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The Factors Influencing Survival of Out-of-hospital Cardiac Arrest with Cardiac Etiology (병원 밖에서 발생한 심인성 심장정지환자의 생존 관련 요인 7년간 국가심장정지조사사업 자료 활용)

  • Jeong, Su-Yeon;Kim, Chul-Woung;Hong, Sung-Ok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.560-569
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    • 2016
  • Purpose The purpose of this study was not only to explore the factors associated with the survival of OHCA(Out-of-hospital Cardiac Arrest), but to provide ideas for improving the operation of emergency medical system in Korea. Method 90,734 OHCAs(Out-of-hospital Cardiac Arrest) with a cardiac etiology, who had been transported by 119 EMS ambulances for seven years from 2006 to 2012 in Korea, were analyzed. The data had a multilevel structure in that patient's survival in the same region is interrelated, so two-level (patient-region) logistic regression analysis was applied to adjust this correlation. Results The adjusted OR in group who were given CPR(Cardiopulmonary Resuscitation) by a bystander were 1.40 for survival to discharge. In addition, the adjusted OR in the group with an implementation of AED (automated external defibrillator) before arriving in hospital was 2.98 for survival to discharge. we categorized some continuous variables (number of emergency physician, OHCAs volume fo hospital, area deprivation level) into five quintiles. The adjusted OR in the number of emergency physician compared with Q1(lowest) was 1.29(Q2), 2.89(Q3), 3.39(Q4), 4.07(Q5), respectively. the adjusted OR in OHCAs volume of each hospital compared with Q1(lowest) was 2.06(Q2), 3.06(Q3), 3.46(Q4), 4.36(Q5), respectively. Lastly, the adjusted OR in deprivation level compared with Q1(least deprived area) was 0.72(Q4), 0.64(Q5) so that the adjusted OR of survival to discharge tended to decrease in more deprived districts. Conclusion The survival to discharge was better significantly in group given CPR by a bystander and with the implementation of AED before arriving in hospital. The survival to discharge tended to be significantly better in hospitals with a larger number of emergency physicians and higher volume of OHCAs in less deprived districts.

Effects of Germanium-fortified Yeast on the Serum Lipids and Immune Cell Subset (게르마늄강화효모가 혈청지질 및 면역세포변화에 미치는 영향)

  • Lee, Sung-Hee;Oh, Sun-Woo;Rho, Sook-Nyung;Lee, Bog-Hieu;Lee, Hyun-Joo;Jin, Dong-Kyu
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.35 no.6
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    • pp.683-689
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    • 2006
  • This study was established to investigate the effect of germanium-fortified yeasts on the serum lipid composition and immune system of human body. All 50 subjects with the age range of $50{\sim}75$ were entered in this clinical trial for 6 months. The effects were determined by the proliferative responses of immune-mediated cells, T-cell, B-cell and NK-cell during daily supplementation with/without germanium-fortified yeast. The results of hematology and blood chemistry didn't show any significant differences during administration periods. Serum lipid compositions also didn't show any significant differences during administration periods except triglyceride (TG) and VLDL-cholesterol. TG and VLDL-cholesterol levels were increased significantly by the consumption of germanium-fortified yeast (p<0.05). Immune mediated T-celt and NK-cell didn't increased in both control and test group supplemented with germanium fortified yeast, while B-cell increased in the germanium fortified yeast group after 8 week (p<0.05). Also $TNF-{\alpha}$ increased in the group of germanium fortified yeast after 8 week (p<0.05) but not in the control group. From the above results, germanium fortified yeast is expected to be useful on the improvement of the cellular immune response and protection of organs from various chronic diseases.

A Basie Health Survey of the Yonsei Community Health Service Area, Seoul (연세지역(延世地域)에 대(對)한 보건기초조사(保健基礎調査))

  • Yang, Jae-Mo;Kim, Myung-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.1 no.1
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    • pp.25-36
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    • 1968
  • Introduction In order to improve medical education through the introduction of a concept of comprehensive health care of a community, an area surrounding the University Campus was chosen for the Community Health Service Project. It has been on operation for last 4 years with its major emphasis on family planning services, and maternal and child health care. The major objectives of this survey at the area are to obtain: 1) The demographic data, 2) The health need and trend of medical care, 3) The attitude and practice in maternity care to be used for further improvement of the planning and the services of the project. Population and Survey Method Out of three Dongs of the Community Health Service Area, only two Dongs namely Changchun and Yonhee were selected for the survey. Total number of households and population in the area studied was 3,683 and 21,857 respectively. An interview was performed with questionnaire schedule which was recorded by interviewers. This includes the degree of utilization of health services provided by the Community Health Service Program such as family planning, prenatal care during their last pregnancy, delivery history and complications of the delivery as well as the incidence of illnesses in general. Prior to the interview, all interviewers were trained for interviewing technique for two days. The survey was carried out during the period from October December 1967. Results 1) Demographic Data : 41.3% of the population studied were children under age 15 and only 3.5% were over 60 years of age. Crude birth rate and crude death rate of this area studied during the period of November 1966-October 1967 were 20.5 and 7.7 respectively. Infant mortality rate during the same period was 35.9. 50.4% of the 2,832 households fell into the category of middle class, 39.8% to the lower class and 9.5% to the upper class in economic condition. 19.8% of 2,832 householders had no formal education, 22.7% primary school, and 57.5% middle or higher school education. 2) Health Status and Utilization of the Community Health Service: Those who suffered from many illnesses during the month of October, 1967 were 690(4.6% of 14,891 persons). Classification of these patients into the type of disease shown respiratory diseases 27.4%, gastrointestinal diseases 18.1%, tuberculosis 10.9%, skin and genitourethral diseases 4.5% and gynecologic patients 4.5%. Only 55.9% of the patients received medical care at hospital or doctor's clinic. But among TB and gynecologic patients, 70.7% and 72.4% were treated at medical facilities. 10.6% of 2,832 householders interviewed has ever utilized the Community Health Service Program provided by the Yonsei Medical School, Classifying these clients into the type of service, 35.9% utilized the wellbaby clinic, 31.0% the family planning clinic, 14.7% the home delivery care, and the rest utilized other services such as the premarital guidance cinlic and the sanitary inspection service. 3) Maternity Care: 23.6% of 2,151 deliveries were done at medical facilities such as hospital, private clinic, while 76.4% were done at home. Acceptance rate of prenatal care was 32.6% as whole, but 49.6 of 774 women who had the prenatal care service had their deliveries at medical facility. 45.1% of total deliveries were attended by medical and or paramedical personnel. 75.8% of the deliveries of those received prenatal care were attended by medical and or paramedical personnel while only 27.8% of the deliveries of those who did not have prenatal care attended by medical and or paramedical personnel. 49.8% of deliveries of the upper class, 29.8% of the middle class and 9.9% of the lower class were attended by medical and or paramedical personnel. 6.2, 3.3% and 24.8% of mothers reported about their xeperience of edema, coma and fever during the period of trimester of pregnancy and puerperium. 4) Family Planning: The rate of practice of family planning was 27.9%. 31.7% of them were by IUD, 2.9% by oral pill, 15.2% by sterilization and the rest by traditional methods. Those women who had 3 to 4 children had highest(30.2%). Practice rate among the various methods of family planning, oral pill was the most popular method to whom had 2 or less children. In relation between the practicing rate of family planning and living standard, the upper, middle and lower class practiced 37.5, 29.4 and 19.9% respectively.

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Histochemical Detection of Ionic Zinc in the Rat Olfactory Mucosa: Zinc Selenium Autometallography ($ZnSe^{AMG}$) (랫드 후각점막내 Zinc 이온의 조직화학적 동정)

  • Nam, Dong-Woo;Sun, Yuan-Jie;Kim, Sung-Joo;Kim, Yong-Kuk;Kim, Soo-Jin;Yu, Yun-Cho;Jeong, Young-Gil;Jo, Seung-Mook
    • Applied Microscopy
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    • v.33 no.2
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    • pp.145-154
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    • 2003
  • The present study was designed to demonstrate ionic zinc in the rat nasal mucosa by means of zinc selenium autometallography ($ZnSe^{AMG}$). Rats were given sodium selenide either intraperitoneally (i.p) or intranasally (i.n). Prior to the i.n. administration the rats were anesthetized with pentobarbital sodium (30 mg/kg, i.p.). A thin plastic tube coupled to a Hamilton syringe was then inserted into the right nostril and $10{\mu}l$ of the solution was instilled. For the i.p. administration non-anesthetized rats were given $100{\mu}l$ of the sodium selenide solution (10 mg/kg). Control rats were instilled with saline. After 2 hrs survival, the rats were anaesthetized and transcardially perfused with 3% glutaraldehyde. The olfactory area was removed and put into same fixative. The nose was then sectioned ($30{\mu}m$) horizontally, autometallography (AMG) was performed according to Danscher et al. (1997). After silver enhancement, fine AMG grains were scattered in the whole length of the olfactory epithelium containing olfactory receptor neurons, sustentacular and basal cells. However, much higher concentration of the AMG grains occupied near the surface and in the basal region of the olfactory epithelium. Both groups of i.p. and i.n. administration showed almost same level in the concentration of the AMG grains. In i.n. group, few AMG grains were also found in olfactory nerves of the lamina propria, suggesting zinc transport into the olfactory bulb via olfactory axons. At the electron microscopic level, the AMG grains were most entirely found in the supporting cells of the olfactory epithelium, and they were mostly localized in lysosome-like organelles. The i.n. group showed various signs of tissue damage of the olfactory mucosa, where dense concentration of AMG grains were localized at crystalloid structures. The present study demonstrated dense population of ionic zinc in the rat olfactory epithelium. zinc may play a role in the olfactory functioin and in the pathogenesis of the neurodegerative disorders affecting nose.

How Reliable is Sputum PCR Test in the Diagnosis of Pulmonary Tuberculosis When Sputum Smear is Negative? (객담 결핵균 도말검사가 음성일때 중합효소연쇄반응검사와 진단적 신뢰도에 관한 연구)

  • Baek, Seung-Hoon;Lee, Jae-Myung;Kang, Min-Jong;Son, Jee-Woong;Lee, Seung-Joon;Kim, Dong-Gyu;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck;Lee, Kyung-Wha;Joe, Hyun-Chan
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.2
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    • pp.222-228
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    • 2001
  • Backgrounds : Recent technological developments have introduced a new method to identifying M. tuberculosis complex DNA in clinical samples directly. The direct amplification test (DAT) is approved for identifying M. tuberculosis complex in respiratory specimens that are smear-positive for acid-fast bacilli (AFB). When there is a discrepancy between the AFB smear and DAT, no information on their clinical utility is currently available. In this study, the diagnostic reliability of DAT was investigated in suspected pulmonary tuberculosis patients whose sputum AFB smear was negative. Methods : From June 1, 1998 through May 30, 1999, 909 patients with presumed active pulmonary tuberculosis were enrolled. A sputum AFB stain, culture, DAT and/or biopsy were performed. Using the criteria of clinical tuberculosis or confirmed tuberculosis, the positive predictive value of DAT in diagnosing pulmonary tuberculosis was investigated. Results : The positive predictive value of DAT was 82.1% by the clinically active tuberculosis criteria. However, it decreased to 61.5% when diagnosis was restricted to only to culture positive or biopsy proven cases. The false positive rate of DAT was 18.0%. Conclusion : The DAT is a valuable diagnostic method in suspected patients whose sputum AFB is was negative.

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Blood chemical values of mixed breed dog in Korea (잡종견(雜種犬)의 혈액화학치(血液化學値)에 관(關)한 연구(硏究))

  • Yoo, Suk-jong;Kim, Tae-jong
    • Korean Journal of Veterinary Research
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    • v.30 no.2
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    • pp.163-170
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    • 1990
  • The blood chemical values and blood enzyme activities were examined from 74 healthy mixed breed dogs in the area of Seoul. The results obtained are summarized as follows; 1. Mean${\pm}$SD values and ranges of glucose were $61.97{\pm}8.41mg/100ml$ and 47.28~81.67mg/100ml, of blood urea nitrogen(BUN) $15.99{\pm}2.31mg/100ml$ and 8.21~21.31mg/100ml, of total protein(TP) $8.17{\pm}0.93g/100ml$ and 6.06~9.91g/100ml, of albumin $4.16{\pm}0.47g/100ml$ and 2.81~5.15g/100ml, of globulin, $4.01{\pm}0.64g/100ml$ and 2.72~5.54g/100ml, of albumin/globulin(A/G) ratio $1.06{\pm}0.17$ and 0.71~1.42, of cholesterol(Chol) $187.33{\pm}19.78mg/100ml$ and 128.70~222.90mg/100ml, of total bilirubin(TB) $0.73{\pm}0.14mg/100ml$ and 0.43~1.16mg/100ml, of phosphorus(Pi) $5.25{\pm}1.00mg/100ml$ and 2.61~7.72mg/100ml, of calcium(Ca) $10.76{\pm}1.08mg/100ml$ and 8.24~12.60mg/100ml, of triglyceride(TG) $89.48{\pm}21.16mg/100ml$ and 47.80~133.00mg/100ml, respectively. 2. The glucose value in the age group of 7~12 months was higher (p<0.01) but in the age group of 3~4 years was lower (p<0.05) than the total glucose value. The TP value in the age group of 7~12 months was lower (p<0.01) but in the age group of 1~2 years was higher (p<0.05) than the total TP value. The globulin value in the age group of 7~12 months was lower (p<0.01) but in the group of 1~2 years was higher (p<0.01) than the total globulin value. The A/G ratio value in the age group of 7~12 months was higher (p<0.05) but in the age group of 1~2 years was lower (p<0.05) than the total A/G ratio value. The phosphorus values in the age group of 1~2 years and the age group of 3~4 years were lower (p<0.01, p<0.001) than the total phosphorus value. The calcium value in the age group of less than 6 months was higher (p<0.05) but in the age group of 7~12 months was lower (p<0.001) than the total calcium value. 3. Mean${\pm}$S.D. values and ranges of alkaline phosphatase(AP) were $72.47{\pm}19.73IU/l$, and 28.13~105.00IU/l, of lactic dehydrogense(LDH) $159.46{\pm}45.11IU/l$ and 60.63~265.30IU/l, of serum aspartate aminotransferase(AST) $38.64{\pm}8.62IU/l$ and 21.47~70.58IU/l, of serum alanine aminotransferase(ALT) $34.88{\pm}11.30IU/l$ and 14.51~73.17IU/l, respectively. 4. The AP value in the age group of 7~12 months was higher (p<0.05) but in the age group of 1~2 years was lower (p<0.01, p<0.001) than the total AP value. The LDH value in the age group of less than 6 months was higher (p<0.001) but in the age group of 1~2 years and the age group of 3~4 years were lower (p<0.05) than the total LDH value. The serum AST value in the age group of 3~4 years was lower (p<0.01) than the total SGOT value. The serum ALT value in the age group of 7~12 months was higher(p<0.05) than the total SGPT value.

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Preliminary Result of Uncertainty on Variation of Flowering Date of Kiwifruit: Case Study of Kiwifruit Growing Area of Jeonlanam-do (기후변화에 따른 국내 키위 품종 '해금'의 개화시기 변동과 전망에 대한 불확실성: 전남 키위 주산지역을 중심으로)

  • Kim, Kwang-Hyung;Jeong, Yeo Min;Cho, Youn-Sup;Chung, Uran
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.18 no.1
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    • pp.42-54
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    • 2016
  • It is highly anticipated that warming temperature resulting from global climate change will affect the phenological pattern of kiwifruit, which has been commercially grown in Korea since the early 1980s. Here, we present the potential impacts of climate change on the variations of flowering day of a gold kiwifruit cultivar, Haegeum, in the Jeonnam Province, Korea. By running six global climate models (GCM), the results from this study emphasize the uncertainty in climate change scenarios. To predict the flowering day of kiwifruit, we obtained three parameters of the 'Chill-day' model for the simulation of Haegeum: $6.3^{\circ}C$ for the base temperature (Tb), 102.5 for chill requirement (Rc), and 575 for heat requirement (Rh). Two separate validations of the resulting 'Chill-day' model were conducted. First, direct comparisons were made between the observed flowering days collected from 25 kiwifruit orchards for two years (2014-15) and the simulated flowering days from the 'Chill-day' model using weather data from four weather stations near the 25 orchards. The estimation error between the observed and simulated flowering days was 5.2 days. Second, the model was simulated using temperature data extracted, for the 25 orchards, from a high-resolution digital temperature map, resulting in the error of 3.4 days. Using the RCP 4.5 and 8.5 climate change scenarios from six GCMs for the period of 2021-40, the future flowering days were simulated with the 'Chill-day' model. The predicted flowering days of Haegeum in Jeonnam were advanced more than 10 days compared to the present ones from multi-model ensemble, while some individual models resulted in quite different magnitudes of impacts, indicating the multi-model ensemble accounts for uncertainty better than individual climate models. In addition, the current flowering period of Haegeum in Jeonnam Province was predicted to expand northward, reaching over Jeonbuk and Chungnam Provinces. This preliminary result will provide a basis for the local impact assessment of climate change as more phenology models are developed for other fruit trees.

Detection of Point Mutations in the rpoB Gene Related to Drug Susceptibility in Mycobacterium Tuberculosis using an Oligonucleotide Chip (올리고뉴클레오티드 칩(Oligonucleotide Chip)을 이용한 항결핵제 감수성과 관련된 Mycobacterium tuberculosis rpoB 유전자의 점돌연변이 판별 방법)

  • Kim, Hyun-Jung;Kim, Seong-Keun;Shim, Tae-Sun;Park, Yong-Doo;Park, Mi-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.1
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    • pp.29-41
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    • 2001
  • Background : The appearance of multiple-drug-resistant Mycobacterium tuberculosis strains has been seriously compromising successful control of tuberculosis. Rifampin-resistance, caused by mutations in the rpoB gene, can be indicative of multiple-drug-resistance, and its detection is of great importance. The present study aimed to develop an oligonucleotide chip for accurate and convenient screening of drug-resistance. Methods : In order to detect point mutations in the rpoB gene, an oligonucleotide chip was prepared by immobilizing specific probe DNA to a microscopic slide glass by a chemical reaction. The probe DNA that was selected from the 81 bp core region of the rpoB gene was designed to have mutation sites at the center. A total of 17 mutant probes related to rifampin-resistance including 8 rifabutin-sensitive mutant probes were used in this study. For accurate determination, wild type probes were prepared for each mutation position with an equal length, which enabled a direct comparison of the hybridization intensities between the mutant and wild type. Results : Mycobacterial genomic DNA from clinical samples was tested with the oligonucleotide chip and the results were compared with those of the drug-susceptibility test in addition to sequencing and INNO-LiPA Rif. TB kit test in some cases. Out of 15 samples, the oligonucleotide chip results of 13 samples showed good agreement with the rifabutin-sensitivity results. The two samples with conflicting result also showed a discrepancy between the other tests, suggesting such possibilities as existence of mixed strains and difference in drug-sensitivity. Further verification of these samples in addition to more case studies are required before the final evaluation of the oligonucleotide chip can be made. Conlcusion : An oligonucleotide chip was developed for the detection of rpoB gene mutations related to drugsusceptibility. The results to date show the potential for using the oligonucleotide chip for accurate and convenient screening of drug-resistance to provide useful information in antituberculosis drug therapy.

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The Role of Resectional Surgery for the Treatment of Localized Multi-drug Resistant Pulmonary Tuberculosis (국소 병변의 다제 내성 폐결핵 환자에서 폐절제술의 역할)

  • An, Chang-Hyeok;Ahn, Jong-Woon;Kang, Kyeong-Woo;Kang, Soo-Jung;Lim, Young-Hee;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.676-683
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    • 2000
  • Background : Surgery may have a role when medical treatment alone is not successful in patients with multidrug resistant (MDR) pulmonary tuberculosis (PTB). To document the role of resection in MDR PTB, we analyzed 4 years of our experience. Methods : A retrospective review was performed on thirteen patients that underwent pulmonary resection for MDR PTB between May 1996 and February 2000. All patients had organisms resistant to many of the first-line drugs including isoniazid (INH) and rifampicin (RFP). Results : The thirteen patients were $37.5{\pm}12.4$ years old (mean${\pm}$S.D.)(M : F=5:8), and their sputum was culture positive even with adequate medication for prolonged periods ($109.7{\pm}132.0$ months), resistant to 2-8 drugs including isoniazid and rifampin. All patients had localized lesion(s) and most (92.3%) had cavities. At least 3 sensitive anti-TB medications were started before surgery in all patients according to the drug sensitivity test. The preoperative $FEV_1$ was $2.37{\pm}0.83$ L. Lobectomy was performed in 11 patients and pleuropneumonectomy in two. Postoperative mortality did not occur, but pneumonia occurred as a complication in one (7.7%). After $41.5{\pm}58.9$ days (range 1~150 days) follow up, negative conversion of sputum culture was achieved in all patients within 5 months. Only one patient (7.7%) recurred 32 months after lung resection. Conclusion : When medical treatment alone is not successful, surgical resection can be a good treatment option in patients with localized MDR PTB.

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Difference in the Quality of Life and Related Factors according to the Employment Status (경제활동 상태에 따른 삶의 질 차이와 관련요인)

  • Gim, Mi-Seon;Han, Ji-Yeon;Kim, Chul-Woung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.9
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    • pp.6080-6088
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    • 2015
  • The purpose of study is to find difference in the quality of life and related factors according to the employment status. Using data from the fifth National Health and Nutrition Survey, economically active population of 20-69 years old 3,429 participants who said to questions of 'economic activity status' were finally used as analysis subjects in Korea. According to economic activity status, individuals were divided by the six different employment status and their quality of life was inspected using the EQ-5D dimensions and index score as well as analyzing the factors affecting the quality of life. As a result, unemployed compared to full-time workers, had significantly higher needs of four dimensions and Unpaid family workers had in the dimensions of Mobility, Self-care and Usual activities and temporary job had in the dimensions of Self-care and Usual activities. After figuring out life quality factors according to employment status, it was found that compared to full-time workers greater age(${\beta}=-0.089$, p<0.001), more stress(${\beta}=-0.143$, p<0.0001), hyperlipidemia(${\beta}=-0.064$, p<0.0001), stroke, arthritis(${\beta}=-0.160$, p<0.0001), respiratory diseases(${\beta}=-0.055$, p<0.001) and chronic health conditions were more influential to low quality of life for temporary job(${\beta}=-0.034$, p<0.05), day workers(${\beta}=-0.078$, p<0.0001) and unemplyed(${\beta}=-0.052$, p<0.01). The study is reported that it is to find difference in the quality of life and related factors according to the employment status and it is considered to provide basis for health evaluation of utilization in the same field of study.