• Pediatric Infection and Vaccine
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• v.26 no.1
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• pp.22-31
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• 2019

Purpose: Campylobacter species are common causes of bacterial enteritis. There is limited knowledge on its prevalence and clinical features because of its fastidious culture conditions. The purpose of this study was to identify the clinical features of Campylobacter enteritis in children. Methods: We obtained stool specimens from patients diagnosed with acute gastroenteritis in the Department of Pediatrics, Nowon Eulji Medical Center (NEMC) and identified the pathogens by performing cultures or polymerase chain reactions (PCR). We retrospectively reviewed the medical records of patients with Campylobacter enteritis at NEMC between January 2012 and December 2017. Results: Overall, 123 patients were diagnosed with Campylobacter enteritis (60 by culture and PCR in EnterNet and 110 by multiplex PCR). The median (interquartile range [IQR]) age of patients was 12 years (IQR, 8 to 16 years). The disease occurred all year round, but 69.9% from June to September. Symptoms included diarrhea (97.6%), fever (96.7%), abdominal pain (94.3%), vomiting (37.4%), and headache (34.1%). Compared with other treatments, treatment with azithromycin was associated with a shorter hospitalization period (P<0.05). Conclusions: Campylobacter enteritis is common during summer and mostly infects adolescent patients. It causes severe abdominal pain and fever preceding the onset of diarrhea. Prompt diagnosis and appropriate use of antibiotics reduces the duration of the disease.

• Journal of Environmental Science International
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• v.11 no.10
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• pp.1061-1068
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• 2002

To identify possible associations with concentrations of ambient air pollutants and daily mortality in Busan, this study assessed the effects of air pollution for the time period 1999-2000. Poisson regression analysis by Generalized Additive Model were conducted considering trend, season, meteorology, and day-of-the-week as confounders in a nonparametric approach. Busan had a 10% increase in mortality in persons aged 65 and older(95% Cl : 1.01-1.10) in association with IQR in $NO_2$(lagged 2 days). An increase of $NO_2$(lagged 2days) was associated with a 4% increase in respiratory mortality(Cl : 1.02-1.11) and CO(lagged 1 day) showed a 3% increase(Cl : 1.00-1.07).

• Proceedings of the Korean Environmental Health Society Conference
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• 2005.06a
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• pp.311-314
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• 2005

To evaluate the acute effects of fine particles on pulmonary function, a longitudinal study was conducted. This study was carried out for the schoolchildren(3rd and 4th grades) living in Inner-Mongolia, China. 113 Chinese children were asked to record their daily levels of peak expiratory flow rate(PEPR) using portable peak flow meter(mini-Wright) for 40 days and 3 time everyday(12 April 2004 to 21 May 2004). The atmospheric concentration of fine particles in study area was also determined everyday during same period. The relationship between dailypeak expiratory flow rate(PEFR) and fine particle levels was analyzed using a mixed linear regression models including gender, age, height, the presence of respiratory symptoms, and daily average relative humidity as extraneous variables. The analysis showed that the increase of fine particle concentrations was negatively associated with the variability in PEPR. The IQR(inter-quartile range) increments of $PM_{10}$ or $PM_{2.5}(66.0{\mu}g/m^3$ and $118.9{\mu}g/m^3$, respectively) were also shown to be related with 1.422L/min(95% Confidence intervals: 0.270 ${\sim}$ 2.574) and 1.214L1min(95% Cl: 0.010 ${\sim}$ 2.418) decline in PEFR.

• Journal of Korea Water Resources Association
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• v.45 no.3
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• pp.275-290
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• 2012

In this study, we have developed an optimal time distribution model through extraction of peaks over threshold (POT) series. The median values for annual maximum rainfall dataset, which are obtained from the magnetic recording (MMR) and the automatic weather system(AWS) data at Seoul meteorological observatory, were used as the POT criteria. We also suggested the improved methodology for the time distribution of extreme rainfall compared to Huff method, which is widely used for time distributions of design rainfall. The Huff method did not consider changing in the shape of time distribution for each rainfall durations and rainfall criteria as total amount of rainfall for each rainfall events. This study have suggested an extracting methodology for rainfall events in each quartile based on interquartile range (IQR) matrix and selection for the mode quartile storm to determine the ranking cosidering weighting factors on minutely observation data. Finally, the optimal time distribution model in each rainfall duration was derived considering both data size and characteristics of distribution using kernel density function in extracted dimensionless unit rainfall hyetograph.

• Quality Improvement in Health Care
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• v.21 no.2
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• pp.12-24
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• 2015

Purpose: The need for the rapid evaluation and treatment of emergency department patients with major trauma is essential. A computerized physician order entry (CPOE) system can improve communication and provide immediate access to information with the goal of reducing ED time delays. The aim of this study was to report on the operation of a trauma CPOE program and demonstrate its usefulness by comparing time intervals from ED arrival to various evaluation steps before and after implementation of the program. Methods: This was a before-and-after observational study from a single emergency department at an academic center. The CPOE program was implemented for 6 months and compared with the data collected from the pre-CPOE implementation period. The efficacy of the program was assessed by comparing the time difference before and after CPOE implementation based on the following factors: total boarding time in ED, door-to-disposition decision time, door-to-blood-test report time, door-to-X-ray time, door-to-CT time, and door-to-transfusion time. Results: Over a period of 6 months, the CPOE was activated for a total of 17 patients. Total boarding time was reduced significantly after implementation [median, 641.5 minutes (IQR, 367.3-859.3) versus289.0 minutes (IQR, 140.0-508.0) for pre-CPOE vs. post-CPOE, respectively, p< 0.05). Time intervals for all evaluation steps were reduced after implementation of the program. The improvements in the door-to-blood-test and door-to-CT times were both statistically significant. Conclusion: This study demonstrated that a standard CPOE system can be successfully implemented and can reduce ED time delays in managing trauma patients.

• Journal of Korean Medical Science
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• v.33 no.45
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• pp.285.1-285.10
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• 2018

Background: Robot-assisted radical prostatectomy (RARP) is a feasible treatment option for high-risk prostate cancer (PCa). While patients may achieve undetectable prostate-specific antigen (PSA) levels after RARP, the risk of disease progression is relatively high. We investigated metastasis-free survival, cancer-specific survival (CSS), and overall survival (OS) outcomes and prognosticators in such patients. Methods: In a single-center cohort of 342 patients with high-risk PCa (clinical stage ${\geq}T3$, biopsy Gleason score ${\geq}8$, and/or PSA levels ${\geq}20ng/mL$) treated with RARP and pelvic lymph node dissection between August 2005 and June 2011, we identified 251 (73.4%) patients (median age, 66.5 years; interquartile range [IQR], 63.0-71.0 years) who achieved undetectable PSA levels (< 0.01 ng/mL) postoperatively. Survival outcomes were evaluated for the entire study sample and in groups stratified according to the time to biochemical recurrence dichotomized at 60 months. Results: During the median follow-up of 75.9 months (IQR, 59.4-85.8 months), metastasis occurred in 38 (15.1%) patients, most often to the bones, followed by the lymph nodes, lungs, and liver. The 5-year metastasis-free, cancer-specific, and OS rates were 87.1%, 94.8%, and 94.3%, respectively. Multivariate Cox-regression analysis revealed time to recurrence as an independent predictor of metastasis (P < 0.001). Time to metastasis was an independent predictor of OS (P = 0.003). Metastasis-free and CSS rates were significantly lower among patients with recurrence within 60 months of RARP (log-rank P < 0.001). Conclusion: RARP confers acceptable oncological outcomes for high-risk PCa. Close monitoring beyond 5 years is warranted for early detection of disease progression and for timely adjuvant therapy.

• Journal of Environmental Health Sciences
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• v.30 no.2
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• pp.140-148
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• 2004

To evaluate the acute effects of fine particles on pulmonary function, a longitudinal study was conducted. This study was carried out for the schoolchildren (3rd and 6th grades) living in Beijing, China. Each child was provided with a mini-Wright peak flow meter and a preformatted health symptom diary for 40 days, and was trained on their proper use. Participants were instructed to perform the peak flow test three times in standing position, three times a day (9 am, 12 pm, and 8 pm), and to record all the readings along with the symptoms (cold, cough, and asthmatic symptoms) experienced on that day. Daily measurement of fine particles (PM$_{10}$ and PM$_{2.5}$) was obtained in the comer of the playground of the participating elementary school for the same period of this longitudinal study. The relationship between daily peak expiratory flow rate (PEFR) and fine particle levels was analyzed using a mixed linear regression models including gender, height, the presence of respiratory symptoms, and daily average temperature and relative humidity as extraneous variables. The total number of students participating in this longitudinal study was 87. The range of daily measured PEFR was 253-501$\ell$/min. In general, the PEFR measured in the morning was lower than the PEFR measured in the evening (or afternoon) on the same day. The daily mean concentrations of PM$_{10}$ and PM$_{2.5}$ over the study period were 180.2$\mu\textrm{g}$/㎥ and 103.2$\mu\textrm{g}$/㎥, respectively. The IQR (inter-quartile range) of PM$_{10}$ and PM$_{2.5}$ were 91.8$\mu\textrm{g}$/㎥ and 58.0$\mu\textrm{g}$/㎥. During the study period, the national ambient air quality standard of 150$\mu\textrm{g}$/㎥ (for PM$_{10}$) was exceeded in 23 days (57.5%). The analysis showed that an increase of 1$\mu\textrm{g}$/㎥ of PM$_{10}$ corresponded to 0.59$\mu\textrm{g}$/㎥ increment of PM$_{2.5}$. Daily mean PEFR was regressed with the 24-hour average PM$_{10}$ (or PM$_{2.5}$) levels, weather information such as air temperature and relative humidity, and individual characteristics including gender, height, and respiratory symptoms. The analysis showed that the increase of fine particle concentrations was negatively associated with the variability in PEFR. The IQR increments of PM$_{10}$ or PM$_{2.5}$ (at 1-day time lag) were also shown to be related with 1.54 $\ell$/min (95% Confidence intervals: 0.94-2.14) and 1.56$\ell$/min (95% CI: 0.95-2.16) decline in PEFR.R.ine in PEFR.ine in PEFR.

• Tuberculosis and Respiratory Diseases
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• v.68 no.2
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• pp.87-92
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• 2010

Background: D-dimer testing is widely applied as a first step in the diagnostic work-up of pulmonary embolism (PE). Although this is the most sensitive assay for ruling out PE, the prognostic implications of D-dimer testing in patients with normotensive PE are not well known. The aim of this study was to determine if D-dimer testing on admission predicts major adverse cardiac events (MACE) in patients with normotensive PE. Methods: A total of 180 consecutive patients with normotensive PE admitted between January 2003 and June 2009 were included. The group was divided into quartiles on the basis of their D-dimer levels. We compared the frequency of MACE by quartile of D-dimer level and estimated sensitivity, specificity, and predictive values for MACE in the first and fourth quartile. Results: In the 37 (20.6%) patients with MACEs, the median D-dimer level (7.94[IQR:4.03~18.17]${\mu}g/mL$) was higher than in patients with a benign course (5.29[IQR:2.60~11.52]${\mu}g/mL$, p<0.01). The occurrence of MACEs was increased with increasing D-dimer level (p=0.017). In the first quartile (D-Dimer <$2.76{\mu}g/mL$) sensitivity, specificity, and positive and negative predictive values for predicting MACEs were, respectively, 91.9%, 29.4%, 25.2%, and 93.3%. Conclusion: Patients with D-dimer levels below $2.76{\mu}g/mL$ have a low risk of MACEs. Our study suggest that D-dimer level may be used to identify low risk patients with normotensive PE.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.6
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• pp.649-655
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• 2018

Objective: This paper reports the possibility of using of a locking horizontal mattress suture technique in repairing lacerations that are difficult to suture with staples. Methods: Data were collected retrospectively over a 6-month period regarding the routine repair of scalp lacerations: those in areas injured by a high energy blunt mechanism, continued to bleed after pressure, nonlinear or damaged skin repaired with a locking horizontal mattress technique, and simple interrupted technique. The effects of the two techniques used to repair scalp lacerations on wound healing, complication rate, and patient satisfaction were examined. The categorical variables are expressed as the number and percent. A Mann-Whitney-Wilcoxon test was used for statistical analysis. A P-value less than 0.05 was considered significant. Results: Thirty-seven consecutive patients with scalp lacerations presented for care. Wound closure was accomplished with the locking horizontal mattress sutures in 40.5% (n=15) (median length, 5.0 cm; interquartile range [IQR], 4.0-7.0 cm). Simple interrupted sutures (median length, 4 cm; IQR, 3.0-5.0 cm) were used in 59.5% (n=22) (P=0.015). The frequency of additional bandage compression (P=0.008), frequency of exudative hemorrhage (P=0.018), and suture mark frequency at suture removal (P=0.047) were significantly lower in the locking horizontal mattress group. Conclusion: The locking horizontal mattress suture, which has the advantage of a horizontal mattress suture, may be one of the ways that can be used alternatively to treat scalp lacerations that difficult to suture with staples.

• Journal of Biomedical Engineering Research
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• v.39 no.2
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• pp.80-86
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• 2018

The aim of this study were to establish the clinical references and guidelines for the maximum standardized uptake ($SUV_{max}$) value of pancreatic cancer, pancreatitis, and normal pancreas in $^{18}F-FDG$ PET-CT examinations for pancreatic disease. For this purpose, we performed the statistical analysis on the descriptive statistics, percentiles and inter quartiles range (IQR), normal distribution, and using the probability density function for pancreatic cancer, pancreatitis, and normal pancreas. As a result, the clinical reference of $SUV_{max}$ for the pancreatic cancer, pancreatitis, and normal pancreas was more than 3.45, 1.91 to 2.62, and less than 1.91, respectively. Also, optimal cut-off value for applying the dual time point PET-CT examination was determined to be 2.62. The results of this study are summarized as follows: first, we suggests the clinical reference and guideline for the pancreatic cancer, pancreatitis, and normal pancreas, and second, suggests a scientific approach to improve diagnostic accuracy of pancreatic disease by deviating from an approximate experience approach.