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A new strategy for transcatheter closure of patent ductus arteriosus with recent-generation devices (경피적 동맥관 폐쇄술에서 최근의 기구들의 전략적 이용과 결과)

  • Kim, Sang Yee;Lee, Soo Hyun;Kim, Nam Kyun;Choi, Jae Young;Sul, Jun Hee
    • Clinical and Experimental Pediatrics
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    • v.52 no.4
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    • pp.488-493
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    • 2009
  • Purpose : The aim of this study was to assess the efficacy and safety of recent-generation patent ductus arteriosus (PDA) closure devices applied by a new selection strategy according to the characteristics of each PDA. Methods : From February 2003 to January 2006, 138 patients underwent transcatheter closure of PDA (study group). According to the size and morphology of each ductus, a COOK Detachable Coil or 'flex' PFM Nit-Occlud was used for a small ductus (group 1, n=43); 'medium' PFM Nit-Occlud (group 2, n=49) for a moderate ductus; and an Amplatzer Duct Occluder (group 3, n=46) for a large ductus. The 83 patients who underwent transcatheter closure of PDA from February 2000 to January 2003 were defined as the comparison group. The Qp/Qs ratio, pulmonary/aorta pressure ratio, and MD of the ductus were compared. Immediate and follow-up results including residual shunts and complications were also evaluated and compared among groups. Results : In all 138 patients, complete occlusions were confirmed without major complications, while procedure failure (n=2, 2.2%), device embolization (n=1, 1.1%), and persistent residual shunt (n=4, 4.5%) were documented in the comparison group. Total complication rates were lower in the study group than in the comparison group (study group, 1.4%; comparison group, 9.0%; P<0.05). Conclusion : A novel strategy adopting the merits of various recent-generation devices for transcatheter closure of PDA provides excellent clinical results with minimal risk.

The Relationship between Oriental Medical Diagnosis and Arteriosclerosis by Carotid-Ankle Vascular Index(CAVI) in Acute Cerebral Infarction Patients (CAVI를 이용한 급성기 중풍환자의 Arteriosclerosis와 한방변증의 관련성 연구)

  • Choi, Won-Woo;Kim, Mi-Young;Kim, Young-Jee;Lee, Seung-Yeop;Leem, Jung-Tae;Kim, Chang-Hyun;Min, In-Kyu;Park, Sung-Wook;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-No;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of Internal Korean Medicine
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    • v.29 no.4
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    • pp.970-978
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    • 2008
  • Objectives : This study aimed to clarify the relationship between the Oriental medical diagnosis and arteriosclerosis by measuring carotid-ankle vascular index(CAVI) in acute cerebral infarction patients. Method : One hundred thirty-one subjects were recruited from the patients admitted to the Internal Medical Department at Kyunghee University Oriental Medical Center from April 2007 to August 2008. We sorted cerebral infarction patients and assessed one hundred fourteen patients' CAVI data. We diagnosed dampness-phlegm by Oriental medical diagnosis and evaluated stroke type by single or multiple infarctions. then, we analyzed their characteristics with type of stroke, risk factor, lifestyle, metabolic syndrome and dampness-phlegm diagnosis. Result : 1. On the demographic variables of the patients, age, hypertension, hyperlipidemia, multiple infarction group and metabolic syndrome and dampness-phlegm group were significantly higher in the high CAVI score group than in the control. 2. According to the significant difference in the dampness-phlegm group, we analyzed dampness-phlegm related index for pattern identifications by CAVI score. As a result, dark circles, insomnia, headache, white coating tongue. slippery pulse, and rough pulse were significantly higher in the high CAVI score group then in the control. 3. In multivariate analysis, age, hypertension, multiple infarction and dampness-phlegm groups showed a close relationship with the high CAVI score group. Conclusions : According to the analysis, significance between dampness-phlegm diagnosed patients group and high CAVI score were clarified. Moreover, multiple location infarctions also have a relationship with high CAVI score in cerebral infarction patients. These results can be utilized in the future as a basis material.

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Awareness of Major Zoonoses among Dairy Farmers in Gyeonggi Province (경기도 낙농업자의 주요 인수공통감염증 인지도)

  • Choi, Kum-Bal;Lim, Hyun-Sul;Lee, Kwan;Min, Young-Sun
    • Journal of agricultural medicine and community health
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    • v.35 no.4
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    • pp.339-349
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    • 2010
  • Objective: We surveyed awareness levels of brucellosis, Q fever and enterohemorrhagic Escherichia coli (EHEC) among dairy farmers in Gyeonggi Province to suggest directions for public education and public relations. Methods: We designed questionnaires to evaluate awareness of 3 major zooneses. We conducted a questionnaire survey to assess knowledge of the general characteristics of them, information sources for the awareness of zooneses, and the mode of transmission. Subjects were 716 workers from 482 dairy farms in Gyeonggi province. Results: The awareness levels for brucellosis, Q fever, and EHEC were 90.2%, 2.5% and 56.6%, respectively. Awareness of brucellosis and EHEC were tended to increase with higher number of school years. Television was the most common route of information for these zoonoses. Most common responses for questions concerning the method of transmission for each zoonoses, 'Contact with parturient fluid or placenta of animal' was 63.2% for brucellosis, 'Ingestion of raw meat or residual product' was 66.7% and 64.2% for Q fever and EHEC, respectively. The most common reason why dairy farmers think that it is difficult to prevent zoonoses was the inconvenience of wearing protection. Conclusions: Education programs for zoonoses, especially Q fever, are needed for dairy farmers. In addition, publicity information activities about prevention of zoonoses are needed for high risk groups, such as the dairy farmers surveyed.

Psychosocial Factors Predicting Delayed Diagnosis of Breast Cancer : The Role of Marital Relationship Functioning (지연된 유방암 진단을 예측하는 정신사회적 요인 : 부부관계기능의 역할)

  • Kim, Ji Young;Woo, Jungmin;Lee, Sang Shin;Kim, Hea Won;Khang, Dongwoo;Rim, Hyo-Deog
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.1
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    • pp.13-22
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    • 2014
  • Objectives : Breast cancer has been the most prevalent female cancer in South Korea since 2001. Early detection of this disease is the most effective strategy for reducing mortality. The objective of this study was to identify factors which could predict advanced stage at diagnosis of breast cancer. Methods : Participants who were initially diagnosed with breast cancer and referred to the Stress Clinic of the Breast Cancer Center at Kyungpook National University Hospital were included. Through a semi-structured interview, the authors investigated psychosocial variables such as the extent of marital and family functioning and emotional-economic family burden as well as sociodemographic and health behavior-, health characteristic- and cancer-related variables. Results : Data were collected from 219 participants. One hundred and twenty(54.8%) subjects were diagnosed with advanced-stage breast cancer. Variables that were significantly different between the advanced-stage and early-stage groups included : monthly breast self examination(p<0.000), annual mammographic screening(p<0.000), mode of tumor detection(p<0.000), nature of the first symptoms(p<0.000), time to treatment after diagnosis(p<0.000), overloaded economic and family burden(p=0.018), marital functioning(p<0.000) and family functioning(p<0.00). Logistic regression analysis indicated that irregular annual mammography screening(OR=7.431 ; 95% CI 2.407-22.944) or a lack of screening(OR=25.299 ; 95% CI 7.855-81.482) and a dysfunctional marital relationship(OR=4.772 ; 95% CI 2.244-10.145) were significantly associated with advanced stage at diagnosis of breast cancer. Conclusions : We reconfirmed screening behavior to be a risk factor for delayed diagnosis of breast cancer. Our findings also emphasized the importance of psychosocial factors such as marital functioning in early detection of breast cancer. Psychiatric consultation in the area of martial functioning could be beneficial for increasing early detection in breast cancer.

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The Methicillin - Resistant Rate of Staphylococcus Aureus Isolated from the Nares and Throat of Patients Admitted to Medical Intensive Care Unit (내과계 중환자실 입원환자의 비,인후 배양에서 메치실린내성 황색포도구균의 빈도)

  • Kim, Hi Gu;Cho, Jae Hwa;Ahn, In Sun;Yoon, Byoung Gap;Lee, Keum Ho;Ryu, Jeong Sun;Kwak, Seung Min;Lee, Hong Lyeol;Kim, Jin Joo
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.2
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    • pp.151-156
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    • 2005
  • Background : Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in hospital-acquired infection, and is prevalent in intensive care units (ICU). The MRSA colonization rates of the nares and throat were examined in both the ICU and general ward. This study was performed to investigate the MRSA rate and necessity for MRSA screening cultures in patients admitted to ICU. Methods : Between June and September 2004, those patients admitted to both the medical ICU and general ward participated in this study. Bacterial cultures were performed on swabs of the nares and throat taken within 24 hours of admission. Clinical data were also collected. Results : One hundred and twenty one patients and 84 patients, admitted to the medical ICU and medical general ward, respectively, were investigated. The numbers of nasal MRSA colonization in the ICU and general ward were 3 (2.5%) and 3 (3.6%), respectively. There were 2 (1.7%) cases of throat MRSA colonization in the ICU, but none in the general ward. The MRSA colonization rates of the nares and throat were no different between the ICU and general ward. There were no significant differences in the previous admission, operation history and admission route between the ICU and general ward groups. Conclusion : The MRSA colonization rates of the nares and throat were 3.3 and 3.6% in the ICU and the general ward, respectively. The MRSA screening test does not appear to be required in all patients admitted to the ICU, but further studies, including high-risk patients, are recommended.

A Study of Serum Lipid Levels, Blood Sugar, Blood Pressure of Vegetarian Buddhist Nuns and Non-Vegetarian Female Adults (II) - Based on Favored Salty Taste - (채식을 하는 여승과 비채식 성인여성의 혈중 지질수준, 혈당, 혈압에 관한 연구(II) -짠맛에 대한 기호를 중심으로-)

  • 차복경
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.31 no.5
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    • pp.871-876
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    • 2002
  • This study was conducted to verify the relation between relation between vegetarian diet and the serum lipid levels, blood sugar and blood pressure from October 1996 to February 1997. The vegetarians subjects were 245 Buddhist nuns (age:23~79 yrs) and control subjects consisted of 235 healthy female adults (age: 23~70 yrs) selected from the teachers, the nurses and the housekeepers living in Chinju Gyeongsang Nam-do. The contents included anthropometric measurement, questionnaires about eating behavior score and preference for taste and biochemical characteristics of the blood. The results were summarized as follows. The average duration of vegetarian diet of the vegetarians was 13.1 years. Vegetarians prefer to a pepper, a sweet and a acidic in the right order but that non-vegetarians prefer to a sweet, a acidic and pepper in the right order. Both groups of less than a decade and more than two decade of vegetarian diet prefer to a pepper, sweet, a acidic, a bitter, a salty and a lily, and a 10~20 yr group with vegetarian diet was fond of a pepper, a bitter, a acidic, a sweet, and a oily, in the right order. This seems to be ascribable to a difference in the health knowledge and interest. Vegetarians and non-vegetarians who said that they were fond of salty were 38.8% and 52.8%, medium was 33.9% and 33.6%, and not salty was 27.3% and 13.6%. Eating behavior score of vegetarians and non-vegetarians were 25.1 and 23.1 respectively. Eating behavior scores of vegetarians were significantly higher than those of non-vegetarians (p<0.05). Eating behavior scores of the group with more than a decade of vegetarian diet were significantly higher than those of the group with less than a decade of vegetarian diet. Levels of serum total-cholesterol, LDL-cholesterol, and AI of the salty group were significantly higher (p<0.05) than those of not salty group. Levels of serum triglyceride, HDL-cholesterol, blood sugar had no significant relation with preference of salty. Blood pressure was not related with preference of salty, but that of those who prefer a salty tended to be high. This study also reveals that the preference of a salty was significant influence on serum total-cholesterol, LDL-cholesterol, and AI, but the vegetarians did not prefer salty and have a good eating behavior. Consequently, vegetarian diet can be considerably effective in reducing the level of the risk factors of cardiovascular disease.

Esophageal Atresia and Tracheoesophageal Fistula in Korea - A National Survey of Its Members by the Korean Association of Pediatric Surgeons - (선천성 식도 무공증 및 기관식도 누공 - 대한 소아외과학회 회원을 대상으로 한 전국 조사 -)

  • Park, W.H.;Kwon, S.I.;Kim, S.C.;Kim, S.K.;Kim, W.K.;Kim, I.K.;Kim, J.E.;Kim, H.H.;Park, K.W.;Park, Y.S.;Song, Y.T.;Yang, J.W.;Oh, S.M.;Yoo, S.Y.;Lee, D.S.;Lee, M.D.;Lee, S.C.;Lee, S.K.;Lee, T.S.;Chang, S.I.
    • Advances in pediatric surgery
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    • v.1 no.2
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    • pp.149-161
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    • 1995
  • The first national survey on esophageal atresia and tracheoesophageal fistula was conducted to access the current status of its incidence, clinical manifestation, preoperative diagnosis and management, type of its anomaly, associated anomalies, and surgical results and course. The 43 members of the Korea Association of Pediatric Surgeons received questionnaires and registration forms to be filled out on each patient who were born during the three years from January 1, 1992 through December 31, 1994. Questionnaires composed of six broad areas which include 1) preoperative diagnosis and management, 2) surgical technic, 3) long gap, 4) postoperative management, and 5) complications and courses. A total of 148 cases was returned by 28 members working at 23 institutions and 27 members returned questionnaires. We obtained the following results by analysis of the 148 cases of tracheoesophageal anomalies. The incidence of tracheoesophageal anomaly was about 1/10,000-11,000 in 1994, which is one third of that of anorectal malformations in Korea and the distribution of the patients was almost proportionate to the size of each province. Both sexes are about equally affected. Majority of the members make diagnosis of tracheoesophageal anomaly by taking a simple infantogram with a radiopaque tube in upper pouch and a little under half(46%) prefers to perform echocardiography as a part of preoperative management to identify congenital heart disease and lateralize the aorta. Esophageal atresia with distal TEF(87.5%) was by far the most common and there were pure esophageal atresia(5.6%), H-type TEF(2.1%), and so on. About half(49%) of the patients had one or more associated anomalies in addition to tracheoesophageal anomalies. Congenital heart disease was associated in 46 cases(31%), anorectral malfomations in 19 cases(13%), musculoskeletal anomalies in 15 cases(10%), genitourinary anomalies in 10 cases(7%) and gastrointestinal anomalies in 7 cases(5%). Postoperatively, parenteral nutrition and assisted ventilation were given in 66% and 52% of patients respectively. Ninety three(74%) of 126 cases who underwent sugical procedure, experienced one or more complications such as respiratory complication(65%), leak(22%), stricture(21%) and so on. The survival rates related to the Waterston risk categories were 90.2% in group A, 71.4-75% in $B_1$, $B_2$, and $C_1$, groups, and 28% in group $C_2$, and the overall survival rate was 71.4%. Thirty six(28.6%) of 126 cases died of pneumonia/sepsis(12 cases), respiratory failure(12 cases), and congenital heart disease(4 cases). With short term follow-up, 69% of patients have been excellent whereas remainders of the cases have suffered from some sort of morbidity related to gastroesophageal reflux, recurrent respiratory infection, and esophageal stricture.

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Antigenotoxic and Anticarcinogenic Effects of Styela plicata (오만둥이(Styela plicata)의 항유전독성 및 대장암 억제효과에 관한 연구)

  • Seo, Bo-Young;Kim, Jung-Mi;Lee, Seung-Cheol;Park, Eun-Ju
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.7
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    • pp.839-845
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    • 2009
  • Colorectal cancer is the third most common malignant neoplasm in the world. Much attention has been focused on reducing colon cancer risk through medical properties of natural compound that could act as anticarcinogens. In this study, we evaluated the antioxidant and antigenotoxic effects of Styela plicata (S. plicata) from in vitro experiments. S. plicata extracts showed antioxidant activity measured by TRAP assay and antigenotoxic effect in $200{\mu}M$ $H_2O_2$ induced DNA damage in human leukocytes. Especially, freeze-dried S. plicata extracted with methanol showed the highest level of TRAP (0.225 mM) and inhibition of DNA damage (66.8%). Additionally we observed the effect of S. plicata on the formation of aberrant crypt foci (ACF) induced by dimethylhydrazine (DMH) and DMH induced DNA damage (by comet assay) in male SD rats. The animals were divided into three groups and fed high-fat and low fiber diet (100 g lard+20 g cellulose/kg diet) without (normal control and DMH control) or with a 3% (w/w) of lyophilized S. plicata powder (DMH+S. plicata). One week after beginning the diets, rats were treated with DMH (30 mg/kg, s.c.) for 6 weeks except for normal control group, which was treated saline instead; dietary treatments were continued for the entire experiment. Nine weeks after DMH injection, administration of S. plicata resulted in reduction of ACF numbers, to 82.7% of the carcinogen control value ($7.67{\pm}2.04$ vs. $1.33{\pm}0.53$: p<0.01). S. plicata supplementation induced antigenotoxic effect on DMH-induced DNA damage in the blood cell (% tail intensity: $6.79{\pm}0.26$ vs. $6.13{\pm}0.22$). These data indicate that S. plicata extract has antigenotoxic and anticarcinogenic effects from in vitro experiments and S. plicata exerts a protective effect on the process of colon carcinogenesis, possibly by suppressing the DMH-induced DNA damage in blood cell and the development of preneoplastic lesions in colon.

An Investigation of Microbial Contamination of Ready-to-Eat Products in Seoul, Korea (서울지역 유통판매 중인 즉석섭취.편의식품의 위해 미생물 오염도 조사)

  • Kim, Hee-Yun;Oh, Seon-Woo;Chung, So-Young;Choi, Seon-Hee;Lee, Ji-Won;Yang, Ji-Yeon;Seo, Eun-Chae;Kim, Yong-Hoon;Park, Hee-Ok;Yang, Cheul-Young;Ha, Sang-Chul;Shin, Il-Shik
    • Korean Journal of Food Science and Technology
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    • v.43 no.1
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    • pp.39-44
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    • 2011
  • This study was carried out to examine microbiological contamination of ready-to-eat products and to propose a draft-standard and specifications according to food types. RTE foods were classified into 6 groups including fish products, meat products, breads, rices, salads, and fresh cut foods. The prevalence rates of pathogens detected from all samples were compared among food categories. The pH ranges for all RTE samples were between 3.8 and 7.3. Total aerobic cell counts ranged from 2 to 6 log CFU/g. Bread, rice and fresh-cut foods showed significantly higher counts, which ranged above 4.0 log CFU/g among the samples. Two kinds of rice were above the level of the KFDA Food Code standard for Eschrichia coli. The prevalence rate of E. coli in the rice was 6.7%. For Staphylococcus aureus, one fish product and one bread-product had levels above 2 log CFU/g. Bacillus cereus counts for all samples were below the level of 3 log CFU/g. Listeria monocytogenes was not detected in the samples. Therefore, these data suggest that the primary microbial hazard factors for ready-to-eat foods and risk assessments should focus on E. coli, S. aureus, and B. cereus.

Clinical Observations in Vancomycin-Resistant Enterococci Isolated from Pediatric Patients (소아 환아에서 분리된 Vancomycin 내성 장구균에 대한 임상적 고찰)

  • Lee, Dong Woo;Lee, Kyung Jae;Jang, Gwang Choen;Kim, Dong Soo;Lee, Kyung Won;Park, Eun Suk
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.199-205
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    • 2001
  • Purpose : Since the first report of vancomycin-resistant enterococci(VRE) in 1986, the resistance to vancomycin in enterococci has been increasingly rapidly. In this study, we investigated the clinical manifestations of pediatric patients with VRE and the pattern of the antibiotic use with increasing the rate of VRE in pediatrics Methods : We studied retrospectively 36 pediatric patients who were isolated VRE from January 1998 to December 2000. We classified patients into ICU and non ICU groups and reviewed species of VRE, specimens in which VRE were first detected and procedures performed before VRE detected. Results : We have found that the number of pediatric patients isolated VRE is increasingly annually in this study. In addition, the number of VRE-isolation in the ICU group and in patients who were operated or who underwent active procedures is much higher than that of in the non ICU group and in patients who were taken medication only. Enterococcus faecium is the main species of VRE. VRE showed high resistance to almost all antibiotics except tetracycline, and resistance was closely related to the duration of hospitalization and history of the antibiotic use. The proportion of the cephalosporin use was higher than any other antibiotic before VRE detection. In contrast, that of teicoplanin was higher than any other antibiotic after VRE detection(P<0.05). The cases of superinfection is higher in the ICU group than in non ICU group. Conclusion : In the hospital level, prevention of nosocomial infection through proper administrative policies, through surveillance of high risk VRE regions and prudent antibiotic use can prevent VRE outbreaks and corresponding side effects.

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