Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.505
Filtrar
1.
PLoS One ; 19(2): e0281006, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38358989

RESUMEN

Wildlife can carry pathogenic organisms, including viruses, bacteria, parasites, and fungi, which can spread to humans and cause mild to serious illnesses and even death. Spreading through animal feces, these pathogens significantly contributes to the global burden of human diseases. Therefore, the present study investigated the prevalence of zoonotic bacterial pathogens, such as Salmonella spp., Escherichia coli, and Shiga toxin-producing E. coli (STEC), in animal feces. Between September 2015 and August 2017, 699 wildlife fecal samples were collected from various agricultural production regions and mountainous areas in South Korea. Fecal samples were collected from wild mammals (85.26%, 596/699) and birds (14.73%, 103/699). Salmonella spp. and E. coli were present in 3% (21/699) and 45.63% (319/699) of the samples, respectively. Moreover, virulence genes stx1 and both stx1 and stx2 were detected in 13.30% (93/699) and 0.72% (5/699) of the samples, respectively. The 21 Salmonella spp. were detected in badgers (n = 5), leopard cats (n = 7), wild boars (n = 2), and magpies (n = 7); STEC was detected in roe deer, water deer, mice, and wild boars. Through phylogenetic and gene-network analyses, the Salmonella spp. isolates (n = 21 laboratory isolates, at least one isolate from each Salmonella-positive animal fecal sample, and n = 6 widely prevalent reference Salmonella serovars) were grouped into two major lineages: S. enterica subsp. enterica and S. enterica subsp. diarizonae. Similarly, 93 E. coli isolates belonged to stx1, including three major lineages (groups 1-3), and stx1 and stx2 detected groups. To the best of our knowledge, this is the first report of a wild leopard cat serving as a reservoir for Salmonella spp. in South Korea. The research findings can help manage the potential risk of wildlife contamination and improve precautionary measures to protect public health.


Asunto(s)
Ciervos , Infecciones por Escherichia coli , Escherichia coli Shiga-Toxigénica , Porcinos , Animales , Humanos , Ratones , Animales Salvajes/microbiología , Prevalencia , Filogenia , Escherichia coli Shiga-Toxigénica/genética , Ciervos/microbiología , Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/veterinaria , Infecciones por Escherichia coli/microbiología , Sus scrofa , Salmonella/genética , Heces/microbiología
2.
Gut and Liver ; : 257-264, 2024.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-1042945

RESUMEN

Background/Aims@#Tegoprazan is a novel potassium-competitive acid blocker that has beneficial effects on acid-related disorders such as gastroesophageal reflux and peptic ulcer diseases.This study aimed to validate the effect of tegoprazan on endoscopic submucosal dissection (ESD)-induced artificial ulcers. @*Methods@#Patients from 16 centers in Korea who underwent ESD for gastric neoplasia were enrolled. After ESD, pantoprazole was administered intravenously for 48 hours. The patients were randomly allocated to either the tegoprazan or esomeprazole group. Tegoprazan 50 mg or esomeprazole 40 mg were administered for 4 weeks, after which gastroscopic evaluation was performed. If the artificial ulcer had not healed, the same dose of tegoprazan or esomeprazole was administered for an additional 4 weeks, and a gastroscopic evaluation was performed. @*Results@#One hundred sixty patients were enrolled in this study. The healing rates of artificial ulcers at 4 weeks were 30.3% (23/76) and 22.1% (15/68) in the tegoprazan and esomeprazole groups, respectively (p=0.006). At 8 weeks after ESD, the cumulative ulcer healing rates were 73.7% (56/76) and 77.9% (53/68) in the tegoprazan and esomeprazole groups, respectively (p=0.210). Delayed bleeding occurred in two patients in the tegoprazan group (2.6%) and in one patient in the esomeprazole group (1.5%). Other adverse events were negligible in both groups. @*Conclusions@#Tegoprazan showed similar effects on post-ESD artificial ulcer healing in comparison with esomeprazole.

3.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-1043645

RESUMEN

Background@#Limited data are available on the mortality rates of patients receiving extracorporeal membrane oxygenation (ECMO) support for coronavirus disease 2019 (COVID-19). We aimed to analyze the relationship between COVID-19 and clinical outcomes for patients receiving ECMO. @*Methods@#We retrospectively investigated patients with COVID-19 pneumonia requiring ECMO in 19 hospitals across Korea from January 1, 2020 to August 31, 2021. The primary outcome was the 90-day mortality after ECMO initiation. We performed multivariate analysis using a logistic regression model to estimate the odds ratio (OR) of 90-day mortality. Survival differences were analyzed using the Kaplan–Meier (KM) method. @*Results@#Of 127 patients with COVID-19 pneumonia who received ECMO, 70 patients (55.1%) died within 90 days of ECMO initiation. The median age was 64 years, and 63% of patients were male. The incidence of ECMO was increased with age but was decreased after 70 years of age. However, the survival rate was decreased linearly with age. In multivariate analysis, age (OR, 1.048; 95% confidence interval [CI], 1.010–1.089; P = 0.014) and receipt of continuous renal replacement therapy (CRRT) (OR, 3.069; 95% CI, 1.312–7.180; P = 0.010) were significantly associated with an increased risk of 90-day mortality. KM curves showed significant differences in survival between groups according to age (65 years) (log-rank P = 0.021) and receipt of CRRT (log-rank P = 0.004). @*Conclusion@#Older age and receipt of CRRT were associated with higher mortality rates among patients with COVID-19 who received ECMO.

4.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-1044908

RESUMEN

Neisseria animaloris is a common flora in animals, but its pathogenicity is rarely reported. In this case report, N. animaloris was isolated from a hospitalized cat with pneumonia. The cat was discharged after testing and treatment with appropriate antibiotics. This paper reports the first case of N. animaloris pneumonia in Korea.

5.
Artículo en Coreano | WPRIM (Pacífico Occidental) | ID: wpr-1044946

RESUMEN

Interprofessional education (IPE) fosters knowledge, skills, and attitudes related to interprofessional collaboration (IPC) for safe, quality patient care. In recent years, the importance of IPC has extended beyond the medical field to local community settings. However, IPE has only recently been introduced and has yet to become widespread. This study reviews the origin and development of IPE in Korean medical education by comparing it with established models in other countries that provide useful insights into future directions for IPE in Korea. Dedicated institutions led the IPE effort in other countries; however, IPE initiatives in Korea were mainly driven by individual professors’ and medical schools’ interest and commitment, without structural support systems. An important finding of this study is that the lack of awareness and organizational support within the medical education community resulted in the absence of a mandatory curriculum for IPE, as it was omitted from the accreditation standards. For more organized adoption and implementation of IPE in Korea, this study suggests the need to widely communicate the importance of IPE to the medical community and the public. It is also imperative to establish leadership capable of guiding IPE, share materials through trusted institutions with IPE experience, and include IPE in the accreditation standards. These steps are essential for actively implementing IPE and meeting societal healthcare needs in Korea.

6.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-1045339

RESUMEN

Background/Aims@#Colorectal adenomas are precancerous lesions that may lead to colorectal cancer. Recent studies have shown that colorectal adenomas are associated with atherosclerosis. The cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) are noninvasive methods for evaluating atherosclerosis. This study examined the association between atherosclerosis and high-risk colorectal adenomas based on the CAVI and ABI. @*Methods@#The data of patients aged ≥50 years who had a colonoscopy and CAVI and ABI measurements from August 2015 to December 2021 at the Kangwon National University Hospital were analyzed retrospectively. After the colonoscopy, subjects were divided into no, overall, and high-risk (size ≥1 cm, high-grade dysplasia or villous adenoma, three or more adenomas) adenoma groups based on the pathology findings. The data were subjected to univariate and multivariate logistic regression analyses. @*Results@#Among the 1,164 subjects, adenomas and high-risk adenomas were found in 613 (52.6%) and 118 (10.1%) patients, respectively. The rate of positive ABI (<0.9) and positive CAVI (≥9.0) were significantly higher in the high-risk adenoma group (22.0% and 55.9%) than in the no adenoma (12.3% and 39.6%) and the overall adenoma group (15.7% and 44.0%) (p=0.008 and p=0.006, respectively). Multivariate analysis revealed a positive CAVI and smoking status to be significantly associated with high-risk adenoma with an odds ratio of 1.595 (95% confidence interval 1.055–2.410, p=0.027) and 1.579 (1.072–2.324, p=0.021), respectively. @*Conclusions@#In this study, a significant correlation between positive CAVI and high-risk adenomas was observed. Therefore, CAVI may be a significant predictor for high-risk colorectal adenoma.

7.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-1045368

RESUMEN

Obesity is defined as a condition characterized by the abnormal accumulation of fat cells, which results in increased body weight.Worldwide, obesity is progressively on the rise, leading to an increased prevalence of chronic conditions such as cardiovascular disease, type 2 diabetes, and hyperlipidemia. Obesity is a result of the interplay between genetic, metabolic, social, behavioral, and cultural factors, necessitating an interdisciplinary and multimodal management approach. Diet therapy, which includes dietary modifications and nutritional interventions, is a fundamental component of the multifaceted approach to managing obesity. The principle of diet therapy is based on achieving weight loss through a negative energy balance and maintaining weight through an equilibrium of energy intake and expenditure. Strategies for weight loss and control rely on caloric restriction, macronutrient distribution, and dietary patterns such as the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets. Recently, studies have been conducted on weight control using information and communication technology-based interventions, as well as interventions based on intestinal microorganisms which consider inter-individual variability and long-term adherence. In conclusion, diet therapy stands as a pivotal element in the management of obesity, providing a personalized and comprehensive approach to weight control. By combining evidence-based dietary strategies with behavioral modifications and consistent support, healthcare professionals can enable individuals to attain and sustain a healthier weight, thereby reducing related health risks.

8.
Environ Int ; 175: 107963, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-37192573

RESUMEN

Arsenic (As)-contaminated soil inevitably exists in nature and has become a global challenge for a sustainable future. Current processes for As capture using natural and structurally engineered nanomaterials are neither scientifically nor economically viable. Here, we established a feasible strategy to enhance As-capture efficiency and ecosystem health by structurally reorganizing iron oxyhydroxide, a natural As stabilizer. We propose crystallization to reorganize FeOOH-acetate nanoplatelets (r-FAN), which is universal for either scalable chemical synthesis or reproduction from natural iron oxyhydroxide phases. The r-FAN with wide interlayer spacing immobilizes As species through a synergistic mechanism of electrostatic intercalation and surface chemisorption. The r-FAN rehabilitates the ecological fitness of As-contaminated artificial and mine soils, as manifested by the integrated bioassay results of collembolan and plants. Our findings will serve as a cornerstone for crystallization-based material engineering for sustainable environmental applications and for understanding the interactions between soil, nanoparticles, and contaminants.


Asunto(s)
Arsénico , Contaminantes del Suelo , Arsénico/análisis , Ecosistema , Cristalización , Contaminantes del Suelo/análisis , Suelo/química
9.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-976759

RESUMEN

Background@#The angular stable locking system (ASLS) was developed to provide additional stability to the distal interlocking screw of the intramedullary (IM) nail. Effects of ASLS on the treatment of femoral diaphyseal fractures in the elderly remain unknown. The aim of this study was to compare radiological outcomes of IM nailing using ASLS screws to IM nails with conventional interlocking screws in elderly patients with femoral shaft fractures. @*Methods@#A multicenter retrospective review of 129 patients (average age, 73.5 years; 98 women and 31 men) aged 65 years or older who underwent IM nail fixation for femoral diaphyseal fractures (AO/Orthopaedic Trauma Association [OTA] classification 32) was conducted. Demographic information of patients, fracture site (subtrochanteric or shaft), fracture type (traumatic or atypical), and AO/OTA fracture classification were investigated. Reduction status was evaluated by postoperative plain radiography. Presence of union and time to union were evaluated through serial plain radiograph follow-up. Reoperation due to nonunion or implant failure was also evaluated. @*Results@#ASLS was used in 65 patients (50.3%). A total of 118 patients (91.5%) achieved union without additional surgery and the mean union time was 31.8 ± 13.0 weeks. In terms of reduction status, angulation was greater in the group using ASLS. There were no statistically significant differences of union rate, time to union, and reoperation rate according to the use of ASLS (p > 0.05). There was no difference in the outcomes according to the use of ASLS even when the analysis was divided in terms of fracture site or fracture type (p > 0.05). In further subgroup analysis, only the traumatic subtrochanteric area group showed statistically significantly shorter time to union when ASLS was used (p = 0.038). @*Conclusions@#In geriatric patients with femoral diaphyseal fractures, the use of ASLS was not considered to have a significant effect on fracture healing. Fracture healing seemed to be more affected by surgical techniques such as minimizing the gap and fracture characteristics such as atypical femoral fractures, rather than implants.

10.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-976922

RESUMEN

Background@#Recent reports have suggested that pneumonitis is a rare complication following vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).However, its clinical features and outcomes are not well known. The aim of this study was to identify the clinical characteristics and outcomes of patients with vaccine-associated pneumonitis following vaccination against SARS-CoV-2. @*Methods@#In this nationwide multicenter survey study, questionnaires were distributed to pulmonary physicians in referral hospitals. They were asked to report cases of development or exacerbation of interstitial lung disease (ILD) associated with the coronavirus disease 2019 vaccine. Vaccine-associated pneumonitis was defined as new pulmonary infiltrates documented on chest computed tomography within 4 weeks of vaccination and exclusion of other possible etiologies. @*Results@#From the survey, 49 cases of vaccine-associated pneumonitis were identified between February 27 and October 30, 2021. After multidisciplinary discussion, 46 cases were analyzed. The median age was 66 years and 28 (61%) were male. The median interval between vaccination and respiratory symptoms was 5 days. There were 20 (43%), 17 (37%), and nine (19%) patients with newly identified pneumonitis, exacerbation of pre-diagnosed ILD, and undetermined pre-existing ILD, respectively. The administered vaccines were BNT162b2 and ChAdOx1 nCov-19/AZD1222 each in 21 patients followed by mRNA-1273 in three, and Ad26.COV2.S in one patient. Except for five patients with mild disease, 41 (89%) patients were treated with corticosteroid. Significant improvement was observed in 26 (57%) patients including four patients who did not receive treatment. However, ILD aggravated in 9 (20%) patients despite treatment. Mortality was observed in eight (17%) patients. @*Conclusion@#These results suggest pneumonitis as a potentially significant safety concern for vaccines against SARS-CoV-2. Clinical awareness and patient education are necessary for early recognition and prompt management. Additional research is warranted to identify the epidemiology and characterize the pathophysiology of vaccine-associated pneumonitis.

11.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-977262

RESUMEN

Purpose@#To develop a deep learning model that can predict the axial lengths of eyes using ultra-widefield (UWF) fundus photography. @*Methods@#We retrospectively enrolled patients who visited the ophthalmology clinic at the Seoul National University Hospital between September 2018 and December 2021. Patients with axial length measurements and UWF images taken within 3 months of axial length measurement were included in the study. The dataset was divided into a development set and a test set at an 8:2 ratio while maintaining an equal distribution of axial lengths (stratified splitting with binning). We used transfer learning-based on EfficientNet B3 to develop the model. We evaluated the model’s performance using mean absolute error (MAE), R-squared (R2), and 95% confidence intervals (CIs). We used vanilla gradient saliency maps to illustrate the regions predominantly used by convolutional neural network. @*Results@#In total, 8,657 UWF retinal fundus images from 3,829 patients (mean age, 63.98 ±15.25 years) were included in the study. The deep learning model predicted the axial lengths of the test dataset with MAE and R2 values of 0.744 mm (95% CI, 0.709–0.779 mm) and 0.815 (95% CI, 0.785–0.840), respectively. The model’s accuracy was 73.7%, 95.9%, and 99.2% in prediction, with error margins of ±1.0, ±2.0, and ±3.0 mm, respectively. @*Conclusions@#We developed a deep learning-based model for predicting the axial length from UWF images with good performance.

12.
Yonsei Medical Journal ; : 375-383, 2023.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-977437

RESUMEN

Purpose@#Junctional adhesion molecule (JAM)-A is an immunoglobulin-like molecule that colocalizes with tight junctions (TJs) in the endothelium and epithelium. It is also found in blood leukocytes and platelets. The biological significance of JAM-A in asthma, as well as its clinical potential as a therapeutic target, are not well understood. The aim of this study was to elucidate the role of JAM-A in a mouse model of asthma, and to determine blood levels of JAM-A in asthmatic patients. @*Materials and Methods@#Mice sensitized and challenged with ovalbumin (OVA) or saline were used to investigate the role of JAM-A in the pathogenesis of bronchial asthma. In addition, JAM-A levels were measured in the plasma of asthmatic patients and healthy controls. The relationships between JAM-A and clinical variables in patients with asthma were also examined. @*Results@#Plasma JAM-A levels were higher in asthma patients (n=19) than in healthy controls (n=12). In asthma patients, the JAM-A levels correlated with forced expiratory volume in 1 second (FEV1%), FEV1/forced vital capacity (FVC), and the blood lymphocyte proportion. JAM-A, phospho-JNK, and phospho-ERK protein expressions in lung tissue were significantly higher in OVA/OVA mice than in control mice. In human bronchial epithelial cells treated with house dust mite extracts for 4 h, 8 h, and 24 h, the JAMA, phospho-JNK, and phospho-ERK expressions were increased, as shown by Western blotting, while the transepithelial electrical resistance was reduced. @*Conclusion@#These results suggest that JAM-A is involved in the pathogenesis of asthma, and may be a marker for asthma.

13.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-999247

RESUMEN

Allergic rhinitis is the most common chronic disease worldwide. Various upper airway symptoms lower quality of life, and due to the recurrent symptoms, multiple treatments are usually attempted rather than one definitive treatment. There are alternatives to medical (medication-based) and nonmedical treatments. A guideline is needed to understand allergic rhinitis and develop an appropriate treatment plan. We have developed guidelines for medical treatment based on previous reports. The current guidelines herein are associated with the “KAAACI Evidence-Based Guidelines for Allergic Rhinitis in Korea, Part 1: Update in pharmacotherapy” in which we aimed to provide evidence-based recommendations for the medical treatment of allergic rhinitis. Part 2 focuses on nonpharmacological management, including allergen-specific immunotherapy, subcutaneous or sublingual immunotherapy, nasal saline irrigation, environmental management strategies, companion animal management, and nasal turbinate surgery. The evidence to support the treatment efficacy, safety, and selection has been systematically reviewed. However, larger controlled studies are needed to elevate the level of evidence to select rational non-medical therapeutic options for patients with allergic rhinitis.

14.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-999248

RESUMEN

The prevalence of allergic rhinitis (AR) and the socioeconomic burden associated with the medical cost and quality of life of AR have progressively increased. Therefore, practical guidelines for the appropriate management of AR need to be developed based on scientific evidence considering the real-world environment, values, and preferences of patients and physicians. The Korean Academy of Asthma, Allergy and Clinical Immunology revised clinical guidelines for AR to address key clinical questions of the management of AR. Part 1 of the revised guideline covers the pharmacological management of patients with AR in Korea. Through a meta-analysis and a systematic review, we made 4 recommendations for AR pharmacotherapy, including intranasal corticosteroid (INCS)/intranasal antihistamine combination therapy, oral antihistamine/INCS combination therapy, leukotriene receptor antagonist treatment in AR patients with asthma, and prophylactic treatment for patients with pollen-induced AR. However, all recommendations are conditional because of the low or very low evidence of certainty. Well-designed and strictly executed randomized controlled trials are needed to measure and report appropriate outcomes.

15.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-999428

RESUMEN

Purpose@#Whether administering chemotherapy followed by tamoxifen plus a gonadotropin-releasing hormone (GnRH) agonist to treat patients with lower-risk hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer provides a greater benefit than administering tamoxifen plus GnRH agonist alone remains unclear. This study aimed to compare the outcomes of propensity score-matched (PSM) patients who underwent these 2 types of treatment plans. @*Methods@#This retrospective study included patients treated at our institution between 2009 and 2019. Eligible patients had HR-positive, HER2-negative, invasive breast cancer who had undergone surgery. There were 579 patients with HR-positive, HER2-negative breast cancer who were treated with a GnRH agonist and tamoxifen; patients with pathologic N2 and those who received neoadjuvant chemotherapy were excluded. After 1:1 PSM of patients who underwent GnRH agonist treatment and tamoxifen with versus without chemotherapy, 122 patients from these 2 groups were analyzed. Survival rates were calculated using the Kaplan-Meier method and compared via the log-rank test. @*Results@#After PSM, there were no significant differences in several baseline characteristics between the 2 groups. After a median follow-up of 62.8 months, the patients in both groups demonstrated similar outcomes with no significant difference in disease-free survival (P = 0.596). @*Conclusion@#Patients derived no significant survival benefit from undergoing a chemotherapy regimen before receiving tamoxifen and GnRH agonist therapy compared to forgoing such chemotherapy.

16.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-999431

RESUMEN

Purpose@#Although the overall survival (OS) of breast cancer patients is increasing with improved detection and therapies, so is the risk of breast cancer patients developing subsequent malignancies. We investigated the OS of breast cancer survivors according to sites of second primary malignancies (SPM). The OS of the second primary hematologic malignancy (SPHM) was then compared with that of metastatic breast cancer (MBC). @*Methods@#We retrospectively analyzed patients diagnosed with primary breast cancer between 1998 and 2019. Only those with SPM were eligible for analysis. First, the OS of patients with SPM diagnosed as the first event after the diagnosis of breast cancer was analyzed. Next, the OS of patients with SPHM, with or without breast cancer relapse, was compared with that of patients with MBC, matched using the propensity score. @*Results@#Patients diagnosed with SPM without breast cancer relapse as the first event had a significantly better OS than did patients with MBC, but the OS of those with SPHM as the first event did not differ significantly from that of patients with MBC (hazard ratio [HR], 1.558; 95% confidence interval [CI], 0.856–2.839; P = 0.147). The OS of patients with SPHM with or without breast cancer relapse was worse than that of the MBC group after propensity score matching (HR, 1.954; 95% CI, 1.045–3.654; P = 0.036). @*Conclusion@#Prognosis of SPM diagnosed as the first event was statistically better than that of MBC, except in case of SPHM. Patients with SPHM, with or without MBC, showed poor OS before and after propensity score matching.

17.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-999784

RESUMEN

Purpose@#The optimal short-course chemotherapeutic regimen for rectal cancer has not been clearly defined until now. KROG 10-01 and KROG 11-02 prospective trials investigated the efficacy and safety of 1- and 2-week chemoradiotherapy (CRT), respectively. @*Materials and Methods@#Patients eligible for KROG 10-01 and KROG 11-02 involved those with clinical T3-4N0-2M0 rectal cancers. They received preoperative CRT and total mesorectal excision. Patients in KROG 10-01 received radiation of 25 Gy in 5 fractions during 1 week with 5-fluorouracil/leucovorin. Patients in KROG 11-02 received radiation of 33 Gy in 10 fractions for 2 weeks with oral capecitabine. @*Results@#A total of 150 patients consisting of 70 patients from KROG 10-01 and 80 patients from KROG 11-02 were collectively analyzed. With a median follow-up time of 89.2 months, the 5-year overall survival rate was 86.5% in 1-week CRT and 85.3% in 2-week CRT (p=0.841). The 5-year recurrence-free survival rate was 83.5% in 1-week CRT and 77.1% in 2-week CRT (p=0.448). One patient (1.4%) in 1-week CRT and 11 patients (13.8%) in 2-week CRT exhibited pathologic complete regression (ypT0N0M0) after radiotherapy (p=0.006). One-week CRT had significantly higher acute hematologic (12.8% vs. 3.8%, p=0.040) and nonhematologic (38.6% vs. 16.3%, p=0.002) toxicity than 2-week CRT. @*Conclusion@#Both 1- and 2-week schedules of CRT showed favorable survival outcomes after 7 years of follow-up. But, 2-week course achieved more increased tumor response and decreased acute toxicity than 1-week course.

18.
Gut and Liver ; : 558-565, 2023.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-1000374

RESUMEN

Background/Aims@#Among several methods used to prevent endoscopic submucosal dissection (ESD) bleeding, the recently developed hemostatic powder (HP) has few technical limitations and is relatively easy-to-use. This study aimed to analyze the hemostatic effects and mechanisms of two HPs using a porcine upper gastrointestinal hemorrhage model. @*Methods@#We evaluated HPs (Endospray and epidermal growth factor [EGF]-endospray) for adhesion, waterproofing ability, permeability, and absorption in vitro. ESD was performed to induce bleeding ulcers in the porcine stomachs. In a total of three pigs, three bleeding ulcers per animal were generated. Hemostasis and rebleeding were evaluated endoscopically. After 72 hours, the animals were sacrificed, and histologically analyzed. @*Results@#The water absorption of HPs was over 20 times the initial value within 30 minutes. The gelated HPs completely blocked water penetration into the applied site within 5 minutes and strongly adhered to the Petri-dish surface for up to 6 hours. The initial hemostasis rates within 5 minutes were 33.3%, 100.0%, and 66.7%, and the rebleeding rates at 6 to 72 hours after HP application were 33.3%, 16.7%, and 33.3% (control, Endospray, and EGF-endospray groups, respectively). Histological analysis revealed the thickness of the regenerated mucosa (522.1, 514.5, and 680.3 µm) and the submucosal layer (1,510.3, 2,848.2, and 3,062.3 µm) and the number of newly formed blood vessels (15.3, 17.9, and 20.5) in the control, Endospray, and EGFendospray groups, respectively. @*Conclusions@#The endoscopic HPs demonstrated the ability to elicit effective initial hemostasis and the histological ulcer-healing effect of EGF in an animal model of hemorrhagic gastric ulcers.

19.
Journal of Gastric Cancer ; : 574-583, 2023.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-1000922

RESUMEN

Purpose@#Gastric cancer (GC) is among the most prevalent and fatal cancers worldwide.National cancer screening programs in countries with high incidences of this disease provide medical aid beneficiaries with free-of-charge screening involving upper endoscopy to detect early-stage GC. However, the coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions to routine healthcare access. Thus, this study aimed to assess the impact of COVID-19 on the diagnosis, overall incidence, and stage distribution of GC. @*Materials and Methods@#We identified patients in our hospital cancer registry who were diagnosed with GC between January 2018 and December 2021 and compared the cancer stage at diagnosis before and during the COVID-19 pandemic. Subgroup analyses were conducted according to age and sex. The years 2018 and 2019 were defined as the “before COVID” period, and the years 2020 and 2021 as the “during COVID” period. @*Results@#Overall, 10,875 patients were evaluated; 6,535 and 4,340 patients were diagnosed before and during the COVID-19 period, respectively. The number of diagnoses was lower during the COVID-19 pandemic (189 patients/month vs. 264 patients/month) than before it.Notably, the proportion of patients with stages 3 or 4 GC in 2021 was higher among men and patients aged ≥40 years. @*Conclusions@#During the COVID-19 pandemic, the overall number of GC diagnoses decreased significantly in a single institute. Moreover, GCs were in more advanced stages at the time of diagnosis. Further studies are required to elucidate the relationship between the COVID-19 pandemic and the delay in the detection of GC worldwide.

20.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-1000999

RESUMEN

Objectives@#This study addressed longstanding issues in Korea’s public health dentist system by defining and standardizing job duties. A practical job description was drafted based on job analysis results to promote work efficiency and lay the groundwork for future educational programs. @*Methods@#The job description elements were selected and drafted based on previous studies.These drafts were revised and refined with expert panel validation. @*Results@#The main job duties of public health dentists encompass community oral health, dental practice, public oral health research, and special oral health, tailored for institutions such as health sub-centers, health centers, health clinics, national health organizations, and correctional facilities. For community oral health at public health subcenters involves 12 key duties including projects, education, and community engagement. Public health centers/clinics focus on 16 key duties mainly around health project planning and evaluation. Dental care across both settings has 15 main duties. Public oral health research emphasizes community surveys and epidemiology. Special oral health in correctional facilities covers 11 main duties including education and external resource linking. @*Conclusions@#It concluded that for the development of public health dentists in South Korea, it is necessary to develop public health dentist education programs to promote the performance of public health dentists and to equip them with the competencies necessary to perform such duties, focusing on job descriptions organized around the characteristics of workplaces and major tasks.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA