• Title/Summary/Keyword: severity levels

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A Study on Nausea & Vomiting, Anorexia and Food intake in Cancer Patients undergoing Chemotherapy Overtime - Comparison between Cervix Cancer and Stomach Cancer - (항암화학요법을 받는 암환자의 시기별 오심과 구토, 식욕부진 및 음식섭취에 관한 연구 - 자궁암 환자와 위암 환자의 비교 -)

  • Yu, Seong-Mi;Gu, Mee-Ock
    • Korean Journal of Adult Nursing
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    • v.15 no.4
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    • pp.573-584
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    • 2003
  • Purpose: This study was conducted to investigate the level of nausea & vomiting, anorexia and food intake during the periods of chemotherapy and 14 days after discharge. Method: The subjects were 40 cancer patients(cervix cancer : 20 patients, stomach cancer: 20 patients) who had chemotherapy with Cisplatin & 5-Fu. Data were analyzed by mean & standard deviation, ANCOVA. Result: 1. The severity of nausea & vomiting with anorexia in cancer patients receiving chemotherapy was the highest at the 3rd day and then it gradually decreased. At the 14th day after discharge, nausea & vomiting with anorexia still remained with very low levels. 2. The amount of food intake was the lowest on the 3rd day and then gradually increased. However, it was 53.3-72.5% of the ordinary food intake on the 14th day after discharge. Calorie intake was 625.31 Kcal on the 3rd day and 1130.92 Kcal on the 7th day after discharge. 3. There were no significant differences in nausea & vomiting, anorexia, food intake, calory intake between those with cervix cancer and stomach cancer. Conclusion: In cancer patients nausea & vomiting and anorexia were severe and food intake was very poor during chemotherapy but afterwards they were gradually improved, but were not completely recovered on the 14th day after discharge. Therefore the nursing intervention regarding the increase of food intake was necessary during chemotherapy and after discharge.

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Theoretically Informed Correlates of Hepatitis B Knowledge among Four Asian Groups: The Health Behavior Framework

  • Maxwell, Annette E.;Stewart, Susan L.;Glenn, Beth A.;Wong, Weng Kee;Yasui, Yutaka;Chang, L. Cindy;Taylor, Victoria M.;Nguyen, Tung T.;Chen, Moon S.;Bastani, Roshan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1687-1692
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    • 2012
  • Background: Few studies have examined theoretically informed constructs related to hepatitis B (HBV) testing, and comparisons across studies are challenging due to lack of uniformity in constructs assessed. The present analysis examined relationships among Health Behavior Framework factors across four Asian American groups to advance the development of theory-based interventions for HBV testing in at-risk populations. Methods: Data were collected from 2007-2010 as part of baseline surveys during four intervention trials promoting HBV testing among Vietnamese-, Hmong-, Korean- and Cambodian-Americans (n = 1,735). Health Behavior Framework constructs assessed included: awareness of HBV, knowledge of transmission routes, perceived susceptibility, perceived severity, doctor recommendation, stigma of HBV infection, and perceived efficacy of testing. Within each group we assessed associations between our intermediate outcome of knowledge of HBV transmission and other constructs, to assess the concurrent validity of our model and instruments. Results: While the absolute levels for Health Behavior Framework factors varied across groups, relationships between knowledge and other factors were generally consistent. This suggests similarities rather than differences with respect to posited drivers of HBV-related behavior. Discussion: Our findings indicate that Health Behavior Framework constructs are applicable to diverse ethnic groups and provide preliminary evidence for the construct validity of the Health Behavior Framework.

The Impact of Trauma Center Establishment on Laparotomy Patterns and Outcomes in Severe Hemoperitoneum Patients

  • Lee, Min A;Lee, Jungnam;Chung, Min;Lee, Giljae;Park, Jaejeong;Choi, Kangkook;Yoo, Byung Chul
    • Journal of Trauma and Injury
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    • v.30 no.1
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    • pp.6-11
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    • 2017
  • Purpose: The establishment of the trauma system has changed the quality of trauma care in many countries. As one of the first designated level I trauma centers in Korea, we hypothesized that there were changes in laparotomy patterns and subsequent survival rates after the center was established. Methods: This was a 5-year retrospective study of all severe hemoperitoneum patients who were transfused with more than 10 units of packed red blood cells (RBCs) within 24 h of hospitalization. Variables related to trauma were collected throughout the study period, and the patients admitted before (period 1) and after (period 2) the establishment of a trauma center were compared. Results: Forty-five patients were managed from January 2009 to March 2015. The baseline patient characteristics of the two groups, including age, Injury Severity Score, blood pressure, and hemoglobin levels, were similar. The time to the operating room (OR) was $144.3{\pm}51.5$ min (period 1) and $79.9{\pm}44.1$ min (period 2) (p<0.0001). Damage control surgery (DCS) was performed in 17% of patients during period 1 and in 73% during period 2. The number of actual survivors (n=10) was higher than expected (n=8) in period 2. Conclusion: This is the first study analyzing the impact of a trauma center on the management of specific injuries, such as severe hemoperitoneum, in patients in Korea. During the study, the time to OR was shortened and DCS was used to a greater extent as a surgical procedure.

Regional Analysis of Particulate Matter Concentration Risk in South Korea (국내 지역별 미세먼지 농도 리스크 분석)

  • Oh, Jang Wook;Lim, Tea Jin
    • Journal of the Korean Society of Safety
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    • v.32 no.5
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    • pp.157-167
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    • 2017
  • Millions of People die every year from diseases caused by exposure to outdoor air pollution. Especially, one of the most severe types of air pollution is fine particulate matter (PM10, PM2.5). South Korea also has been suffered from severe PM. This paper analyzes regional risks induced by PM10 and PM2.5 that have affected domestic area of Korea during 2014~2016.3Q. We investigated daily maxima of PM10 and PM2.5 data observed on 284 stations in South Korea, and found extremely high outlier. We employed extreme value distributions to fit the PM10 and PM2.5 data, but a single distribution did not fit the data well. For theses reasons, we implemented extreme mixture models such as the generalized Pareto distribution(GPD) with the normal, the gamma, the Weibull and the log-normal, respectively. Next, we divided the whole area into 16 regions and analyzed characteristics of PM risks by developing the FN-curves. Finally, we estimated 1-month, 1-quater, half year, 1-year and 3-years period return levels, respectively. The severity rankings of PM10 and PM2.5 concentration turned out to be different from region to region. The capital area revealed the worst PM risk in all seasons. The reason for high PM risk even in the yellow dust free season (Jun. ~ Sep.) can be inferred from the concentration of factories in this area. Gwangju showed the highest return level of PM2.5, even if the return level of PM10 was relatively low. This phenomenon implies that we should investigate chemical mechanisms for making PM2.5 in the vicinity of Gwangju area. On the other hand, Gyeongbuk and Ulsan exposed relatively high PM10 risk and low PM2.5 risk. This indicates that the management policy of PM risk in the west side should be different from that in the east side. The results of this research may provide insights for managing regional risks induced by PM10 and PM2.5 in South Korea.

Seismic pounding effects on adjacent buildings in series with different alignment configurations

  • Abdel Raheem, Shehata E.;Fooly, Mohamed Y.M.;Abdel Shafy, Aly G.A.;Abbas, Yousef A.;Omar, Mohamed;Abdel Latif, Mohamed M.S.;Mahmoud, Sayed
    • Steel and Composite Structures
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    • v.28 no.3
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    • pp.289-308
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    • 2018
  • Numerous urban seismic vulnerability studies have recognized pounding as one of the main risks due to the restricted separation distance between neighboring structures. The pounding effects on the adjacent buildings could extend from slight non-structural to serious structural damage that could even head to a total collapse of buildings. Therefore, an assessment of the seismic pounding hazard to the adjacent buildings is superficial in future building code calibrations. Thus, this study targets are to draw useful recommendations and set up guidelines for potential pounding damage evaluation for code calibration through a numerical simulation approach for the evaluation of the pounding risks on adjacent buildings. A numerical simulation is formulated to estimate the seismic pounding effects on the seismic response demands of adjacent buildings for different design parameters that include: number of stories, separation distances; alignment configurations, and then compared with nominal model without pounding. Based on the obtained results, it has been concluded that the severity of the pounding effects depends on the dynamic characteristics of the adjacent buildings and the input excitation characteristics, and whether the building is exposed to one or two-sided impacts. Seismic pounding among adjacent buildings produces greater acceleration and shear force response demands at different story levels compared to the no pounding case response demands.

Clinical manifestation of Campylobacter enteritis in children

  • Bae, Joon Yeol;Lee, Dong Hyuk;Ko, Kyung Ok;Lim, Jae Woo;Cheon, Eun Jeong;Song, Young Hwa;Yoon, Jung Min
    • Clinical and Experimental Pediatrics
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    • v.61 no.3
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    • pp.84-89
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    • 2018
  • Purpose: Timely antibiotic therapy in selected cases of diarrhea associated with bacterial infections can reduce the duration and severity of illness and prevent complications. The availability of a predictive index before identification of causative bacteria would aid in the choice of a therapeutic agent. Methods: The study included patients admitted to the pediatrics unit at Konyang University Hospital for acute inflammatory diarrhea from August 1, 2015 to July 31, 2016 who underwent multiplex polymerase chain reaction testing. Of 248 patients, 83 had positive results. The clinical symptoms and blood test results were examined in 61 patients with Campylobacter spp. (25 patients), Salmonella spp. (18 patients), and Clostridium perfringens (18 patients) infections. The mean age of the 61 patients (male:femal=31:30) was $84.0{\pm}54.8months$, and the mean hospital stay was $4.6{\pm}1.7days$. Results: There were no statistical differences in sex, age, clinical symptoms, or signs. Patients with Campylobacter infection were significantly older (P=0.00). C-reactive protein (CRP) levels in patients with Campylobacter infection were higher than those in the other 2 groups, at $9.6{\pm}6.1mg/dL$. The results of receiver-operating characteristic curve analysis showed that the cutoff age was ${\geq}103.5months$ (sensitivity, 72%; specificity, 86%) and the CRP cutoff level was ${\geq}4.55mg/dL$ (sensitivity, 80%; specificity, 69%). Conclusion: Age (${\geq}103.5months$) and higher CRP level (${\geq}4.55mg/dL$) were good predictors of Campylobacter enterocolitis. If neither criterion was met, Campylobacter enterocolitis was unlikely (negative predictive value 97.2%). When both criteria were met, Campylobacter enterocolitis was highly likely.

Association of Toll-like receptor 2-positive monocytes with coronary artery lesions and treatment nonresponse in Kawasaki disease

  • Kang, Soo Jung;Kim, Nam Su
    • Clinical and Experimental Pediatrics
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    • v.60 no.7
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    • pp.208-215
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    • 2017
  • Purpose: Activation of Toll-like receptor 2 (TLR2) present on circulating monocytes in patients with Kawasaki disease (KD) can lead to the production of proinflammatory cytokines and interleukin-10 (IL-10). We aimed to determine the association of the frequency of circulating TLR2+/ CD14+ monocytes (FTLR2%) with the outcomes of KD, as well as to compare FTLR2% to the usefulness of sIL-10. Methods: The FTLR2% in patients with KD was measured by flow cytometry. Serum levels of IL-10 (sIL-10) were determined in 31 patients with KD before the initial treatment with intravenous immunoglobulin (IVIG) and in 21 febrile controls by using enzyme-linked immunosorbent assay. Patients were classified as having coronary artery lesions (CALs) based on the maximal internal diameters of the proximal right coronary artery and proximal left anterior descending coronary artery one month after the initial diagnosis. Results: We found that FTLR2% greater than 92.62% predicted CALs with 80% sensitivity and 68.4% specificity, whereas FTLR2% more than 94.61% predicted IVIG resistance with 66.7% sensitivity and 71.4% specificity. Moreover, sIL-10 more than 15.52 pg/mL predicted CALs and IVIG resistance with 40% and 66.7% sensitivity, respectively, and 73.7% and 76.2% specificity, respectively. Conclusion: We showed that measuring FTLR2% before the initial treatment could be useful in predicting CAL development with better sensitivity than sIL-10 and with results comparable to sIL-10 results for the prediction of IVIG resistance in patients with KD. However, further studies are necessary to validate FTLR2% as a marker of prognosis and severity of KD.

The Analysis of Surgical Results to the Lumbar Spinal Disorders of Aged Persons (노령인구의 요추질환에 대한 수술적 치료결과의 분석)

  • Lee, Sei-Young;Youn, Seung-Hwan;Cho, Joon;Moon, Chang-Taek;Chang, Sang-Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.12
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    • pp.1612-1619
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    • 2000
  • Objective : To retrospectively analyse the surgical outcome and efficacy of the lumbar spinal surgery in sixty to older patients who failed to conservative treatments. Methods : Between July 1990 and November 1996, the authors retrospectively investigated the medical records of 46 patients who over 60 years of age at the time of surgery. The clinical severity was assessed with Prolo's grade(economic and functional). Questionnaire was sent to each patient regarding long-term effect, satisfaction, and side effects. Results : In 46 patients, 2 patients(1 case died of lung cancer, 1 case lost in follow-up) were lost. Among 44 patients (28 men, 16 women ; mean age 64 years), 22 patients underwent partial or total laminectomy, 17 spinal fusion with instruments, 2 chemonucleolysis, 2 adhesiolysis for failed back surgery syndrome, and 1 automated percutaneous lumbar discectomy. Although postoperative complications were observed in 5 patients, they were successfully managed. No deaths were documented in the perioperative periods. The average Prolo's economic and functional grade improved from 2.98 to 3.48 and 2.81 to 3.75, respectively. Conclusion : In overall, the favorable surgical outcome was obtained. This results indicated that with appropriate preoperative selections and indications, careful intraoperative monitoring, and attentive postoperative care, the surgical treatment of eldery patients for the lumbar spinal disorders, significant improvement with acceptable levels of morbidity and mortality can be achived.

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Attenuation of Hepatic Graft-versus-host Disease in Allogeneic Recipients of MyD88-deficient Donor Bone Marrow

  • Lim, Ji-Young;Lee, Young-Kwan;Lee, Sung-Eun;Ju, Ji-Min;Park, Gyeongsin;Choi, Eun Young;Min, Chang-Ki
    • IMMUNE NETWORK
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    • v.15 no.3
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    • pp.125-134
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    • 2015
  • Acute graft-versus-host-disease (GVHD) is characterized by selective damage to the liver, the skin, and the gastrointestinal tract. Following allogeneic hematopoietic stem cell transplantation, donor bone marrow (BM) cells repopulate the immune system of the recipient. We previously demonstrated that the acute intestinal GVHD (iGVHD) mortality rate was higher in MyD88-deficient BM recipients than that in the control BM recipients. In the present study, the role of MyD88 (expressed by donor BM) in the pathophysiology of hepatic GVHD (hGVHD) was examined. Unlike iGVHD, transplantation with MyD88-deficient T-cell depleted (TCD) BM attenuated hGVHD severity and was associated with low infiltration of T cells into the liver of the recipients. Moreover, GVHD hosts, transplanted with MyD88-deficient TCD BM, exhibited markedly reduced expansion of $CD11b^+Gr-1^+$ myeloidderived suppressor cells (MDSC) in the liver. Adoptive injection of the MDSC from wild type mice, but not MyD88-deficient mice, enhanced hepatic T cell infiltration in the MyD88-deficient TCD BM recipients. Pre-treatment of BM donors with LPS increased MDSC levels in the liver of allogeneic wild type BM recipients. In conclusion, hGVHD and iGVHD may occur through various mechanisms based on the presence of MyD88 in the non-T cell compartment of the allograft.

Clinical investigation of bisphosphonate-related osteonecrosis of the jaws in patients with malignant tumors

  • Kim, Sei-Kyoung;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.3
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    • pp.152-159
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    • 2012
  • Objectives: This study evaluated bisphosphonate-related osteonecrosis of the jaws (BRONJ) in patients diagnosed with malignant bone tumors. Demographic findings, laboratory, and radiographic analyses were performed to characterize disease severity and progression. Materials and Methods: Patients who had been diagnosed with BRONJ (2005-2010) at the authors' hospital according to the American Association of Oral and Maxillofacial Surgeons were investigated. Twenty-one patients (12 with multiple myelomas, 7 with breast cancer, and 2 with prostate cancer) who had been treated with bisphosphonates (BPs) for malignant bone tumors were included. Radiographic evaluations with a panorama, computed tomography, whole body bone scan, and laboratory findings were evaluated for erythrocyte sedimentation rate (ESR), c-reactive proteins (CRPs), and c-terminal cross-linked telopeptides (CTXs). Results: The average age of the patients was 64.3 (range 51-80), and they were treated with BPs for an average of $35{\pm}19$ months before BRONJ was diagnosed. Types of BPs were zolendronic acid (81%, intravenous [IV]), pamidronate (4.8%, IV), zoledronic acid+pamidronate (4.8%, IV), alendronate (4.8%, per os [PO]), and ibadronate (4.75%, PO). Extraction (67%) and persistent irritation of dentures (20%) were the most common triggering factors. BRONJ in the mandible was reported in 62% of the cases, in the maxilla 24%, and both 14%. BRONJ occurred more frequently in patients with multiple myelomas (n=12, 57.1%). Most of the patients revealed an advanced BRONJ stage; Stage I (n=2, 9%), Stage II (n=13, 62%), and Stage III (n=6, 29%). Conclusion: The differences of the ESR, CRP, and CTX values between the BRONJ-recurring and non-recurring patients after the treatment were not evident. Later stage BRONJ patients showed lower CTX levels. A drug holiday after the diagnosis of BRONJ did not remarkably influence the surgical outcomes. However, the limited number of patients in the study should be considered.