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1.
Appl Radiat Isot ; 205: 111173, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38211394

RESUMO

A 4πß(PPC)-γ coincidence system has been made at KRISS based on a digital DAQ. 60Co sources were measured to verify the system. The maximum detection efficiency for beta particles was estimated to be 96.7 %. Massic activities for sample sources had 0.005 % of the sample variability error, which was well within the expanded standard uncertainty of 0.54 % (k = 2).

2.
J Hosp Infect ; 139: 93-98, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37419187

RESUMO

BACKGROUND: The effective implementation of antimicrobial stewardship requires an a-priori assessment of the appropriateness of antimicrobial prescriptions. AIM: To evaluate the effectiveness of quality indicators (QIs) in determining the appropriateness of antimicrobial prescriptions compared to that of expert opinions. METHODS: The study assessed antimicrobial use in 20 hospitals in Korea, with infectious disease specialists rating the appropriateness based on QIs and expert opinions. The selected QIs were (1) taking two blood cultures, (2) taking cultures from suspected sites of infection, (3) prescribing empirical antimicrobials according to guidelines, and (4) changing from empirical to pathogen-directed therapy for hospitalized patients and (2, 3, and 4) for ambulatory patients. Applicability, compliance with QIs, and agreement between QIs and expert opinions were investigated. FINDINGS: Overall, 7999 therapeutic uses of antimicrobials were investigated at the study hospitals. The experts rated 20.5% (1636/7999) as inappropriate use. For hospitalized patients, antimicrobial use was assessed based on all four QIs in 28.8% (1798/6234) of the cases. For ambulatory care patients, only 7.5% (102/1351) of the antimicrobial use cases were assessed using all three QIs. The agreement between expert opinions and all four QIs for hospitalized patients was minimal (κ = 0.332), whereas that between expert opinions and all three QIs for ambulatory patients was weak (κ = 0.598). CONCLUSION: QIs have limitations in determining the appropriateness of antimicrobial use, and the degree of agreement with expert opinions was low. Therefore, these QI limitations should be considered when determining the appropriateness of antimicrobial use.


Assuntos
Anti-Infecciosos , Gestão de Antimicrobianos , Humanos , Indicadores de Qualidade em Assistência à Saúde , Prova Pericial , Anti-Infecciosos/uso terapêutico , Hospitais
3.
Wound Repair Regen ; 31(4): 500-515, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37183189

RESUMO

A new in vitro chronic wound biofilm model was recently published, which provided a layered scaffold simulating mammalian tissue composition on which topical wound care products could be tested. In this paper, we updated the model even further to mimic the dynamic influx of nutrients from below as is the case in a chronic wound. The modified in vitro model was created using collagen instead of agar as the main matrix component and contained both Staphylococcus aureus and Pseudomonas aeruginosa. The model was cast in transwell inserts and then placed in wound simulating media, which allowed for an exchange of nutrients and waste products across a filter. Three potential wound care products and chlorhexidine digluconate 2% solution as a positive control were used to evaluate the model. The tested products were composed of hydrogels made from completely biodegradable starch microspheres carrying different active compounds. The compounds were applied topically and left for 2-4 days. Profiles of oxygen concentration and pH were measured to assess the effect of treatments on bacterial activity. Confocal microscope images were obtained of the models to visualise the existence of microcolonies. Results showed that the modified in vitro model maintained a stable number of the two bacterial species over 6 days. In untreated models, steep oxygen gradients developed and pH increased to >8.0. Hydrogels containing active compounds alleviated the high oxygen consumption and decreased pH drastically. Moreover, all three hydrogels reduced the colony forming units significantly and to a larger extent than the chlorhexidine control treatment. Overall, the modified model expressed several characteristics similar to in vivo chronic wounds.


Assuntos
Anti-Infecciosos , Infecção dos Ferimentos , Animais , Cicatrização , Infecção dos Ferimentos/microbiologia , Anti-Infecciosos/farmacologia , Colágeno/farmacologia , Bactérias , Biofilmes , Oxigênio , Hidrogéis/farmacologia , Pseudomonas aeruginosa , Antibacterianos/farmacologia , Mamíferos
4.
Rhinology ; 61(4): 338-347, 2023 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-37083114

RESUMO

BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by chronic eosinophilic inflammation and new bone formation (NBF). These processes may be associated with each other in the pathogenesis and influence the severity and prognosis of the disease. However, it is still unclear how eosinophilic inflammation is involved in the NBF. METHODOLOGY: Sinus bone cells were isolated from ethmoid bone tissues of patients with CRSwNP and controls. Transforming growth factor beta 1 (TGFß1) and alkaline phosphatase (ALP) expression in sinus bone cells was determined using quantitative RT-PCR, immunoblotting, and immunohistochemistry. The co-localization of TGFß1 with eosinophils was assessed by immunofluorescence staining. Sinus bone cells were co-cultured with eosinophils (Eol-1 cell line), which were differentiated with butyrate, to measure the osteoblast differentiation activity of sinus bone cells. RESULTS: TGFß1 expression was increased in sinus bone tissues and correlated with CT scores in CRSwNP. TGFß1 was also increased in the submucosa of CRSwNP and co-localized predominantly with eosinophils compared with neutrophils Differentiated Eol-1 cells-derived TGFß1 increased ALP expression in sinus bone cells. Treatment with a TGFß inhibitor attenuated TGFß1-induced ALP expression and staining in sinus bone cells of CRSwNP, leading to loss of bone formation. CONCLUSIONS: Eosinophil-derived TGFß1 was enriched in the submucosa of CRSwNP, which induced ALP expression in sinus bone cells and NBF. Therefore, eosinophil-derived TGFß1 may mediate aberrant bone remodeling in CRSwNP.


Assuntos
Pólipos Nasais , Rinite , Sinusite , Humanos , Eosinófilos , Rinite/complicações , Rinite/patologia , Fator de Crescimento Transformador beta , Pólipos Nasais/complicações , Pólipos Nasais/patologia , Osteogênese , Sinusite/complicações , Sinusite/patologia , Inflamação/patologia , Doença Crônica
5.
AJNR Am J Neuroradiol ; 43(2): 195-201, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35027347

RESUMO

BACKGROUND AND PURPOSE: Contrast-enhanced 3D T1WI is a preferred sequence for brain tumor imaging despite the long scan time. This study investigated the clinical feasibility of ultrafast contrast-enhanced T1WI by 3D echo-planar imaging compared with a standard contrast-enhanced 3D MPRAGE sequence for evaluating intracranial enhancing lesions in oncology patients. MATERIALS AND METHODS: Sixty-one patients in oncology underwent brain MR imaging including both contrast-enhanced T1WI, 3D-EPI and 3D MPRAGE, in a single examination session for evaluating intracranial tumors. Two neuroradiologists evaluated image quality, lesion conspicuity, diagnostic confidence, number and size of the lesions, and contrast-to-noise ratio measurements from the 2 different sequences. RESULTS: Ultrafast 3D-EPI T1WI did not reveal significant differences in diagnostic confidence, contrast-to-noise ratiolesion/parenchyma, and the number of enhancing lesions compared with MPRAGE (P > .05). However, ultrafast 3D-EPI T1WI revealed inferior image quality, inferior anatomic delineation and greater susceptibility artifacts with fewer motion artifacts than images obtained with MPRAGE. The mean contrast-to-noise ratioWM/GM and visual conspicuity of the lesion on ultrafast 3D-EPI T1WI were lower than those of MPRAGE (P < .001). CONCLUSIONS: Ultrafast 3D-EPI T1WI showed comparable diagnostic performance with sufficient image quality and a 7-fold reduction in scan time for evaluating intracranial enhancing lesions compared with standard MPRAGE, even though it was limited by an inferior image quality and frequent susceptibility artifacts. Therefore, we believe that ultrafast 3D-EPI T1WI may be a viable option in oncology patients prone to movement during imaging studies.


Assuntos
Neoplasias Encefálicas , Imagem Ecoplanar , Neoplasias Encefálicas/diagnóstico por imagem , Imagem Ecoplanar/métodos , Estudos de Viabilidade , Humanos , Imageamento Tridimensional , Imageamento por Ressonância Magnética/métodos
6.
Osteoarthritis Cartilage ; 30(2): 280-290, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34826571

RESUMO

OBJECTIVE: Although cartilage degeneration and invasion of the subchondral bone plate in entheseal lesion has been considered to consequently lead bony ankylosis in ankylosing spondylitis (AS), no evident mechanisms are known. DESIGN: To identify histopathological and physiological changes in enthesitis-related ankylosis in AS, we performed molecular characterization of transcription factors and surface markers, and transcriptome analysis with human tissues. Entheseal tissue containing subchondral bone was obtained from the facet joints of 9 patients with AS and 10 disease controls, and assessed by using differential staining techniques. Enthesis cells were isolated, characterized, stimulated with TNF and/or IL-17A, and analysed by cell-based experimental tools. RESULTS: We found diffusely distributed granular tissue and cartilage in the subchondral bone in AS. Co-expression of SOX9, a specific transcription factor in cartilage, and matrix metalloproteinase 13 (MMP13) was found in the granular tissues within the subchondral bone from AS patients. Intriguingly, SOX9 expression was significantly higher in AS enthesis cells than controls and correlated with TNFR1 and IL-17RA expressions, which is important for high reactivity to TNF and IL-17A cytokines. Co-stimulation by TNF and IL-17A resulted in accelerated mineralization/calcification features, and increased OCN expression in AS enthesis cells. Furthermore, SOX9 overexpression in enthesis leads to promoting mineralization feature by TNF and IL-17A stimuli. Finally, OCN expression is elevated in the destructive enthesis of advanced AS. CONCLUSION: These findings provide insight into the links between inflammation and the mineralization of entheseal tissue as the initiation of spinal ankylosis, emphasizing the importance of SOX9+ enthesis cells.


Assuntos
Anquilose/patologia , Fatores de Transcrição SOX9 , Doenças da Coluna Vertebral/patologia , Espondilite Anquilosante/patologia , Adulto , Células/metabolismo , Feminino , Humanos , Ligamentos Articulares/citologia , Masculino , Pessoa de Meia-Idade , Fatores de Transcrição SOX9/biossíntese , Tendões/citologia
7.
Anim Genet ; 53(1): 166-170, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34910829

RESUMO

We developed a high-resolution and comprehensive typing method for swine leukocyte antigen 3 (SLA-3), an MHC class I gene, employing locus-specific genomic PCR followed by subsequent direct sequencing. A total of 292 individuals from nine pure, one cross-breed and six cell lines were successfully typed. A total of 21 SLA-3 alleles were identified, of which four were found to be novel alleles. However, the allelic diversity of SLA-3 was lower than that of previously reported class I genes, SLA-1 and -2. More SLA-3 alleles were observed in the Landrace and Yorkshire breeds than the other breeds. SLA-3*04:01 was identified in seven out of nine breeds and was the most widely distributed allele across all breeds. Therefore, the typing method reported in this study completes our efforts to develop high-resolution typing methods for major SLA molecules, facilitating the combined analysis of major SLA genes from field samples, which is important to understand the relationship between the adaptive immune responses against pathogens and the immunogenetic makeup of an individual.


Assuntos
Técnicas de Genotipagem/veterinária , Antígenos de Histocompatibilidade Classe I/genética , Análise de Sequência de DNA/veterinária , Sus scrofa/genética , Animais , Análise de Sequência de DNA/métodos
8.
Nat Commun ; 12(1): 6784, 2021 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-34811372

RESUMO

The control of the in-plane domain evolution in ferroelectric thin films is not only critical to understanding ferroelectric phenomena but also to enabling functional device fabrication. However, in-plane polarized ferroelectric thin films typically exhibit complicated multi-domain states, not desirable for optoelectronic device performance. Here we report a strategy combining interfacial symmetry engineering and anisotropic strain to design single-domain, in-plane polarized ferroelectric BaTiO3 thin films. Theoretical calculations predict the key role of the BaTiO3/PrScO3 [Formula: see text] substrate interfacial environment, where anisotropic strain, monoclinic distortions, and interfacial electrostatic potential stabilize a single-variant spontaneous polarization. A combination of scanning transmission electron microscopy, piezoresponse force microscopy, ferroelectric hysteresis loop measurements, and second harmonic generation measurements directly reveals the stabilization of the in-plane quasi-single-domain polarization state. This work offers design principles for engineering in-plane domains of ferroelectric oxide thin films, which is a prerequisite for high performance optoelectronic devices.

10.
Pulmonology ; 27(4): 286-295, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32474057

RESUMO

OBJECTIVE: Smoking is an important causative factor of chronic obstructive pulmonary disease (COPD), and females are considered more susceptible to the effects of smoking than males. However, in previous Korean studies, the effects of sex differences on the association between smoking and COPD have been controversial. In this study, the effects of sex differences on the association between smoking and COPD and the effects of female hidden smokers on that association in Korean adults were investigated. METHODS: Data were acquired from the Korea National Health and Nutrition Examination Surveys (KNHANES). RESULTS: The multivariate logistic regression analysis showed that self-reported smoking status for ex-smoker and current smoker correlated with COPD (odds ratio, OR: 1.67 and OR: 2.41, respectively). Self-reported smoking status for ex-smoker and current smoker correlated with COPD in men (OR: 1.61, OR: 2.43, respectively). Female self-reported current smoking status correlated with COPD (OR: 2.52), but female ex-smoker status was not significantly correlated with COPD. The ratios of cotinine-verified to self-reported smoking rates were 1.95 for women and 1.07 for men. CONCLUSION: The results of this study were that sex differences might affect the association between COPD and smoking and that female hidden smoking might affect the association between smoking and COPD in Korean adults.


Assuntos
Doença Pulmonar Obstrutiva Crônica/epidemiologia , Fumantes/estatística & dados numéricos , Fumar/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Cotinina , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População , Doença Pulmonar Obstrutiva Crônica/etiologia , República da Coreia/epidemiologia
11.
Epidemiol Psychiatr Sci ; 29: e176, 2020 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-33077022

RESUMO

AIMS: To investigate the association between parity and the risk of incident dementia in women. METHODS: We pooled baseline and follow-up data for community-dwelling women aged 60 or older from six population-based, prospective cohort studies from four European and two Asian countries. We investigated the association between parity and incident dementia using Cox proportional hazards regression models adjusted for age, educational level, hypertension, diabetes mellitus and cohort, with additional analysis by dementia subtype (Alzheimer dementia (AD) and non-Alzheimer dementia (NAD)). RESULTS: Of 9756 women dementia-free at baseline, 7010 completed one or more follow-up assessments. The mean follow-up duration was 5.4 ± 3.1 years and dementia developed in 550 participants. The number of parities was associated with the risk of incident dementia (hazard ratio (HR) = 1.07, 95% confidence interval (CI) = 1.02-1.13). Grand multiparity (five or more parities) increased the risk of dementia by 30% compared to 1-4 parities (HR = 1.30, 95% CI = 1.02-1.67). The risk of NAD increased by 12% for every parity (HR = 1.12, 95% CI = 1.02-1.23) and by 60% for grand multiparity (HR = 1.60, 95% CI = 1.00-2.55), but the risk of AD was not significantly associated with parity. CONCLUSIONS: Grand multiparity is a significant risk factor for dementia in women. This may have particularly important implications for women in low and middle-income countries where the fertility rate and prevalence of grand multiparity are high.


Assuntos
Doença de Alzheimer/epidemiologia , Demência/epidemiologia , Paridade/fisiologia , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos de Coortes , Europa (Continente)/epidemiologia , Feminino , Psiquiatria Geriátrica , Humanos , Incidência , Vida Independente , Pessoa de Meia-Idade , Gravidez , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Fatores de Risco , Fatores Socioeconômicos
12.
Opt Express ; 28(19): 27316-27323, 2020 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-32988028

RESUMO

Investigation of photodarkening (PD) in Yb-doped fibers tandem-pumped at 1018 nm is reported. For a homemade Yb-doped aluminosilicate double-clad fiber (YADF), the transmitted power of a 633 nm probe beam is reduced by 2.4% over 2 hours for the tandem pumping configuration at 1018 nm, which is significantly smaller than 33.3% for a laser diode (LD) pumping at 976 nm. A tandem-pumped Yb fiber amplifier also shows a much smaller decrease in the amplified output power over time than a LD-pumped Yb fiber amplifier. Based on fluorescence spectra of the YADF, we can not only associate PD of the YADF to intrinsic oxygen deficiency centers or Tm3+ impurities but also confirm the impact of the excited Yb3+ ion density on PD. The benefits of the tandem pumping in a high-power Yb fiber laser system will be discussed.

13.
Clin Radiol ; 75(12): 962.e1-962.e8, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32888654

RESUMO

AIM: To investigate the best cut-off percentage volume of delayed kinetics using magnetic resonance imaging (MRI) with computer-aided diagnosis (CAD) to reduce unnecessary biopsies in patients with newly diagnosed breast cancer. MATERIALS AND METHODS: Between January 2017 and December 2018, 94 malignant and 56 benign masses were analysed using MRI CAD. All malignant and benign masses measured <2 cm and were confirmed histopathologically. The optimal cut-off values for washout, plateau, and persistent components were determined using the maximum Youden Index. The positive predictive value (PPV) was analysed using morphological descriptors and combining the percentage volume of delayed kinetics. RESULTS: The area under the curve (AUC) was highest at ≤73% persistent component (AUC=0.759). In the subgroup analyses of masses <1 cm, the AUC was highest a plateau of >26% (AUC=0.697). When the persistent ≤73% criterion was applied to the lesions of C4a, the positive predictive value (PPV) increased from 61.9% to 72.44% with reduced false-negative cases and when applied to the lesions of C4a and C4b, the PPV increased from 61.9% to 78.1% with slightly increased false-negative cases. For subcentimetre lesions, the PPV increased from 46.77% to 54.72% with the same number of false-negative cases, when a plateau of >26% was applied to C4a, and the PPV increased from 46.77% to 61.36% with five false-negative cases when applied to C4a and C4b. CONCLUSION: The percentage volume of delayed kinetics has the potential to improve the PPV of breast MRI. When suspicious masses <2 cm do not show ≤73% persistence, follow-up rather than biopsy could be considered; however, to avoid increasing false-negative cases, delayed kinetic information should be used with caution and accurate margin assessment is essential.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Diagnóstico por Computador , Imageamento por Ressonância Magnética/métodos , Adulto , Idoso , Biópsia/estatística & dados numéricos , Neoplasias da Mama/patologia , Reações Falso-Positivas , Feminino , Humanos , Cinética , Pessoa de Meia-Idade , Estudos Retrospectivos , Carga Tumoral , Procedimentos Desnecessários/estatística & dados numéricos
14.
Biotechnol Lett ; 42(10): 2001-2009, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32488442

RESUMO

OBJECTIVE: To produce high concentrations of 13-hydroxy-14,15-epoxy-eicosatrienoic acid (14,15-hepoxilin B3, 14,15-HXB3) and 13,14,15-trihydroxy-eicosatrienoic acid (13,14,15-trioxilin B3, 13,14,15-TrXB3) from arachidonic acid (ARA) using microbial 15-lipoxygenase (15-LOX) without and with epoxide hydrolase (EH), respectively. RESULTS: The products obtained from the bioconversion of ARA by recombinant Escherichia coli cells containing Archangium violaceum 15-LOX without and with Myxococcus xanthus EH were identified as 14,15-HXB3 and 13,14,15-TrXB3, respectively. Under the optimal conditions of 30 g cells L-1, 200 mM ARA, 25 °C, and initial pH 7.5, the cells converted 200 mM ARA into 192 mM 14,15-HXB3 and 100 mM 13,14,15-TrXB3 for 150 min, with conversion yields of 96 and 51% and productivities of 77 and 40 mM h-1, respectively. CONCLUSION: These are the highest concentrations, productivities, and yields of hepoxilin and trioxilin from ARA reported thus far.


Assuntos
Ácido 8,11,14-Eicosatrienoico/análogos & derivados , Araquidonato 15-Lipoxigenase/metabolismo , Ácidos Araquidônicos , Proteínas de Bactérias/metabolismo , Epóxido Hidrolases/metabolismo , Ácido 8,11,14-Eicosatrienoico/química , Ácido 8,11,14-Eicosatrienoico/metabolismo , Araquidonato 15-Lipoxigenase/genética , Ácidos Araquidônicos/química , Ácidos Araquidônicos/metabolismo , Proteínas de Bactérias/genética , Epóxido Hidrolases/genética , Myxococcales/enzimologia , Myxococcales/genética , Myxococcus xanthus/enzimologia , Myxococcus xanthus/genética
15.
Biotechnol Lett ; 42(10): 2011-2012, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32564168

RESUMO

In the original publication of the article, some chirality of Fig. 1 was published incorrectly. The corrected figure is provided below.

16.
Int J Tuberc Lung Dis ; 24(6): 597-605, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32553011

RESUMO

SETTING: Multicentre retrospective study in South Korea.OBJECTIVE: To longitudinally evaluate changes in lung volume and diffusing capacity for carbon monoxide (DLCO) with forced expiratory volume in 1 sec (FEV1).DESIGN: A total of 155 patients with chronic obstructive pulmonary disease (COPD), whose pulmonary function parameters were measured annually for 5 years, were selected from a prospective cohort in South Korea. A random coefficients model was used to estimate mean annual FEV1, lung volume parameter and DLCO change rates.RESULTS: Patients were classified into four groups based on baseline DLCO and residual volume/total lung capacity (RV/TLC) measurements. The annual FEV1 decline rate was greater in patients with low DLCO than in those with normal DLCO, with the greatest decline occurring in patients with low DLCO and normal RV/TLC. RV and RV/TLC declined in patients with high RV/TLC, whereas these increased in patients with normal RV/TLC. DLCO decreased longitudinally in all four groups, with the greatest decline occurring in patients with normal DLCO and normal RV/TLC.CONCLUSIONS: Different subgroups of patients with COPD exhibited distinctive pulmonary function change patterns. Baseline DLCO and RV/TLC may be used as physiological markers to predict long-term changes in pulmonary function.


Assuntos
Pulmão , Capacidade de Difusão Pulmonar , Volume Expiratório Forçado , Humanos , Medidas de Volume Pulmonar , Estudos Prospectivos , República da Coreia , Estudos Retrospectivos
17.
Clin Microbiol Infect ; 26(10): 1375-1379, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31972318

RESUMO

OBJECTIVES: Cryptococcal meningitis (CM) remains an important cause of morbidity and mortality among immunocompromised patients. Laboratory diagnostics for CM includes antigen detection, staining and culture. Data on the performance of the Biofire® FilmArray® meningitis/encephalitis (ME) panel for detecting Cryptococcus neoformans/gattii is limited, with several reports describing false negativity for this target. METHODS: A retrospective analysis of 1384 physician-ordered ME panel tests ordered between January 2017 to October 2018 was performed. ME panel results were compared to cerebrospinal fluid (CSF) cryptococcal antigen (CrAg) and CSF culture testing and clinical significance of cryptococcal detection was determined. RESULTS: There were 34 patients positive for cryptococcal detection by either ME panel, CSF CrAg or CSF culture in 2.7% of CSF specimens tested (38/1384). Of the 34 patients positive for cryptococcal detection, 85.3% were human immunodeficiency virus positive (29/34). The ME panel detected 32/38 (84.2%) cryptococcal-positive specimens, culture detected 28/38 (73.7%) and CSF CrAg was positive in 37/38 specimens (97.4%). The ME panel had a sensitivity and specificity of 96.4% (95% CI 81.7-99.9%) and 99.6% (95% CI 99.2-99.9%) compared with culture, and 83.8% (95% CI 68.0-93.8%) and 99.9% (95% CI 99.6-100.0%) compared to CSF CrAg testing, respectively. CrAg titres were lower among ME panel-negative, culture-negative specimens compared with ME panel-positive, culture-negative specimens (reciprocal median end-point titres of 128 ± 60 vs. 1920 ± 1730, p 0.04). All five CrAg-positive, ME panel- and culture-negative specimens were obtained from previously treated CM patients. DISCUSSION: The ME panel had high correlation with CSF culture and a somewhat lower correlation with CSF CrAg testing. The potential utility of using negative ME panel test results to predict culture sterility among patients undergoing treatment for CM warrants further study.


Assuntos
Cryptococcus gattii/isolamento & purificação , Cryptococcus neoformans/isolamento & purificação , Meningite Criptocócica/diagnóstico , Análise Serial de Proteínas/métodos , Adulto , Idoso , Antígenos de Fungos/líquido cefalorraquidiano , Testes Diagnósticos de Rotina/métodos , Feminino , Infecções por HIV/complicações , Humanos , Masculino , Meningite Criptocócica/microbiologia , Meningite Criptocócica/mortalidade , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex/métodos , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto Jovem
18.
Br J Dermatol ; 182(2): 427-433, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31077333

RESUMO

BACKGROUND: Sentinel lymph node biopsy (SLNB) is usually performed using a triple technique that includes lymphoscintigraphy (LSG), which involves the injection of a radiolabelled tracer, blue dye injection, and detection of the radioisotope with a gamma probe. However, blue dye injection may cause pathological misinterpretation and obscure clinical margins, especially when combined with Mohs micrographic surgery (MMS) for cutaneous melanoma. OBJECTIVES: To assess the efficacy of SLNB without blue dye injection in patients who subsequently underwent MMS for melanomas of the lower extremities. METHODS: We evaluated patients who underwent MMS with or without SLNB using preoperative localization of the primary melanoma via LSG and intraoperative confirmation using a gamma probe between 2010 and 2016. RESULTS: Seventy-two patients with melanoma of mean Breslow thickness 3·03 ± 1·44 mm were evaluated. Sixty-five of the 72 patients underwent SLNB, the success rate of which was 98%. The 5-year overall and disease-free survival rates were 78% and 76%, respectively. CONCLUSIONS: Blue dye injection can be omitted without compromising the accuracy of standard SLNB. Omitting blue dye injection also has marked advantages in MMS for melanoma. What's already known about this topic? Sentinel lymph node biopsy (SLNB) is usually performed using a triple technique including lymphoscintigraphy, which involves the injection of a radiolabelled tracer, blue dye injection, and radioisotope detection using a gamma probe. Blue dye injection may cause pathological misinterpretation and obscure clinical margins. What does this study add? Omitting the dye does not decrease diagnostic accuracy and is particularly advantageous for Mohs micrographic surgery (MMS) in melanomas with clinically indistinct tumour borders. SLNB without blue dye injection is feasible in MMS for melanoma.


Assuntos
Melanoma , Neoplasias Cutâneas , Humanos , Extremidade Inferior , Linfonodos , Melanoma/diagnóstico por imagem , Melanoma/cirurgia , Cirurgia de Mohs , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/cirurgia
19.
J Public Health (Oxf) ; 42(2): e165-e173, 2020 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-31219159

RESUMO

BACKGROUND: This study aimed to identify the effect of the overweight or obesity (OWOB) trajectory on current health care expenditure in South Korea. METHODS: Ten years of publicly released data (2002-12) were obtained in 2016 from a retrospective cohort of National Health Insurance System claims. This study included 51,844 adults (aged 30-59 years in 2002) and 21,196 elderly adults (aged ≥ 60 years in 2002). RESULTS: Compared with adults who maintained normal weight (NW), higher yearly total health expenditures were estimated for adults who lost weight over the 10-year period: by 11.5% (95% confidence interval (CI): 0.18-22.96%) when changing from NW to underweight (UW) and 6.2% (95% CI: 0.47-12.01%) from OWOB to UW/NW. Elderly adults had higher health expenditures when they lost weight by 14.0% (95% CI: 0.37-27.70%) from NW to UW and 6.8% (95% CI: 0.13-13.51%) from OWOB to UW/NW compared with when they maintained NW. CONCLUSIONS: These findings indicate the importance of early intervention to control OWOB, particularly because people in late adulthood have greater health care needs for reasons other than OWOB.


Assuntos
Gastos em Saúde , Sobrepeso , Adulto , Idoso , Índice de Massa Corporal , Humanos , Obesidade/epidemiologia , Sobrepeso/epidemiologia , República da Coreia/epidemiologia , Estudos Retrospectivos
20.
J Hosp Infect ; 104(2): 172-180, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31513880

RESUMO

BACKGROUND: Antimicrobial stewardship programmes (ASPs) are suggested as a vital strategy to address antimicrobial resistance. AIM: To examine the current status of ASPs in Korean hospitals, to identify problems and challenges for the implementation of proper ASPs, and to provide a reference for developing more effective ASP policies. METHODS: A questionnaire based on the 'Seven Core Elements of Hospital Antibiotic Stewardship Programs' from the US Centers for Disease Control and Prevention was developed, modified from the previous questionnaire on ASPs in Korea, 2015. ASP-participating physicians such as infectious disease specialists (IDSs), paediatric IDSs, and directors of infection control departments were targeted. Only one ASP-associated physician per hospital participated in the survey. FINDINGS: The survey response rate was 88.4% (84/95). The median number of medical personnel participating in ASPs was 3 (interquartile range (IQR): 1-5), most of whom were IDS (median: 2; IQR: 1-2). Only 6.0% (5/84) of hospitals had full-time workers for ASPs. Whereas restrictive measures for designated antimicrobials were widely implemented among Korean hospitals (88.1%, 74/84), the proportion of hospitals with interventions for inappropriate long-term antimicrobial use and a conversion strategy from parenteral to oral antimicrobial administration was only 9.5% (8/84) and 1.2% (1/84), respectively. Lack of time, personnel, and appropriate compensation was perceived as the major barrier to establishing an ASP in Korean hospitals. CONCLUSION: ASPs in Korean hospitals were primarily carried out by one or two IDSs, and programmes mostly comprised restrictive measures for designated antimicrobials. National-level support to implement appropriate ASPs in Korean hospitals is necessary.


Assuntos
Gestão de Antimicrobianos/métodos , Gestão de Antimicrobianos/organização & administração , Hospitais/estatística & dados numéricos , Anti-Infecciosos/uso terapêutico , Humanos , Guias de Prática Clínica como Assunto , República da Coreia , Inquéritos e Questionários
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