• Title/Summary/Keyword: 다중인자분석

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Quality of Life among Family Caregivers of Terminal Cancer Patient (말기 암 환자 가족 간병인의 삶의 질)

  • Jung, Jin-Gyu;Kim, Sung-Soo;Kang, Dong-Soo;Kim, Sung-Min;Lee, Dong-Hoon;Han, Kyung-Hee;Kim, Jong-Sung
    • Journal of Hospice and Palliative Care
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    • v.9 no.1
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    • pp.1-10
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    • 2006
  • Purpose: Terminal cancer influences on patients as well as their family members. This research was performed to evaluate the quality of lift of primary family caregivers and to investigate the influencing factors. Methods: The results of survey were collected from 81 family caregivers who were taking care of hospitalized terminal cancer patients at an oncology department of university hospital in Daejeon from March 2005 to January 2006 with questionnaires. The questionnaires were consisted of the general characteristics of the subjects, and 36-items short-form Health Survey (SE-36) Korean version to evaluate the quality of life of family caregivers, the characteristics of patients and family caregivers' caring trait. Results: Family caregivers' mean (${\pm}SD$) SF-36 score was 47.9 (${\pm}20.7$). Influential factors on family caregivers' life quality were daily raring hours, economic burden, type of treatment; only supportive care, caring duration, sex, the numbers of ADLs (activity of daily livings) items that patients needed help in order by stepwised multiple logistic regression analysis (overall $R^2=0.639$, P=0.044). Conclusion: Daily raring hours and economic burden were two influential modifiable factors on family caregivers' quality of life. Therefore, social supportive systems are required to reduce family caregivers' daily caring hour and economic burden.

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The Evaluation of IL-8 in the Serum of Pneumoconiotic patients (진폐증 환자에서의 혈청내 IL-8 농도)

  • Ahn, Hyeong Sook;Kim, Ji Hong;Chang, Hwang Sin;Kim, Kyung Ah;Lim, Young
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.945-953
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    • 1996
  • Background : Many acute and chronic lung diseases including pneumoconiosis are characterized by the presence of increased numbers of activated macrophages. These macrophages generate several inflammatory cell chemoattractants, by which neutrophil migrate from vascular compartment to the alveolar space. Recruited neutrophils secrete toxic oxygen radicals or proteolytic enzymes and induce inflammatory response. Continuing inflammatory response results in alteration of the pulmonary structure and irreversible fibrosis. Recently, a polypeptide with specific neutrophil chemotactic activity, interleukin-8(IL-8), has been cloned and isolated from a number of cells including : monocytes, macrophages and fibroblasts. IL-1 and/or TNF-${\alpha}$ preceded for the synthesis of IL-8, and we already observed high level of IL-1 and TNF-${\alpha}$ in the pneumoconioses. So we hypothesized that IL-8 may be a central role in the pathogenesis of pneumoconiosis. In order to evaluate the clinical utility of IL-8 as a biomarker in the early diagnosis of pneumoconiosis, we investigated the increase of IL-8 in the pneumoconiotic patient and the correlation between IL-8 level and progression of pneumoconiosis. Method : We measured IL-8 in the serum of 48 patients with pneumoconiosis and 16 persons without dust exposure history as a control group. Pneumoconiotic cases were divided into 3 groups according to ILO Classification : suspicious group(n=16), small opacity group(n=16) and large opacity group(n=16). IL-8 was measured by a sandwich enzytne immunoassay technique. All data were expressed as the $mean{\pm}standard$ deviation. Results: 1) The mean value of age was higher in the small opacity and large opacity group than comparison group, but smoking history was even. Duration of dust exposure was not different among 3 pneumoconiosis groups. 2) IL-8 level was $70.50{\pm}53.63pg/m{\ell}$ in the suspicious group, $107.50{\pm}45.88pg/m{\ell}$ in the small opacity group, $132.50{\pm}73.47pg/m{\ell}$ in the large opacity group and $17.85{\pm}33.85pg/m{\ell}$ in the comparison group. IL-8 concentration in all pneumoconiosis group was significant higher than that in the comparison group(p<0.001). 3) IL-8 level tended to increase with the progression of pneumoconiosis. Multiple comparison test using Anova/Scheffe analysis showed a significant difference between suspicious group and large opacity group(p<0.05). 4) The level of IL-8 was correlated with the progression of pneumoconiosis(r=0.4199, p<0.05). Conclusion : IL-8 is thought to be a good biomarker for the early diagnosis of pneumoconiosis.

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M-mode Ultrasound Assessment of Diaphragmatic Excursions in Chronic Obstructive Pulmonary Disease : Relation to Pulmonary Function Test and Mouth Pressure (만성폐쇄성 폐질환 환자에서 M-mode 초음파로 측정한 횡격막 운동)

  • Lim, Sung-Chul;Jang, Il-Gweon;Park, Hyeong-Kwan;Hwang, Jun-Hwa;Kang, Yu-Ho;Kim, Young-Chul;Park, Kyung-Ok
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.736-745
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    • 1998
  • Background: Respiratory muscle interaction is further profoundly affected by a number of pathologic conditions. Hyperinflation may be particularly severe in chronic obstructive pulmonary disease(COPD) patients, in whom the functional residual capacity(FRC) often exceeds predicted total lung capacity(TLC). Hyperinflation reduces the diaphragmatic effectiveness as a pressure generator and reduces diaphragmatic contribution to chest wall motion. Ultrasonography has recently been shown to be a sensitive and reproducible method of assessing diaphragmatic excursion. This study was performed to evaluate how differences of diaphragmatic excursion measured by ultrasonography associate with normal subjects and COPD patients. Methods: We measured diaphragmatic excursions with ultrasonography on 28 healthy subjects(l6 medical students, 12 age-matched control) and 17 COPD patients. Ultrasonographic measurements were performed during tidal breathing and maximal respiratory efforts approximating vital capacity breathing using Aloka KEC-620 with 3.5 MHz transducer. Measurements were taken in the supine posture. The ultrasonographic probe was positioned transversely in the midclavicular line below the right subcostal margin. After detecting the right hemidiaphragm in the B-mode the ultrasound beam was then positioned so that it was approximately parallel to the movement of middle or posterior third of right diaphragm. Recordings in the M-mode at this position were made throughout the test. Measurements of diaphragmatic excursion on M-mode tracing were calculated by the average gap in 3 times-respiration cycle. Pulmonary function test(SensorMedics 2800), maximal inspiratory(PImax) and expiratory mouth pressure(PEmax, Vitalopower KH-101, Chest) were measured in the seated posture. Results: During the tidal breathing, diaphragmatic excursions were recorded $1.5{\pm}0.5cm$, $1.7{\pm}0.5cm$ and $1.5{\pm}0.6cm$ in medical students, age-matched control group and COPD patients, respectively. Diaphragm excursions during maximal respiratory efforts were significantly decreased in COPD patients ($3.7{\pm}1.3cm$) when compared with medical students, age-matched control group($6.7{\pm}1.3cm$, $5.8{\pm}1.2cm$, p< 0.05}. During maximal respiratory efforts in control subjects, diaphragm excursions were correlated with $FEV_1$, FEVl/FVC, PEF, PIF, and height. In COPD patients, diaphragm excursions during maximal respiratory efforts were correlated with PEmax(maximal expiratory pressure), age, and %FVC. In multiple regression analysis, the combination of PEmax and age was an independent marker of diaphragm excursions during maximal respiratory efforts with COPD patients. Conclusion: COPD subjects had smaller diaphragmatic excursions during maximal respiratory efforts than control subjects. During maximal respiratory efforts in COPD patients, diaphragm excursions were well correlated with PEmax. These results suggest that diaphragm excursions during maximal respiratory efforts with COPD patients may be valuable at predicting the pulmonary function.

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Fertility and Rate of Fertilizer Application for Orchard Soils of Apple and Pear (사과 및 배 과수토양(果樹土壤)의 비옥도구분(肥沃度區分)에 의한 시비기준(施肥基準) 설정(設定))

  • Lee, Choon-Soo;Lee, Ju-Young;Lee, Yong-Jae;Shin, Jae-Sung;Han, Ki-Hak;Kim, Dong-Soo
    • Korean Journal of Soil Science and Fertilizer
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    • v.26 no.2
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    • pp.103-110
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    • 1993
  • This study was made to evaluate the chemical properties of 481 farmers' orchard fields in An-Seong area. And the reasonable ferilizer rates were recommended utilizing the result of soil analysis. The results are summarized as follows : 1. As the soil fertility status of collected soil samples were evaluated on the basis of temporary optimal range for each soil chemical properties, 12.7 to 49.6% of the total 481 farmers' fields were range for soil improvement. 2. The contents of chemical component have a tendancy to decrease with depth gradually from surface to subsoil. 3. According to the relationship between the contents of soil component in subsoil and those in surface soil, the fertility condition of subsoil could be estimated on the basis of analysis data of surface soil. 4. The multiple regression equation for pear yield prediction to the organic matter and exchangable calcium contents in the soil were obtained. 5. Referring the average value, distribution ratio compared to the optimum level for each soil chemical properties and standard fertilizer rate, the soil fertility status could be categorized as "High" "Medium" and "Low". For each category, the recommended amounts for NPK and organic matter application were established. 6. The recommended rates through soul fertility diagnosis were less than farmer's dosage in the range 7.1~7.7 kg/10a for N, 0.8~11.5 kg/10a for $P_2O_5$, 7.1~19.9 kg/10a for $K_2O$ and 90~116 kg/10a for lime.

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Early Results of Coronary Artery Bypass Graft with Purely Bilateral Internal Thoracic Arteries Using Y-anastomosis in Multiple Coronary Artery Disease Patients: Coronary Angiographic Analysis (다중혈관 관상동맥 환자에서 Y-문합을 이용하여 양쪽 내흉동맥만을 사용한 우회술의 조기 성적: 관상동맥 조영술 분석)

  • 성기익;이영탁;박계현;전태국;박표원;한일용;장윤희
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.142-149
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    • 2003
  • To know the feasibility of the coronary artery bypass graft (CABG) for multivessel coronary artery disease with purely bilateral internal thoracic arteries (ITAs), we analyzed the short-term clinical results and the coronary angiography of the patients. Material and Method: From March 2001 to June 2002, four hundred and five patients underwent CABG. Purely bilateral ITAs were used in 159 patients (39.3%). We analyzed these patients retrospectively The mean age of these patients was $61.2{\pm}8.5$ (range: 30 ~80) years and there were 123 male patients. The preoperative risk factors were as follows: diabetes in 54 patients (34.0%), history of acute myocardiac infarction within 4 weeks in 29 (18.2%), and emergency operation in 6 (3.8%). Off-pump CABG was carried out in 128 patients (80.5%). Associated procedures were mitral valvuloplasty (5), aortic valve replacement (3), Dor procedure (1), and so on. Result: The mean number of distal anastomoses was $3.1{\pm}0.9$ (range: 2~6), the mean duration of hospital stay was $8.4{\pm}4.5$ days. There was one (0.6%) operative death. Except for one early death, no other patients suffered from low cardiac output. The other postoperative complications were occurred as follows: reoperation due to bleeding in 3 patients, perioperative myocardiac infarction in 1, transient cardiac arrest in 2, transient cognitive dysfunction in 7, and transient ischemic attack in 1, and deep sternal wound infection in 1 patient. Recently, early postoperative angiography was performed in 19 patients who had triple vessel disease. The total number of distal anastomosis was 78 (mean $4.1{\pm}0.8$/patient). All distal anastomosis sites were patent, but competition flow was observed at the bypass sites where the native coronary artery stenosis was not significant. Conclusion: The CABG with purely bilateral ITAs for triple vessel disease was performed safely. The early patency rate was relatively good in small number of patients. However the long-term patency rate and the functional study to evaluate the sites where competition flow was observed should be followed.

Empirical Estimation and Diurnal Patterns of Surface PM2.5 Concentration in Seoul Using GOCI AOD (GOCI AOD를 이용한 서울 지역 지상 PM2.5 농도의 경험적 추정 및 일 변동성 분석)

  • Kim, Sang-Min;Yoon, Jongmin;Moon, Kyung-Jung;Kim, Deok-Rae;Koo, Ja-Ho;Choi, Myungje;Kim, Kwang Nyun;Lee, Yun Gon
    • Korean Journal of Remote Sensing
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    • v.34 no.3
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    • pp.451-463
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    • 2018
  • The empirical/statistical models to estimate the ground Particulate Matter ($PM_{2.5}$) concentration from Geostationary Ocean Color Imager (GOCI) Aerosol Optical Depth (AOD) product were developed and analyzed for the period of 2015 in Seoul, South Korea. In the model construction of AOD-$PM_{2.5}$, two vertical correction methods using the planetary boundary layer height and the vertical ratio of aerosol, and humidity correction method using the hygroscopic growth factor were applied to respective models. The vertical correction for AOD and humidity correction for $PM_{2.5}$ concentration played an important role in improving accuracy of overall estimation. The multiple linear regression (MLR) models with additional meteorological factors (wind speed, visibility, and air temperature) affecting AOD and $PM_{2.5}$ relationships were constructed for the whole year and each season. As a result, determination coefficients of MLR models were significantly increased, compared to those of empirical models. In this study, we analyzed the seasonal, monthly and diurnal characteristics of AOD-$PM_{2.5}$model. when the MLR model is seasonally constructed, underestimation tendency in high $PM_{2.5}$ cases for the whole year were improved. The monthly and diurnal patterns of observed $PM_{2.5}$ and estimated $PM_{2.5}$ were similar. The results of this study, which estimates surface $PM_{2.5}$ concentration using geostationary satellite AOD, are expected to be applicable to the future GK-2A and GK-2B.

Usefulness of auditory brainstem response as early predictor of kernicterus in early breast-feeding jaundice (조기 모유 황달에서 핵황달의 조기 예측도구로서의 청성 뇌간유발 반응 검사의 유용성)

  • Jang, Jae Won;Lee, Gil Sang;Song, Dae Keun;Kim, Sung Hee;Kim, Won Duck;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.50 no.9
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    • pp.848-854
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    • 2007
  • Purpose : The present study examined the etiology and risk factors of the early breast-feeding jaundice and the usefulness of auditory brainstem response test as early predictor of kernicterus. Methods : Medical records of neonatal jaundice in newborn admitted to Daegu Fatima Hospital between September 2005 and May 2006 were analyzed prospectively. Infants were grouped according to feeding method : breast feeding group (breast feeding only, n=23), mixed feeding group (breast feeding mainly plus addition of fomula feeding, n=13). Results : There were no significant differences in gestational age, birth weight, sex, duration of phototherapy, serum bilirubin and hemolytic evidence between the two study groups. First visiting day of life at out patient department was significantly delayed in breast feeding group ($8.7{\pm}3.6day$) compared to mixed feeding group ($6.0{\pm}1.9$) (P=0.009). Weight loss was significantly severe in breast feeding group compared to mixed feeding group (P<0.05). In auditory brainstem response test, loss of Wave V in 3 cases was observed and recoverd after blood exchange transfusion in follow up test.Wave III latency had significant correlation to serum bilirubin in auditory brainstem response test (70 dB) (P=0.002). Conclusion : Our study suggest that further education about breast feeding and follow up within the first postnatal week would be necessary for early detection and prevention of early breast-feeding jaundice. Test of serum bilirubin and auditory brainstem response would be helpful in determination of blood exchange transfusion.

Diagnostic Value of Serum Procalcitonin in Febrile Infants Under 6 Months of Age for the Detection of Bacterial Infections (발열이 있는 6개월 미만의 영아에서 세균성 감염에 대한 procalcitonin의 진단적 가치)

  • Kim, Nam Hyo;Kim, Ji Hee;Lee, Taek Jin
    • Pediatric Infection and Vaccine
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    • v.16 no.2
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    • pp.142-149
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    • 2009
  • Purpose : The aim of this study was to determine the diagnostic value of serum procalcitonin (PCT) compared with that of C-reactive protein (CRP) and the total white blood cell count (WBC) in predicting bacterial infections in febrile infants<6 months of age. Methods : A prospective study was performed with infants <6 months of age who were admitted to the Department of Pediatrics with a fever of uncertain source between July and September 2008. Spinal taps were performed according to clinical symptoms and physical examination. Serum PCT levels were measured using an enzyme-linked fluorescent assay. Results : Seventy-one infants (mean age, 2.62 months) were studied. Twenty-six infants (36.6%) had urinary tract infections (UTIs), and 22 infants (31.0%) had viral meningitis. The remaining infants had acute pharyngitis (n=1), herpangina (n=1), upper respiratory tract infections (n=7), acute bronchiolitis (n=8), acute gastroenteritis (n=4), and bacteremia (n=2). The median WBC and CRP levels were significantly higher in infants with UTIs than in infants with viral meningitis. However, there were no differences in the median PCT levels between the groups (0.14 ng/mL vs. 0.11 ng/mL, P=0.419). The area under the receiver operating characteristic curve was 0.792 (95% CI, 0.65-0.896) for WBC, 0.77 (95% CI, 0.626-0.879) for CRP, and 0.568 (95% CI, 0.417-0.710) for PCT. An elevated WBC count (>11,920/${\mu}L$) and an increased CRP level (>1.06mg/dL) were significant predictors of UTIs based on multiple logistic regression analysis. Conclusion : Serum PCT concentrations should be interpreted with caution in infants <6 months of age with a fever of uncertain source.

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Decomposition Characteristics of Fungicides(Benomyl) using a Design of Experiment(DOE) in an E-beam Process and Acute Toxicity Assessment (전자빔 공정에서 실험계획법을 이용한 살균제 Benomyl의 제거특성 및 독성평가)

  • Yu, Seung-Ho;Cho, Il-Hyoung;Chang, Soon-Woong;Lee, Si-Jin;Chun, Suk-Young;Kim, Han-Lae
    • Journal of Korean Society of Environmental Engineers
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    • v.30 no.9
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    • pp.955-960
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    • 2008
  • We investigated and estimated at the characteristics of decomposition and mineralization of benomyl using a design of experiment(DOE) based on the general factorial design in an E-beam process, and also the main factors(variables) with benomyl concentration(X$_1$) and E-beam irradiation(X$_2$) which consisted of 5 levels in each factor was set up to estimate the prediction model and the optimization conditions. At frist, the benomyl in all treatment combinations except 17 and 18 trials was almost degraded and the difference in the decomposition of benomyl in the 3 blocks was not significant(p > 0.05, one-way ANOVA). However, the % of benomyl mineralization was 46%(block 1), 36.7%(block 2) and 22%(block 3) and showed the significant difference of the % that between each block(p < 0.05). The linear regression equations of benomyl mineralization in each block were also estimated as followed; block 1(Y$_1$ = 0.024X$_1$ + 34.1(R$^2$ = 0.929)), block 2(Y$_2$ = 0.026X$_2$ + 23.1(R$^2$ = 0.976)) and block 3(Y$_3$ = 0.034X$_3$ + 6.2(R$^2$ = 0.98)). The normality of benomyl mineralization obtained from Anderson-Darling test in all treatment conditions was satisfied(p > 0.05). The results of prediction model and optimization point using the canonical analysis in order to obtain the optimal operation conditions were Y = 39.96 - 9.36X$_1$ + 0.03X$_2$ - 10.67X$_1{^2}$ - 0.001X$_2{^2}$ + 0.011X$_1$X$_2$(R$^2$ = 96.3%, Adjusted R$^2$ = 94.8%) and 57.3% at 0.55 mg/L and 950 Gy, respectively. A Microtox test using V. fischeri showed that the toxicity, expressed as the inhibition(%), was reduced almost completely after an E-beam irradiation, whereas the inhibition(%) for 0.5 mg/L, 1 mg/L and 1.5 mg/L was 10.25%, 20.14% and 26.2% in the initial reactions in the absence of an E-beam illumination.

The Correction Factor of Sensitivity in Gamma Camera - Based on Whole Body Bone Scan Image - (감마카메라의 Sensitivity 보정 Factor에 관한 연구 - 전신 뼈 영상을 중심으로 -)

  • Jung, Eun-Mi;Jung, Woo-Young;Ryu, Jae-Kwang;Kim, Dong-Seok
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.3
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    • pp.208-213
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    • 2008
  • Purpose: Generally a whole body bone scan has been known as one of the most frequently executed exams in the nuclear medicine fields. Asan medical center, usually use various gamma camera systems - manufactured by PHILIPS (PRECEDENCE, BRIGHTVIEW), SIEMENS (ECAM, ECAM signature, ECAM plus, SYMBIA T2), GE (INFINIA) - to execute whole body scan. But, as we know, each camera's sensitivity is not same so it is hard to consistent diagnosis of patients. So our purpose is when we execute whole body bone scans, we exclude uncontrollable factors and try to correct controllable factors such as inherent sensitivity of gamma camera. In this study, we're going to measure each gamma camera's sensitivity and study about reasonable correction factors of whole body bone scan to follow up patient's condition using different gamma cameras. Materials and Methods: We used the $^{99m}Tc$ flood phantom, it recommend by IAEA recommendation based on general counts rate of a whole body scan and measured counts rates by the use of various gamma cameras - PRECEDENCE, BRIGHTVIEW, ECAM, ECAM signature, ECAM plus, IFINIA - in Asan medical center nuclear medicine department. For measuring sensitivity, all gamma camera equipped LEHR collimator (Low Energy High Resolution multi parallel Collimator) and the $^{99m}Tc$ gamma spectrum was adjusted around 15% window level, the photo peak was set to 140-kev and acquirded for 60 sec and 120 sec in all gamma cameras. In order to verify whether can apply calculated correction factors to whole body bone scan or not, we actually conducted the whole body bone scan to 27 patients and we compared it analyzed that results. Results: After experimenting using $^{99m}Tc$ flood phantom, sensitivity of ECAM plus was highest and other sensitivity order of all gamma camera is ECAM signature, SYMBIA T2, ECAM, BRIGHTVIEW, IFINIA, PRECEDENCE. And yield sensitivity correction factor show each gamma camera's relative sensitivity ratio by yielded based on ECAM's sensitivity. (ECAM plus 1.07, ECAM signature 1.05, SYMBIA T2 1.03, ECAM 1.00, BRIGHTVIEW 0.90, INFINIA 0.83, PRECEDENCE 0.72) When analyzing the correction factor yielded by $^{99m}Tc$ experiment and another correction factor yielded by whole body bone scan, it shows statistically insignificant value (p<0.05) in whole body bone scan diagnosis. Conclusion: In diagnosing the bone metastasis of patients undergoing cancer, whole body bone scan has been conducted as follow up tests due to its good points (high sensitivity, non invasive, easily conducted). But as a follow up study, it's hard to perform whole body bone scan continuously using same gamma camera. If we use same gamma camera to patients, we have to consider effectiveness of equipment's change by time elapsed. So we expect that applying sensitivity correction factor to patients who tested whole body bone scan regularly will add consistence in diagnosis of patients.

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