Urinary tract infections are among the most common infectious diseases and are the major causes of mortality and morbidity. These diseases result in many severe hospitalizations each year. Severe sepsis and septic shock are common and life-threatening medical conditions, and large cases are associated with urinary tract infection. The medical term "severe sepsis" is defined as sepsis complicated by hypotension, organ dysfunction, and tissue hypoperfusion, whereas "septic shock" is defined as sepsis complicated either by hypotension that is refractory to fluid resuscitation or by hyperlacteremia. A recent multicenter-study in Korea reported that the rate of in-hospital mortality associated with severe sepsis and septic shock was > 34%. Among the causative diseases, urogenital tract infection showed a high correlation. Moreover, it is very important that clinicians detect severe sepsis and septic shock early and treat them properly. The principles of initial treatment include provision of sufficient hemodynamic resuscitation and early administration of appropriate antibiotic therapy to mitigate uncontrolled infection. Initial resuscitation includes the use of vasopressors and intravenous fluids, and it is a key to achieve the target of initial resuscitation. Supportive care in the intensive care unit, such as glucose control, stress ulcer prophylaxis, blood transfusion, deep vein thrombosis prophylaxis, and renal replacement therapy, is also significant. We have summarized the key components in the treatment of severe sepsis and septic shock in patients with urinary tract infection. Urologists should be aware that appropriate early treatment is necessary to prevent fatal outcomes in these patients.
The periodic health examination have been shown the important role on early detection, early treatment and prevention of disease. Until now, there have been many studies that showed the effectiveness of the periodic health examination on the early detection and early treatment of disease to some extent. But there are few studies about primary prevention before health problem arise. In this case-control study, 29 newly detected hypertensive cases, 31 liver disease cases and 65 controls which are all available for 6-year data in the periodic health examination of a occupational field were compared to investigate the significant increase trend of health status between the groups. The results will be used for the occupational health nurses to provide appropriate primary prevention to the employees. The hypertensive and liver disease cases were divided observation-needed group and treatment-needed group. The data on systolic blood pressure, diastolic blood pressure, Body Mass Index and Broca Index in hypertensive cases and SGOT, SGPT, Body Mass Index and Broca Index in liver disease cases were analyzed by t-test and ANOVA. The specific findings are summarized as follows. 1. In the comparison between the hypertensive cases and controls, SBP and DBP of the observation-needed group and the treatment-needed group were significantly higher than the data of the controls for past 6 years. It was 2-3 years ago showing increase over 140/90mmHg of blood pressure in the hypertensive cases before they are categorized as hypertensive cases. In the observation-needed group and the treatment-needed group, the trend of the blood pressure for 6 years were significantly higher than the one of the controls. 2. In the comparison between the liver disease cases and controls, SGOT and SGPT of the observation-needed group and the treatment-needed group were significantly higher than the data of the controls for past 6 years. It was 2 years ago showing increase within upper normal limit of SGOT and 5 years ago of SGPT in the liver disease cases before they are categorized as liver disease cases. In the observation-needed group and the treatment-needed group, the trend of the liver enzyme for 6 years were significantly higher than the one of the controls. With these results, the author proposed that intervention for the primary prevention such as continuous follow-up, health education and weight control to the population who has over 140/90mmHg of blood pressure and upper normal limit of AST and ALT.
The purpose of this study was to investigate the change of temperature, moisture content, weight and chemical properties in swine manure during the maturing process and moisture content of swine manure. The manure production on the early time(1 days), middle(25 days: and late(50 days) were made by moisture 45%, 55%, 65%, 75% in swine manure, according to manure treatment of the early time, the highest temperature of swine manure treatment was 59$^{\circ}C$ as moisture 75% after mixed 24 hours, the lowest 45% in mixed 25 days(middle time), 32$^{\circ}C$ as moisture 45% in mixed 50 days(late time). 2. Weight change during maturing manure, the most treatment of weight decrease was 17.4% as moisture 45%, the least of those was 12.2% as moisture 75% during maturing process of swine manure. 3. Volume change during maturing manure, the most treatment of volume decrease was 37.1% as moisture 65%, the least of those was 32.1% as moisture 55% during maturing swine manure, but not big difference between treatment. 4. T-N, P2O5, K2O content of compost were increased during maturing process, On the contrary, T-C content and C/N ratio were reduced.
Effects on nonylphenol (NP) treatment on early development of fertilized eggs and survival of larvae in olive flounder, Paralichthys olivaceus were investigated. Fertilized eggs and hatched larvae were exposed to aqueous solutions of NP at nominal concentrations of 50, 100, 150 and 200 $\mu\textrm{g}$/L. In the control I and II (methanol-carrier control) groups, the hatchability of fertilized eggs were 90.7$\pm$7.02 and 90.0$\pm$5.29% (P <0.05), respectively. However, treatments of NP concentrations at 50, 100, 150 and 200 ug/L were reduced to 78.7$\pm$4.16, 46.0$\pm$9.17, 48.0$\pm$3.46 and 33.3$\pm$11.02% (P<0.05), respectively. The time to hatching of fertilized eggs was delayed in high-dose NP treatment groups rather than control groups. Fertilized eggs of NP immersed group could not hatch normally, and also vertebra of the larvae observed as abnormal shape. Cumulative mortality of hatched larvae after 26hr NP treatment was 38.3, 78.3, 88.3 and 100% in NP 50, 100, 150 and 200 ug/L treatment groups, respectively. Whereas, control I and II were 11.7, 16.7% (P<0.05). Hatched larvae showed most death at the embryonic development stage with abnormalities. These results suggest that NP treatment in fertilized eggs and larvae was inhibited as normally development for fertilized egg and growing of larvae.
The biodegradation of aromatic compounds by a mixed culture GE1 was investigated in an artificial wastewater containing 250 mg/l of benzene, toluene, and phenol in semicontinuous culture. In the control group (no strains) with an aeration rate of 75 ml/l/min, 37% of phenol and 83% of benzene were volatilized during early 24 hrs and toluene was disappeared from the medium within 12 hrs. The biodegradation of benzene and toluene was effective in SB (strains + biofilm) treatment, while phenol was degraded more quickly in SG (strains + glucose) treatment including glucose as an additional carbon source. aromatic compounds added at a concentration of 250 mg/l were completely removed by SG treatment after 16 hrs or 32 hrs, respectively. The removal rate of COD was high as much as 80 mg/l/h in SG treatment during early period, but COD revealed a stable value of 116~140 mg/l after 12 hrs caused by increased biomass. Therefore, it is concluded that the mixed GE1 could be used for the wastewater treatment including aromatic compounds such as benzene, toluene, and phenol.
Journal of the korean academy of Pediatric Dentistry
/
v.24
no.4
/
pp.735-742
/
1997
Class II malocclusion can be treated via early orthopedic, orthodontic treatment or orthognathic surgery with orthodontic treatment. In the mixed dentition, early orthopedic treatment can be used. Especially, in the case of mandibular retrognathism, the functional appliances can be used, and in the case of maxillary protrusion is combined, they can be used together with headgear. After using activator and activator combined with headgear to the class II malocclusion paitent in the mixed dentition, the results were as follows: 1. Lateral profile was improved, and lower face height was increaed. 2. Overjet was decreased, and molar relationship was changed to class I molar relationship. 3. Growth can be undisturbed, and the aggravation of malocclusion can be prevented to make the 2nd phase orthodontic treatment be much easier.
Surgical treatment of refractory and extensive cerebral venous sinus thrombosis (CVST) has limited applications. Here, we describe an open, direct sinus thrombectomy in the early phase of extensive CVST. A 49-year-old man with extensive CVST that occurred after the coronavirus disease 2019 (COVID-19) vaccination and affected the drainage of the Labbé vein presented with clinical deterioration and left temporal hemorrhagic infarction. Since the patient had extensive CVST, we determined that systemic anticoagulation and endovascular treatment were not suitable treatment options. Therefore, we decided on an emergency surgical treatment and performed direct surgical thrombectomy. We followed extended suboccipital approach and made multiple incisions on the sinuses, exposing the posterior superior sagittal sinus to the transverse sigmoid junction. Consequently, the clinical condition of the patient dramatically improved, resulting in a favorable outcome with a modified Rankin scale score of 0. Performing emergency open surgical thrombectomy was a technically feasible treatment option that recanalize obstructed sinuses. Importantly, the patient recovered with a good clinical outcome. Early maximal surgical thrombectomy can be an effective and lifesaving method to treat extensive CVST with hemorrhagic infarction.
Kim, Sun Young;Choi, Sung Chul;Park, Jae Hong;Kim, Kwang Chul
The Journal of Korea Assosiation for Disability and Oral Health
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v.9
no.1
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pp.25-29
/
2013
Most of disabled people face hardness in caring their general oral hygiene by themselves. So that, they are once involved in dental caries or periodontal disease, they have much bigger chance of aggressive progress. Therefore preventive dentistry is more important to disabled one than non-disabled. They need to be checked with routine periodic dental examination and by that, oral disease must be found at initial stage. We selected 37 patients from newly visited 237 patients who had dental treatment at the free dental clinic, Gangnam district, Seoul, between 2000 and 2001. This study is a comparative evaluation of first 2 years' treatment records of selected 37 patients (male 28, female 9) with that of their last 2 years. 24 of 37 have mental retardation, 9 have autistic disorder, 2 have auditory disorder, 1 has brain disorder and 1 has crippled disorder. Their dental treatment records categorized by 4 level; score 4 stands for endodontic treatment, score 3 stands for general conservative treatment, score 2 stands for preventive treatment, such as sealant and score 1 stands for routine check. In first 2 years of treatment, average score was 2.85 which score means approximately general conservative treatment. And that of last 2 years was 1.44, which means routine check. In early time of their visit, they will receive the treatment due to their chief complaint. And after that early time, they can have a routine check so that they can be treated before the disease get worse. The patient's oral health can remain decent only by a simple treatment.
This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.
Background: To improve postoperative outcomes associated with interstitial pneumonia (IP) in patients with lung cancer, the management of the postoperative acute exacerbation of IP (PAEIP) was investigated. Methods: Patients with primary lung cancer were considered to be at risk for PAEIP (possible PAEIP) based on a preoperative evaluation. The early phase of this study was from January 2001 to December 2008, and the late phase was from January 2009 to December 2014. In the early phase, chest computed tomography (CT) was performed for patients for whom PAEIP was suspected based on their symptoms, whereas in the late phase, chest CT was routinely performed within a few days postoperatively. The numbers of possible PAEIP cases, actual PAEIP cases, and deaths within 90 days due to PAEIP were compared between both phases. Results: In the early and late phases, surgery was performed in 712 and 617 patients, 31 and 72 possible PAEIP cases were observed, nine and 12 actual PAEIP cases occurred, and the mean interval from the detection of PAEIP to starting treatment was $7.3{\pm}2.3$ and $5.0{\pm}1.8$ days, respectively. Five patients died in the early phase, and one patient died in the late phase. Significantly fewer PAEIP-related deaths were observed in the late phase (p<0.05). Conclusion: Identifying patients at risk for PAEIP by routine postoperative CT examinations led to the early diagnosis and treatment of PAEIP, resulting in the reduction of PAEIP-related mortality.
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