There are conflicting studies about efficacy of postnatal prophylactic antibiotics. It still seems reasonable to consider use of a prophylactic antibiotic to prevent infant UTIs in high-risk populations, such as females and uncircumcised males with high grades of hydronephrosis, hydroureteronephrosis, or vesicouretral reflux.

• Journal of Gastric Cancer
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• 제20권1호
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• pp.1-18
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• 2020

Splenic hilar lymph node dissection has been the standard treatment for advanced proximal gastric cancer. Splenectomy is typically performed as part of this procedure. However, splenectomy has some disadvantages, such as increased risk of postoperative complications, especially pancreatic fistula. Moreover, patients who underwent splenectomy are vulnerable to potentially fatal infection caused by encapsulated bacteria. Furthermore, several studies have shown an association of splenectomy with cancer development and increased risk of thromboembolic events. Therefore, splenectomy should be avoided if it does not confer a distinct oncological advantage. Most studies that compared patients who underwent splenectomy and those who did not failed to demonstrate the efficacy of splenectomy. Based on the results of a randomized controlled trial conducted in Japan, prophylactic dissection with splenectomy is no longer recommended in patients with gastric cancer with no invasion of the greater curvature. However, patients with greater curvature invasion or those with remnant gastric cancer still need to undergo splenectomy to facilitate splenic hilar node dissection. Spleen-preserving splenic hilar node dissection is a new procedure that may help delink splenic hilar node dissection and splenectomy. In this review, we examine the evidence pertaining to the efficacy and disadvantages of splenectomy. We discuss the possibility of spleen-preserving surgery for prophylactic splenic hilar node dissection to overcome the disadvantages of splenectomy.