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1.
Article in English | WPRIM | ID: wpr-898192

ABSTRACT

Background@#Data on the association between coronavirus disease 2019 (COVID-19) and thyroid have been reported, including overt thyrotoxicosis and suppression of thyroid function. We aimed to evaluate the thyroid hormone profile and its association with the prognosis of COVID-19 in Korean patients. @*Methods@#The clinical data of 119 patients with COVID-19, admitted in the Myongji Hospital, Goyang, South Korea, were retrospectively evaluated. The thyroid hormone profiles were analyzed and compared based on disease severity (non-severe disease vs. severe to critical disease). Clinical outcomes were analyzed according to the tertiles of thyroid hormones. @*Results@#Of the 119 patients, 76 (63.9%) were euthyroid, and none presented with overt thyroid dysfunction. Non-thyroidal illness syndrome was the most common manifestation (18.5%), followed by subclinical thyrotoxicosis (14.3%) among patients with thyroid dysfunction. Thyroid stimulating hormone (TSH) and triiodothyronine (T3) levels were significantly lower in patients with severe to critical disease than in those with non-severe disease (P1.00 ng/mL) T3 tertiles (P<0.05). COVID-19 patients in the lowest T3 tertile were independently associated with mortality (hazard ratio, 5.27; 95% confidence interval, 1.09 to 25.32; P=0.038) compared with those in the highest T3 tertile. @*Conclusion@#Thyroid dysfunction is common in COVID-19 patients. Changes in serum TSH and T3 levels may be important markers of disease severity in COVID-19. Decreased T3 levels may have a prognostic significance in COVID-19 related outcome.

2.
Article in English | WPRIM | ID: wpr-897568

ABSTRACT

Objective@#Although fluid resuscitation is the cornerstone of treatment for sepsis, the role of body water status in sepsis is poorly understood. This study aimed to understand how body water and its distribution are modified in patients with sepsis and those with non-septic infection compared to healthy individuals. @*Methods@#Two groups of adults presumed to have non-septic infection (n=87) and sepsis (n=54) were enrolled in this prospective study in a single emergency department, and they were compared to sex-, age-, and height-matched (1:3 ratio) healthy controls (n=11,190) from retrospective data in a health promotion center. Total body water (TBW), intracellular water (ICW), and extracellular water (ECW), determined using direct segmental multi-frequent bioelectrical impedance analysis (InBody S10) were expressed as indices for normalization by body weight (BW). The ratio of ECW to TBW (ECW/TBW) was evaluated to determine body water distribution. @*Results@#TBW/BW, ICW/BW, and ECW/BW were significantly higher in the non-septic infection group than in the healthy group (P<0.001), but ECW/TBW was not significantly different (P=0.690). There were no differences in TBW/BW and ICW/BW between the sepsis and healthy groups (P=0.083 and P=0.963). However, ECW/BW and ECW/TBW were significantly higher in the sepsis group than in the healthy group (P<0.001). @*Conclusion@#Compared to the healthy group, the ratio of body water to BW was significantly increased in the non-septic infection group, while ECW/BW and ECW/TBW were significantly increased in the sepsis group. These indices could be utilized as diagnostic variables of body water deficit in septic patients.

3.
Article in English | WPRIM | ID: wpr-897548

ABSTRACT

Objective@#Early defibrillation is crucial for the survival of patients with out-of-hospital cardiac arrest. This study aimed to examine the trends and associated factors regarding public awareness and willingness to use automated external defibrillators (AEDs) through citywide surveys. @*Methods@#Three-round surveys were conducted in February 2012 (n=1,000), December 2016 (n=1,141), and December 2018 (n=1,001) among citizens in Daegu, South Korea, who were aged ≥19 years. The subjects were selected through a three-stage quota sampling. Awareness and willingness to use an AED were assessed in the three groups. The primary outcome was willingness to use AEDs. @*Results@#Of 3,142 respondents, 3,069 were eligible for analysis. The proportion of respondents who knew how to use AEDs increased from 4.7% in 2012 to 20.8% in 2018. Of the respondents in 2012, 2016, and 2018, 39.7%, 50.0%, and 43.2%, respectively, were willing to use an AED. Factors associated with willingness to use AEDs were male sex (adjusted odds ratio [AOR], 1.39; 95% confidence interval [CI], 1.10–1.75), cardiopulmonary resuscitation training experience in the previous 2 years (AOR, 1.80; 95% CI, 1.43–2.28), recognition of the Good Samaritan law (AOR, 1.45; 95% CI, 1.13–1.86), and awareness of how to use an AED (AOR, 4.40; 95% CI, 3.26–5.93). @*Conclusion@#To increase willingness to use AEDs, education in AED use and the Good Samaritan law, along with re-education to maintain knowledge of AED use, should be considered.

4.
Article in English | WPRIM | ID: wpr-890488

ABSTRACT

Background@#Data on the association between coronavirus disease 2019 (COVID-19) and thyroid have been reported, including overt thyrotoxicosis and suppression of thyroid function. We aimed to evaluate the thyroid hormone profile and its association with the prognosis of COVID-19 in Korean patients. @*Methods@#The clinical data of 119 patients with COVID-19, admitted in the Myongji Hospital, Goyang, South Korea, were retrospectively evaluated. The thyroid hormone profiles were analyzed and compared based on disease severity (non-severe disease vs. severe to critical disease). Clinical outcomes were analyzed according to the tertiles of thyroid hormones. @*Results@#Of the 119 patients, 76 (63.9%) were euthyroid, and none presented with overt thyroid dysfunction. Non-thyroidal illness syndrome was the most common manifestation (18.5%), followed by subclinical thyrotoxicosis (14.3%) among patients with thyroid dysfunction. Thyroid stimulating hormone (TSH) and triiodothyronine (T3) levels were significantly lower in patients with severe to critical disease than in those with non-severe disease (P1.00 ng/mL) T3 tertiles (P<0.05). COVID-19 patients in the lowest T3 tertile were independently associated with mortality (hazard ratio, 5.27; 95% confidence interval, 1.09 to 25.32; P=0.038) compared with those in the highest T3 tertile. @*Conclusion@#Thyroid dysfunction is common in COVID-19 patients. Changes in serum TSH and T3 levels may be important markers of disease severity in COVID-19. Decreased T3 levels may have a prognostic significance in COVID-19 related outcome.

5.
Article in English | WPRIM | ID: wpr-889864

ABSTRACT

Objective@#Although fluid resuscitation is the cornerstone of treatment for sepsis, the role of body water status in sepsis is poorly understood. This study aimed to understand how body water and its distribution are modified in patients with sepsis and those with non-septic infection compared to healthy individuals. @*Methods@#Two groups of adults presumed to have non-septic infection (n=87) and sepsis (n=54) were enrolled in this prospective study in a single emergency department, and they were compared to sex-, age-, and height-matched (1:3 ratio) healthy controls (n=11,190) from retrospective data in a health promotion center. Total body water (TBW), intracellular water (ICW), and extracellular water (ECW), determined using direct segmental multi-frequent bioelectrical impedance analysis (InBody S10) were expressed as indices for normalization by body weight (BW). The ratio of ECW to TBW (ECW/TBW) was evaluated to determine body water distribution. @*Results@#TBW/BW, ICW/BW, and ECW/BW were significantly higher in the non-septic infection group than in the healthy group (P<0.001), but ECW/TBW was not significantly different (P=0.690). There were no differences in TBW/BW and ICW/BW between the sepsis and healthy groups (P=0.083 and P=0.963). However, ECW/BW and ECW/TBW were significantly higher in the sepsis group than in the healthy group (P<0.001). @*Conclusion@#Compared to the healthy group, the ratio of body water to BW was significantly increased in the non-septic infection group, while ECW/BW and ECW/TBW were significantly increased in the sepsis group. These indices could be utilized as diagnostic variables of body water deficit in septic patients.

6.
Article in English | WPRIM | ID: wpr-889844

ABSTRACT

Objective@#Early defibrillation is crucial for the survival of patients with out-of-hospital cardiac arrest. This study aimed to examine the trends and associated factors regarding public awareness and willingness to use automated external defibrillators (AEDs) through citywide surveys. @*Methods@#Three-round surveys were conducted in February 2012 (n=1,000), December 2016 (n=1,141), and December 2018 (n=1,001) among citizens in Daegu, South Korea, who were aged ≥19 years. The subjects were selected through a three-stage quota sampling. Awareness and willingness to use an AED were assessed in the three groups. The primary outcome was willingness to use AEDs. @*Results@#Of 3,142 respondents, 3,069 were eligible for analysis. The proportion of respondents who knew how to use AEDs increased from 4.7% in 2012 to 20.8% in 2018. Of the respondents in 2012, 2016, and 2018, 39.7%, 50.0%, and 43.2%, respectively, were willing to use an AED. Factors associated with willingness to use AEDs were male sex (adjusted odds ratio [AOR], 1.39; 95% confidence interval [CI], 1.10–1.75), cardiopulmonary resuscitation training experience in the previous 2 years (AOR, 1.80; 95% CI, 1.43–2.28), recognition of the Good Samaritan law (AOR, 1.45; 95% CI, 1.13–1.86), and awareness of how to use an AED (AOR, 4.40; 95% CI, 3.26–5.93). @*Conclusion@#To increase willingness to use AEDs, education in AED use and the Good Samaritan law, along with re-education to maintain knowledge of AED use, should be considered.

7.
Journal of Breast Cancer ; : 463-473, 2021.
Article in English | WPRIM | ID: wpr-914833

ABSTRACT

Immunoreactive dynamics of tumor-infiltrating lymphocytes (TILs) within the tumor microenvironment in breast cancer are not well understood. This study aimed to investigate the spatiotemporal cellular dynamics of TILs in breast cancer models. Breast cancer cells were implanted into the dorsal skinfold chamber of BALB/c nude mice, and T lymphocytes were adoptively transferred. Longitudinal intravital imaging was performed, and the spatiotemporal dynamics of TILs were assessed. In the 4T1 model, TILs progressively exhibited increased motility, and their motility inside the tumor was significantly higher than that outside the tumor. In the MDA-MB-231 model, the motility of TILs progressively decreased after an initial increase. TIL motility in the MDA-MB-231 and MCF-7 models differed significantly, suggesting an association between programmed death-ligand 1 expression levels and TIL motility, which warrants further investigation. Furthermore, intravital imaging of TILs can be a useful method for addressing dynamic interactions between TILs and breast cancer cells.

8.
Article in English | WPRIM | ID: wpr-874524

ABSTRACT

We investigated the cardiovascular complications and mortality rates of patients with diabetes in South Korea. The rates of hospitalization due to cardiovascular complications and mortality were analyzed using the Korean National Health Insurance Service-National Sample Cohort. From 2006 to 2015, the rates of hospitalization due to major cardiovascular complications decreased, while those due to heart failure (from 72 to 146 and 124 to 161 per 10,000 men and women, respectively) and peripheral artery disease (from 39 to 55 and 19 to 35 per 10,000 men and women, respectively) increased. In the period 2007 to 2015, the mortality rates for cancer, cerebrovascular disease, diabetes, heart disease, and hypertensive disease all decreased. However, the mortality rate for pneumonia increased. We observed a continuous reduction in cardiovascular complications and mortality in adults with diabetes. However, with the increase in some diabetes complications, more efforts are needed to prevent diabetes complications.

9.
Article in English | WPRIM | ID: wpr-898150

ABSTRACT

Background@#Whether hyperthyroidism is an independent risk factor for cardiovascular events remains controversial. We aimed to evaluate the association of overt and subclinical hyperthyroidism with the risk of ischemic heart disease (IHD), stroke, heart failure, and cardiovascular mortality. @*Methods@#Studies regarding the association between hyperthyroidism and cardiovascular events were searched on PubMed and Embase databases. The cardiovascular disease (CVD) risk was classified as high and low, based on pre-existing diseases, including history of coronary, cerebral, or peripheral artery disease; heart failure; atrial fibrillation; diabetes mellitus; or chronic kidney disease. @*Results@#Thirty-seven cohort studies were included in this meta-analysis. The pooled hazard ratio for subjects with overt hyperthyroidism compared with the control group was 1.11 (95% confidence interval [CI], 1.03 to 1.19) for IHD, 1.35 (95% CI, 1.03 to 1.75) for stroke, and 1.20 (95% CI, 1.00 to 1.46) for cardiovascular mortality. For subjects with subclinical hyperthyroidism, the pooled hazard ratio was 1.24 (95% CI, 1.07 to 1.45) for IHD, when compared with the control group. Subgroup analysis by CVD risk showed that the risk of stroke in overt hyperthyroidism was increased in the low CVD risk group; however, these association was not observed in the high CVD risk group. Similarly, the risk of IHD in subjects with subclinical hyperthyroidism was significantly increased in the low CVD risk group. @*Conclusion@#Overt hyperthyroidism is associated with increased risk of IHD, stroke, and cardiovascular mortality, and subclinical hyperthyroidism is associated with increased risk of IHD. These associations were particularly observed in the low risk CVD group without underlying CVD.

10.
Article in English | WPRIM | ID: wpr-890446

ABSTRACT

Background@#Whether hyperthyroidism is an independent risk factor for cardiovascular events remains controversial. We aimed to evaluate the association of overt and subclinical hyperthyroidism with the risk of ischemic heart disease (IHD), stroke, heart failure, and cardiovascular mortality. @*Methods@#Studies regarding the association between hyperthyroidism and cardiovascular events were searched on PubMed and Embase databases. The cardiovascular disease (CVD) risk was classified as high and low, based on pre-existing diseases, including history of coronary, cerebral, or peripheral artery disease; heart failure; atrial fibrillation; diabetes mellitus; or chronic kidney disease. @*Results@#Thirty-seven cohort studies were included in this meta-analysis. The pooled hazard ratio for subjects with overt hyperthyroidism compared with the control group was 1.11 (95% confidence interval [CI], 1.03 to 1.19) for IHD, 1.35 (95% CI, 1.03 to 1.75) for stroke, and 1.20 (95% CI, 1.00 to 1.46) for cardiovascular mortality. For subjects with subclinical hyperthyroidism, the pooled hazard ratio was 1.24 (95% CI, 1.07 to 1.45) for IHD, when compared with the control group. Subgroup analysis by CVD risk showed that the risk of stroke in overt hyperthyroidism was increased in the low CVD risk group; however, these association was not observed in the high CVD risk group. Similarly, the risk of IHD in subjects with subclinical hyperthyroidism was significantly increased in the low CVD risk group. @*Conclusion@#Overt hyperthyroidism is associated with increased risk of IHD, stroke, and cardiovascular mortality, and subclinical hyperthyroidism is associated with increased risk of IHD. These associations were particularly observed in the low risk CVD group without underlying CVD.

11.
Yonsei Medical Journal ; : 942-950, 2020.
Article | WPRIM | ID: wpr-833386

ABSTRACT

Purpose@#Implantable cardioverter defibrillators (ICD) are the standard of care for primary prevention (PP) in patients with ischemic cardiomyopathy (ICM). However, PP ICD implantation is underused in Asian countries. This study investigated ICD implantation rates and factors associated with appropriate PP ICD implants for ICM. @*Materials and Methods@#In this prospective multicenter observational registry (ADVANCE-ICM registry), ICM patients who were eligible for PP ICD were screened and enrolled. Factors associated with appropriate ICD implantation, including hospital and clinical factors, were investigated. @*Results@#Of the 1453 ICM patients eligible for PP ICD [1111 male; median age, 71.0 (61.0–78.0) years], only 76 (5.2%) patients underwent ICD implantation. Among hospital factors, a non-monetary incentive for referral (72.4% vs. 52.9%, p=0.001) and total hospital system score (6.0 vs. 5.0, p=0.013) were higher in the ICD than in the no-ICD group. In multivariate analysis, total hospital system score [odds ratio (OR), 1.28; 95% confidence interval (CI), 1.10–1.50] was an independent factor for predicting ICD implantation, along with clinical factors, including high New York Heart Association class (≥III: OR, 7.29; 95% CI, 2.97–17.87) and younger age (<70 years: OR, 2.14; 95% CI, 1.30–3.53). @*Conclusion@#PP ICD implantation for ICM patients is underused in Korea. Hospital factors were important for improving PP ICD implantation rate, suggesting that new screening and referral systems for ICM patients would improve the PP ICD implantation rate (Clinical trial registration No. NCT03590925).

12.
Article in English | WPRIM | ID: wpr-811146

ABSTRACT

BACKGROUND: Cardiovascular risk remains increased despite optimal low density lipoprotein cholesterol (LDL-C) level induced by intensive statin therapy. Therefore, recent guidelines recommend non-high density lipoprotein cholesterol (non-HDL-C) as a secondary target for preventing cardiovascular events. The aim of this study was to assess the efficacy and tolerability of omega-3 fatty acids (OM3-FAs) in combination with atorvastatin compared to atorvastatin alone in patients with mixed dyslipidemia.METHODS: This randomized, double-blind, placebo-controlled, parallel-group, and phase III multicenter study included adults with fasting triglyceride (TG) levels ≥200 and <500 mg/dL and LDL-C levels <110 mg/dL. Eligible subjects were randomized to ATOMEGA (OM3-FAs 4,000 mg plus atorvastatin calcium 20 mg) or atorvastatin 20 mg plus placebo groups. The primary efficacy endpoints were the percent changes in TG and non-HDL-C levels from baseline at the end of treatment.RESULTS: After 8 weeks of treatment, the percent changes from baseline in TG (−29.8% vs. 3.6%, P<0.001) and non-HDL-C (−10.1% vs. 4.9%, P<0.001) levels were significantly greater in the ATOMEGA group (n=97) than in the atorvastatin group (n=103). Moreover, the proportion of total subjects reaching TG target of <200 mg/dL in the ATOMEGA group was significantly higher than that in the atorvastatin group (62.9% vs. 22.3%, P<0.001). The incidence of adverse events did not differ between the two groups.CONCLUSION: The addition of OM3-FAs to atorvastatin improved TG and non-HDL-C levels to a significant extent compared to atorvastatin alone in subjects with residual hypertriglyceridemia.


Subject(s)
Adult , Atorvastatin , Cholesterol , Cholesterol, LDL , Dyslipidemias , Fasting , Fatty Acids, Omega-3 , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Hypertriglyceridemia , Incidence , Lipoproteins , Triglycerides
13.
Article in English | WPRIM | ID: wpr-763662

ABSTRACT

BACKGROUND: The objective of this study was to investigate the prevalence, management, and comorbidities of diabetes among Korean adults aged 30 years and older. METHODS: This study used 2013 to 2016 data from the Korea National Health and Nutrition Examination Survey, a nationally-representative survey of the Korean population. Diabetes was defined as fasting glucose ≥126 mg/dL, current use of antidiabetic medication, a previous history of diabetes, or glycosylated hemoglobin (HbA1c) ≥6.5%. RESULTS: In 2016, 14.4% (approximately 5.02 million) of Korean adults had diabetes. The prevalence of impaired fasting glucose was 25.3% (8.71 million). From 2013 to 2016, the awareness, control, and treatment rates for diabetes were 62.6%, 56.7%, and 25.1%, respectively. People with diabetes had the following comorbidities: obesity (50.4%), abdominal obesity (47.8%), hypertension (55.3%), and hypercholesterolemia (34.9%). The 25.1%, 68.4%, and 44.2% of people with diabetes achieved HbA1c <6.5%, blood pressure <140/85 mm Hg, and low density lipoprotein cholesterol <100 mg/dL. Only 8.4% of people with diabetes had good control of all three targets. CONCLUSION: This study confirms that diabetes is as an important public health problem. Efforts should be made to increase awareness, detection, and comprehensive management of diabetes to reduce diabetes-related morbidity and mortality.


Subject(s)
Adult , Blood Pressure , Cholesterol, LDL , Comorbidity , Diabetes Mellitus , Fasting , Glucose , Glycated Hemoglobin A , Humans , Hypercholesterolemia , Hypertension , Korea , Mortality , Nutrition Surveys , Obesity , Obesity, Abdominal , Prevalence , Public Health , Republic of Korea
14.
Cancer Research and Treatment ; : 1568-1577, 2019.
Article in English | WPRIM | ID: wpr-763204

ABSTRACT

PURPOSE: The diagnostic criteria of gastric intraepithelial neoplasia (IEN) are controversial across the world. We investigated how many discrepancies occur in the pathologic diagnosis of IEN and early gastric carcinoma in endoscopic submucosal dissection (ESD) specimens, and evaluated the reasons of the discordance. MATERIALS AND METHODS: We retrospectively reviewed 1,202 ESD specimens that were originally diagnosed as gastric IEN and early carcinoma at 12 institutions. RESULTS: The final consensus diagnosis of carcinoma were 756 cases, which were originally 692 carcinomas (91.5%), 43 high-grade dysplasias (5.7%), 20 low-grade dysplasias (2.6%), and 1 others (0.1%), respectively. High- and low-grade dysplasia were finally made in 63 and 342 cases, respectively. The diagnostic concordance with the consensus diagnosis was the highest for carcinoma (91.5%), followed by low-grade dysplasia (86.3%), others (63.4%) and high-grade dysplasia (50.8%). The general kappa value was 0.83, indicating excellent concordance. The kappa values of individual institutions ranged from 0.74 to 1 and correlated with the proportion of carcinoma cases. The cases revised to a final diagnosis of carcinoma exhibited both architectural abnormalities and cytologic atypia. The main differential points between low- and high-grade dysplasias were the glandular distribution and glandular shape. Additional features such as the glandular axis, surface maturation, nuclear stratification and nuclear polarity were also important. CONCLUSION: The overall concordance of the diagnosis of gastric IEN and early carcinoma in ESD specimens was excellent. It correlated with the proportion of carcinoma cases, demonstrating that the diagnostic criteria for carcinoma are more reproducible than those for dysplasia.


Subject(s)
Consensus , Diagnosis , Retrospective Studies , Stomach Neoplasms
15.
Article in Korean | WPRIM | ID: wpr-770049

ABSTRACT

PURPOSE: The aim of this study was to determine if preoperative temporary discontinuation of antiplatelet medication (aspirin, clopidogrel, or cilostazol) is a safe procedure that does not increase early postoperative bleeding and allogenic blood transfusion after a total knee arthroplasty. MATERIALS AND METHODS: A retrospective analysis was conducted among consecutive patients who underwent navigation assisted primary total knee arthroplasty performed by a single surgeon, from January 2013 to December 2016. A total of 369 patients enrolled in this study were divided into two groups, 271 patients with no history of antiplatelet therapy and 98 patients who underwent 7 days of temporary withdrawal of antiplatelet therapy. Comparative analysis between the two groups, on the variation of hemoglobin and hematocrit during the first and second postoperative days, was conducted to determine the amount of early postoperative bleeding and the frequency of allogenic blood transfusion during hospitalization. RESULTS: The variation of hemoglobin, hematocrit during the first and second postoperative days and the frequency of allogenic blood transfusion between no history of antiplatelet medication and discontinuation antiplatelet medication before 7 days from surgery were similar in both groups. Of the 369 patients, 149 patients received a blood transfusion during their hospitalization. Compared to patients who did not receive a blood transfusion, those who did received blood transfusion were significantly older in age, smaller in height, lighter in weight, and showed significantly lower preoperative hemoglobin and hematocrit values. No statistically significant differences in sex, preoperative American Society of Anesthesiologists scores, and the history of antiplatelet medication until 7 days prior to surgery were observed between the two groups according to blood transfusion. CONCLUSION: Compared to patients with no history of antiplatelet medication, the temporary discontinuation of antiplatelet medication 7 days prior to surgery in patients undergoing antiplatelet medication did not increase the amount of postoperative bleeding or the need for allogenic blood transfusion.


Subject(s)
Arthroplasty, Replacement, Knee , Blood Transfusion , Hematocrit , Hemorrhage , Hospitalization , Humans , Retrospective Studies
16.
Article in English | WPRIM | ID: wpr-785587

ABSTRACT

OBJECTIVE: To test the hypothesis that the quick Sepsis-related Organ Failure Assessment (qSOFA) score, derived from vital signs taken during triage and recommended by current sepsis guidelines for screening patients with infections for organ dysfunction, is not sensitive enough to predict the risk of mortality in emergency department (ED) sepsis patients.METHODS: Patients diagnosed with severe sepsis and septic shock using the old definition between May 2014 and April 2015 were retrospectively reviewed in three urban tertiary hospital EDs. The sensitivities of systemic inflammatory response syndrome (SIRS) criteria, qSOFA, and Sequential Organ Failure Assessment (SOFA) scores ≥2 were compared using McNemar’s test. Diagnostic performances were evaluated using specificity, positive predictive value, and negative predictive value.RESULTS: Among the 928 patients diagnosed with severe sepsis or septic shock using the old definition, 231 (24.9%) died within 28 days. More than half of the sepsis patients (493/928, 53.1%) and more than one-third of the mortality cases (88/231, 38.1%) had a qSOFA score <2. The sensitivity of a qSOFA score ≥2 was 61.9%, which was significantly lower than the sensitivity of SIRS ≥2 (82.7%, P<0.001) and SOFA ≥2 (99.1%, P<0.001). The specificity, positive predictive value, and negative predictive value of a qSOFA score ≥2 for 28-day mortality were 58.1%, 32.9%, and 82.2%, respectively.CONCLUSION: The current clinical criteria of the qSOFA are less sensitive than the SIRS assessment and SOFA to predict 28-day mortality in ED patients with sepsis.


Subject(s)
Emergencies , Emergency Service, Hospital , Humans , Mass Screening , Mortality , Prognosis , Retrospective Studies , Sensitivity and Specificity , Sepsis , Shock, Septic , Systemic Inflammatory Response Syndrome , Tertiary Care Centers , Triage , Vital Signs
17.
Article in English | WPRIM | ID: wpr-766021

ABSTRACT

Due to the progressive aging of Korean society and the introduction of brain banks to the Korean medical system, the possibility that pathologists will have access to healthy elderly brains has increased. The histopathological analysis of an elderly brain from a subject with relatively well-preserved cognition is quite different from that of a brain from a demented subject. Additionally, the histology of elderly brains differs from that of young brains. This brief review discusses primary age-related tauopathy; this term was coined to describe elderly brains with Alzheimer’s diseasetype neurofibrillary tangles mainly confined to medial temporal structures, and no β-amyloid pathology.


Subject(s)
Aged , Aging , Amyloid beta-Peptides , Autopsy , Brain , Cognition , Dementia , Humans , Neurofibrillary Tangles , Numismatics , Pathology , Tauopathies
18.
Chonnam Medical Journal ; : 36-40, 2018.
Article in English | WPRIM | ID: wpr-739314

ABSTRACT

The benefits of resection for gastric carcinoma patients with non-curative factors remain controversial. Thus, we evaluated the survival benefits of resection in these gastric carcinoma patients. We reviewed the hospital records of 467 gastric carcinoma patients with non-curative factors who had resection (n=305) and compared their clinicopathological findings with individuals (n=162) who underwent bypass or exploration from 1996 to 2010. The 3-year survival rate of patients who had resection was higher than was that of patients who did not (13.2 vs. 7.2%, respectively p < 0.001). Cox's proportional hazard regression analysis revealed that only one factor was an independent, statistically significant prognostic parameter: the presence of peritoneal dissemination (risk ratio, 1.37; 95% confidence interval, 1.04–1.79; p < 0.05). The 3-year survival rate of patients with peritoneal dissemination was higher in individuals who underwent resection compared with those who did not (9.5 vs. 4.7%, respectively; p < 0.001). The current results highlight the improved survival rates of gastric carcinoma patients with non-curative factors who underwent surgery compared with those who did not. Although resection is not curative in this group of patients, we still recommend performing the procedure.


Subject(s)
Gastrectomy , Hospital Records , Humans , Stomach Neoplasms , Survival Rate
19.
Article in English | WPRIM | ID: wpr-758425

ABSTRACT

PURPOSE: This study was conducted to investigate the relationship of time interval from intubation to return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA) patients according to the presence or absence of intracranial hemorrhage (ICH). METHODS: This retrospective study used data from a prospectively collected OHCA registry for patients treated from January 2008 to December 2016. Non-traumatic adult OHCA patients who underwent brain computed tomography were included, while patients who achieved a prehospital ROSC or required advanced airway management were excluded. Utstein variables, initial blood gas analysis, electrolyte levels, and the time interval from intubation to ROSC were used to compare the ICH and non-ICH groups. RESULTS: A total of 448 patients were analyzed. The ICH group was younger and had more females than the non-ICH group. The time interval from intubation to ROSC was significantly shorter in the ICH group than the non-ICH group. The median time and interquartile range were 3 (2 to 7) minutes in the ICH group and 6 (3 to 10) minutes in the non-ICH group. The patient age, gender, potassium level, and time interval from intubation to ROSC were significant variables in the multivariable analysis. In a multivariable logistic regression model that included these variables, the area under the receiver operating characteristic curve was 0.838. CONCLUSION: OHCA patients with ICH achieve ROSC after intubation in a shorter amount of time than those without ICH.


Subject(s)
Adult , Advanced Cardiac Life Support , Airway Management , Blood Gas Analysis , Brain , Cardiopulmonary Resuscitation , Female , Humans , Intracranial Hemorrhages , Intubation , Logistic Models , Out-of-Hospital Cardiac Arrest , Potassium , Prognosis , Prospective Studies , Retrospective Studies , ROC Curve
20.
Article in English | WPRIM | ID: wpr-717564

ABSTRACT

OBJECTIVE: The time to positivity (TTP) of blood culture reflects bacterial load and has been reported to be associated with outcome in bloodstream infections. This study was performed to evaluate the relationship between the TTP of blood culture and the mortality rates associated with sepsis and septic shock according to the site of infection. METHODS: We performed a retrospective cohort study on patients with sepsis and septic shock. The rates of blood culture positivity and mortality as well as the relationship between the TTP and 28-day mortality rate were compared among patients with different sites of infection, such as the lungs, abdomen, urogenital tract, and other sites. RESULTS: A total of 2,668 patients were included, and the overall mortality rate was 21.6%. The rates of blood culture positivity and mortality were different among the different infection sites. There was no relationship between the TTP and mortality rates of total, lung, and urogenital infections. Patients with abdominal infections showed a negative correlation between the TTP and 28-day mortality rate. In patients with abdominal infections, a TTP < 20 hours was independently associated with 28-day mortality compared with patients with negative blood culture (hazard ratio, 1.73; 95% confidence interval, 1.16–2.58). However, there was no difference in mortality rates of patients with a TTP≥20 hours and a negative blood culture. CONCLUSION: The shorter TTP in patients with abdominal infections in sepsis and septic shock was associated with a higher 28-day mortality rate.


Subject(s)
Abdomen , Bacterial Load , Cohort Studies , Humans , Lung , Mortality , Retrospective Studies , Sepsis , Shock, Septic
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