Abstract:
PURPOSE:Owing to the recommendations of the Surviving Sepsis Campaign guidelines, protocol-based resuscitation or goal-directed therapy (GDT) is broadly advocated for the treatment of septic shock. However, the most recently published trials showed no survival benefit from protocol-based resuscitation in septic shock patients. Hence, we aimed to assess the effect of GDT on clinical outcomes in such patients. MATERIALS AND METHODS:We performed a systematic review that included a meta-analysis. We used electronic search engines including PubMed, Embase, and the Cochrane database to find studies comparing protocol-based GDT to common or standard care in patients with septic shock and severe sepsis. RESULTS:A total of 13269 septic shock patients in 24 studies were included [12 randomized controlled trials (RCTs) and 12 observational studies]. The overall mortality odds ratio (OR) [95% confidence interval (CI)] for GDT versus conventional care was 0.746 (0.631-0.883). In RCTs only, the mortality OR (95% CI) for GDT versus conventional care in the meta-analysis was 0.93 (0.75-1.16). The beneficial effect of GDT decreased as more recent studies were added in an alternative, cumulative meta-analysis. No significant publication bias was found. CONCLUSION:The result of this meta-analysis suggests that GDT reduces mortality in patients with severe sepsis or septic shock. However, our cumulative meta-analysis revealed that the reduction of mortality risk was diminished as more recent studies were added.
journal_name
Yonsei Med Jjournal_title
Yonsei medical journalauthors
Lee WK,Kim HY,Lee J,Koh SO,Kim JM,Na Sdoi
10.3349/ymj.2016.57.5.1260subject
Has Abstractpub_date
2016-09-01 00:00:00pages
1260-70issue
5eissn
0513-5796issn
1976-2437pii
57.1260journal_volume
57pub_type
杂志文章,meta分析abstract::We report three cases of solitary rectal ulcer syndrome (SRUS). The diagnosis was established according to histopathologic criteria. But, the initial clinical diagnosis was carcinoma, non-specific ulcer and localized proctitis respectively. SRUS is considered as one of functional disorder in pelvic floor which might g...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.1994.35.2.223
更新日期:1994-06-01 00:00:00
abstract:PURPOSE:Massive blood transfusios are uncommon. The goal of this study was to propose an ideal ratio for the blood component of massive hemorrhage treatment after review of five years of massive transfusion practice, in order to have the best possible clinical outcomes. MATERIALS AND METHODS:We defined a 'massive tran...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2011.52.3.469
更新日期:2011-05-01 00:00:00
abstract::Axotomy of the vagal motor neurons by cervical vagotomy induces NADPH diaphorase staining due to increased nitric oxide synthase expression in both the rat dorsal motor nucleus and nucleus ambiguous; furthermore, cerical vagotomy leads to cell death of the dorsal motor nucleus cells. Subdiaphragmatic vagotomy axotomiz...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2001.42.2.215
更新日期:2001-04-01 00:00:00
abstract:PURPOSE:This study aimed to evaluate the correlation between associating factors of moderate to severe asthma with obstructive sleep apnea (OSA). MATERIALS AND METHODS:One hundred and sixty-seven patients who visited the pulmonary and sleep clinic in Severance Hospital presenting with symptoms of sleep-disordered brea...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2013.54.4.942
更新日期:2013-07-01 00:00:00
abstract:PURPOSE:Pouch dilatation and band slippage are the most common long-term complications after laparoscopic adjustable gastric banding (LAGB). The aim of the study is to present our experience of diagnosis and management of these complications. MATERIALS AND METHODS:The pars flaccida technique with anterior fixation of ...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2014.55.1.149
更新日期:2014-01-01 00:00:00
abstract::Familial Mediterranean fever (FMF) is an auto-inflammatory disease characterized by periodic episodes of fever and recurrent polyserositis. It is caused by a dysfunction of pyrin (or marenostrin) as a result of a mutation within the MEFV gene. It occurs mostly in individuals of Mediterranean origin; however, it has al...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2012.53.2.454
更新日期:2012-03-01 00:00:00
abstract::Transhiatal gastric transposition was performed in a long gap esophageal atresia without tracheoesophageal fistula. The patient was a 12 months old female infant with previous stamm-type gastrostomy. The stomach was mobilized preserving the right gastric artery, the right gastroepiploic artery and spleen. The proximal...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.1995.36.1.89
更新日期:1995-03-01 00:00:00
abstract::Contribution of histamine H1- and H2-receptors to the effect of compound 48/80, a potent histamine releaser, upon asphyxiation and body temperature in mice was investigated in the present experiments. Compound 48/80 showed an apparent protective potency against hypoxia and significantly prolonged the latencies for con...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.1996.37.2.97
更新日期:1996-04-01 00:00:00
abstract:PURPOSE:Tenofovir disoproxil fumarate (TDF) is commonly prescribed as a fixed-dose, co-formulated antiretroviral drug for HIV-1 infection. The major concern of long-term TDF use is renal dysfunction. However, little is known about the long-term patterns of changes in renal function in HIV-infected Koreans receiving TDF...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2017.58.4.770
更新日期:2017-07-01 00:00:00
abstract:PURPOSE:Pathogenesis and treatment of spontaneous dissecting aneurysm of the intracranial vertebral artery (VA) remain controversial. This study was designed to provide management strategies and to improve management outcome in patients with these aneurysms. MATERIALS AND METHODS:Among a total of 1,990 patients treate...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2007.48.3.425
更新日期:2007-06-30 00:00:00
abstract::A 50-year-old peri-menopausal woman presented with hard palpable mass on her lower abdomen and anemia from heavy menstrual bleeding. Ultrasonography showed a 13×12 cm sized hypoechoic solid mass in pelvis and a 2.5×2 cm hypoechoic cystic mass in uterine endometrium. Abdomino-pelvic computed tomography revealed a hypod...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2016.57.2.523
更新日期:2016-03-01 00:00:00
abstract::The clinicopathological features of 9 cases of Kimura's disease and 5 cases of epithelioid hemangioma(EH) were reviewed. Patients with Kimura's disease presented with multiple or solitary large tumors occurring in the thigh, arms as well as parotid gland. Histologically, the lesions were characterized by numerous lymp...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.1990.31.3.205
更新日期:1990-09-01 00:00:00
abstract:PURPOSE:Curative surgery for patients with advanced or even early gastric cancer can be defined as resection of the stomach and dissection of the first and second level lymph nodes, including the greater omentum. The aim of this study was to evaluate the short- and long- term outcomes of partial omentectomy (PO) as com...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2011.52.6.961
更新日期:2011-11-01 00:00:00
abstract::This study was performed to investigate the effect of peritoneal glucose load on plasma leptin concentrations in the continuous ambulatory peritoneal dialysis (CAPD) performed on 13 non-diabetic ESRD patients. Plasma leptin and insulin concentrations were measured for 2 hours during a single 2 liter exchange of 1.5% g...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2000.41.4.485
更新日期:2000-08-01 00:00:00
abstract:PURPOSE:To report long term treatment outcomes of osteofibrous dysplasia and association with adamantinoma. PATIENTS AND METHODS:From January 1984 to July 2001, 14 patients with osteofibrous dysplasia were followed for an average of 108 months (78 to 260 months). Our patient group consisted of 6 men and 8 women, with ...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2007.48.3.502
更新日期:2007-06-30 00:00:00
abstract:PURPOSE:The clinical usefulness of subcutaneous allergen immunotherapy (SCIT) in the treatment of atopic dermatitis (AD) is still controversial. We analyzed the clinical efficacy of SCIT in patients with AD and the clinical characteristics of patients showing a favorable clinical response to the treatment. MATERIALS A...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2016.57.6.1420
更新日期:2016-11-01 00:00:00
abstract:PURPOSE:To describe the therapeutic effect and possibility of the ultra-early surgery for poor-grade aneurysmal subarachnoid hemorrhage (Hunt-Hess grades IV-V). MATERIALS AND METHODS:Nine cases with intracranial aneurysms, demonstrated by computed tomographic angiography (CTA), were treated by ultra-early surgery unde...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2009.50.4.521
更新日期:2009-08-31 00:00:00
abstract:PURPOSE:High mobility group box 1 (HMGB1) plays a central role in the pathogenesis of sepsis and multiple organ dysfunction syndromes. We investigated the associations of a single nucleotide polymorphism (SNP; rs1045411) in HMGB1 with various clinical parameters, severity, and prognosis in patients with sepsis, severe ...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2016.57.1.111
更新日期:2016-01-01 00:00:00
abstract::Steroid cell tumors, not otherwise specified (NOS), are rare ovarian sex cord-stromal tumors with malignant potential. The majority of these tumors produce several steroids, particularly testosterone. Various virilizing symptoms such as hirsutism, temporal balding, and amenorrhea are common in these patients; however ...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2007.48.1.142
更新日期:2007-02-28 00:00:00
abstract::A 44-year-old woman underwent surgery for an asymptomatic primary tumor of the heart located in the right atrium. The tumor was detected incidentally during follow-up computed tomography for a resected breast cancer. The mass, lying along the lower portion of the right atrial septum, was homogenous and cystic in natur...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2007.48.6.1043
更新日期:2007-12-31 00:00:00
abstract:PURPOSE:To evaluate the clinicopathological characteristics and prognosis of localized resectable genitourinary sarcomas in adults. MATERIALS AND METHODS:Between September, 1996 and November, 2008, 18 consecutive cases of adults (12 men and 6 women; median age 48.8 years) who were treated for primary genitourinary sar...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2011.52.5.761
更新日期:2011-09-01 00:00:00
abstract::We report the sonographic features of an intracystic papillary carcinoma of the breast presenting as recurrent hemorrhagic cysts following trauma. A 56-year-old woman presented with palpable breast masses after a traumatic event; sonography showed multiple, well-defined, hemorrhagic cysts. Hemorrhagic fluid was evacua...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2006.47.4.575
更新日期:2006-08-31 00:00:00
abstract:PURPOSE:Although follicular thyroid cancer (FTC) has a relatively fair prognosis, distant metastasis sometimes results in poor prognosis and survival. There is little understanding of the mechanisms contributing to the aggressiveness potential of thyroid cancer. We showed that hypoxia inducible factor-1α (HIF-1α) induc...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2015.56.6.1503
更新日期:2015-11-01 00:00:00
abstract::The spinal motonucleus of the genitofemoral nerve regulating scrotal temperature can also be related to prenatal and neonatal testicular descent by gubernacular change in rats, and a sexually dimorphic-like bulbocavernosus/dorsolateral motonucleus. There is a hypothesis that neonatal androgen affects these motonuclei,...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.1998.39.1.13
更新日期:1998-02-01 00:00:00
abstract:PURPOSE:We developed a numerical model that predicts cardiovascular system response to hemodialysis, focusing on the effect of sodium profile during treatment. MATERIALS AND METHODS:The model consists of a 2-compartment solute kinetics model, 3-compartment body fluid model, and 12-lumped-parameter representation of th...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2008.49.4.581
更新日期:2008-08-30 00:00:00
abstract::Pathogenic bacteria have increasingly been resisting to antimicrobial therapy. Recently, resistance problem has been relatively much worsened in Gram-negative bacilli. Acinetobacter spp. are typical nosocomial pathogens causing infections and high mortality, almost exclusively in compromised hospital patients. Acineto...
journal_title:Yonsei medical journal
pub_type: 杂志文章,评审
doi:10.3349/ymj.2011.52.6.879
更新日期:2011-11-01 00:00:00
abstract:PURPOSE:Pharmacological inhibition of mutant isocitrate dehydrogenase (IDH) reduces R-2-hydroxyglutarate (2-HG) levels and restores cellular differentiation in vivo and in vitro. The IDH2 inhibitor enasidenib (AG-221) has been approved by the FDA as a first-in-class inhibitor for the treatment of relapsed or refractory...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2020.61.9.762
更新日期:2020-09-01 00:00:00
abstract::Effects of a platelet-released, naturally occurring nucleotide, adenosine 5'-tetraphosphate (ATPP) on vascular tone were analyzed in the isolated rat aorta. Under resting tension ATPP (1 approximately 100 microM) elicited concentration-dependent contractions in endothelium-intact aortic rings in contrast to the concen...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.1995.36.6.487
更新日期:1995-12-01 00:00:00
abstract::Sarcoma of the kidney is a rare condition. Leiomyosarcoma is the most common of the kidney sarcomas. Renal leiomyosarcoma usually originates from the smooth muscle layers of the kidney, for example, the renal capsule and renal vessels. Renal pelvis neoplasms, however, are primarily transitional cell carcinomas, and re...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2007.48.3.557
更新日期:2007-06-30 00:00:00
abstract:PURPOSE:Long non-coding RNA taurine upregulated gene 1 (TUG1) is reported to be a vital regulator of the progression of various cancers. This study aimed to explore the exact roles and molecular mechanisms of TUG1 in osteosarcoma (OS) development. MATERIALS AND METHODS:Real-time quantitative PCR was applied to detect ...
journal_title:Yonsei medical journal
pub_type: 杂志文章
doi:10.3349/ymj.2018.59.2.226
更新日期:2018-03-01 00:00:00