Increased Readmission Risk and Healthcare Cost for Delirium Patients without Immediate Hospitalization in the Emergency Department

I Chun Ma,Kao Chin Chen,Wei Tseng Chen,Hsin Chun Tsai,Chien-Chou Su,Ru-Band Lu,Po See Chen,Wei Hung Chang,Yen Kuang Yang 대한정신약물학회 2018 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.16 No.4

Objective: Hospitalization of patients with delirium after visiting the emergency department (ED) is often required. However, the readmission risk after discharge from the ED should also be considered. This study aimed to explore whether (i) immediate hospitalization influences the readmission risk of patients with delirium; (ii) the readmission risk is affected by various risk factors; and (iii) the healthcare cost differs between groups within 28 days of the first ED visit. Methods: Using the National Health Insurance Research Database, the data of 2,780 subjects presenting with delirium at an ED visit from 2000 to 2008 were examined. The readmission risks of the groups of patients (i.e., patients who were and were not admitted within 24 hours of an ED visit) within 28 days were compared, and the effects of the severities of different comorbidities (using Charlson’s comorbidity index, CCI), age, gender, diagnosis and differences in medical healthcare cost were analyzed. Results: Patients without immediate hospitalization had a higher risk of readmission within 3, 7, 14, or 28 days of discharge from the ED, especially subjects with more severe comorbidities (CCI≥3) or older patients (≥65 years). Subjects with more severe comorbidities or older subjects who were not admitted immediately also incurred a greater healthcare cost for re-hospitalization within the 28-day follow-up period. Conclusion: Patients with delirium with a higher CCI or of a greater age should be carefully considered for immediate hospitalization from ED for further examination in order to reduce the risk of re-hospitalization and cost of healthcare.

Switchable redox activity by proton fuelled DNA nano-machines

Shin, Su Ryon,Lee, Chang Kee,Lee, Sun Hee,Kim, Sun I.,Spinks, Geoffrey M.,Wallace, Gordon G.,So, Insuk,Jeong, Ju-Hong,Kang, Tong Mook,Kim, Seon Royal Society of Chemistry 2009 Chemical communications Vol.2009 No.10

<P>The switching electrochemical property of an SWNT/DNA hybrid can be produced through reversible conformational changes between the closed and open state originating from the pH-responding i-motif DNA which significantly improves its molecular switching and stability by hydrophobic interactions with SWNTs.</P> <P>Graphic Abstract</P><P>The switching electrochemical property of an SWNT/DNA hybrid can be produced through reversible conformational changes between the closed and open state originating from the pH-responding i-motif DNA which significantly improves its molecular switching and stability by hydrophobic interactions with SWNTs. <IMG SRC='http://pubs.rsc.org/services/images/RSCpubs.ePlatform.Service.FreeContent.ImageService.svc/ImageService/image/GA?id=b820634a'> </P>

악교정 수술 후 발생하는 신경회복에 대한 연구Ⅰ

이동근,조이수,민승기,오승환,정창주,이은택 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.2

Dysfunction of the inferior alveolar nerve indicated by various degree of numbness of the lower lip and chin is one of the few drawbacks of mandibular osteotomy, especially Bilateral Sagittal Split Ramus Osteotomy(BSSRO) and genioplasty. Although it has been recorded throughout the history of this techniques, it is true etiology poorly understood. In this study, 22 consecutive patients under class III malocclusiion impression and undergoing orthognathic surgery(BSSRO only 11 case, BSSRO with genioplasty 11 case) were studied using 4 neurosensory test(static light touch, directional discrimination, two-point discrimination, pin pressure nociception) with post OP 1 week, 2 weeks,4 weeks, 8 weeks, 12 weeks, 24 weeks, On control group, 10 members without trauma and nerve damage history, nerve test was accomplished. We concluded majority of patients return of sensation during post operative 24 weeks. Althought immediate nerve deficit are 92.2%, 97.2% 88.9% these are recovered to 25%, 35.72%, 10.71% at 24 weeks. Nerve recovery rate increased prominently between post 4 weeks and 8 weeks. There is no statistically difference about neurosensory deficit among the chin area. Neurosensory deficit more severe when the BSSRO with genioplasty group than the only BSSRO group. Immediate neurosensory deficit is larger left side than right side but after 6 months, there is no significantly difference between left side and right side. Static light touch and pin pressure nociception are more sensitive method of neurosensory deficit than two point discrimination.

The Peculiar Response of DNA Hydrogel Fibers to a Salt and pH Stimulus

Lee, Sun Hee,Lee, Chang Kee,Shin, Su Ryon,Kim, Sun I.,So, Insuk,Kim, Seon Jeong WILEY-VCH Verlag 2009 Macromolecular Rapid Communications Vol.30 No.6

<P>DNA hydrogels which are composed of an entangled network without a crosslinker are synthesized and examined in regards to their sensitivity to salt and pH changes. The DNA hydrogel fibers only exhibited a marked response – that is a fast and large change in length – under biological conditions ([Na<SUP>+</SUP>] = 0.15 M at pH = 7) and are therefore suitable materials for bio-inspired devices.</P><P> <img src='wiley_img/10221336-2009-30-6-MARC200800677-gra001.gif' alt='wiley_img/10221336-2009-30-6-MARC200800677-gra001'> </P>

홈 네트워크를 위한 자동화된 사용자 인증 메커니즘

이창욱(Chang-Uk I),이형수(Hyung-Su Lee),장훈(Hoon Chang),김석윤(Seok-Yoon Kim) 한국컴퓨터정보학회 2009 한국컴퓨터정보학회 학술발표논문집 Vol.16 No.2

본 논문에서는 홈 네트워크 환경을 위하여 다양한 정보가전들에 서비스를 제공하고 운용하기 위해 OSGi 프레임워크를 이용하여 게이트웨이를 구성하였다. 홈 네트워크의 특성상 네트워크를 구성하는 정보가전들의 입력 수단에 대한 제약이 많고 자원이 한정적이다. 따라서 이러한 문제를 해결하기 위해 사용자에게 패스워드를 입력받지 않고 자동으로 인증 과정을 마치는 인증 메커니즘을 연구하였다. 패스워드를 입력받지 않음으로써 사용자 입력 대기 시간을 줄일 수 있고, 대칭키를 이용하여 암호화 과정의 연산량을 줄여 소규모로 구성되는 흠 네트워크 구조에 효율적으로 적용할 수 있었다.

Ginsenoside Rg1 supplementation clears senescence-associated β-galactosidase in exercising human skeletal muscle

Jinfu Wu,Suchada Saovieng,I-Shiung Cheng,Tiemin Liu,Shangyu Hong,Chang-Yu Lin,I-Chen Su,Chih-Yang Huang,Chia-Hua Kuo 고려인삼학회 2019 Journal of Ginseng Research Vol.43 No.4

Background: Ginsenoside Rg1 has been shown to clear senescence-associated beta-galactosidase (SA-β-gal) in cultured cells. It remains unknown whether Rg1 can influence SA-β-gal in exercising human skeletal muscle. Methods: To examine SA-β-gal change, 12 young men (age 21±0.2 years) were enrolled in a randomized double-blind placebo controlled crossover study, under two occasions: placebo (PLA) and Rg1 (5 mg) supplementations 1 h prior to a high-intensity cycling (70% VO2max). Muscle samples were collected by multiple biopsies before and after cycling exercise (0 h and 3 h). To avoid potential effect of muscle biopsy on performance assessment, cycling time to exhaustion test (80% VO2max) was conducted on another 12 participants (age 23±0.5 years) with the same experimental design. Results: No changes of SA-β-gal were observed after cycling in the PLA trial. On the contrary, nine of the 12 participants showed complete elimination of SA-β-gal in exercised muscle after cycling in the Rg1 trial (p < 0.05). Increases in apoptotic DNA fragmentation (PLA: +87% vs. Rg1: +133%, p < 0.05) and CD68+(PLA:+78% vs. Rg1:+121%, p=0.17) occurred immediately after cycling in both trials. During the 3-h recovery, reverses in apoptotic nuclei content (PLA:+5% vs. Rg1:-32%, p<0.01) and increases in inducible nitrate oxide synthase and interleukin 6 mRNA levels of exercised muscle were observed only in the Rg1 trial (p < 0.01). Conclusion: Rg1 supplementation effectively eliminates senescent cells in exercising human skeletal muscle and improves high-intensity endurance performance.

Ginsenoside Rg1 supplementation clears senescence-associated β-galactosidase in exercising human skeletal muscle

Wu, Jinfu,Saovieng, Suchada,Cheng, I-Shiung,Liu, Tiemin,Hong, Shangyu,Lin, Chang-Yu,Su, I-Chen,Huang, Chih-Yang,Kuo, Chia-Hua The Korean Society of Ginseng 2019 Journal of Ginseng Research Vol.43 No.4

Background: Ginsenoside Rg1 has been shown to clear senescence-associated beta-galactosidase (SA-${\beta}$-gal) in cultured cells. It remains unknown whether Rg1 can influence SA-${\beta}$-gal in exercising human skeletal muscle. Methods: To examine SA-${\beta}$-gal change, 12 young men (age $21{\pm}0.2years$) were enrolled in a randomized double-blind placebo controlled crossover study, under two occasions: placebo (PLA) and Rg1 (5 mg) supplementations 1 h prior to a high-intensity cycling (70% $VO_{2max}$). Muscle samples were collected by multiple biopsies before and after cycling exercise (0 h and 3 h). To avoid potential effect of muscle biopsy on performance assessment, cycling time to exhaustion test (80% $VO_{2max}$) was conducted on another 12 participants (age $23{\pm}0.5years$) with the same experimental design. Results: No changes of SA-${\beta}$-gal were observed after cycling in the PLA trial. On the contrary, nine of the 12 participants showed complete elimination of SA-${\beta}$-gal in exercised muscle after cycling in the Rg1 trial (p < 0.05). Increases in apoptotic DNA fragmentation (PLA: +87% vs. Rg1: +133%, p < 0.05) and $CD68^+$ (PLA:+78% vs. Rg1:+121%, p = 0.17) occurred immediately after cycling in both trials. During the 3-h recovery, reverses in apoptotic nuclei content (PLA:+5% vs. Rg1 -32%, p < 0.01) and increases in inducible nitrate oxide synthase and interleukin 6 mRNA levels of exercised muscle were observed only in the Rg1 trial (p < 0.01). Conclusion: Rg1 supplementation effectively eliminates senescent cells in exercising human skeletal muscle and improves high-intensity endurance performance.

Photoinduced Electron Tansfer of Microperoxidase-8

Su, Chien-Hua,Lin, Ren-Jay,Chang, I-Jy Korean Society of Photoscience 1999 Journal of Photosciences Vol.6 No.3

Microperoxidase 8 (MP8) has been prepared by sequential hydrolysis of cytochrome C by pepsin and trypsin. This five-coordinated heme-octapetide fragment provides a uniques structure to evaluate the electronic coupling efficiency to the iron through axial position and porphyrin edge. At alkali pH, Ru(bpy)2(im)22+ is completely quenched in AcMP8Ru complex . Transient kinetics measurement showed the decay rate to be ~1 $\times$1012S-1. Ruthenium bipyridine complex with a carboxyl group substituted bipyridine has been prepared adn reacted with MR 8 to yield N-terminus bound RuMP8 complex. The luminescence decay rate has been measured as 1 $\times$109S-1. By using semiclassical electron transfer theory, we found the electron transfer efficiency through axial positioin of iron prophyrin is as good through prophyrin edge.

The Surgical Outcome for Patients with Tracheobronchial Injury in Blunt Group and Penetrating Group

( Chang Wan Kim ),( Jung Joo Hwang ),( Hyun Min Cho ),( Jeong Su Cho ),( Ho Seok I ),( Yeong Dae Kim ),( Do Hyung Kim ) 대한외상학회 2016 大韓外傷學會誌 Vol.29 No.1

Purpose: Tracheobronchial injuries caused by trauma are rare, but can be life threatening. The objective of this study was to evaluate the surgical outcome for patients with tracheobronchial injuries and to determine the difference, if any, between the outcomes for patients with penetrating trauma and those for patients with blunt trauma. Methods: From January 2010 to June 2015, 40 patients underwent tracheobronchial repair surgery due to trauma. We excluded 14 patients with iatrogenic injuries, and divided the remaining 26 into two groups. Results: In the blunt trauma group, injury mechanisms were motor vehicle accident (9 cases), free falls (3 cases), flat falls (1 case) and mechanical injury (1 case). In the penetrating trauma group, injury mechanisms were stab wounds (10 cases), a gunshot wound (1 case) and a stab wound caused by metal pieces (1 case). The mean RTS (Revised Trauma Score) was 6.89±1.59 (range: 2.40-7.84) and the mean ISS (Injury Severity Score) was 24.36±7.16 (range: 11-34) in the blunt group; the mean RTS was 7.56±0.41 (range: 7.11-7.84), and the mean ISS was 13±5.26 (range: 9-25) in the penetrating trauma group. In the blunt trauma group, 9 primary repairs, 1 resection with end-end anastomosis, 2 lobectomies, 1 sleeve bronchial resection and 1 pneumonectomy were performed. In the penetrating trauma group, 10 primary repairs and 2 resections with end-end anastomosis were performed. Complications associated with surgery were found in one patient in the blunt trauma group, and one patient in the penetrating trauma group. No mortalities occurred in either groups. Conclusion: Surgical management of a traumatic tracheobronchial injury is a safe procedure for both patients with a penetrating trauma and those with a blunt trauma. [ J Trauma Inj 2016; 29: 1-7 ]

The Immunotyping Distribution of Serum Monoclonal Paraprotein and Environmental Impact on Multiple Myeloma (MM) and Monoclonal Gammopathy of Uncertain Significance (MGUS) in Taiwan: A Medical Center-Based Experience

Chang, Chih-Chun,Su, Ming-Jang,Lee, Shu-Jene,Tsai, Yu-Hui,Kuo, Lin-Yin,Lin, I-Hsin,Huang, Hui-Ling,Yen, Tzung-Hai,Chu, Fang-Yeh Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.1

Background: Whether ambient exposure to environmental pollutants leads to hematopoietic malignancies such as multiple myeloma (MM) remains to be ascertained. Therefore, we aimed to investigate the immunotyping distribution of serum monoclonal paraprotein and the environmental influence on MM and monoclonal gammopathy of uncertain significance (MGUS) in the Taiwanese population. Materials and Methods: Serum protein electrophoresis with immunosubtraction by the capillary zone electrophoresis method was performed as primary screening for MM and MGUS. Clinical, pathological, and residence data of patients were also obtained. Results: From August, 2013 to June, 2015, a total of 327 patients underwent serum protein electrophoresis with immunosubtraction. Among these, 281 demonstrated no remarkable findings or non-malignant oligoclonal gammopathy, 23 were detected to have MGUS, 18 were identified as MM, and a further 5 were found as other malignancies. The most frequent immunotyping distribution of serum monoclonal paraprotein was IgG kappa (54.3%, n=25), followed by IgA lambda (15.2%, n=7) and IgG lambda (10.9%, n=5) in subjects with gammopathy. Additionally, it was shown that the elderly (OR: 4.61, 95% CI: 1.88-11.30, P<0.01) and males (OR: 2.04, 95% CI: 1.04-4.02, P=0.04) had significantly higher risk of developing MM and MGUS. There was no obvious impact of environmental factors on the health risk of MM and MGUS evolution (OR: 0.77, 95% CI: 0.40-1.50, P=0.49). Conclusions: The most frequent immunotyping distribution of serum monoclonal paraprotein included IgG kappa, IgA lambda and IgG lambda in MM and MGUS in the Taiwanese population. The elderly and male subjects are at significantly higher risk of MM and MGUS development, but there was no obvious impact of environmental factors on risk.