1.A collaborative model between dialysis clinics and a hospital center improves the quality of vascular access care and intervention for hemodialysis patients
Chung-Kuan WU ; Yu-Wei FANG ; Chia-Hsun LIN
Kidney Research and Clinical Practice 2024;43(2):216-225
This study reports the outcomes of a collaborative program between dialysis clinics and a referral hospital, which consisted of clinical monitoring and supplementary routine surveillance, for improving the quality of vascular access care. Methods: This retrospective observational study was performed at five dialysis clinics as part of a 2-year collaborative program (2019–2020) in conjunction with a hospital-based dialysis access management center. A total of 392 hemodialysis patients (arteriovenous fistula [AVF], n = 339 and arteriovenous graft [AVG], n = 53) were included. Outcome measures included the prognosis of vascular access, clinic satisfaction, and referral rate to the hospital. Results: Increased vascular access flow was observed and critical flow events decreased from the first to the second year (AVF: 18.3% vs. 12.7%, p < 0.001; AVG: 26.2% vs. 20.1%, p = 0.30). There were fewer percutaneous transluminal angioplasty events in the AVG group (0.77 per person-year vs. 0.51 per person-year, p = 0.005). New AVF or AVG creation events also remained low. All dialysis clinics were satisfied with the program. The overall referral rate from the participating clinics increased (65.7% vs. 72.0%) during the study period independently of the physical distance between the dialysis clinic and the hospital. Conclusion: The collaboration between dialysis clinics and a referral hospital for improving the quality of vascular access care was successful in this study, and the model can be used by other clinics and hospitals looking to improve care coordination in dialysis patients.
2.Soft Tissue Infection Caused by Rapid Growing Mycobacterium following Medical Procedures: Two Case Reports and Literature Review.
Shih Sen LIN ; Chin Cheng LEE ; Tsrang Neng JANG
Annals of Dermatology 2014;26(2):236-240
Non-tubecrulosis mycobacterium infections were increasingly reported either pulmonary or extrapulmonary in the past decades. In Taiwan, we noticed several reports about the soft tissue infections caused by rapid growing mycobacterium such as Mycobacterium abscessus, Mycobacterium chelonae, on newspaper, magazines, or the multimedia. Most of them occurred after a plastic surgery, and medical or non-medical procedures. Here, we reported two cases of these infections following medical procedures. We also discussed common features and the clinical course of the disease, the characteristics of the infected site, and the treatment strategy. The literatures were also reviewed, and the necessity of the treatment guidelines was discussed.
Multimedia
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Mycobacterium chelonae
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Mycobacterium Infections
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Mycobacterium*
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Periodicals
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Periodicals as Topic
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Soft Tissue Infections*
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Surgery, Plastic
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Taiwan
3.A Case of Benign Abducens Nerve Palsy of Childhood.
Su Ye SOHN ; Jeong Hee SHIN ; Jang Hoon LEE ; So Hee EUN ; Baik Lin EUN
Journal of the Korean Child Neurology Society 2010;18(1):133-139
Benign abducens nerve palsy is rare in children. Identifiable causes of abducens nerve palsy include neoplasm, elevated intracranial pressure, infection and trauma. Isolated abducens nerve palsy with unknown etiology is classified as benign or idiopathic. The diagnosis is made by excluding underlying pathologies. Prognosis is favorable. Most patients have been found to recover spontaneously within 6 months. Recurrent palsy is observed in some patients and is more pronounced in younger girls with left-sided palsy. Even the recurrent cases, however, are still benign. We report a case of benign abducens nerve palsy presenting diplopia and headache with normal results from MRIs and microbiologic studies. The patient underwent rapid, spontaneous recovery.
Abducens Nerve
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Abducens Nerve Diseases
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Child
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Diplopia
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Headache
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Humans
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Intracranial Hypertension
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Paralysis
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Prognosis
4.Left-sided Ulcerative Colitis Reactivated and Aggravated during Clostridium difficile Infection.
Dong Kil NA ; Jin Bae KIM ; Young Chul SHIN ; Su Lin SHIN ; Hyo Jung KIM ; Il Hyun BAEK ; Sang Hoon PARK ; Myung Seok LEE
The Korean Journal of Gastroenterology 2011;57(6):374-378
Clostridium difficile (C. difficile) infection appears to be closely related to reactivation, diagnostic delay, and disease progression in patients with inflammatory bowel disease. However, whether C. difficile infection triggers the reactivation of inflammatory bowel disease or vice versa is not certain. We report a case of reactivated and progressed left ulcerative colitis following C. difficile infection in a 56-year-old woman. A series of endoscopic findings in this case report strongly supports a causative role of C. difficile infection on the reactivation and progression of ulcerative colitis.
5.Direct-to-implant breast reconstruction following nipple-sparing mastectomy: predictive factors of adverse surgical outcomes in Asian patients
Chun-Lin SU ; Jia-Ruei YANG ; Wen-Ling KUO ; Shin-Cheh CHEN ; David Chon-Fok CHEONG ; Jung-Ju HUANG
Archives of Plastic Surgery 2021;48(5):483-493
Background:
Direct-to-implant (DTI) breast reconstruction after nipple-sparing mastectomy (NSM) with the use of acellular dermal matrix (ADM) provides reliable outcomes; however, the use of ADM is associated with a higher risk of complications. We analyzed our experiences of post-NSM DTI without ADM and identified the predictive factors of adverse surgical outcomes.
Methods:
Patients who underwent NSM and immediate DTI or two-stage tissue expander (TE) breast reconstruction from 2009 to 2020 were enrolled. Predictors of adverse endpoints were analyzed.
Results:
There were 100 DTI and 29 TE reconstructions. The TE group had a higher rate of postmastectomy radiotherapy (31% vs. 11%; P=0.009), larger specimens (317.37±176.42 g vs. 272.08±126.33 g; P=0.047), larger implants (360.84±85.19 g vs. 298.83±81.13 g; P=0.004) and a higher implant/TE exposure ratio (10.3% vs. 1%; P=0.035). In DTI reconstruction, age over 50 years (odds ratio [OR], 5.43; 95% confidence interval [CI], 1.50–19.74; P=0.010) and a larger mastectomy weight (OR, 1.65; 95% CI, 1.08–2.51; P=0.021) were associated with a higher risk of acute complications. Intraoperative radiotherapy for the nipple-areolar complex increased the risk of acute complications (OR, 4.05; 95% CI, 1.07–15.27; P=0.039) and the likelihood of revision surgery (OR, 5.57; 95% CI, 1.25–24.93; P=0.025).
Conclusions
Immediate DTI breast reconstruction following NSM is feasible in Asian patients with smaller breasts.
6.Direct-to-implant breast reconstruction following nipple-sparing mastectomy: predictive factors of adverse surgical outcomes in Asian patients
Chun-Lin SU ; Jia-Ruei YANG ; Wen-Ling KUO ; Shin-Cheh CHEN ; David Chon-Fok CHEONG ; Jung-Ju HUANG
Archives of Plastic Surgery 2021;48(5):483-493
Background:
Direct-to-implant (DTI) breast reconstruction after nipple-sparing mastectomy (NSM) with the use of acellular dermal matrix (ADM) provides reliable outcomes; however, the use of ADM is associated with a higher risk of complications. We analyzed our experiences of post-NSM DTI without ADM and identified the predictive factors of adverse surgical outcomes.
Methods:
Patients who underwent NSM and immediate DTI or two-stage tissue expander (TE) breast reconstruction from 2009 to 2020 were enrolled. Predictors of adverse endpoints were analyzed.
Results:
There were 100 DTI and 29 TE reconstructions. The TE group had a higher rate of postmastectomy radiotherapy (31% vs. 11%; P=0.009), larger specimens (317.37±176.42 g vs. 272.08±126.33 g; P=0.047), larger implants (360.84±85.19 g vs. 298.83±81.13 g; P=0.004) and a higher implant/TE exposure ratio (10.3% vs. 1%; P=0.035). In DTI reconstruction, age over 50 years (odds ratio [OR], 5.43; 95% confidence interval [CI], 1.50–19.74; P=0.010) and a larger mastectomy weight (OR, 1.65; 95% CI, 1.08–2.51; P=0.021) were associated with a higher risk of acute complications. Intraoperative radiotherapy for the nipple-areolar complex increased the risk of acute complications (OR, 4.05; 95% CI, 1.07–15.27; P=0.039) and the likelihood of revision surgery (OR, 5.57; 95% CI, 1.25–24.93; P=0.025).
Conclusions
Immediate DTI breast reconstruction following NSM is feasible in Asian patients with smaller breasts.
7.Prevalence of Anti-HCV in Hemodialysis Patients in Taegu and Kyeongbuk, Korea.
Young Ho SHIN ; Ho Kyu KIM ; Sung Dae CHOI ; Yang Sik KIM ; Hyun Su SHIN ; Young Jun WON ; Ill Sae LEE ; Mun Kyu KANG ; Jung Ho LEE ; Sung Bae PARK ; Hyun Chul KIM
Korean Journal of Medicine 1998;54(5):640-646
To determine the prevalence and risk factor of anti-HCV in ESRD patients under chronic maitenance hemodialysis, the prevalence of serum antibodies to hepatitis C Virus(Anti-HCV) was assessed by an enzyme immunoassay (Abbott HCV EIA) in 253 patients with long-term Hemodialysis in Daegu & Kyoungbuk. 15 patients(5.9%) were anti-HCV positive. All dialysis patients had the history of transfusion. The number of transfusion units was not significant in anti-HCV positive patients(mean 17+/-20 pints) in comparison with the number in anti-HCV negative patients (mean 16+/-17 pints). The frequency of hemodialysis was also not significant in anti-HCV positive patients(mean 477+/-618 ) compared with anti-HCV negative patients (mean 462+/-616). The mean duration of hemodialysis was significantly higher(P<0.001) in the anti-HCV positive patients (74+/-42 months) in comparison with anti-HCV negative patients (45+/-41 months). We concluded that the prevalence of anti-HCV in hemodialysis patients is 5.9% and that HCV infection is significantly related with the duration of hemodialysis rather than the number of transfusion units and the frequency of hemodialysis
Antibodies
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Daegu*
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Dialysis
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Hepacivirus
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Hepatitis C
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Humans
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Immunoenzyme Techniques
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Kidney Failure, Chronic
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Korea*
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Prevalence*
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Renal Dialysis*
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Risk Factors
8.Introduction of National Health Screening Program for Infant and Children.
Baik Lin EUN ; Seong Woo KIM ; Young Key KIM ; Jung Wook KIM ; Jin Soo MOON ; Su Kyoung PARK ; In Kyung SUNG ; Son Moon SHIN ; Sun Mi YOO ; So Hee EUN ; Hea Kyoung LEE ; Hyun Taek LIM ; Hee Jung CHUNG
Journal of the Korean Child Neurology Society 2007;15(2):142-147
No abstract available.
Child*
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Humans
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Infant*
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Mass Screening*
9.Overview of the national health screening program for infant and children.
Baik Lin EUN ; Seong Woo KIM ; Young Key KIM ; Jung Wook KIM ; Jin Soo MOON ; Su Kyung PARK ; In Kyung SUNG ; Son Moon SHIN ; Sun Mi YOO ; So Hee EUN ; Hea Kyoung LEE ; Hyun Taek LIM ; Hee Jung CHUNG
Korean Journal of Pediatrics 2008;51(3):225-232
The mission of National Health Screening Program for Infant and Children is to promote and improve the health, education, and well-being of infants, children, families, and communities. Although the term 'diagnosis' usually relates to pathology, a similar diagnostic approach applies to the child seen primarily for health supervision. In the case of health, diagnosis determines the selection of appropriate health promoting and preventive interventions, whether medical, dental, nutritional, educational, or psychosocial. Components of the diagnostic process in health supervision include the health 'interview'; assessment of physiological, emotional, cognitive, and social development (including critical developmental milestones); physical examination; screening procedures; and evaluation of strengths and issues. Open and informed communication between the health professional and the family remains the most significant component of both health diagnosis and health promotion. Families complete medical history forms at their health supervision visit. Family-friendly questionnaires, checklists, and surveys that are appropriate for the child''s age are additional tools to improve and update data gathering. This type of information helps initiate and inform discussions between the family and the health professional. This article provides a comprehensive review of current National Health Screening Program for Infant and Children in Korea.
Checklist
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Child
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Health Occupations
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Health Promotion
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Humans
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Infant
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Korea
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Mass Screening
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Missions and Missionaries
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National Health Programs
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Organization and Administration
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Surveys and Questionnaires
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Social Change
10.The Progression of SARS Coronavirus 2 (SARS-CoV2): Mutation in the Receptor Binding Domain of Spike Gene
Sinae KIM ; Jong Ho LEE ; Siyoung LEE ; Saerok SHIM ; Tam T. NGUYEN ; Jihyeong HWANG ; Heijun KIM ; Yeo-Ok CHOI ; Jaewoo HONG ; Suyoung BAE ; Hyunjhung JHUN ; Hokee YUM ; Youngmin LEE ; Edward D. CHAN ; Liping YU ; Tania AZAM ; Yong-Dae KIM ; Su Cheong YEOM ; Kwang Ha YOO ; Lin-Woo KANG ; Kyeong-Cheol SHIN ; Soohyun KIM
Immune Network 2020;20(5):e41-
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) is a positive-sense singlestranded RNA (+ssRNA) that causes coronavirus disease 2019 (COVID-19). The viral genome encodes twelve genes for viral replication and infection. The third open reading frame is the spike (S) gene that encodes for the spike glycoprotein interacting with specific cell surface receptor – angiotensin converting enzyme 2 (ACE2) – on the host cell membrane. Most recent studies identified a single point mutation in S gene. A single point mutation in S gene leading to an amino acid substitution at codon 614 from an aspartic acid 614 into glycine (D614G) resulted in greater infectivity compared to the wild type SARS-CoV2. We were interested in investigating the mutation region of S gene of SARS-CoV2 from Korean COVID-19 patients. New mutation sites were found in the critical receptor binding domain (RBD) of S gene, which is adjacent to the aforementioned D614G mutation residue. This specific sequence data demonstrated the active progression of SARS-CoV2 by mutations in the RBD of S gene.The sequence information of new mutations is critical to the development of recombinant SARS-CoV2 spike antigens, which may be required to improve and advance the strategy against a wide range of possible SARS-CoV2 mutations.