• Tuberculosis and Respiratory Diseases
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• v.83 no.4
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• pp.303-311
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• 2020

Background: If the duration of mechanical ventilation (MV) is related with the intensive care unit (ICU) readmission must be clarified. The purpose of this study was to elucidate if prolonged MV duration increases ICU readmission rate. Methods: The present observational cohort study analyzed national healthcare claims data from 2006 to 2015. Critically ill patients who received MV in the ICU were classified into five groups according to the MV duration: MV for <7 days, 7-13 days, 14-20 days, 21-27 days, and ≥28 days. The rate and risk of the ICU readmission were estimated according to the MV duration using the unadjusted and adjusted analyses. Results: We found that 12,929 patients had at least one episode of MV in the ICU. There was a significant linear relationship between the MV duration and the ICU readmission (R²=0.85, p=0.025). The total readmission rate was significantly higher as the MV duration is prolonged (MV for <7 days, 13.9%; for 7-13 days, 16.7%; for 14-20 days, 19.4%; for 21-27 days, 20.4%; for ≥28 days, 35.7%; p<0.001). The analyses adjusted by covariables and weighted with the multinomial propensity scores showed similar results. In the adjusted regression analysis with a Cox proportional hazards model, the MV duration was significantly related to the ICU readmission (hazard ratio, 1.058 [95% confidence interval, 1.047-1.069], p<0.001). Conclusion: The rate of readmission to the ICU was significantly higher in patients who received longer durations of the MV in the ICU. In the clinical setting, closer observation of patients discharged from the ICU after prolonged periods of MV is required.

• Journal of Yeungnam Medical Science
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• v.37 no.3
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• pp.186-193
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• 2020

Background: Non-tunneled catheters (NTCs) are used for hemodialysis (HD) in many centers in which fluoroscopy is not easily accessed despite high complication rates and conditions requiring long-term HD. Therefore, here we aimed to evaluate the superiority of catheter-related outcomes after the application of tunneled cuffed catheter (TCC) without fluoroscopy versus unconditioned NTC insertion. Methods: We divided the participants into two phases: those receiving NTCs between March 2010 and February 2011 (phase I), and those receiving TCCs or NTCs between March 2011 and February 2012 (phase II). Catheter survival, nurse satisfaction, and reasons for catheter removal were analyzed. Results: Two hundred and sixty patients in phase I and 300 patients in phase II were enrolled in this study. The success rate of TCC insertion was 99.2%. The catheter survival rate in phase I was 65.5% at 1 month, while that in phase II was 74.9% at 1 month (p=0.023). We compared catheter survival between TCCs and NTCs for all periods regardless of phase. The TCC survival rate was higher than the NTC survival rate (p<0.001). Catheter-associated problems led to catheter removal in 97 patients (26.6%) in phase I and 68 patients (18.5%) in phase II (p=0.009). Among 14 HD nurses, all reported being satisfied with manipulation during pre-/post-HD, manupulation during HD, and overall. Eleven HD nurses (78.6%) reported being satisfied with the workload. Conclusion: Compared with unconditional NTC insertion for HD, TCC insertion without fluoroscopy improved the overall catheter survival and nurse satisfaction rates.

• Tuberculosis and Respiratory Diseases
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• v.72 no.1
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• pp.1-7
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• 2012

Extracorporeal Membrane Oxygenation (ECMO) support to tissue oxygenation has been shown to improve survival in patients with life threatening respiratory distress syndrome or cardiac failure. Extracorporeal life support such as ECMO, including extracorporeal $CO_2$ removal ($ECCO_2R$), is used as temporary support until successful recovery of organs. A recently published multicentre randomized controlled trial, known as the CESAR (conventional ventilation or extracorporeal membrane oxygenation for severe adult respiratory failure) trial, was the first trial to demonstrate the utility of ECMO in acute respiratory distress syndrome (ARDS). During the 2009 influenza A (H1N1) pandemic, there were many reports of patients with severe ARDS related to H1N1 infection treated with ECMO. These reports revealed a high survival rate and effectiveness of ECMO. In this review, we explain the indication of ECMO clinical application, the practical types of ECMO, and complications associated with ECMO. In addition, we explain recent new ECMO technology and management of patients during ECMO support.

• Journal of Animal Science and Technology
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• v.49 no.2
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• pp.279-286
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• 2007

A submerged biofilm sequencing batch reactor (SBSBR) process, which liquor was internally circulated through sandfilter, was designed, and performances in swine wastewater treatment was evaluated under a condition of no external carbon source addition. Denitrification of NOx-N with loading rate in vertical and slope type of sandfilter was 19% and 3.8%, respectively, showing approximately 5 times difference, and so vertical type sandfilter was chosen for the combination with SBSBR. When the process was operated under 15 days HRT, 105L/hr.m3 of internal circulation rate and 54g/m3.d of NH4-N loading rate, treatment efficiencies of STOC, NH4-N and TN (as NH4-N plus NOx-N) was 75%, 97% and 85%, respectively. By conducting internal circulation through sandfilter, removal performances of TN were enhanced by 14%, and the elevation of nitrogen removal was mainly attributed to occurrence of denitrification in sandfilter. Also, approximately 57% of phosphorus was removed with the conduction of internal circulation through sandfilter, meanwhile phosphorus concentration in final effluent rather increased when the internal circulation was not performed. Therefore, It was quite sure that the continuous internal circulation of liquor through sandfilter could contribute to enhancement of biological nutrient removal. Under 60g/m3.d of NH4-N loading rate, the NH4-N level in final effluent was relatively low and constant(below 20mg/L) and over 80% of nitrogen removal was maintained in spite of loading rate increase up to 100g/m3.d. However, the treatment efficiency of nitrogen was deteriorated with further increase of loading rate. Based on this result, an optimum loading rate of nitrogen for the process would be 100g/m3.d.

• The Journal of Internal Korean Medicine
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• v.29 no.1
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• pp.90-103
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• 2008

Objective : This study wascarried out to understand the effect of Sopyung-tang (SPT) on blood glucose & antioxidant enzyme activities in streptozotocin-induced diabetic rats. Methods : SD rats were separated into three groups, each with 20 rats. Except the normal group, the other two groups were intra-peritoneally injected with streptozotocin 6mg/kg. The experimental group was treated with SPT extract 500mgkg/day for 4 weeks. The normal and control groups were treated with saline 500mg/kg/day for 4 weeks. Changes of plasma glucose level and body weight were observed. After4 weeks, liver and kidney weight, antioxidant enzyme activities, and survival rate were observed with histological changes on liver, kidney and pancreas. Results : In the experimental group, body weight and survival rate increased, while plasma glucose level decreased significantly. Liver and kidney weight, XOD activity decreased in the experimental group compared to the control. GSH-px and CAT activities andinsulin-immunoreactive granules in ${\beta}-cells$ increased significantly in the experimental group compared to the control. Conclusions : This study shows that SPT might be effective for treatment of diabetes and its complications, as well as reduction of oxidative stress.

• Microbiology and Biotechnology Letters
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• v.15 no.5
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• pp.356-360
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• 1987

Effects of temperature on sisomicin fermentation were investigated. From the specific growth rates for logarithmic phase estimated at various temperatures, 8.2 kcal/g-mol was obtained as an activation energy for cell growth. It suggests that cell growth rate was limited by the internal diffusion layers for nutrients or oxygen caused by aggregated cells. Final antibiotic titer was decreased with in-creasing temperature, and it depended highly on the temperature to which cells were exposed during the logarithmic phase of growth. Temperature shifts during fermentation brought about an increase in antibiotic productivity.

• Korean Journal of Transplantation
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• v.31 no.4
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• pp.182-192
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• 2017

Background: In recent years, introduction of novel immunosuppressive agents and its proper implementation for clinical practice have contributed to improving clinical outcomes of kidney transplantation (KT). Here, we report clinical outcomes of KTs and related risk factors. Methods: From July 1998 to June 2016, 354 KTs (182 from living and 172 from deceased donors) have been performed at Ulsan University Hospital. We retrospectively reviewed the clinical characteristics and outcomes of KT recipients, then estimated graft and patient survival rate were estimated and analyzed risk factors using Cox-regression. Results: The median follow-up period was 53 months (range; 3 to 220 months). The mean ages of recipients and donors were 45.0 years (SD, 12.5) and 44.7 years (SD, 13.6) years, respectively. During follow-up, 18 grafts were lost and 5- and 10-year death-censored graft survival was 96.7% and 91.5%, respectively. Biopsy-proven acute rejection (BPAR) occurred in 71 patients (55 cases of acute cellular rejection and 16 of antibody-mediated rejection). Cox-regression analysis showed that BPAR was a risk factor related to graft loss (hazard ratio [HR], 14.38; 95% confidence interval [CI], 3.79 to 54.53; P<0.001). In addition, 15 patients died, and the 5- and 10-year patient survival was 97.2% and 91.9%, respectively. Age ≥60 years (HR, 6.03; 95% CI, 1.12 to 32.61; P=0.037) and diabetes (HR, 6.18; 95% CI, 1.35 to 28.22; P=0.019) were significantly related to patient survival. Conclusions: We experienced excellent clinical outcomes of KT in terms of graft failure and patient survival despite the relatively high proportion of deceased donors. Long-term and short-term clinical outcomes have improved in the last two decades.

• Journal of Digestive Cancer Research
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• v.2 no.2
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• pp.75-77
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• 2014

Ampulla of Vater (AOV) cancer is rare malignant tumor which arises within the vicinity of the AOV. Metastatic AOV adenocarcinoma has poor prognosis, with an overall survival rate at 2 years ranging from 5 to 10%. The Surveillance, Epidemiology and End Results Program of the National Cancer Institute indicated that lymph node metastasis was present in as many as half of patients which were associated with poor prognosis and liver was the second most common site of distant metastasis in AOV cancer. In this case report, we describe a case of complete resolution of AOV cancer, which was already spread to retroperitoneal lymph node and liver. The patient underwent gemcitabine plus cisplatin chemotherapy for palliative aim. After 12 month of chemotherapy, image study showed partial remission, so intraoperative radiofrequency ablation therapy and pylorus preserving pancreaticoduodenectomy was done. AOV cancer was completely resected and the patient was followed up without recurrence for 7 months.

• Journal of Chest Surgery
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• v.53 no.5
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• pp.277-284
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• 2020

Background: Cardiac arrest during or after office-based cosmetic surgery is rare, and little is known about its prognosis. We assessed the clinical outcomes of patients who developed cardiac arrest during or after cosmetic surgery at office-based clinics. Methods: Between May 2009 and May 2016, 32 patients who developed cardiac arrest during or after treatment at cosmetic surgery clinics were consecutively enrolled. We compared clinical outcomes, including complications, between survivors (n=19) and non-survivors (n=13) and attempted to determine the prognostic factors of mortality. Results: All 32 of the patients were female, with a mean age of 30.40±11.87 years. Of the 32 patients, 13 (41%) died. Extracorporeal life support (ECLS) was applied in a greater percentage of non-survivors than survivors (92.3% vs. 47.4%, respectively; p=0.009). The mean duration of in-hospital cardiopulmonary resuscitation (CPR) was longer for the non-survivors than the survivors (31.55±33 minutes vs. 7.59±9.07 minutes, respectively; p=0.01). The mean Acute Physiology and Chronic Health Evaluation score was also higher among non-survivors than survivors (23.85±6.68 vs. 16.79±7.44, respectively; p=0.01). No predictor of death was identified in the patients for whom ECLS was applied. Of the 19 survivors, 10 (52.6%) had hypoxic brain damage, and 1 (5.3%) had permanent lower leg ischemia. Logistic regression analyses revealed that the estimated glomerular filtration rate was a predictor of mortality. Conclusion: Patients who developed cardiac arrest during or after cosmetic surgery at office-based clinics experienced poor prognoses, even though ECLS was applied in most cases. The survivors suffered serious complications. Careful monitoring of subjects and active CPR (when necessary) in cosmetic surgery clinics may be essential.

• Tuberculosis and Respiratory Diseases
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• v.81 no.1
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• pp.19-28
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• 2018

Cancer is the leading cause of death in the Republic of Korea and cancer death accounts for 27.8% of the total deaths, which is not only a social issue but also a concern for the public. Among the cancer death rates, lung cancer mortality account for 34 deaths per 100,000 populations, making it the number one cancer death rate. In a preliminary report on cancer death in 2012, the lung cancer mortality ratio showed the regional variation indicating that there were differences in the qualitative level and the structure among the medical care benefit agency and in the assessment of the treatment process. Therefore, the Health Insurance Review and Assessment Service (HIRA) had begun evaluation of the assessment of lung cancer treatment since 2014 to improve the quality of lung cancer care through evaluation and feeds back the results of lung cancer care process. In this report, authors described the current Indicators for the lung cancer adequacy assessment proposed by HIRA and results of the evaluation reported in 2017.