• Title/Summary/Keyword: risk factors

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The Research to Correct Overestimation in TOF-MRA for Severity of Cerebrovascular Stenosis (3D-SPACE T2 기법에 의한 TOF-MRA검사 시 발생하는 혈관 내 협착 정도의 측정 오류 개선에 관한 연구)

  • Han, Yong Su;Kim, Ho Chul;Lee, Dong Young;Lee, Su Cheol;Ha, Seung Han;Kim, Min Gi
    • Journal of the Institute of Electronics and Information Engineers
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    • v.51 no.12
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    • pp.180-188
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    • 2014
  • It is very important accurate diagnosis and quick treatment in cerebrovascular disease, i.e. stenosis or occlusion that could be caused by risk factors such as poor dietary habits, insufficient exercise, and obesity. Time-of-flight magnetic resonance angiography (TOF-MRA), it is well known as diagnostic method without using contrast agent for cerebrovascular disease, is the most representative and reliable technique. Nevertheless, it still has measurement errors (also known as overestimation) for length of stenosis and area of occlusion in celebral infarction that is built by accumulation and rupture of plaques generated by hemodynamic turbulence. The purpose of this study is to show clinical trial feasibility for 3D-SPACE T2, which is improved by using signal attenuation effects of fluid velocity, in diagnosis of cerebrovascular disease. To model angiostenosis, strictures of different proportions (40%, 50%, 60%, and 70%) and virtual blood stream (normal saline) of different velocities (0.19 ml/sec, 1.5 ml/sec, 2.1 ml/sec, and 2.6 ml/sec) by using dialysis were made. Cross-examinations were performed for 3D-SPACE T2 and TOF-MRA (16 times each). The accuracy of measurement for length of stenosis was compared in all experimental conditions. 3D-SPACE 2T has superiority in terms of accuracy for measurements of the length of stenosis, compared with TOF-MRA. Also, it is robust in fast blood stream and large stenosis than TOF-MRA. 3D-SPACE 2T will be promising technique to increase diagnosis accuracy in narrow complex lesions as like two cerebral small vessels with stenosis, created by hemodynamic turbulence.

Predictive Modeling of Bacillus cereus on Carrot Treated with Slightly Acidic Electrolyzed Water and Ultrasonication at Various Storage Temperatures (미산성 차아염소산수와 초음파를 처리한 당근에서 저장 중 Bacillus cereus 균의 생육 예측모델)

  • Kim, Seon-Young;Oh, Deog-Hwan
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.8
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    • pp.1296-1303
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    • 2014
  • This study was conducted to develop predictive models for the growth of Bacillus cereus on carrot treated with slightly acidic electrolyzed water (SAcEW) and ultrasonication (US) at different storage temperatures. In addition, the inactivation of B. cereus by US with SAcEW was investigated. US treatment with a frequency of 40 kHz and an acoustic energy density of 400 W/L at $40^{\circ}C$ for 3 min showed the maximum reduction of 2.87 log CFU/g B. cereus on carrot, while combined treatment of US (400 W/L, $40^{\circ}C$, 3 min) with SAcEW reached to 3.1 log CFU/g reduction. Growth data of B. cereus on carrot treated with SAcEW and US at different temperatures (4, 10, 15, 20, 25, 30, and $35^{\circ}C$) were collected and used to develop predictive models. The modified Gompertz model was found to be more suitable to describe the growth data. The specific growth rate (SGR) and lag time (LT) obtained from the modified Gompertz model were employed to establish the secondary models. The newly developed secondary models were validated using the root mean square error, bias factor, and accuracy factor. All results of these factors were in the acceptable range of values. After compared SGR and LT of B. cereus on carrot, the results showed that the growth of B. cereus on carrot treated with SAcEW and US was slower than that of single treatment. This result indicates that shelf life of carrot treated with SAcEW and US could be extended. The developed predictive models might also be used to assess the microbiological risk of B. cereus infection in carrot treated with SAcEW and US.

Clinical Evaluation of Implant-Supported Fixed Prostheses (임플란트-지지 고정성 보철물의 임상적 상태에 대한 평가)

  • Park, Chan-Yong;Yun, Mi-Jung;Huh, Jung-Bo;Jeong, Chang-Mo;Jeon, Yeong-Chan
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.4
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    • pp.317-326
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    • 2013
  • This study was to compare the cumulative survival rate of implant-supported fixed prostheses and to analyze association between risk factors and cumulative survival rate of implant-supported fixed prostheses. In order to assess the clinical status of implant-supported fixed prostheses, individuals who treated in the Department of Prosthodontics, Pusan National University Dental Hospital, between 2000 to 2007 were examined. The results of this study were as follows: 1. Length of service of implant-supported fixed prostheses was $6.6{\pm}32.0$ years (mean), 11.7 years (median). 2. Age and sex of patient was found to have no statistically significant influence on longevity of implant-supported fixed prostheses (P>.05). 3. Reason of tooth extraction wax found to have statistically significant influence on implant-supported fixed prostheses (P<.05). The longevity of fixed prostheses was low in tooth extraction case due to periodontal disease (median:9.0 years). 4. Location of implant-supported fixed prostheses was found to have statistically significant influence on longevity of fixed prostheses (P<.05). The longevity of fixed prostheses was low in molar region (median:8.8 years). 5. Number of units in implant-supported fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 6. Condition of opposing dentition was found to have no statistically significant influence on longevity of implant-supported fixed prostheses (P>.05). 7. Food impaction (40.5%), porcelain fracture (25.8%), screw loosening (23.6%) were frequent complications.

Delayed Diagnosis of Primary Lung Cancer (원발성 폐암의 지연진단에 관한 임상적 고찰)

  • Kim, Sun-Young;Cho, Hae-Jeong;Kim, Geun-Hwa;Ko, Dong-Seok;Suh, Jae-Chul;Shin, Kyoung-Sang;Jeong, Seong-Su;Kim, Ju-Ock
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.754-759
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    • 1998
  • Background : Lung cancer is an important public health problem because of rapidly increasing malignancy in both sexes in relation with high smoking rate in Korea. Despite advances in therapeutic modalities and supportive cares, 5-year survival rate has improved only marginally during the past 2 decades. Therefore, the early detection of lung cancer is strongly needed for better prognosis and we conducted this study to review the clinical factors resulting in delayed diagnosis of lung cancer. Method: The clinical data such as presenting symptoms, duration for diagnosis, disease entities causing misdiagnosis or delayed diagnosis, were analyzed retrospectively in 154 patients with primary lung cancer diagnosed at Chungnam National university hospital from January to December in 1995. Results : 63 patients(40.9%) out of 154 patients were delayed diagnosed with the duration of 6.3 months compared with 3.6 months in patients diagnosed without delay. In delayed diagnosed group, Cough & sputum and dyspnea as presenting symptom were more critical than hemoptysis and chest pain, and doctor's delay was more critical than patient's delay. Tuberculosis(30/63) was most frequent disease entity causing delayed diagnosis, followed by pneumorua(9/63), COPD(6/63), heart diseases(5/63), etc.. Conclusion: It should be emphasized that any respiratory symptom be checked with chest X-ray to differentiate lung cancer and periodic check of chest X-ray be also needed for the longterm patients with any disease, especially with high risk group.

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The Comparison of Work of Breathing Between Before Extubation and After Extubation of Endotracheal Tube (기계 호흡 치료후 기관내관 제거 전후 호흡 일(Work of Breathing)의 비교)

  • Jung, Bock-Hyun;Koh, Youn-Suck;Lim, Chae-Man;Choe, Kang-Hyeon;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.329-337
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    • 1997
  • Background : Since endotracheal tube is the most important factor involved in the imposed work of breathing during mechanical ventilation, extubation of endotracheal tube is supposed to reduce respiratory work of patient. However, some patients show labored breathing after extubation despite acceptable blood gases. We investigated the changes of work of breathing before and after extubation and the factors involved in the change of WOB after extubation. Methods : The subjects were 34 patients(M : F = 20 : 14, mean age = $61{\pm}17yre$) who recovered from respiratory failure after ventilatory support and were considered to be ready for extubation. The patients with clinical or radiologic evidences of upper airway obstruction before endotracheal intubation for mechanical ventilation were excluded. Vital sign, physical examination, chest X-ray, work of breathing and other respiratory mechanic indices were measured prior to, immediately, 6, 24 and 48 hours after extubation serially. Definition of weaning failure after extubation was resumption of ventilatory support or reintubation of endotracheal tube within 48 hour after extubation because of respiratory failure. The patients were classified into group 1(decreased work of breathing), group 2(unchanged work of breathing) and group 3(increased work of breathing) depending on the statistical difference in the change of work of breathing before and after extubation. Results : Work of breathing decreased in 33%(11/34, group 1), unchanged in 41%(14/34, group 2) and increased in 26%(9/34, group 3) of patients after extubation compared with before extubation. Weaning failure occurred 9%(1/11) of group, 1, 28.6%(4/14) of group 2 and 44%(4/9) of group 3 after extubation(p = 0.07). The change of work of breathing after extubation was positively correlated with change of mean airway resistance(mRaw). (r = 0.794, p > 0.01). In three cases of group 3 whose respiratory indices could be measured until 48 hr after extubation, the change in work of breathing paralleled with the sequential change of mRaw. The work of breathing was peaked at 6 hr after extubation, which showed a tendency to decrease thereafter. Conclusions : Reversible increase of work of breathing after extubation may occur in the patients who underwent extubation, and the increase in mRaw could be responsible for the increase in work of breathing. In addition, the risk of weaning failure after extubation may increase in the patients who have increased WOB immediately after extubation.

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Clinical Characteristics and Abnormal p53 Expression of Lung Cancer Associated with Multiple Primary Cancer (다발성 악성종양에 동반된 폐암의 임상 특징과 변이형 p53 발현)

  • Shin, Chang-Jin;Park, Hye-Jung;Shin, Kyeong-Cheol;Shim, Young-Ran;Chung, Jin-Hong;Lee, Kwan-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.331-338
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    • 1999
  • Background: Nearly 10% of cancer patients will develop a second primary cancer within ten years after surgical removal of the primary tumor. The detection of risk factors for developing multiple primary tumors would be important This study was conducted to evaluate the clinical characteristics and abnormal p53 expression of lung cancer associated with multiple primary cancer(MPC). Method: Clinical characteristics and abnormal p53 expression were compared between 20 cases of lung cancer(NSCLC ; 16 cases, SCLC ; 4 cases) associated with MPC and 26 cases of primary non-small cell lung cancer. Result: MPC associated with lung cancer was gastric cancer(8), lung cancer(2), esophageal cancer(2), colon cancer(2), laryngeal cancer(1), bladder cancer(1), small bowel cancer(l), adrenal cancer(1), hepatocellular carcinoma(1), and breast cancer (1) in order. The clinical stage of primary NSCLC was relatively advanced, but NSCLC associated with MPC was even distribution at each stage. The detected incidences of abnormal p53 expressions were 62.5% in NSCLC associated with MPC and 76.9% in primary NSCLC(p>0.05). Conclusion: There was no difference in abnormal p53 expression between non-small cell carcinoma associated with multiple primary cancer and primary non-small cell carcinoma.

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Clinical Characteristics of Pulmonary Tuberculosis Presenting Prolonged Fever Despite Primary Short-Course Anti-tuberculosis Treatment (1차 항결핵약제 치료 후에도 지속적으로 발열을 보인 폐결핵 환자의 임상상)

  • Kim, Eun-Kyung;Hwang, Jung-Hwa;Song, Kun-Sick;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.2
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    • pp.169-178
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    • 2000
  • Background : Usually fever subsides within one week in over 90% of pulmonary tuberculosis (TBp) patients after the start of short-course anti-tuberculosis therapy, but occasionally it persists over two weeks after treatment. When the fever persists, drug resistance, combined infection, or drug fever, and so on, are considered as an etiology and, in some cases, drugs are changed. But inadvertent discontinuation of a short-course regimen inevitably will extend the duration of treatment, and the treatment completion may be delayed. This study was performed to investigate the causes of prolonged fever (PF) and to identify the predictors of PF in drug-susceptible TBp patients in Korea. Method : Five hundred-ninety-eight patients, who were admitted to Asan Medical Center from January 1996 to March 1999, diagnosed with TBp and prescribed short-course, anti-tuberculosis treatment, were reviewed. PF was defined as having fever over two weeks despite treatment. The causes of PF were analyzed. Drug-sus-ceptible TBp patients who presented no causes for PF, except turberculosis itself, were selected(n=22), and they were compared with those who had no fever at diagnosis (n=22) and those who had fever at diagnosis, which had subsided within two weeks after treatment (n=22). Clinical, laboratory, and radiological parameters were compared among the three groups. Results : Twenty-eight (4.8%) of 598 patients showed PF over two weeks despite short-course treatment. The causes of PF were drug fever (n=2), multi-drug resistant tuberculosis (n=3), disseminated Mycobacterium kansasii infection (n=1), and drug-susceptible tuberculosis itself (n=22). The patients with PF had more risk factors for tuberculosis, long duration of symptoms before treatment, night sweats, weight long, numerous acid fast bacilli on sputum smear, anemia, hyponatremia, hypoalbuminemia, over three lung cavity numbers and extensive infiltration, indicating that they had prolonged and extensive lung diseases. Conclusion : The main cause of PF in TBp despite short-course regimen seems to be drug-susceptible but extensive disease in Korea. Any changes to the drug regiment provided for TBp patients with prolonged fever despite treatment should be carefully considered.

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Comparison of Clinical Characteristics of Pneumocystis Carinii Pneumonia Between HIV Infected and Non-infected Persons (인간 면역결핍 바이러스 감염자와 비감염자에서 발생한 주폐포자충 폐렴의 임상 양상 비교)

  • Choi, Jun Yong;Lee, Kkot Sil;Park, Yoon Soo;Cho, Cheong Ho;Han, Sang Hoon;Choi, Suk Hoon;Chin, Bum Sik;Park, Yoon Seon;Chang, Kyung Hee;Song, Young Goo;Kim, June Myung
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.4
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    • pp.370-377
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    • 2003
  • Background : Pneumocystis carinii pneumonia (PCP) is one of the most common cause of infection in patients with HIV infection. Recently, the incidence of PCP have been increasing in immunocompromised hosts without HIV infection. We compared the clinical characteristics of PCP between HIV infected and non-infected persons. Patients and Methods : We retrospectively reviewed the charts of 25 patients diagnosed as PCP from 1996 to 2002. Age, sex, underlying conditions, use of immunosuppressants, clinical courses, laboratory findings, treatment and prognosis were compared between HIV infected and non-infected persons. Results : Twenty-five patients with PCP were identified. 16 were HIV infected, and 9 were HIV non-infected. The mean age of overall patients was $43.4{\pm}13.2$ years. Underlying conditions in HIV non-infected persons were hematologic malignancy (7 cases), solid organ transplant (1 case), and autoimmune disease (1 case). Seven cases (77.8%) of HIV non-infected persons had a history of steroid use. Mean duration of symptoms was longer in HIV infected persons than in HIV non-infected persons, but it was not statistically significant. PaO2 was lower in HIV infected persons ($61.2{\pm}16.9$ mmHg vs. $65.4{\pm}15.4$), but it was not statistically significant. Chest X ray showed typical ground glass opacity in 12 cases (75%) of HIV infected persons and in 4 cases (44.4%) of HIV non-infected persons. Twelve cases (75%) of HIV infected persons were treated with steroid, as were 6 cases (66.7%) of HIV non-infected persons. Ventilator care was needed in 6 cases (37.5%) of HIV infected persons and in 2 cases (22.2%) of HIV non-infected persons. Mortality of HIV infected persons was 50%, and that of HIV non-infected persons was 11.1%. Conclusions : PCP showed some different clinical characteristics between HIV infected and non-infected persons. Prospective studies regarding the risk factors of PCP, prophylaxis, treatment and prognosis in HIV infected and non-infected persons are warranted.

Pleural Fluid Analysis in Tuberculous Pleurisy Progressing into Severe Pleural Thickening Underwent Pleural Decortication (심한 흉막비후로 진행하여 흉막박피술을 시행받은 결핵성 흉막염 환자들의 흉막액 분석)

  • Chung, Jae Ho;Park, Moo Suk;Kim, Se Kyu;Chang, Joon;Chung, Kyung Young;Kim, Sung Kyu;Kim, Young Sam
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.4
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    • pp.353-360
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    • 2003
  • Background : Although most patients with tuberculous pleurisy respond well to anti-tuberculous drugs, some are known to progress into severe pleural thickening which needs decortication despite adequate anti-tuberculous treatment. Therefore, the purpose of this study was to identify factors associated with the development of severe pleural thickening in patients who finally underwent pleural decortication in tuberculous pleurisy. Patients and Methods : From retrospective medical records review, 121 patients initially diagnosed as tuberculous pleurisy without initial pleural fluid loculation were enrolled between January 1998 and December 2002. They were separated into two groups: 85 patients in group 1 who improved by anti-tuberculous drugs only, and 36 patients in group 2 who had progressed into pleural adhesion and finally underwent pleural decortication despite adequate (more than 6 months) anti-tuberculous treatment. Results : Males were more common in group 2 (M/F=31/5) than in group 1 (M/F=53/32) (p=0.010). Group 2 patients tended to have lower pleural fluid glucose level ($58{\pm}4$ mg/dL) than group 1 ($89{\pm}3$ mg/dL) (p=0.001) and higher pleural fluid adenosine deaminase level ($86{\pm}5$ IU/L) than group 1 ($76{\pm}3$ IU/L), (p=0.038). There were no significant differences in age, symptom duration, pleural fluid amount, or pleural fluid LDH level between groups 1 and 2. Conclusions : There was a relative risk of tuberculous pleurisy progression into severe pleural thickening which needed decortication in the case of male patients, low pleural fluid glucose or high adenosine deaminase level. But further, large-scale, prospective studies should be investigated.

A Study on Health Statue of the Elderly in Rural Community according to Drinking Pattern (일부 농촌지역 노인의 음주양상에 따른 건강상태)

  • Baek, Dal-Hyun;Hwang, Byung-Deog;Moon, Hyo-Jung;Yoon, Hee-Jung;Lee, Sung-Kook
    • Journal of agricultural medicine and community health
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    • v.31 no.3
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    • pp.263-273
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    • 2006
  • Objectives: This study was conducted to investigate the trend of health statue of the elderly living in rural area according to drinking patterns. Methods: This study was conducted with 2,421 elderly people (male 1,273 and female 1,148) residing in the selected 25 villages, with exclusion of a few elderly people who were in hospital, out for a long time or had an unknown address. This study were carried out, face-to-face interviews with the subjects were made from January to March 2002. Results: The investigation of drinking state showed that for male subjects, drinkers accounted for 48.8%, nondrinkers 35.1% and abstainers from drinking 16.1%, whereas for female subjects, drinkers accounted 15.3%, nondrinkers 80.2% and abstainers from drinking 4.5%. The health status was analyzed according to drinking pattern. For elderly men, abstainers from drinking showed worse health state than nondrinkers and drinkers. Elderly women showed the same result. It is widely known that drinking are the important causes of chronic diseases. Therefore, it is needed to provide the elderly with education on control of preventable health risk factors and effect of living state on health, in order to prevent aggravation of health level of the elder population aged 65 and over. This will also help them promote their health. It will be desirable that for the elderly, the objective will focus on health promotion rather than treatment of diseases. Conclusions: Carry out health plan for rural communities and health maintenance programs and health promotion of the elderly in those communities shall be developed. In addition, preventive education and health examination shall be conducted more frequently with the elderly who drink but are still healthy.

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