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Background/Aims: Percutaneous endoscopic gastrostomy (PEG) is a method of providing enteral nutrition using endoscopy. The PEG techniques differ according to the insertion method, and include the pull type, push type, and introducer type. The aim of this study was to compare the clinical outcomes associated with the pull-type and introducer-type PEG insertion techniques, which included the adverse events, at our tertiary care center in Korea. Methods: We retrospectively reviewed 141 cases that had undergone PEG insertion at our center from January 2009 to June 2012. The indications for PEG insertion and the acute and chronic complications caused by each type of PEG insertion were analyzed. Results: The indications for PEG insertion in our cohort included neurologic disease (58.7%), malignancy (21.7%), and other indications (19.6%). Successful PEG insertions were performed on 136 cases (96.5%), and there were no PEG-associated deaths. Bleeding was the most frequent acute complication (12.8%), and wound problems were the most frequent chronic complications (8.8%). There were no statistically significant differences between the pull-type and introducer-type PEG insertion techniques in relation to complication rates in our study population. Conclusions: PEG insertion is considered a safe procedure. The pull-type and introducer-type PEG insertion techniques produce comparable outcomes, and physicians may choose either of these approaches according to the circumstances.
Since the introduction of highly active antiretroviral therapy, the life span of people with human immunodeficiency virus (HIV) or AIDS (PWHA) has been extended significantly. Therefore, the importance of non-AIDS-defining cancers (NADCs), as well as AIDS-defining cancers (ADCs) has increased. There is little information concerning the epidemiology of malignancies in PWHA in Korea. A descriptive epidemiologic study was conducted at a tertiary care hospital in Korea. PWHA who visited Pusan National University Hospital from January 2000 to October 2014 were included. Demographics and clinical data were obtained from the medical records and analyzed. A total of 950 PWHA were observed for 4,439.71 person-years. Forty-eight episodes (5.05%) of cancers were diagnosed in 47 patients. Mean age of the enrolled patients was 40.66 ± 12.15 years and 88% were male. Among the 48 cancer episodes, 20 (42%) were ADCs and 28 were NADCs. The most common ADCs was non-Hodgkin's lymphoma (53.6%), followed by Kaposi's sarcoma (17.9%). The most common NADCs were lung cancer (25%) and hepatocellular carcinoma (25%). The overall incidence of total cancers, ADCs, and NADCs was 10.8 (95% confidence interval [CI], 8.0–14.3), 4.5 (95% CI, 2.8–7.0), and 6.3 (95% CI, 4.2–9.1)/1,000 person-years, respectively. NADCs accounted for 12/15 (80%) of cancers among PWHA with good adherence to care. The 5-year survival rate of PWHA and NADC was 26.3%. NADCs have become the main type of malignancy among Korean PWHA with good adherence to care. Effective strategies to improve screening of NADCs among PWHA are required in Korea.
Toxic shock syndrome is an acute, multi-systemic, toxin-mediated illness caused by toxin-producing strains of Staphylococcus aureus and Streptococcus species. Streptococcal toxic shock syndrome is usually caused by Streptococcus pyogenes but Group G streptococcal toxic shock syndrome is rare. Herein, we report a case of group G streptococcal toxic shock syndrome that was successfully treated with toxin reducing antibiotics and intravenous immunoglobulin therapies.
Fast and high-quality document clustering algorithms play an important role in providing data exploration by organizing large amounts of information into a small number of meaningful clusters. Many papers have shown that the hierarchical clustering method takes good-performance, but is limited because of its quadratic time complexity. In contrast, with a large number of variables, K-means has a time complexity that is linear in the number of documents, but is thought to produce inferior clusters. In this paper, Condor system using K-Means algorithm Compares with regular method that the initial centroids have been established in advance, our method performance has been improved a lot. 정보통신의 기술이 발달하면서 정보의 양이 많아지고 사용자의 질의에 대한 검색 결과 리스트도 많이 추출되므로 빠르고 고품질의 문서 클러스터링 알고리즘이 중요한 역할을 하고 있다. 많은 논문들이 계층적 클러스터링 방법을 이용하여 좋은 성능을 보이지만 시간이 많이 소요된다. 반면 K-means 알고리즘은 시간 복잡도를 줄일 수 있는 방법이다. 본 논문에서는 계층적 클러스터링 시스템인 콘도르(Condor) 시스템에서 간단하고 고품질이며 효율적으로 정보 검색 할 수 있도록 구현하였다. 이 시스템은 K-Means Algorithm을 이용하였으며 클러스터 계층 깊이와 초기값을 조절하여 88%의 정확율을 보였다.
본 논문에서는 능동형 샤시 시스템이 정착된 차량의 안정성(Stability), 조종성(Handling) 및 승차감(Ridecomfort)을 향상시키기 위한 새로운 통합제어기를 설계한다. 하이브리드 퍼지논리 제어기는 퍼지논리 제어기, 스카이 훅 제어기, 자세 제어기 및 롤 모멘트 분포 제어기로 이루어지며, 차량의 주행상태에 기초한 통합제어로직을 이용하여 위와 같은 제어기들을 적절히 결합시켜 사용한다. 또한 MATRIXx/SYSTEMBBUILD 소프트웨어를 이용하여 16자유도 차량모델에 대하여 시뮬레이션을 수행함으로써 차량의 승차감, 조종성 및 능동적 안전도가 향상됨을 확인한다. In this paper, a novel type of an integrated controller is designed for vehicles equipped with active classis systems to improve vehicle stability, handling, and ride comfort. The hybrid fuzzy logic controller consists of a fuzzy logic controller, a skyhook controller, an attitude controller, and a roll moment distribution controller, and these controllers are used with a proper combination which is determined by the integrated control logic based on driving conditions of a vehicle. It is shown by simulations using MATRIXx/SYSTEMBBUILD software that ride comfort, handling, and active safety are improved for a 16 degree-of-freedom vehicle dynamic model.
Successful tuberculosis control depends on good adherence to treatment. Yet, limited data are available on the efficacy of methods for improving the adherence of patients of low socioeconomic status. We evaluated the impact of physician-provided patient education on adherence to anti-tuberculosis medication in a low socioeconomic status and resource-limited setting. A pre-/post-intervention study was conducted at a suburban primary health care clinic in Bangladesh where an intensive education strategy was established in May 2006. Treatment outcomes of tuberculosis patients from March 2005 to April 2006 (pre-intervention) and from May 2006 to December 2007 (post-intervention)were compared. Among 354 patients, 198 (56%) were treated before intervention and 156 (44%) were treated after intervention. Cumulative adherence to anti-tuberculosis medication was significantly greater in the intervention group than in the control group in univariate and multivariate analyses. Physician’s education can contribute to increasing the adherence of patients in resource-limited settings.