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Kang BJ, Hong SB, Jeon K, Lee SM, Lee DH, Moon JY, Lee YJ, Kim JS, Park J, Ahn JJ. Rapid Response System Should Be Enhanced at Non-general Ward Locations: a Retrospective Multicenter Cohort Study in Korea. J Korean Med Sci 2021; 36:e7. [PMID: 33429471 PMCID: PMC7801145 DOI: 10.3346/jkms.2021.36.e7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 10/26/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND A rapid response system (RRS) contributes to the safety of hospitalized patients. Clinical deterioration may occur in the general ward (GW) or in non-GW locations such as radiology or dialysis units. However, there are few studies regarding RRS activation in non-GW locations. This study aimed to compare the clinical characteristics and outcomes of patients with RRS activation in non-GW locations and in the GW. METHODS From January 2016 to December 2017, all patients requiring RRS activation in nine South Korean hospitals were retrospectively enrolled and classified according to RRS activation location: GW vs non-GW RRS activations. RESULTS In total, 12,793 patients were enrolled; 222 (1.7%) were non-GW RRS activations. There were more instances of shock (11.6% vs. 18.5%) and cardiac arrest (2.7% vs. 22.5%) in non-GW RRS activation patients. These patients also had a lower oxygen saturation (92.6% ± 8.6% vs. 88.7% ± 14.3%, P < 0.001) and a higher National Early Warning Score 2 (7.5 ± 3.4 vs. 8.9 ± 3.8, P < 0.001) than GW RRS activation patients. Although non-GW RRS activation patients received more intubation (odds ratio [OR], 3.135; P < 0.001), advanced cardiovascular life support (OR, 3.912; P < 0.001), and intensive care unit transfer (OR, 2.502; P < 0.001), their hospital mortality (hazard ratio, 0.630; P = 0.013) was lower than GW RRS activation patients upon multivariate analysis. CONCLUSION Considering that there were more critically ill but recoverable cases in non-GW locations, active RRS involvement should be required in such locations.
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Kim T, Kim JS, Choi EY, Chang Y, Choi WI, Hwang JJ, Moon JY, Lee K, Kim SW, Kang HK, Sim YS, Park TS, Park SY, Park S, Cho JH. Utilization of pain and sedation therapy on noninvasive mechanical ventilation in Korean intensive care units: a multi-center prospective observational study. Acute Crit Care 2020; 35:255-262. [PMID: 33161687 PMCID: PMC7808848 DOI: 10.4266/acc.2020.00164] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 09/10/2020] [Indexed: 11/30/2022] Open
Abstract
Background The use of sedative drugs may be an important therapeutic intervention during noninvasive ventilation (NIV) in intensive care units (ICUs). The purpose of this study was to assess the current application of analgosedation in NIV and its impact on clinical outcomes in Korean ICUs. Methods Twenty Korean ICUs participated in the study, and data was collected on NIV use during the period between June 2017 and February 2018. Demographic data from all adult patients, NIV clinical parameters, and hospital mortality were included. Results A total of 155 patients treated with NIV in the ICUs were included, of whom 26 received pain and sedation therapy (sedation group) and 129 did not (control group). The primary cause of ICU admission was due to acute exacerbation of obstructed lung disease (45.7%) in the control group and pneumonia treatment (53.8%) in the sedation group. In addition, causes of NIV application included acute hypercapnic respiratory failure in the control group (62.8%) and post-extubation respiratory failure in the sedation group (57.7%). Arterial partial pressure of carbon dioxide (PaCO2) levels before and after 2 hours of NIV treatment were significantly decreased in both groups: from 61.9±23.8 mm Hg to 54.9±17.6 mm Hg in the control group (P<0.001) and from 54.9±15.1 mm Hg to 51.1±15.1 mm Hg in the sedation group (P=0.048). No significant differences were observed in the success rate of NIV weaning, complications, length of ICU stay, ICU survival rate, or hospital survival rate between the groups. Conclusions In NIV patients, analgosedation therapy may have no harmful effects on complications, NIV weaning success, and mortality compared to the control group. Therefore, sedation during NIV may not be unsafe and can be used in patients for pain control when indicated.
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Walker PM, Hirayama Y, Lane GJ, Watanabe H, Dracoulis GD, Ahmed M, Brunet M, Hashimoto T, Ishizawa S, Kondev FG, Litvinov YA, Miyatake H, Moon JY, Mukai M, Niwase T, Park JH, Podolyák Z, Rosenbusch M, Schury P, Wada M, Watanabe XY, Liang WY, Xu FR. Properties of ^{187}Ta Revealed through Isomeric Decay. PHYSICAL REVIEW LETTERS 2020; 125:192505. [PMID: 33216598 DOI: 10.1103/physrevlett.125.192505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
Mass-separated ^{187}Ta_{114} in a high-spin isomeric state has been produced for the first time by multinucleon transfer reactions, employing an argon gas-stopping cell and laser ionization. Internal γ rays revealed a T_{1/2}=7.3±0.9 s isomer at 1778±1 keV, which decays through a rotational band with perturbations associated with the approach to a prolate-oblate shape transition. Model calculations show less influence from triaxiality compared to heavier elements in the same mass region. The isomer-decay reduced E2 hindrance factor f_{ν}=27±1 supports the interpretation that axial symmetry is approximately conserved.
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Lee N, Oh DG, Choi S, Moon JY, Kim JH, Shin HJ, Son K, Nuss J, Kiryukhin V, Choi YJ. Highly nonlinear magnetoelectric effect in buckled-honeycomb antiferromagnetic Co 4Ta 2O 9. Sci Rep 2020; 10:12362. [PMID: 32703982 PMCID: PMC7378256 DOI: 10.1038/s41598-020-69117-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/06/2020] [Indexed: 11/09/2022] Open
Abstract
Strongly correlated materials with multiple order parameters provide unique insights into the fundamental interactions in condensed matter systems and present opportunities for innovative technological applications. A class of antiferromagnetic honeycomb lattices compounds, A4B2O9 (A = Co, Fe, Mn; B = Nb, Ta), have been explored owing to the occurrence of linear magnetoelectricity. From our investigation of magnetoelectricity on single crystalline Co4Ta2O9, we discovered strongly nonlinear and antisymmetric magnetoelectric behavior above the spin-flop transition for magnetic fields applied along two orthogonal in-plane directions. This observation suggests that two types of inequivalent Co2+ sublattices generate magnetic-field-dependent ferroelectric polarization with opposite signs. The results motivate fundamental and applied research on the intriguing magnetoelectric characteristics of these buckled-honeycomb lattice materials.
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Na KR, Kim HR, Ham Y, Choi DE, Lee KW, Moon JY, Kim YS, Cheon S, Sohn KM, Kim J, Kim S, Jeong H, Jeon JW. Acute Kidney Injury and Kidney Damage in COVID-19 Patients. J Korean Med Sci 2020; 35:e257. [PMID: 32686373 PMCID: PMC7371456 DOI: 10.3346/jkms.2020.35.e257] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/30/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This disease, which is quickly spreading worldwide, has high potential for infection and causes rapid progression of lung lesions, resulting in a high mortality rate. This study aimed to investigate the effects of SARS-CoV-2 infection on renal function in patients with COVID-19. METHODS From February 21 to April 24, 2020, 66 patients diagnosed with COVID-19 at Chungnam National University Hospital were analyzed; all patients underwent routine urinalysis and were tested for serum creatinine, urine protein to creatinine ratio (PCR), and urine albumin to creatinine ratio (ACR). RESULTS Acute kidney injury (AKI) occurred in 3 (4.5%) of the 66 patients, and 1 patient with AKI stage 3 underwent hemodialysis. Upon follow-up, all 3 patients recovered normal renal function. Compared with patients with mild COVID-19, AKI (n = 3) occurred in patients with severe COVID-19, of whom both urine PCR and ACR were markedly increased. CONCLUSION The incidence of AKI was not high in COVID-19 patients. The lower mortality rate in SARS-CoV-2 infection compared with previous Middle East respiratory syndrome and SARS-CoV infections is thought to be associated with a low incidence of dysfunction in organs other than the lungs.
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Park MJ, Cho JH, Chang Y, Moon JY, Park S, Park TS, Lee YS. Factors for Predicting Noninvasive Ventilation Failure in Elderly Patients with Respiratory Failure. J Clin Med 2020; 9:E2116. [PMID: 32635559 PMCID: PMC7408979 DOI: 10.3390/jcm9072116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 11/17/2022] Open
Abstract
Noninvasive ventilation (NIV) is useful when managing critically ill patients. However, it is not easy to apply to elderly patients, particularly those with pneumonia, due to the possibility of NIV failure and the increased mortality caused by delayed intubation. In this prospective observational study, we explored whether NIV was appropriate for elderly patients with pneumonia, defined factors that independently predicted NIV failure, and built an optimal model for prediction of such failure. We evaluated 78 patients with a median age of 77 years. A low PaCO2 level, a high heart rate, and the presence of pneumonia were statistically significant independent predictors of NIV failure. The predictive power for NIV failure of Model III (pneumonia, PaCO2 level, and heart rate) was better than that of Model I (pneumonia alone). Considering the improvement in parameters, patients with successful NIV exhibited significantly improved heart rates, arterial pH and PaCO2 levels, and patients with NIV failure exhibited a significantly improved PaCO2 level only. In conclusion, NIV is reasonable to apply to elderly patients with pneumonia, but should be done with caution. For the early identification of NIV failure, the heart rate and arterial blood gas parameters should be monitored within 2 h after NIV commencement.
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Park JH, Moon JY, Sohn KM, Kim YS. Two Fatal Cases of Stress-induced Cardiomyopathy in COVID-19 Patients. J Cardiovasc Imaging 2020; 28:300-303. [PMID: 33086446 PMCID: PMC7572266 DOI: 10.4250/jcvi.2020.0125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 08/02/2020] [Indexed: 11/22/2022] Open
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Sugiyama M, Fukaya T, Moon JY, Ishida K, Matsushita A, Kim SY, Yeo SH. Analysis and enhancement of the ethanol resistance of Pichia kudriavzevii N77-4, a strain newly isolated from the Korean traditional fermentation starter Nuruk, for improved fermentation performance. ACTA ACUST UNITED AC 2019. [DOI: 10.1088/1742-6596/1282/1/012062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Choi Y, Park M, Kang DH, Lee J, Moon JY, Ahn H. The quality of dying and death for patients in intensive care units: a single center pilot study. Acute Crit Care 2019; 34:192-201. [PMID: 31723928 PMCID: PMC6849018 DOI: 10.4266/acc.2018.00374] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 04/16/2019] [Accepted: 05/03/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To identify the necessary care for dying patients in intensive care units (ICUs), we designed a retrospective study to evaluate the quality of dying and death (QODD) experienced by the surrogates of patients with medical illness who died in the ICU of a tertiary referral hospital. METHODS To achieve our objective, the authors compared the QODD scores as appraised by the relatives of patients who died of cancer under hospice care with those who died in the ICU. For this study, a Korean version of the QODD questionnaire was developed, and individual interviews were also conducted. RESULTS Sixteen people from the intensive care group and 23 people from the hospice care group participated in the survey and completed the questionnaire. The family members of patients who died in the ICU declined participation at a high rate (50%), with the primary reason being to avoid bringing back painful memories (14 people, 87.5%). The relatives of the intensive care group obtained an average total score on the 17-item QODD questionnaire, which was significantly lower than that of the relatives of the hospice group (48.7±15.5 vs. 60.3±14.8, P=0.03). CONCLUSIONS This work implies that there are unmet needs for the care of dying patients and for the QODD in tertiary hospital ICUs. This result suggests that shared decision making for advance care planning should be encouraged and that education on caring for dying patients should be provided to healthcare professionals to improve the QODD in Korean ICUs.
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Kim JY, Kim HI, Suh GY, Yoon SW, Kim TY, Lee SH, Moon JY, Kwon JY, Na S, Ryu HG, Park J, Koh Y. Erratum: Application of sepsis-3 criteria to Korean patients with critical illnesses. Acute Crit Care 2019; 34:172. [PMID: 31723925 PMCID: PMC6786670 DOI: 10.4266/acc.2018.00318.e1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
[This corrects the article on p. 30 in vol. 34.].
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Nam H, Cho JH, Choi EY, Chang Y, Choi WI, Hwang JJ, Moon JY, Lee K, Kim SW, Kang HK, Sim YS, Park TS, Park SY, Park S. Current Status of Noninvasive Ventilation Use in Korean Intensive Care Units: A Prospective Multicenter Observational Study. Tuberc Respir Dis (Seoul) 2019; 82:242-250. [PMID: 30841017 PMCID: PMC6609522 DOI: 10.4046/trd.2018.0064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/29/2018] [Accepted: 11/22/2018] [Indexed: 11/24/2022] Open
Abstract
Background Data on noninvasive ventilation (NIV) use in intensive care units (ICUs) are very limited in South Korea. Methods A prospective observational study was performed in 20 ICUs of university-affiliated hospitals from June 2017 to February 2018. Adult patients (age>18 years) who were admitted to the ICU and received NIV treatment for acute respiratory failure were included. Results A total of 156 patients treated with NIV were enrolled (mean age, 71.9±11.6 years). The most common indications for NIV were acute hypercapnic respiratory failure (AHRF, n=89) and post-extubation respiratory failure (n=44). The main device for NIV was an invasive mechanical ventilator with an NIV module (61.5%), and the majority of patients (87.2%) used an oronasal mask. After the exclusion of 32 do-not-resuscitate patients, NIV success rate was 68.5% (85/124); ICU and hospital mortality rates were 8.9% and 15.3%, respectively. However, the success rate was lower in patients with de novo respiratory failure (27.3%) compared to that of patients with AHRF (72.8%) or post-extubation respiratory failure (75.0%). In multivariate analysis, immunocompromised state, de novo respiratory failure, post-NIV (2 hours) respiratory rate, NIV mode (i.e., non-pressure support ventilation mode), and the change of NIV device were significantly associated with a lower success rate of NIV. Conclusion AHRF and post-extubation respiratory failure were the most common indications for NIV in Korean ICUs. Overall NIV success was achieved in 68.5% of patients, with the lowest rate in patients with de novo respiratory failure.
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Kim JY, Kim HI, Suh GY, Yoon SW, Kim TY, Lee SH, Moon JY, Kwon JY, Na S, Ryu HG, Park J, Koh Y. Application of Sepsis-3 Criteria to Korean Patients with Critical Illnesses. Acute Crit Care 2019; 34:30-37. [PMID: 31723902 PMCID: PMC6849039 DOI: 10.4266/acc.2018.00318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/11/2018] [Accepted: 12/14/2018] [Indexed: 12/12/2022] Open
Abstract
Background The 2016 Society of Critical Care Medicine (SCCM)/European Society of Intensive Care Medicine (ESICM) task force for Sepsis-3 devised new definitions for sepsis, sepsis with organ dysfunction and septic shock. Although Sepsis-3 was data-driven, evidence-based approach, East Asian descents comprised minor portions of the project population. Methods We selected Korean participants from the fever and antipyretics in critically ill patients evaluation (FACE) study, a joint study between Korea and Japan. We calculated the concordance rates for sepsis diagnosis between Sepsis-2 and Sepsis-3 criteria and evaluated mortality rates of sepsis, sepsis with organ dysfunction, and septic shock by Sepsis-3 criteria using the selected data. Results Korean participants of the FACE study were 913 (383 with sepsis and 530 without sepsis by Sepsis-2 criteria). The concordance rate for sepsis diagnosis between Sepsis-2 and Sepsis-3 criteria was 55.4%. The intensive care unit (ICU) and 28-day mortality rates of sepsis, sepsis with organ dysfunction, and septic shock patients according to Sepsis-3 criteria were 26.2% and 31.0%, 27.5% and 32.5%, and 40.8% and 43.4%, respectively. The quick Sequential Organ Failure Assessment (qSOFA) was inferior not only to SOFA but also to systemic inflammatory response syndrome (SIRS) for predicting ICU and 28-day mortality. Conclusions The concordance rates for sepsis diagnosis between Sepsis-2 and Sepsis-3 criteria were low. Mortality rate for septic shock in Koreans was consistent with estimates made by the 2016 SCCM/ESICM task force. SOFA and SIRS were better than qSOFA for predicting ICU and 28-day mortality in Korean ICU patients.
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Kim HI, Cho JH, Park SY, Lee YS, Chang Y, Choi WI, Sim YS, Moon JY, Lee K, Jung KS, Park S. Home Mechanical Ventilation Use in South Korea Based on National Health Insurance Service Data. Respir Care 2018; 64:528-535. [PMID: 30584068 DOI: 10.4187/respcare.06310] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND In Asian countries, nationwide data on patients undergoing home mechanical ventilation are limited. METHODS This study investigated the prevalence and primary indications for home mechanical ventilation use in South Korea by using nationwide registry data from the National Health Insurance Service. RESULTS The study period included a total of 4,785 subjects on home mechanical ventilation (mean ± SD age, 56.0 ± 23.9 y; females, 40.1%). The estimated overall prevalence of home mechanical ventilation use in South Korea was 9.3 per 100,000, with a prevalence of 6.3 per 100,000 among children (ages < 15 y). The most common primary diagnoses were neuromuscular diseases (42.0%) and lung and/or airway diseases (27.7%). The prevalence of lung and/or airway and cerebrovascular diseases as the primary diagnosis increased with age (r = 0.310, P < .001; and r = 0.156, P < .001, respectively). Noninvasive ventilation was used by 37.2% of all the subjects, with the highest prevalence in those with neuromuscular diseases (54.4%) or chest wall diseases (53.4%). Noninvasive ventilation use was lowest among subjects with brain lesions. Home mechanical ventilation was most commonly prescribed by internists (41.3% of cases), followed by rehabilitation and neurology physicians. CONCLUSIONS These data will aid in planning the optimal health-care system for users of home mechanical ventilation locally and will allow for comparison of home mechanical ventilation use rates among countries.
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Lee SY, Oh MH, Yun SH, Choi CW, Park EC, Song HS, Lee H, Yi YS, Shin J, Chung C, Moon JY, Lee JC, Kim GH, Kim SI. Genomic characterization of extensively drug-resistant Acinetobacter baumannii strain, KAB03 belonging to ST451 from Korea. INFECTION GENETICS AND EVOLUTION 2018; 65:150-158. [PMID: 30053642 DOI: 10.1016/j.meegid.2018.07.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 07/06/2018] [Accepted: 07/23/2018] [Indexed: 12/23/2022]
Abstract
Extensively drug-resistant (XDR) Acinetobacter baumannii strains have emerged rapidly worldwide. The antibiotic resistance characteristics of XDR A. baumannii strains show regional differences; therefore, it is necessary to analyze both genomic and proteomic characteristics of emerging XDR A. baumannii clinical strains isolated in Korea to elucidate their multidrug resistance. Here, we isolated new sequence type of XDR A. baumannii clinical strain (KAB03) from Korean hospitals and performed comprehensive genome analyses. The strain belongs to new sequence type, ST451. Single nucleotide polymorphism (SNP) analysis with other types of A. baumannii strains revealed that KAB03 has unique SNP pattern in the regions of gyrB and gpi of MLST profiles. A. baumannii KAB03 harbours three antibiotic resistance islands (AbGRI1, 2, and 3). AbGRI1 harbours two copies of Tn2006 containing blaOXA-23, which play an important role in antibiotic resistance. AbGRI2 possesses aminoglycoside resistant gene aph(3')-Ic and class A β-lactamase blaTEM. AbGIR3 has macrolide resistant genes and aminoglycoside resistant gene armA. A. baumannii KAB03 harbours mutations in pmrB and pmrC, which are believed to confer colistin resistance. In addition, proteomic and transcriptional analysis of KAB03 confirmed that β-lactamases (ADC-73 and OXA-23), Ade efflux pumps (AdeIJK), outer membrane proteins (OmpA and OmpW), and colistin resistance genes (PmrCAB) were major proteins responsible for antibiotic resistance. Our proteogenomic results provide valuable information for multi-drug resistance in emerging XDR A. baumannii strains belonging to ST451.
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Lee YS, Choi JW, Park YH, Chung C, Park DI, Lee JE, Lee HS, Moon JY. Evaluation of the efficacy of the National Early Warning Score in predicting in-hospital mortality via the risk stratification. J Crit Care 2018; 47:222-226. [PMID: 30036835 DOI: 10.1016/j.jcrc.2018.07.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/18/2018] [Accepted: 07/13/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the efficacy of the National Early Warning Score (NEWS) in predicting in-hospital mortality. MATERIALS AND METHODS This was a retrospective observational study and the electronic medical records of the patients were reviewed based on NEWS at the time of admission. RESULTS The performance of NEWS was effective in predicting hospital mortality (area under the curve: 0.765; 95% confidence interval: 0.659-0.846). Based on the Kaplan Meier survival curves, the survival time of patients who are at high risk according to NEWS was significantly shorter than that of patients who are at low risk (p < 0.001). Results of the multivariate Cox proportional hazards regression analysis showed that the hazard ratios of patients who are at medium and high risk based on NEWS were 2.6 and 4.7, respectively (p < 0.001). In addition, our study showed that the combination model that used other factors, such as age and diagnosis, was more effective than NEWS alone in predicting hospital mortality (NEWS: 0.765; combination model: 0.861; p < 0.005). CONCLUSIONS NEWS is a simple and useful bedside tool for predicting in-hospital mortality. In addition, the rapid response team must consider other clinical factors as well as screening tools to improve clinical outcomes.
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Jeon MC, Kim JO, Jung SS, Park HS, Lee JE, Moon JY, Chung CU, Kang DH, Park DI. CT-Guided Percutaneous Transthoracic Needle Biopsy Using the Additional Laser Guidance System by a Pulmonologist with 2 Years of Experience in CT-Guided Percutaneous Transthoracic Needle Biopsy. Tuberc Respir Dis (Seoul) 2018; 81:330-338. [PMID: 29926547 PMCID: PMC6148095 DOI: 10.4046/trd.2017.0123] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 01/16/2018] [Accepted: 02/20/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND We developed an additional laser guidance system to improve the efficacy and safety of conventional computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB), and we conducted this study to evaluate the efficacy and safety of our system. METHODS We retrospectively analyzed the medical records of 244 patients who underwent CT-guided PTNB using our additional laser guidance system from July 1, 2015, to January 20, 2016. RESULTS There were nine false-negative results among the 238 total cases. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of our system for diagnosing malignancy were 94.4% (152/161), 100% (77/77), 100% (152/152), 89.5% (77/86), and 96.2% (229/238), respectively. The results of univariate analysis showed that the risk factors for a false-negative result were male sex (p=0.029), a final diagnosis of malignancy (p=0.033), a lesion in the lower lobe (p=0.035), shorter distance from the skin to the target lesion (p=0.003), and shorter distance from the pleura to the target lesion (p=0.006). The overall complication rate was 30.5% (74/243). Pneumothorax, hemoptysis, and hemothorax occurred in 21.8% (53/243), 9.1% (22/243), and 1.6% (4/243) of cases, respectively. CONCLUSION The additional laser guidance system might be a highly economical and efficient method to improve the diagnostic efficacy and safety of conventional CT-guided PTNB even if performed by inexperienced pulmonologists.
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Kang DH, Park DI, Chung C, Moon JY, Park HS, Jung SS, Kim JO, Lee JE. Efficacy of weekly vinorelbine monotherapy in patients with lung adenocarcinoma. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e21157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ito Y, Schury P, Wada M, Arai F, Haba H, Hirayama Y, Ishizawa S, Kaji D, Kimura S, Koura H, MacCormick M, Miyatake H, Moon JY, Morimoto K, Morita K, Mukai M, Murray I, Niwase T, Okada K, Ozawa A, Rosenbusch M, Takamine A, Tanaka T, Watanabe YX, Wollnik H, Yamaki S. First Direct Mass Measurements of Nuclides around Z=100 with a Multireflection Time-of-Flight Mass Spectrograph. PHYSICAL REVIEW LETTERS 2018; 120:152501. [PMID: 29756864 DOI: 10.1103/physrevlett.120.152501] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 02/05/2018] [Indexed: 06/08/2023]
Abstract
The masses of ^{246}Es, ^{251}Fm, and the transfermium nuclei ^{249-252}Md and ^{254}No, produced by hot- and cold-fusion reactions, in the vicinity of the deformed N=152 neutron shell closure, have been directly measured using a multireflection time-of-flight mass spectrograph. The masses of ^{246}Es and ^{249,250,252}Md were measured for the first time. Using the masses of ^{249,250}Md as anchor points for α decay chains, the masses of heavier nuclei, up to ^{261}Bh and ^{266}Mt, were determined. These new masses were compared with theoretical global mass models and demonstrated to be in good agreement with macroscopic-microscopic models in this region. The empirical shell gap parameter δ_{2n} derived from three isotopic masses was updated with the new masses and corroborates the existence of the deformed N=152 neutron shell closure for Md and Lr.
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Yeo MK, Park HS, Park YH, Lee CS, Yoo G, Park DI, Lee JE, Moon JY, Jung SS, Kim JO, Kang D, Cho HJ, Kang MW, Kim JW, Kim SS, Chung C. Expression Pattern of the Hippo Pathway Effector TAZ in Cellular and Fibrotic Nonspecific Interstitial Pneumonia. Chin Med J (Engl) 2018; 131:626-628. [PMID: 29483403 PMCID: PMC5850685 DOI: 10.4103/0366-6999.226059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Kang MC, Kim JH, Ryu SW, Moon JY, Park JH, Park JK, Park JH, Baik HW, Seo JM, Son MW, Song GA, Shin DW, Shin YM, Ahn HY, Yang HK, Yu HC, Yun IJ, Lee JG, Lee JM, Lee JH, Lee TH, Yim H, Jeon HJ, Jung K, Jung MR, Jeong CY, Lim HS, Hong SK. Prevalence of Malnutrition in Hospitalized Patients: a Multicenter Cross-sectional Study. J Korean Med Sci 2018; 33:e10. [PMID: 29215819 PMCID: PMC5729651 DOI: 10.3346/jkms.2018.33.e10] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 10/14/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Malnutrition is associated with many adverse clinical outcomes. The present study aimed to identify the prevalence of malnutrition in hospitalized patients in Korea, evaluate the association between malnutrition and clinical outcomes, and ascertain the risk factors of malnutrition. METHODS A multicenter cross-sectional study was performed with 300 patients recruited from among the patients admitted in 25 hospitals on January 6, 2014. Nutritional status was assessed by using the Subjective Global Assessment (SGA). Demographic characteristics and underlying diseases were compared according to nutritional status. Logistic regression analysis was performed to identify the risk factors of malnutrition. Clinical outcomes such as rate of admission in intensive care units, length of hospital stay, and survival rate were evaluated. RESULTS The prevalence of malnutrition in the hospitalized patients was 22.0%. Old age (≥ 70 years), admission for medical treatment or diagnostic work-up, and underlying pulmonary or oncological disease were associated with malnutrition. Old age and admission for medical treatment or diagnostic work-up were identified to be risk factors of malnutrition in the multivariate analysis. Patients with malnutrition had longer hospital stay (SGA A = 7.63 ± 6.03 days, B = 9.02 ± 9.96 days, and C = 12.18 ± 7.24 days, P = 0.018) and lower 90-day survival rate (SGA A = 97.9%, B = 90.7%, and C = 58.3%, P < 0.001). CONCLUSION Malnutrition was common in hospitalized patients, and resulted in longer hospitalization and associated lower survival rate. The rate of malnutrition tended to be higher when the patient was older than 70 years old or hospitalized for medical treatment or diagnostic work-up compared to elective surgery.
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Lee SM, Kim SJ, Choi YS, Heo DS, Baik S, Choi BM, Kim D, Moon JY, Park SY, Chang YJ, Hwang IC, Kwon JH, Kim SH, Kim YJ, Park J, Ahn HJ, Lee HW, Kwon I, Kim DK, Kim OJ, Yoo SH, Cheong YS, Koh Y. Consensus guidelines for the definition of the end stage of disease and last days of life and criteria for medical judgment. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2018. [DOI: 10.5124/jkma.2018.61.8.509] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Moon JY, Kim MK, Choi YJ, Lee N. Giant Anisotropic Magnetocaloric Effect in Double-perovskite Gd 2CoMnO 6 Single Crystals. Sci Rep 2017; 7:16099. [PMID: 29170464 PMCID: PMC5700970 DOI: 10.1038/s41598-017-16416-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 11/13/2017] [Indexed: 11/24/2022] Open
Abstract
The magnetocaloric effect (MCE) is described by the change in temperature of a material by magnetic field variation and is a crucial subject in magnetism; it is motivated by the desire to enhance energy-efficient magnetic refrigeration for clean technology. Despite the recent discovery of the giant cryogenic MCE in double perovskites, the role of magnetic anisotropy has not yet been clearly discussed, because of the averaging effect of polycrystalline samples. Here, we investigated the anisotropic MCE in the single-crystal double perovskite Gd2CoMnO6. In addition to the ferromagnetic order of the Co2+ and Mn4+ moments, the large Gd3+ moments align below T Gd = 21 K, exhibiting an isotropic nature. Because of the intricate temperature development of magnetically hysteretic behaviour and metamagnetism, the change in magnetic entropy along the c-axis appears to be relatively small. On the contrary, the smaller but almost reversible magnetization perpendicular to the c-axis leads to a large MCE with a maximum entropy change of 25.4 J/kg·K. The anisotropic MCE generates a giant rotational MCE, estimated as 16.6 J/kg·K. Our results demonstrate the importance of magnetic anisotropy for understanding the MCE and reveal essential clues for exploring suitable magnetic refrigerant compounds aiming at magnetic functional applications.
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Kang EY, Jee SJ, Kim CS, Suh KS, Wong AWK, Moon JY. The feasibility study of Computer Cognitive Senior Assessment System-Screen (CoSAS-S) in critically ill patients with sepsis. J Crit Care 2017; 44:128-133. [PMID: 29096231 DOI: 10.1016/j.jcrc.2017.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 09/06/2017] [Accepted: 10/09/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE Early cognitive assessment in the intensive care unit (ICU) is essential to monitor cognitive dysfunction after critical illness. We have implemented a Computer Cognitive Senior Assessment System-Screen (CoSAS-S) which is a brief, objective, and tablet-based cognitive screening test as a mobile platform to detect any cognitive problems in ICUs. This study aimed to evaluate the feasibility and initial validation of a tablet-based CoSAS-S in critically ill patients with sepsis. MATERIALS AND METHODS Thirty-six eligible patients completed CoSAS-S, Mini-Mental State Examination-Korean Version (MMSE-K) and Korean Version of Montreal Cognitive Assessment (K-MoCA) for validity testing at the ICU. RESULTS Eighty-eight percent of programmed assessments were completed by the sample. Spearman correlations of the CoSAS-S with MMSE-K (rho=0.613-0.874, p<0.00) and K-MoCA scores (rho=0.666-0.897, p<0.001) were moderate to high. Intra-class correlation coefficient (ICC) of total CoSAS-S score between two raters was 0.93 (p<0.001; 95% CI=0.82-0.97), suggesting the inter-rater reliability of CoSAS-S was excellent. CONCLUSIONS Support was found for the feasibility and validity of CoSAS-S. The application of CoSAS-S could identify the cognitive functioning of the patients. Utility of CoSAS-S in other clinical populations should be tested.
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Park Y, Ahn JJ, Kang BJ, Lee YS, Ha SO, Min JS, Cho WH, Na SH, Lee DH, Park SY, Hong GH, Kim HJ, Shim S, Kim JH, Lee SJ, Park SY, Moon JY. Rapid Response Systems Reduce In-Hospital Cardiopulmonary Arrest: A Pilot Study and Motivation for a Nationwide Survey. Korean J Crit Care Med 2017; 32:231-239. [PMID: 31723641 PMCID: PMC6786727 DOI: 10.4266/kjccm.2017.00024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 05/03/2017] [Accepted: 05/30/2017] [Indexed: 11/30/2022] Open
Abstract
Background Early recognition of the signs and symptoms of clinical deterioration could diminish the incidence of cardiopulmonary arrest. The present study investigates outcomes with respect to cardiopulmonary arrest rates in institutions with and without rapid response systems (RRSs) and the current level of cardiopulmonary arrest rate in tertiary hospitals. Methods This was a retrospective study based on data from 14 tertiary hospitals. Cardiopulmonary resuscitation (CPR) rate reports were obtained from each hospital to include the number of cardiopulmonary arrest events in adult patients in the general ward, the annual adult admission statistics, and the structure of the RRS if present. Results Hospitals with RRSs showed a statistically significant reduction of the CPR rate between 2013 and 2015 (odds ratio [OR], 0.731; 95% confidence interval [CI], 0.577 to 0.927; P = 0.009). Nevertheless, CPR rates of 2013 and 2015 did not change in hospitals without RRS (OR, 0.988; 95% CI, 0.868 to 1.124; P = 0.854). National university-affiliated hospitals showed less cardiopulmonary arrest rate than private university-affiliated in 2015 (1.92 vs. 2.40; OR, 0.800; 95% CI, 0.702 to 0.912; P = 0.001). High-volume hospitals showed lower cardiopulmonary arrest rates compared with medium-volume hospitals in 2013 (1.76 vs. 2.63; OR, 0.667; 95% CI, 0.577 to 0.772; P < 0.001) and in 2015 (1.55 vs. 3.20; OR, 0.485; 95% CI, 0.428 to 0.550; P < 0.001). Conclusions RRSs may be a feasible option to reduce the CPR rate. The discrepancy in cardiopulmonary arrest rates suggests further research should include a nationwide survey to tease out factors involved in in-hospital cardiopulmonary arrest and differences in outcomes based on hospital characteristics.
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Choi JW, Park YS, Lee YS, Park YH, Chung C, Park DI, Kwon IS, Lee JS, Min NE, Park JE, Yoo SH, Chon GR, Sul YH, Moon JY. The Ability of the Acute Physiology and Chronic Health Evaluation (APACHE) IV Score to Predict Mortality in a Single Tertiary Hospital. Korean J Crit Care Med 2017; 32:275-283. [PMID: 31723646 PMCID: PMC6786733 DOI: 10.4266/kjccm.2016.00990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 04/17/2017] [Accepted: 05/24/2017] [Indexed: 12/16/2022] Open
Abstract
Background The Acute Physiology and Chronic Health Evaluation (APACHE) II model has been widely used in Korea. However, there have been few studies on the APACHE IV model in Korean intensive care units (ICUs). The aim of this study was to compare the ability of APACHE IV and APACHE II in predicting hospital mortality, and to investigate the ability of APACHE IV as a critical care triage criterion. Methods The study was designed as a prospective cohort study. Measurements of discrimination and calibration were performed using the area under the receiver operating characteristic curve (AUROC) and the Hosmer-Lemeshow goodness-of-fit test respectively. We also calculated the standardized mortality ratio (SMR). Results The APACHE IV score, the Charlson Comorbidity index (CCI) score, acute respiratory distress syndrome, and unplanned ICU admissions were independently associated with hospital mortality. The calibration, discrimination, and SMR of APACHE IV were good (H = 7.67, P = 0.465; C = 3.42, P = 0.905; AUROC = 0.759; SMR = 1.00). However, the explanatory power of an APACHE IV score >93 alone on hospital mortality was low at 44.1%. The explanatory power was increased to 53.8% when the hospital mortality was predicted using a model that considers APACHE IV >93 scores, medical admission, and risk factors for CCI >3 coincidentally. However, the discriminative ability of the prediction model was unsatisfactory (C index <0.70). Conclusions The APACHE IV presented good discrimination, calibration, and SMR for hospital mortality.
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