• Safety and Health at Work
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• 제10권1호
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• pp.122-124
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• 2019

Simian malaria is a zoonotic disease caused by Plasmodium knowlesi infection. The common natural reservoir of the parasite is the macaque monkey and the vector is the Anopheles mosquito. Human cases of P. knowlesi infection has been reported in all South East Asian countries in the last decade, and it is currently the most common type of malaria seen in Malaysia and Brunei. Between 2007-2017, 73 cases of P. knowlesi infection were notified and confirmed to the Ministry of Health in Brunei. Of these, 15 cases (21%) were documented as work-related, and 28 other cases (38%) were classified as probably related to work (due to incomplete history). The occupations of those with probable and confirmed work related infections were border patrol officers, Armed Forces and security personnel, Department of Forestry officers, boatmen and researchers. The remaining cases classified as most likely not related to work were possibly acquired via peri-domestic transmission. The risk of this zoonotic infection extends to tourists and overseas visitors who have to travel to the jungle in the course of their work. It can be minimised with the recommended use of prophylaxis for those going on duty into the jungles, application of mosquito/insect repellants, and use of repellant impregnated uniforms and bed nets in jungle camp sites.

• Journal of Korean Neurosurgical Society
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• 제65권6호
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• pp.853-860
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• 2022

Objective : This prospective, randomized, double-blinded trial aimed to evaluate the efficacy and safety of prophylactic ramosetron administration against postoperative nausea and vomiting (PONV) in patients undergoing microvascular decompression (MVD). Methods : In this study, 100 patients undergoing MVD were randomly allocated to the control (normal saline, 2 mL) or ramosetron (ramosetron, 0.3 mg) groups at the end of surgery. The incidence and severity of PONV, need for rescue antiemetics, patient satisfaction score, duration of hospital stay, and the occurrence of adverse events were evaluated 48 hours post-surgery. Results : Data obtained from 97 patients were included in the final analysis. The incidence of PONV was significantly lower in the ramosetron group than in the control group throughout the 48-hour postoperative period (29.2% vs. 51.0%, p=0.028). A similar trend was observed with regard to PONV severity (p=0.041). The need for rescue antiemetics, satisfaction score, duration of hospital stays, and the occurrence of adverse events did not significantly differ between the groups. Conclusion : Prophylactic ramosetron administration reduced the incidence and severity of PONV in patients undergoing MVD without causing serious adverse events. Thus, ramosetron use may improve patient recovery following MVD.

• 한국치위생학회지
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• 제21권2호
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• pp.193-201
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• 2021

Objectives: We evaluated the learning objectives of dental hygiene courses based on Bloom's learning objectives, and analyze the degree of match with the dental hygienist's job for each detailed subject. Methods: The 5th edition of 'Dental hygiene and learning objectives' was analyzed by subject based on Bloom's cognitive domain classification from March 10 to April. In addition, the degree of match between the contents of the secondary job analysis of the dental hygienist and the learning objectives for each detailed subject were analyzed. Results: The total number of dental hygiene learning objectives was 2,975 (2,762 theory, 52 practice). Among the cognitive domains, the comprehension domain was the most common (79.8%), and the skill domain was very low (4.9%). In the job for each detailed subject of dental hygiene, the most frequently performed was 'dental prophylaxis and practice' with 103 subjects. Conclusions: Overall, dental hygiene learning objectives are mostly theory-oriented, so it is necessary to expand and improve in the direction related to the jobs that clinical dental hygienists perform in the field. In addition, it is necessary to continuously develop timely learning goals, and prepare active strategies for developing high-quality items.

• Biomolecules & Therapeutics
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• 제31권2호
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• pp.148-160
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• 2023

Depression is a neuropsychiatric disorder associated with persistent stress and disruption of neuronal function. Persistent stress causes neuronal atrophy, including loss of synapses and reduced size of the hippocampus and prefrontal cortex. These alterations are associated with neural dysfunction, including mood disturbances, cognitive impairment, and behavioral changes. Synaptic plasticity is the fundamental function of neural networks in response to various stimuli and acts by reorganizing neuronal structure, function, and connections from the molecular to the behavioral level. In this review, we describe the alterations in synaptic plasticity as underlying pathological mechanisms for depression in animal models and humans. We further elaborate on the significance of phytochemicals as bioactive agents that can positively modulate stress-induced, aberrant synaptic activity. Bioactive agents, including flavonoids, terpenes, saponins, and lignans, have been reported to upregulate brain-derived neurotrophic factor expression and release, suppress neuronal loss, and activate the relevant signaling pathways, including TrkB, ERK, Akt, and mTOR pathways, resulting in increased spine maturation and synaptic numbers in the neuronal cells and in the brains of stressed animals. In clinical trials, phytochemical usage is regarded as safe and well-tolerated for suppressing stress-related parameters in patients with depression. Thus, intake of phytochemicals with safe and active effects on synaptic plasticity may be a strategy for preventing neuronal damage and alleviating depression in a stressful life.

• 한국동물위생학회지
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• 제45권4호
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• pp.317-323
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• 2022

Dirofilariasis is a mosquito-borne parasitic infection that mainly causes symptoms such as chronic cough, respiratory distress, abnormal breath sounds, heart valve dysfunction, right heart hypertrophy, liver congestion and cirrhosis, ascites, and pleural effusion in dogs. In this study, from June to September 2021, we collected and identified mosquitoes in parks where citizens often take their dogs for a walk, and created pools from them by month, species, and location. These pools were checked for the infection of Dirofilaria immitis by PCR and the minimum infection rates (MIRs) were calculated. The MIR of all mosquitoes collected was 6.4, and the MIRs of mosquitoes from Daewangam Park, Yeocheoncheon Walk, Taehwagang National Garden, and Sinbulsan County Park were 9.7, 4.7, 2.1, and 0, respectively. It also confirmed that Aedes hatorii, Aedes vexans nipponii, and Ochlerotatus koreicus were major vectors of heartworm in Ulsan. Our results suggest that heartworm prophylaxis should be considered in Ulsan.

• 임상간호연구
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• 제16권1호
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• pp.71-82
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• 2010

Purpose: The study was aimed to investigate the effects of warm fluid used during surgery on the patients' hypothermia prophylaxis and recovery after surgery. Methods: This data were collected from Jul. 13 to Nov. 31. 2009 at S hospital in M City. 60 patients who met the selection criteria were recruited in the study and divided into two groups. The warmed fluids were used for 30 patients in the experimental group, and the fluids in room air temperature were used for the others in the control group. Collected data were statistically analyzed using SPSS/win 18.0. Results: The body temperatures of the control group were significantly lower during surgery than those of the experimental group (p<.001). Shivering was significantly less occurred in the experimental group than the control group (p=.018). The experimental group used warmed fluids recovered faster than the control group. Conclusion: Warming fluid for the patients with general anesthesia was revealed to be effective in decreasing hypothermia during surgery, reducing shivering, helping recovery from the anesthesia. Further research is warranted to refine and apply this evidence in nursing practice.

• Clinical Endoscopy
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• 제56권4호
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• pp.433-445
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• 2023

Endoscopic retrograde cholangiopancreatography (ERCP) plays a crucial role in the management of pancreaticobiliary disorders. Although the ERCP technique has been refined over the past five decades, it remains one of the endoscopic procedures with the highest rate of complications. Risk factors for ERCP-related complications are broadly classified into patient-, procedure-, and operator-related risk factors. Although non-modifiable, patient-related risk factors allow for the closer monitoring and instatement of preventive measures. Post-ERCP pancreatitis is the most common complication of ERCP. Risk reduction strategies include intravenous hydration, rectal nonsteroidal anti-inflammatory drugs, and pancreatic stent placement in selected patients. Perforation is associated with significant morbidity and mortality, and prompt recognition and treatment of ERCP-related perforations are key to ensuring good clinical outcomes. Endoscopy plays an expanding role in the treatment of perforations. Specific management strategies depend on the location of the perforation and the patient's clinical status. The risk of post-ERCP bleeding can be attenuated by preprocedural optimization and adoption of intra-procedural techniques. Endoscopic measures are the mainstay of management for post-ERCP bleeding. Escalation to angioembolization or surgery may be required for refractory bleeding. Post-ERCP cholangitis can be reduced with antibiotic prophylaxis in high risk patients. Bile culture-directed therapy plays an important role in antimicrobial treatment.

• Clinical Endoscopy
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• 제55권4호
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• pp.520-524
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• 2022

Background/Aims: Intralesional steroid injections have been administered as prophylaxis for stenosis after esophageal endoscopic submucosal dissection. However, this method carries a risk of potential complications such as perforation because a fine needle is used to directly puncture the postoperative ulcer. We devised a new method of steroid intralesional infusion using a spray tube and evaluated its efficacy and safety. Methods: Intralesional steroid infusion using a spray tube was performed on 27 patients who underwent endoscopic submucosal dissection for superficial esophageal cancer with three-quarters or more of the lumen circumference resected. The presence or absence of stenosis, complications, and the number of endoscopic balloon dilations (EBDs) performed were evaluated after treatment. Results: Although stenosis was not observed in 22 of the 27 patients, five patients had stenosis and dysphagia requiring EBD. The stenosis in these five patients was relieved after four EBDs. No complications related to intralesional steroid infusion using the spray tube were observed. Conclusions: Intralesional steroid infusion using a spray tube is a simple and safe technique that is adequately effective in preventing stenosis (clinical trial number, UMIN000037567).

• Clinical Endoscopy
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• 제55권5호
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• pp.665-673
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• 2022

Background/Aims: In patients undergoing endoscopic retrograde cholangiopancreatography (ERCP), calcineurin activates zymogen, which results in pancreatitis. In this study, we aimed to determine the efficacy of tacrolimus, a calcineurin inhibitor, in preventing post-ERCP pancreatitis (PEP). Methods: This was a prospective pilot study in which patients who underwent ERCP received tacrolimus (4 mg in two divided doses); this was the Tac group. A contemporaneous cohort of patients was included as a control group. All patients were followed-up for PEP. PEP was characterized by worsening abdominal pain with an acute onset, elevated pancreatic enzymes, and a duration of hospital stay of more than 48 hours. Serum tacrolimus levels were measured immediately before the procedure in the Tac group. Results: There were no differences in the baseline characteristics between the Tac group (n=48) and the control group (n=51). Only four out of 48 patients (8.3%) had PEP in the Tac group compared to eight out of 51 patients (15.7%) who had PEP in the control group. The mean trough tacrolimus level in patients who developed PEP was significantly lower (p<0.05). Conclusions: Oral tacrolimus at a cumulative dose of 4 mg safely prevents PEP. Further randomized controlled studies are warranted to establish the role of tacrolimus in this context.

• Clinical Endoscopy
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• 제55권1호
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• pp.95-100
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• 2022

Background/Aims: Endoscopic mucosal resection (EMR) is the primary treatment for duodenal adenomas; however, it is associated with a high risk of perforation and bleeding, especially with larger lesions. The goal of this study was to demonstrate the feasibility and safety of endoscopic suturing (ES) for the closure of mucosal defects after duodenal EMR. Methods: Consecutive adult patients who underwent ES of large mucosal defects after EMR of large (>2 cm) duodenal adenomas were retrospectively enrolled. The OverStitch ES system was employed for closing mucosal defects after EMR. Clinical outcomes and complications, including delayed bleeding and perforation, were documented. Results: During the study period, ES of mucosal defects was performed in seven patients in eight sessions (six for prophylaxis and two for the treatment of perforation). All ES sessions were technically successful. No early or delayed post-EMR bleeding was recorded. In addition, no clinically obvious duodenal stricture or recurrence was encountered on endoscopic follow-up evaluation, and no patients required subsequent surgical intervention. Conclusions: ES for the prevention and treatment of duodenal perforation after EMR is technically feasible, safe, and effective. ES should be considered an option for preventing or treating perforations associated with EMR of large duodenal adenomas.