• Title/Summary/Keyword: disease gradient

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Association of Comorbidities With Pneumonia and Death Among COVID-19 Patients in Mexico: A Nationwide Cross-sectional Study

  • Hernandez-Vasquez, Akram;Azanedo, Diego;Vargas-Fernandez, Rodrigo;Bendezu-Quispe, Guido
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.4
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    • pp.211-219
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    • 2020
  • Objectives: The goal of this study was to identify chronic conditions and multimorbidity patterns in patients with coronavirus disease 2019 (COVID-19) and to examine their associations with pneumonia and death. Methods: This cross-sectional study analyzed the official data of COVID-19 patients in Mexico through May 18, 2020 (released by the Secretaría de Salud de México). Adjusted logistic regression models were applied to assess the associations of comorbidities with pneumonia and death. The marginal effects were estimated, and the probability of pneumonia or death according to the number of comorbidities was graphed for each year of age. Results: Of the 51 053 COVID-19 patients enrolled in the final analysis, 27 667 (54.2%) had no chronic conditions, while 13 652 (26.7%), 6518 (12.8%) and 3216 (6.3%) were reported to have 1, 2, and 3 or more simultaneous conditions, respectively. Overall, a significant incremental gradient was observed for the association between multimorbidity and pneumonia (p<0.001); for 2 chronic conditions, the adjusted odds ratio (aOR) was 2.07 (95% confidence interval [CI], 1.95 to 2.20), and for ≥3 conditions, the aOR was 2.40 (95% CI, 2.22 to 2.60). A significant incremental gradient was also found for the relationship between multimorbidity and death (p<0.001); an aOR of 2.51 (95% CI, 2.30 to 2.73) was found for 2 chronic conditions and an aOR of 3.49 (95% CI, 3.15 to 3.86) for ≥3 conditions. Conclusions: Underlying chronic conditions and multimorbidity are associated with pneumonia and death in Mexican COVID-19 patients. Future investigation is necessary to clarify the pathophysiological processes behind this association, given the high burden of chronic diseases in various countries, including Mexico.

Changes of [A-a] gas Gradient in Rabbits with Oxygen Toxicity (산소중독시 가토의 [A-a] gas Gradient 의 변화)

  • 이두연
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.1-12
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    • 1987
  • Respiratory care with oxygen inhalation is often a necessity to maintain life, and it is one of the important therapeutic adjuncts in respiratory disease and in intensive care after surgery. However, it has been reported that oxygen toxicity occurs after prolonged exposure to 100% 0, [Smith, 1899; Kistler et al. 1967; Schaffner et al. 1967; Rowland and Newman, 1969. Subjective symptoms of oxygen toxicity include tracheal irritation, frequent cough, some burning sensation in the trachea, tachypnea, severe dyspnea, etc. [Welch, 1963; Fisher et al, 1968; Milier et al, 1970; Clark and Lambertsen, 1971; Sackner, 1975]. Pathologic findings are atelectasis, injuries to the pulmonary capillaries and hemorrhage in the alveoli in gross specimens. There can be inflammation, proliferation of fibrin, thickening of alveolar membranes, degeneration of collagen fibers and interstitial edema in the microscopic findings. [Penrod, 1956; Cedergren, 1959; Bean, 1965; Schaffner, 1967]. Dubois and colleagues [1961] found that the amount of pulmonary surfactant was decreased in oxygen toxicity and atelectasis followed by the decreased pulmonary surfactant. Many authors reported that vital capacity, inspiratory force, pulmonary compliance, pulmonary capillary blood flow and pulmonary elasticity were deceased and arteriovenous shunting increased. [Comroe et al, 1945; Fuson et al, 1965; Kistler et al, 1966; Knowles and Blenner-hassett, 1967; Barber et al, 1978]. Many human volunteers were examined after prolonged exposure in a high oxygenated chamber and there were a few reports on animals with oxygen toxicity, subjects including rabbits. Gas partial pressures of alveoli and arteries were measured in rabbits exposed to 100% $O_2$ and the alveolar-arterial gas gradients were analyzed, which is the basis for the study of oxygen toxicity. These rabbits were divided into two groups; rabbits under natural respiration, and second group under artificial respiration with a respirator. The alveolar $PO_2$ [$P]AO_2$] and $PCO_2$ [$PACO_2$], and the arterial $PO_2$ [$PaO_2$] were measured under varying $O_2$ pressures; 15% $O_2$, 21% $O_2$ and 100% $O_2$.

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Extra-Anatomic Ascending Aorta to Abdominal Aorta Bypass in Takayasu Arteritis Patients with Mid-Aortic Syndrome

  • Kim, Hak Ju;Choi, Jae-Woong;Hwang, Ho Young;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.270-274
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    • 2017
  • Background: We evaluated the operative outcomes of an extra-anatomic bypass from the ascending aorta to the abdominal aorta in patients with type II or III Takayasu arteritis (TA) with mid-aortic syndrome. Methods: From 1988 to 2014, 8 patients with type II (n=2) or III (n=6) TA underwent an ascending aorta to abdominal aorta bypass. The mean patient age was $43.5{\pm}12.2years$ and the mean peak pressure gradient between the upper and lower extremities was $54.8{\pm}39.0mm\;Hg$. The median follow-up duration was 54.4 months (range, 17.8 to 177.4 months). Results: There were no cases of operative mortality. The mean peak pressure gradient significantly decreased to $-2.4{\pm}32.3mm\;Hg$ (p=0.017 compared to the preoperative value). Late death occurred in 2 patients. The symptoms of upper extremity hypertension and claudication improved in all patients. The bypass grafts were patent at $47.1{\pm}58.9months$ in 7 patients who underwent follow-up imaging studies. Conclusion: An extra-anatomic ascending aorta to abdominal aorta bypass could be an effective treatment option for severe aortic steno-occlusive disease in patients with type II or III TA, with favorable early and long-term outcomes.

Polymorphisms of SLC22A9 (hOAT7) in Korean Females with Osteoporosis

  • Ahn, Seong Kyu;Suh, Chang Kook;Cha, Seok Ho
    • The Korean Journal of Physiology and Pharmacology
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    • v.19 no.4
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    • pp.319-325
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    • 2015
  • Among solute carrier proteins, the organic anion transporters (OATs) play an important role for the elimination or reabsorption of endogenous and exogenous negatively charged anionic compounds. Among OATs, SLC22A9 (hOAT7) transports estrone sulfate with high affinity. The net decrease of estrogen, especially in post-menopausal women induces rapid bone loss. The present study was performed to search the SNP within exon regions of SLC22A9 in Korean females with osteoporosis. Fifty healthy controls and 50 osteoporosis patients were screened for the genetic polymorphism in the coding region of SLC22A9 using GC-clamped PCR and denaturing gradient gel electrophoresis (DGGE). Six SNPs were found on the SLC22A9 gene from Korean women with/without osteoporosis. The SNPs were located as follows: two SNPs in the osteoporosis group (A645G and T1277C), three SNPs in the control group (G1449T, C1467T and C1487T) and one SNP in both the osteoporosis and control groups (G767A). The G767A, T1277C and C1487T SNPs result in an amino acid substitution, from synonymous vs nonsynonymous substitution arginine to glutamine (R256Q), phenylalanine to serine (F426S) and proline to leucine (P496L), respectively. The Km values and Vmax of the wild type, R256Q, P496L and F426S were 8.84, 8.87, 9.83 and $12.74{\mu}M$, and 1.97, 1.96, 2.06 and 1.55 pmol/oocyte/h, respectively. The present study demonstrates that the SLC22A9 variant F426S is causing inter-individual variation that is leading to the differences in transport of the steroid sulfate conjugate (estrone sulfate) and, therefore this could be used as a marker for certain disease including osteoporosis.

Convergence study to predict length of stay in premature infants using machine learning (머신러닝을 이용한 미숙아의 재원일수 예측 융복합 연구)

  • Kim, Cheok-Hwan;Kang, Sung-Hong
    • Journal of Digital Convergence
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    • v.19 no.7
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    • pp.271-282
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    • 2021
  • This study was conducted to develop a model for predicting the length of stay for premature infants through machine learning. For the development of this model, 6,149 cases of premature infants discharged from the hospital from 2011 to 2016 of the discharge injury in-depth survey data collected by the Korea Centers for Disease Control and Prevention were used. The neural network model of the initial hospitalization was superior to other models with an explanatory power (R2) of 0.75. In the model added by converting the clinical diagnosis to CCS(Clinical class ification software), the explanatory power (R2) of the cubist model was 0.81, which was superior to the random forest, gradient boost, neural network, and penalty regression models. In this study, using national data, a model for predicting the length of stay for premature infants was presented through machine learning and its applicability was confirmed. However, due to the lack of clinical information and parental information, additional research is needed to improve future performance.

Characterization of Microbial Community in the Leachate Associated with the Decomposition of Entombed Pigs

  • Yang, Seung-Hak;Hong, Sun Hwa;Cho, Sung Back;Lim, Joung Soo;Bae, Sung Eun;Ahn, Heekwon;Lee, Eun Young
    • Journal of Microbiology and Biotechnology
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    • v.22 no.10
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    • pp.1330-1335
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    • 2012
  • Foot and mouth disease (FMD) is one of the acute infectious diseases in hoofed and even-toed mammals, including pigs, and it occurs via acute infection by Aphthovirus. When FMD is suspected, animals around the location of origin are typically slaughtered and buried. Other methods such as rendering, composting, and incineration have not been verified in practice in Korea. After the FMD incident, the regular monitoring of the microbial community is required, as microorganisms greatly modify the characteristics of the ecosystem in which they live. This is the result of their metabolic activities causing chemical changes to take place in the surrounding environment. In this study, we investigated changes in the microbial community during a 24 week period with DNA extracts from leachate, formed by the decomposition of buried pigs at a laboratory test site, using denaturing gradient gel electrophoresis (DGGE) with a genomic DNA. Our results revealed that Bacteroides coprosuis, which is common in pig excreta, and Sporanaerobacter acetigenes, which is a sulfur-reduced microbe, were continuously observed. During the early stages (0~2 weeks) of tissue decomposition, Clostridium cochlearium, Fusobacterium ulcerans, and Fusobacterium sp., which are involved in skin decomposition, were also observed. In addition, various microbes such as Turicibacter sanguinis, Clostridium haemolyticum, Bacteroides propionicifaciens, and Comamonas sp. were seen during the later stages (16~24 weeks). In particular, the number of existing microbial species gradually increased during the early stages, including the exponential phase, decreased during the middle stages, and then increased again during the later stages. Therefore, these results indicate that the decomposition of pigs continues for a long period of time and leachate is created continuously during this process. It is known that leachate can easily flow into the neighboring environment, so a long-term management plan is needed in burial locations for FMD-infected animals.

Epidemiology of Soybean Mosaic Virus Diseases (콩모자이크바이러스병의 역학적 연구)

  • Cho Eui-Kyoo;Choi S.H.;Hwang C.Y.
    • Korean journal of applied entomology
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    • v.23 no.4 s.61
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    • pp.197-202
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    • 1984
  • Two soybean cultivars Hanan and Kwanggyo were used to monitor SMV spread in the field. The Haman producing mosaic symptoms by infection with SMV strain G7 was planted in $2.2m^2$ at the coater of $320.7m^2$ field and Kwanggyo producing necrosis by infection with SMV-G7 was planted around the Haman one day after inoculation of Heman with SMV-G7. The most severe incidence of the necrotic disease in soybean cultivar Kwanggyo occurred on 43 days after planting(July 13) whereas aphid population reached peak around 22 days after planting(June 22). Total incidence of the necrotic disease was $20.4\%$, in the whole field and $56\%$, in eight $mall plots around the spreader of SMV. The spread of S MV outward from the spreader source was greater downwind than it was upwind. Spread also showed a signigicant gradieut pattern leeward from the infection focus.

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A Case of Hepatopumonary Syndrome with Cyanosis (청색증으로 내원한 간폐증후군 1예)

  • Ryu, Dae-Sik;Jung, Bock-Hyun;Jung, Sang-Sik;Kim, Ho-Dong;Yoo, Chul-Hee;Kang, Kil-Hyeon;Kim, Nam-Hyeon;Jung, Seung-Mun;Park, Man-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.420-425
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    • 1999
  • We report a case of hepatopulmonary syndrome defined as a triad of chronic liver disease, increased alveolar oxygen gradient on room air, and intrapulmonary arteriovenous shunting. Chest rediographs showed bilateral, basilar, medium sized reticulonodular opacities. High resolution CT scand showed multiple centrilobular nodules and branching structures in the subpleural lung that suggested dilatation of lung vessels with abnormally large number of visible terminal branches. $^{99m}Tc$-macroaggregated albumin(MAA) perfusion lung scan showed right to left shunt. Contrast echocardiography demonstrated intrapulmonary vascular shunt without intracardiac shunt.

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Forecasting of the COVID-19 pandemic situation of Korea

  • Goo, Taewan;Apio, Catherine;Heo, Gyujin;Lee, Doeun;Lee, Jong Hyeok;Lim, Jisun;Han, Kyulhee;Park, Taesung
    • Genomics & Informatics
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    • v.19 no.1
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    • pp.11.1-11.8
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    • 2021
  • For the novel coronavirus disease 2019 (COVID-19), predictive modeling, in the literature, uses broadly susceptible exposed infected recoverd (SEIR)/SIR, agent-based, curve-fitting models. Governments and legislative bodies rely on insights from prediction models to suggest new policies and to assess the effectiveness of enforced policies. Therefore, access to accurate outbreak prediction models is essential to obtain insights into the likely spread and consequences of infectious diseases. The objective of this study is to predict the future COVID-19 situation of Korea. Here, we employed 5 models for this analysis; SEIR, local linear regression (LLR), negative binomial (NB) regression, segment Poisson, deep-learning based long short-term memory models (LSTM) and tree based gradient boosting machine (GBM). After prediction, model performance comparison was evelauated using relative mean squared errors (RMSE) for two sets of train (January 20, 2020-December 31, 2020 and January 20, 2020-January 31, 2021) and testing data (January 1, 2021-February 28, 2021 and February 1, 2021-February 28, 2021) . Except for segmented Poisson model, the other models predicted a decline in the daily confirmed cases in the country for the coming future. RMSE values' comparison showed that LLR, GBM, SEIR, NB, and LSTM respectively, performed well in the forecasting of the pandemic situation of the country. A good understanding of the epidemic dynamics would greatly enhance the control and prevention of COVID-19 and other infectious diseases. Therefore, with increasing daily confirmed cases since this year, these results could help in the pandemic response by informing decisions about planning, resource allocation, and decision concerning social distancing policies.

Experimental Applications of in situ Liver Perfusion Machinery for the Study of Liver Disease

  • Choi, Won-Mook;Eun, Hyuk Soo;Lee, Young-Sun;Kim, Sun Jun;Kim, Myung-Ho;Lee, Jun-Hee;Shim, Young-Ri;Kim, Hee-Hoon;Kim, Ye Eun;Yi, Hyon-Seung;Jeong, Won-Il
    • Molecules and Cells
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    • v.42 no.1
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    • pp.45-55
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    • 2019
  • The liver is involved in a wide range of activities in vertebrates and some other animals, including metabolism, protein synthesis, detoxification, and the immune system. Until now, various methods have been devised to study liver diseases; however, each method has its own limitations. In situ liver perfusion machinery, originally developed in rats, has been successfully adapted to mice, enabling the study of liver diseases. Here we describe the protocol, which is a simple but widely applicable method for investigating the liver diseases. The liver is perfused in situ by cannulation of the portal vein and suprahepatic inferior vena cava (IVC), with antegrade closed circuit circulation completed by clamping the infrahepatic IVC. In situ liver perfusion can be utilized to evaluate immune cell migration and function, hemodynamics and related cellular reactions in each type of hepatic cells, and the metabolism of toxic or other compounds by changing the composition of the circulating media. In situ liver perfusion method maintains liver function and cell viability for up to 2 h. This study also describes an optional protocol using density-gradient centrifugation for the separation of different types of hepatic cells, allowing the determination of changes in each cell type. In summary, this method of in situ liver perfusion will be useful for studying liver diseases as a complement to other established methods.