Purpose : Recently, different results about factors affecting accurate quantitation of 24-hr urinary protein(24UP) amount using spot urine protein/creatinine ratio(PCR) have been reported. The current study was designed to evaluate correlation between 24UP amounts and PCR in children, and the effect of 24UP amounts, age, sex, and glomerular filtration rate(GFR) on this correlation. Methods : Among 94 patients who visited the department of pediatrics in Busan Paik Hospital from March 2002 to August 2002, 68 patients whose urinary creatinine excretion was ${\geq}15mg/kg/day$ were included in this study. All the patients were divided into I, II/A, B group(I : 24UP<500 mg/day, II : $24UP{\geq}500mg/day$, A : <10 years of age, B : ${\geq}10years$ of age). Pearson correlation analysis was performed between 24UP and PCR to evaluate the relationship. We defined fractional difference between 24UP and PCR, and then performed multiple regression analysis with 24UP amount, age, GFR and fractional difference. Results : There was a strong positive linear correlation between 24UP and PCR(R=0.936, P<0.0001) in all patients, and the correlation was also good in each group. Using PCR cutoff values of 0.5, the PCR provided high sensitivity, specificity, positive and negative predictive value in predicting 24UP amount ${\geq}500mg$. The factors affecting accurate quantitation of proteinuria using spot urine PCR was age, not 24UP amount, GFR or sex. Conclusion : Spot urine PCR is a useful test but has limitations in predicting 24UP amount. Therefore, it should be used only as screening method. Age-adjusted PCR cutoff values may be necessary to predict 24UP amount in children with proteinuria.
Primary percutaneous coronary intervention (PCI) has been found to be superior, in terms of hospital mortality and long-term outcome, compared with thrombolytic therapy in patients with acute myocardial infarction (AMI). However, the clinical benefits of primary PCI have not been precisely evaluated in elderly patients.1,974 patients (Group I: n=1,018, $age{\geq}65years$, $73.8{\pm}5.99years$; Group II: n=956, age<65years, $52.8{\pm}7.96years$) who underwent primary PCI for AMI at Chonnam National University Hospital between 2006 and 2010 were analyzed according to their clinical, angiographic characteristics for hospital and one-year survival. Group I had a higher percentage of women, diabetes mellitus, hypertension, multi-vessel disease and lower prevalence of current smoking, hyperlipidemia, familial history than Group II. Culprit lesions were at the left anterior descending artery, left circumflex artery, right coronary artery and left main artery in 42.8% vs. 45.0%, 34.1% vs. 29.6%, 14.6% vs 14.6, 2.7% vs. 1.6%, respectively (p=0.007). Stent diameter was smaller in group I ($3.17{\pm}0.39$ vs. $3.29{\pm}0.42mm$, p=0.001). In-hospital mortality was higher in group I (8.4 vs. 1.9%, p<0.001). There were significant differences in the rates of major adverse cardiac events between the two groups during one-year clinical follow-up (20.1 vs.14.0%, p<0.001). On multiple logistic regression analysis, systolic blood pressure<100mmHg, serum $creatinine{\geq}1.3mg/dL$, Killip class> I, multivessel disease, left ventricular ejection fraction <40% and cerebro vascular disease were independent predictors of one-year motality in patients over 65 years after PCI.
In this present study, the sensitivity of O4 Air Mass Factor (AMF) to Aerosol Peak Height (APH) has been investigated using radiative transfer model according to various parameters(wavelength (340 nm and 477 nm), aerosol type (smoke, dust, sulfate), aerosol optical depth (AOD), surface reflectance, solar zenith angle, and viewing zenith angle). In general, it was found that O4 AMF at 477 nm is more sensitive to APH than that at 340 nm and is stably retrieved with low spectral fitting error in Differential Optical Absorption Spectroscopy (DOAS) analysis. In high AOD condition, sensitivity of O4 AMF on APH tends to increase. O4 AMF at 340 nm decreased with increasing solar zenith angle. This dependency isthought to be induced by the decrease in length of the light path where O4 absorption occurs due to the shielding effect caused by Rayleigh and Mie scattering at high solar zenith angles above 40°. At 477 nm, as the solar zenith angle increased, multiple scattering caused by Rayleigh and Mie scattering partly leads to the increase of O4 AMF in nonlinear function. Based on synthetic radiance, APHs have been retrieved using O4 AMF. Additionally, the effect of AOD uncertainty on APH retrieval error has been investigated. Among three aerosol types, APH retrieval for sulfate type is found to have the largest APH retrieval error due to uncertainty of AOD. In the case of dust aerosol, it was found that the influence of AOD uncertainty is negligible. It indicates that aerosol types affect APH retrieval error since absorption scattering characteristics of each aerosol type are various.
Song, Jae-Uk;Kim, Su-A;Choi, E Ryoung;Kim, Soo Min;Choi, Hee Jung;Lim, So Yeon;Park, So Young;Suh, Gee Young;Jeon, Kyeongman
Tuberculosis and Respiratory Diseases
/
v.67
no.1
/
pp.21-26
/
2009
Background: Non-invasive positive pressure ventilation (NPPV) ensures adequate gas exchange during bronchoscopy in spontaneously breathing, hypoxemic patients, thus avoiding endotracheal intubation. However, in some patients, endotracheal intubation is eventually required after bronchoscopy. This study investigated the incidence of intubation and predictors of a need for emergency intubation prior to NPPV bronchoscopy initiation. Methods: On a retrospective basis, we reviewed the medical records of 36 patients (median age, 55 years; interquartile range [IQR], 43~65 years) with acute hypoxemic respiratory failure who required NPPV during bronchoscopy between January 2005 and October 2007. Results: All patients were hypoxemic (median $PaO_2/FiO_2$ ratio 155; IQR 90~190), but tolerated bronchoscopy with NPPV support. SOFA score and SAPS II score immediately before NPPV initiation were 4 (3~7) and 36 (30~42), respectively. Seventeen (47%) patients needed endotracheal intubation at a median time of 22 (2~50) hours after bronchoscopy. Patients who needed intubation after bronchoscopy had a higher in-hospital mortality (11 [65%] vs. 4 [21%], p=0.017). Upon multiple logistic regression analysis, the need for intubation after bronchoscopy was independently associated with a $P_aO_2/FiO_2$ ratio (OR, 0.961; 95% CI, 0.924~0.999; p=0.047) immediately before NPPV initiation for bronchoscopy. Conclusion: The severity of the hypoxemia immediately prior to NPPV initiation for bronchoscopy was associated with the need for intubation after bronchoscopy in patients with hypoxemic respiratory failure.
Purpose: The purpose of this study was to evaluate the relationship between cord blood adiponectin and insulin-like growth factor (IGF)-I and their effect on fetal growth and insulin resistance in mothers with gestational diabetes mellitus (GDM). Methods: Cord blood adiponectin and IGF-I were compared between mothers with GDM (GDM group, N=53) and controls (non-GDM group, N=101). Neonates were classified into three groups of small for gestational age (SGA, N=26), appropriate for gestational age (AGA, N=97), and large for gestational age (LGA, N=31) by birth weight. The association between cord adiponectin and IGF-I levels was evaluated in relation to maternal and neonatal clinical data. Results: Cord adiponectin was lower in the GDM group than in the non-GDM group (P<0.001). There was no significant difference in cord adiponectin among the SGA, AGA, and LGA groups in the GDM group (P=0.228). The cord adiponectin of AGA in the GDM group was significantly lower than that in the non-GDM group (P<0.001). The most powerful predictor affecting cord adiponectin was the result of maternal 75 g oral glucose tolerance test. The cord IGF-I values between the GDM group and the non-GDM group were not different (P=0.834). Neonates with the heavier birth weight had the higher cord IGF-I levels. The most powerful predictor affecting cord IGF-I was birth weight and the next was maternal parity. Conclusion: Both cord blood adiponectin and IGF-I were associated with fetal growth, but IGF-I was a more general and direct factor affecting fetal body size, and adiponectin seemed to have more association with insulin sensitivity than growth.
Purpose: The purpose of this study was to evaluate the differences according to the hospitals of antenatal care in premature infants. Methods: We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and very low birth weights who were admitted immediately after birth to the neonatal intensive care unit (NICU) at the Dongguk University Ilsan Hospital between March 2007 and February 2009. The hospitals of antenatal care were divided into two levels (primary antenatal care hospital: hospitals with less than a level 2 NICU, secondary antenatal care hospital: hospitals with a level 3 NICU) based on the level of NICU in hospitals. In addition, total infants were divided into two groups (Immediate group: infants born within 24 hours of maternal admission, Delayed group: infants born after 24 hours of maternal admission). The differences between maternal and neonatal variables in each groups were studied. Results: Neonates in secondary antenatal care hospitals comprised 11.0% of the study neonates (10 of 91). We compared with two groups (primary antenatal care hospital and secondary antenatal care hospital), but there were no differences in all subjects. However, the 1 minute Apgar score ($\leq3$) was lower in the immediate group than the delayed group. Conclusion: Shorter duration of maternal admission to delivery was associated with a lower 1 minute Apgar score of neonates. These findings suggest that if maintenance of pregnancy is difficult when high-risk gravidas are transferred, clinicians must prepare for emergencies of neonates.
Purpose: The aim of this study was to evaluate the influence of leptin on biochemical markers of bone metabolism in childhood obesity. Methods: A total of 50 male children (25 obese and 25 controls) were recruited from the pediatric outpatient clinic at the Chosun University Hospital from November 1st 2005 to May 30th 2006. BMI, body fat percentage, serum leptin, bone-specific alkaline phosphatase (B-ALP), C-terminal propeptide of type 1 collagen (CICP), total deoxypyridinoline crosslinks (total DPD) were measured. The correlations of leptin with BMI, body fat percentage, B-ALP, CICP, total DPD were analyzed by Pearson's correlation. In a multiple stepwise regression analysis, leptin after correction for body weight was evaluated if there was a correlation with biochemical markers of bone formation and resorption respectively. Results: The leptin levels of the obese group were significantly higher than those of the control group (p=0.012). In the obese group, the leptin level was significantly positively correlated with the BMI (r=0.551, p=0.01) and the percentage of body fat (r=0.584, p=0.018). In the obese group, of bone markers, B-ALP (r=-0.613, p=0.026) and CICP (r=-0.583, p=0.037) were negatively correlated with leptin. B-ALP (r=-0.728, p=0.007) and CICP (r=-0.684, p=0.014) were negatively correlated with leptin when corrected for body weight. In the control group, bone markers were not correlated with leptin. In the multiple stepwise regression analyses, there was a negative correlation between the leptin and B-ALP (Y=-39.653X+356.341, p=0.026), CICP (Y=-13.437X+ 116.013, p=0.037) respectively in the obese group. Conclusion: Leptin was a significant factor in the bone formation but not in bone resorption in childhood obesity.
Kim, Ju-O;Sim, Sang-Don;Noh, Kyung-Hwan;Shon, Suk-June;Kim, Sul-Jun;Yang, Yun-Hyeok
Journal of the Korean Arthroscopy Society
/
v.13
no.2
/
pp.155-160
/
2009
Purpose: The purpose of this study was to evaluate the pain recovery pattern according to the integrity and to analyze the factors affecting the progress and level of pain postoperatively. Materials and Methods: We examined 153 patients, who were treated with arthroscopic rotator cuff repair. 101 rotator cuff tears were full-thickness tear and 52 were partial tear. The mean follow up duration was 20 months (12~30 months). We evaluated the visual analogue scale, range of motion, ASES (American Shoulder and Elbow Surgeons), and UCLA (University of California at Los Angeles) scores preoperatively and postoperatively. We analyzed the pain recovery pattern between partial and full thickness tear using Student T-test and the factors affecting the progress and level of postoperative pain using multiple regression analysis. Results: The change patterns of visual analogue scale after arthroscpoic repair were similar regardless of the tear integrity. The VAS showed a continuous decreasing pattern, but increased at first 3 weeks postoperatively and at 7 weeks postoperatively, and then, decreased thereafter. The average VAS was ${\leqq}2$ points by postoperative 3 months. The factor affecting the pain score at 3 months was related to the preoperative limitation in forward flexion ($r^2=0.377$, p=0.021). Conclusion: There was no differences of the pain recovery pattern according to the integrity, and the factor affecting the progress of postoperative pain was preoperative angle of forward elevation. So, the appropriate preoperative rehabilitation protocol that can improve motions of the shoulder joint would help to improve the level of postoperative pain and functional recovery.
The deep geological repository for high-level radioactive waste disposal is a multi barrier system comprised of engineered barriers and a natural barrier. The long-term integrity of the deep geological repository is affected by the coupled interactions between the individual barrier components. Erosion and piping phenomena in the compacted bentonite buffer due to buffer-rock interactions results in the removal of bentonite particles via groundwater flow and can negatively impact the integrity and performance of the buffer. Rapid groundwater inflow at the early stages of disposal can lead to piping in the bentonite buffer due to the buildup of pore water pressure. The physiochemical processes between the bentonite buffer and groundwater lead to bentonite swelling and gelation, resulting in bentonite erosion from the buffer surface. Hence, the evaluation of erosion and piping occurrence and its effects on the integrity of the bentonite buffer is crucial in determining the long-term integrity of the deep geological repository. Previous studies on bentonite erosion and piping failed to consider the complex coupled thermo-hydro-mechanical-chemical behavior of bentonite-groundwater interactions and lacked a comprehensive model that can consider the complex phenomena observed from the experimental tests. In this technical note, previous studies on the mechanisms, lab-scale experiments and numerical modeling of bentonite buffer erosion and piping are introduced, and the future expected challenges in the investigation of bentonite buffer erosion and piping are summarized.
BACKGROUND: Sarcopenic obesity(SO), a condition of the reduction in muscle mass paired with an increased fat mass has been paid attention because of its association with disability in later life. A few evidence, however, has reported the association with these factors. PURPOSE: To explore the association among SO, physical function and fitness in older women. METHOD: 257 older women(age of 74) were recruited from Y city and 7 physical functions and 4 fitness tests were measured. Participants were classified into one of four groups based on their body fat and muscle mass: Normal group (GR-A), high fat(GR-B), sarcopenia(GR-C), and sarcopenic obese(GR-D). GLMand LSD-test were conducted with SPSS 12.0. RESULTS: Chair stand, arm-curl, back-scratch, 2-min steps of GR-A was higher than GR-C and GR-D(p<.05). One-leg stand of GR-A was higher than GR-D(p<.01) and of GR-C was higher than GR-D(p<.01).8ft-TUG of GR-D was lower than GR-A(p<.01). Grip strength, knee extension of GR-A was higher than that of GR-C and GR-D(p<.01) and knee flexion of GR-A was also higher than that of GR-C and GR-D(p<.01). CONCLUSION: Based on our findings, we conclude that SO is significantly associated with lower physical function and fitness in older Korean women, which alarm the risk of frailty induced by SO.
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