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Risk Factors for Nosocomial Pneumonia in Patients at NS ICU (신경외과 중환자실의 병원성 폐렴 발생 위험요인)

  • Kim Nam Cho;Kim So Yeon
    • Journal of Korean Public Health Nursing
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    • v.15 no.2
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    • pp.239-248
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    • 2001
  • The purpose of this study was to analyze risk factors for nosocomial pneumonia in patients admitted to NS ICU, and to provide a basic data to decrease respiratory nosocomial infection rate engendered from medical environments in NS ICU. The study site was the NS ICU at a university hospital located in Seoul, Korea. The subjects were 31 patients diagnosed with nosocomial pneumonia, who were selected from the initial list of 300 potential subjects who had been a) admitted between September 1999 and January 2000, and September 2000 and January 2001, b) resided at the NS ICU over 72 hours. The diagnostic standard of nosocomial pneumonia was based on the nosocomial infection guides of C university hospital. The data were analyzed using frequencies and logistic regression analysis. The sputums obtained from the subjects were cultivated and causal viruses were separated. The results were as follows: 1. The nosocomial pneumonia rate was $10.3\%$. There were 7 types of causal viruses separated from the sputum. and the most prevalent type of virus was MRSA as $62.2\%$. 2. The factors significantly influencing the incidence of nosocomial pneumonia included age, the residential duration at the NS ICU, GCS scores, diabetes mellitus, insertion of tracheal tube and its duration, tracheostomy and its length of insertion, the use of artificial ventilator and the length of its use, and the insertion of naso-gastic tube. The most significant risk factor among these was the insertion of tracheal tube (odds ratio=18.684. $95\%$ CI=6.849-50.974), followed by the use of tracheostomy (odds ratio=15.419, $95\%$ CI=6.615-35.942), the insertion of naso-gastric tube (odds ratio=14.875, $95\%$ CI=6.396-34.595), and the use of artificial ventilator (odds ratio=13.000. $95\%$ CI=5.633­30.001). 3. Regarding the use of the mechanical aids, the insertion of tracheal tube resulted in 12.968 times increase of the nosocomial pneumonia rate, and the use of artificial ventilator lead 6.714 times increase of the nosocomial pneumonia rate. One point increase of the GCS score resulted in the 1.210 times increase of the nosocomial pneumonia rate. For patients who had tracheal tube, tracheostomy, and artificial ventilator, one day increase of their residential duration at NS ICU lead 1.073 times increase of the nosocomial pneumonia rate. 4. In terms of duration of the mechanical aid usage, one day increase in the use of artificial ventilator engendered 1.080 times increase in the nosocomial pneumonia rate. One day increase of the residential duration at the NS ICU lead 1.604 times increase in the nosocomial pneumonia rate. As one point of the GCS score increased, 0.876 times decrease of the nosocomial pneumonia rate was reported. These study findings show that the risk factors significantly influencing the incidence of nosocomial pneumonia include the use of tracheal tube, tracheostomy, naso-gastic tube, and artificial ventilator. It is recommended that nurses working at NS ICU should pay more attention to the patients with these factors as the risky group for the nosocomial pneumonia, and thus make more active efforts to provide nosocomial pneumonia prevention strategies for them. In further studies patients admitted to the different types of ICUs such as internal medicine or surgery unit ICU will be also included, and more wide investigation of nosocomial pneumonia risk factors will be conducted through one-year longitudinal follow up.

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Effect of Blue Color-deficient Sunlight on the Productivity and Cold Tolerance of Crop Plants II. On the unsaturation of mitochondrial phospholipid (청색파장(靑色波長)영역이 결여된 태양광이 작물(作物)의 생산성(生産性) 및 내냉성(耐冷性)의 향상에 미치는 효과 II. 미토콘드리아막(膜)의 인지질불포화도(燐脂質不飽和度)의 증가)

  • Jung, Jin;Kim, Chang-Sook
    • Korean Journal of Environmental Agriculture
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    • v.5 no.2
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    • pp.149-155
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    • 1986
  • The fatty acid compositions of phospholipids extracted from leaves and leaf mitochondria, which were sampled from several horicultural plants grown under blue color-deficient sunlight (BCDS), were determined and compared with those from plants grown under natural white colored sunlight(WCS). It was found that the mitochondria isolated from plants grown under BCDS contained phospholipid whose degree of unsaturation in unit of number of double bonds per lipid molecule was remarkably higher than that from plants grown under WCS, the relative increment being $8{\sim}49%$. This was significantly larger than the relative increment, $4{\sim}8%$ for total phospholipid extracted from whole leaves grown under BCDS campared to WCS. This observation demonstrated that the blue light effect of sunlight on the chemical property of cellular membranes, as long as it was concerned with fatty acid composition, arose mainly at the mitochondrial membrane. Also observing that the degree of unsaturation of mitochondrial phospholipid was much lower than that of total phospholipid, it was interpreted that this was the consequence of rather active oxidative destruction of lipid-fatty acid components occuring in mitochondrial membrane by the reactive oxygen species, especially superoxide($O_2-$), which was known to be produced in mitochondrial inner membrane through the side reactions of the respiratory electron transport chain and also probably through the photosensitized reaction involving oxygen induced by blue colored light. Thus, it may be tentatively concluded that the extent of photosensitization in mitochondrial membrane could be considerably reduced under BCDS resulting in lowering of the $O_2-$ level in the respirating organelle The possible involvement of photodynamic action in membrane oxidation was also indicated by the fact that the typical fat-soluble antioxidant, ${\alpha}-tocopherol$, was found to be contained on a higher level in leaves under BCDS than those under WCS.

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Outcomes and Management of Fetal Infants with Birth Weight Below 500 g at a Tertiary Center (출생체중 500 g 미만의 태아영아 치료성적 및 치료의 실제)

  • Chang, Yun Sil;Kim, Yu Jin;Koo, Soo Hyun;Lee, Jang Hoon;Hwang, Jong Hee;Choi, Chang Won;Shim, Jae Won;Kim, Sung Shin;Ko, Sun Young;Lee, Eun Kyung;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.48 no.9
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    • pp.939-945
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    • 2005
  • Purpose : The purpose of this study was to report outcome of fetal infants with birth weight below 500 g known as lower limit of viability and to evaluate treatment characteristics and short-term morbidity of their survivors. Methods : We retrospectively analyzed the medical records of all fetal infants with birth weight below 500 g who were delivered at Samsung Medical Center(SMC), or transferred to neonatal intensive care unit(NICU) of SMC within 24 hrs after birth between 1994 and 2004. Data for all interventions and morbidity outcome were analyzed for infants who were admitted to the NICU and were compared between NICU survivors and deaths. Results : Among 53 infants with birth weights of 400 to 499 g who were born in SMC during the study period, 8(15.1%) infants were admitted to the NICU and one was transferred to NICU from other hospital. Overall, 4(44%) of 9 survived and were discharged from the NICU. The smallest infant who survived weighed 439 grams. The least gestational age was $23^{+3}$ among the survivors. Compared with NICU deaths, NICU survivors had larger gestational age($24^{+2}{\pm}1^{+3}$ vs. $25^{+4}{\pm}2^{+3}$) and birth weight($424{\pm}17$ vs. $453{\pm}19$)(P<0.05). Median survival duration of NICU deaths was 15 days. None of NICU survivors had severe IVH, but 3(75%) had laser therapy for retinopathy of prematurity and bronchopulmonary dysplasia, respectively. Conclusion : Fetal infants with birth weight below 500 g known as lower limit of viability survived successfully. Study for their long-term follow-up will be needed to define our limit of viability and indication for their active resuscitation.

Clinical Study of Group B β-Hemolytic Streptococcal Meningitis (B군 연쇄상구균 뇌막염에 대한 임상적 고찰)

  • Lee, Seo-Young;You, Sou-Jeong;Kim, Deok-Soo;Ko, Tae-Sung
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1224-1229
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    • 2003
  • Purpose : Bacterial meningitis is a serious disease, especially in the neonatal period, and it carries a significant degree of mortality and morbidity. Group B streptococcus(GBS) is a common cause of neonatal bacterial meningitis. The purpose of this study was to evaluate the clinical manifestations, treatment results and complications of GBS meningitis. Methods : We analyzed 29 cases retrospectively who had been admitted to the pediatric ward or NICU in Asan Medical Center from May 1990 to January 2002. They had proven GBS in culture or latex agglutination test in CSF. Results : The male to female ratio was 1 : 1.9. There were two cases of early onset type and 27 cases of late onset type. All cases had normal birth weight with full term at delivery. The perinatal predisposing factors were premature rupture of membrane(two cases), and maternal colonization(two cases). The most common presenting symptoms were fever and irritability. Associated diseases were GBS sepsis(21 cases). There was relatively high sensitivity to penicillin derivatives. There were abnormal brain CT or MRI findings in 16 cases(64%), such as infarction, encephalomalatic change, effusion, hydrocephalus, hemorrhage and abscess. The intensive care unit admission rate and the incidence of DIC were higher in the group with complications. Two cases were discharged against advice. Conclusion : We recommend early detection and active treatment in Group B streptococcal meningitis to improve the prognosis.

The Impact of the Reclamation and Utilization of Idle Hillside Lands on Future Food Production in Korea (식량(食糧)의 안정적(安定的) 공급(供給)을 위한 산지개발이용의 필요성(必要性)과 전망(展望))

  • Park, Johng-Moon
    • Korean Journal of Soil Science and Fertilizer
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    • v.11 no.4
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    • pp.213-233
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    • 1979
  • It is generally agreed that the country's population will grow up to the level of 52 million by the year of 2000 and that due the active growth of industry, urbanization and road constructions, sizable portion of existing arable lands will be utilized for other purposes than agriculture in near future. From 1966 to 1977, it was estimated that, the average annual conversion of arable lands to other uses, was 12,909 ha. If this trend persists, it is predicted that from 1978 to 1991 when the 6th Five Years Economic Development Plan will terminate, approximately 181,000 ha of arable lands will be converted for other uses again. On the other hand, it is certain that the increased population (39 million in 1981, 45 million in 1991, 52 million in 2001) and the changes in food pattern along with the enhancement of living standards will bring about the phenomenal increase in demands for not only the staple food but also the livestock products such as meat, milk and eggs, vegetables and fruits. These future increased demands for various foods, naturally mean the increased needs for the expansion of arable lands at the same time. It is predicted that, if more activities than present scale are not taken for the expansion of arable lands, the national food self sufficiency level will drop from 79% in 1977 down to 62% in 1991. To meet the increased food demands in future, there are several ways and means. These will include the increased land use intensity, elevation of unit area yield levels, minimization of conversion of arable lands to other uses and expansion of arable lands through the reclamations of idle hillside lands and tidal lands. Among these, the expansion of arable lands through reclamations of idle hillside lands and tidal lands are more positive measures to cope with the increased production of foods in future. The reclamation of hillside lands demands more attention because it needs more advanced technologies in agronomical and engineering aspects, larger scale fundings and integrated socioeconomic considerations. In agromical aspects, the thechniques for early improvement of chemical and physical properties of soils, proper soil conservation measures and rational cropping systems are of particular importance. As to the financial supports to encourage the farmings in hillside land, much bold fund inputs are essential for the construction of roads, installation of irrigation and drainage facilities, soil conservation mechanisms, which will ensure the stabilized farming with reasonable incomes in the newly reclaimed lands.

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Importance of Strain Improvement and Control of Fungal cells Morphology for Enhanced Production of Protein-bound Polysaccharides(β-D-glucan) in Suspended Cultures of Phellinus linteus Mycelia (Phellinus linteus의 균사체 액상배양에서 단백다당체(β-D-glucan)의 생산성 향상을 위한 균주 개량과 배양형태 조절의 중요성)

  • Shin, Woo-Shik;Kwon, Yong Jung;Jeong, Yong-Seob;Chun, Gie-Taek
    • Korean Chemical Engineering Research
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    • v.47 no.2
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    • pp.220-229
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    • 2009
  • Strain improvement and morphology investigation in bioreactor cultures were undertaken in suspended cultures of Phellinus linteus mycelia for mass production of protein-bound polysaccharides(soluble ${\beta}$-D-glucan), a powerful immuno-stimulating agent. Phellineus sp. screened for this research was identified as Phellinus linteues through ITS rDNA sequencing method and blast search, demonstrating 99.7% similarity to other Phellinus linteus strains. Intensive strain improvement program was carried out by obtaining large amounts of protoplasts for the isolation of single cell colonies. Rapid and large screening of high-yielding producers was possible because large numbers of protoplasts ($1{\times}10^5{\sim}10^6\;protoplasts/ml$) formed using the banding filtration method with the cell wall-disrupting enzymes could be regenerated in relatively high regeneration frequency($10^{-2}{\sim}10^{-3}$) in the newly developed regeneration medium. It was demonstrated that the strains showing high performances in the protoplast regeneration and solid growth medium were able to produce 5.8~6.4%(w/w) of ${\beta}$-D-glucan and 13~15 g/L of biomass in stable manners in suspended shake-flask cultures of P. linteus mycelia. In addition, cell mass increase was observed to be the most important in order to enhance ${\beta}$-D-glucan productivity during the course of strain improvement program, since the amount of ${\beta}$-D-glucan extracted from the cell wall of P. linteus mycelia was almost constant on the unit biomass basis. Therefore we fully investigated the fungal cell morphology, generally known as one of the key factors affecting cell growth extent in the bioreactor cultures of mycelial fungal cells. It was found that, in order to obtain as high cell mass as possible in the final production bioreactor cultures, the producing cells should be proliferated in condensed filamentous forms in the growth cultures, and optimum amounts of these filamentous cells should be transferred as active inoculums to the production bioreactor. In this case, ideal morphologies consisting of compacted pellets less than 0.5mm in diameter were successfully induced in the production cultures, resulting in shorter period of lag phase, 1.5 fold higher specific cell growth rate and 3.3 fold increase in the final biomass production as compared to the parallel bioreactor cultures of different morphological forms. It was concluded that not only the high-yielding but also the good morphological characteristics led to the significantly higher biomass production and ${\beta}$-D-glucan productivity in the final production cultures.

Examination of the Current Situations of Security Dogs and it's Development Plans (경호탐지견의 운용실태 및 발전방안)

  • Park, Hyung-Kyu;Kim, Doo-Hyun
    • Korean Security Journal
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    • no.14
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    • pp.215-234
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    • 2007
  • Our country security industry 1960's service expense of the beginning U.S. army unit it accomplishes the growth which is quick with start, currently about 2,500 triumph the security enterprises which it goes over are being active. But the majority in these enterprise about lower cotton can a forever characteristic with pressure and the manpower civil official ability insufficient back of faithlessness management and capital power. To sleep with afterwords it presents the security dogs deployment plan for an efficient security together from the research which it sees hereupon and it does. First, it cultivates the domestic mountain progress dog which is a breed which is suitable with the security dogs and the shovel flesh dog back with the security dogs. Specially the Jindo of the breed which is excellent training which is suitable in task of the security dogs it leads and if it uses appropriately, it industrializes our specific the Jindo and protection there is a possibility of getting the effect which falls to also the gist which it rears rightly. It cultivate the second, security dogs and it magnifies training. The security dogs consequently is it will be able to accomplish the task above 2 branches to training method. Namely, after finishing obedience training, it is to be in security activity it will execute guard or detection back special training which is suitable in task and it will be able to commit. Third, it uses the security dogs which is trained rightly in task. The security dogs the adult escorts, facility expense, the explosive and narcotic drug detection, it will be able to use with the other blind man guidance dogs back. The narcotic drug detection dogs which currently is used specially technique intelligence anger, when considering the tendency of the narcotic drug smuggling offense field which becomes diversification that the role very it is important is a possibility of saying at day. It cultivate a fourth, escort relation specialty manpower and it improves the breed of the security dogs. The hazard which cultivate the security dogs use necessary personnel the breed of security dogs, the security dogs training center it opens the security crane relation subject of the college which stands and (university) it improves it establishes and training which is suitable in task it is to do to execute letting in the training map company. Specially, the hazard which improves the breed of security dogs in the progress mind quality which stands against the portion where the breed improvement is demanded as the portion where the internal organs research and investment are necessary sees. The security dogs compares in labor cost and the expense holds few, if it uses the our specific domestic dogs it will be able to use efficiently in the task which is various it solves the multi branch plans for wisly with the security dogs industrial development security of course contemporary history sliced raw fish sees demands compared to being immediacy and the life which is happy business the place where it does it sees it will be able to contribute a lot as.

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The Effects of Home Economics Instruction Using Motivation(ARCS) Strategy on the Learning Motivation and Academic Attitude toward the Subject (동기유발(ARCS) 전략을 적용한 가정과 수업이 학습동기 및 교과에 대한 태도에 미치는 효과)

  • Yu Me-Suk;Chae Jung-Hyun
    • Journal of Korean Home Economics Education Association
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    • v.17 no.4 s.38
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    • pp.157-173
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    • 2005
  • The purpose of this study is to clarify the effects of Home Economics instruction using motivation(ARCS) strategy on the learning motivation and academic attitude toward the subject. To accomplish the purpose, teaching-learning plan using motivation(ARCS) strategy was developed and the subjects for this study were 155 End grade male students randomly chosen from four classes at a middle school in Incheon Metropolitan City. In the 5th period instruction about 'utilization of resources and environment' unit, 76 students of two classes as an experimental group received the Home Economics instruction using motivation(ARCS) strategy, while 79 students of two classes as a comparative group took lecture type instruction. The results of this study were as the follows 1. Home Economics instruction using motivation(ARCS) strategy was more effective than the lecture type instruction to improve learning motivation and positive change in academic attitude toward Home Economics subject. 2. Home Economics instruction using motivation(ARCS) strategy was effective to improving learning motivation regardless of their levels of students prior learning motivation and learning achievement. 3. Home Economics instruction using motivation(ARCS) strategy was effective to positive change in academic attitude toward Home Economics subject regardless of their levels of students Prior learning achievement and at the aspect of prior motivation to learn, the high level students were more effective than the low level students. 4. According to responses of students and teacher for Home Economics instruction using motivation(ARCS) strategy, it was effective to improving active participation and interest for Home Economics instruction.

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Changes in Radiation Use Efficiency of Rice Canopies under Different Nitrogen Nutrition Status (질소영양 상태에 따른 벼 군락의 광 이용효율 변화)

  • Lee Dong-Yun;Kim Min-Ho;Lee Kyu-Jong;Lee Byun-Woo
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.8 no.3
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    • pp.190-198
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    • 2006
  • Radiation use efficiency (RUE), the amount of biomass produced per unit intercepted photosynthetically active radiation (PAR), constitutes a main part of crop growth simulation models. The objective of the present study was to evaluate the variation of RUE of rice plants under various nitrogen nutritive conditions. from 1998 to 2000, shoot dry weight (DW), intercepted PAR of rice canopies, and nitrogen nutritive status were measured in various nitrogen fertilization regimes using japonica and Tongil-type varieties. These data were used for estimating the average RUEs before heading and the relationship between RUE and the nitrogen nutritive status. The canopy extinction coefficient (K) increased with the growth of rice until maximum tillering stage and maintained constant at about 0.4 from maximum tillering to heading stage, rapidly increasing again after heading stage. The DW growth revealed significant linear correlation with the cumulative PAR interception of the canopy, enabling the estimation of the average RUE before heading with the slopes of the regression lines. Average RUE tended to increase with the increased level of nitrogen fertilization. RUE increased approaching maximum as the nitrogen nutrition index (NNI) calculated by the ratio of actual shoot N concentration to the critical N concentration for the maximum growth at any growth stage and the specific leaf nitrogen $(SLN;\;g/m^2\;leaf\;area)$ increased. This relationship between RUE (g/MJ of PAR) and N nutritive status was expressed well by the following exponential functions: $$RUE=3.13\{1-exp(-4.33NNNI+1.26)\}$$ $$RUE=3.17\{1-exp(-1.33SLN+0.04)\}$$ The above equations explained, respectively, about 80% and 75% of the average RUE variation due to varying nitrogen nutritive status of rice plants. However, these equations would have some limitations if incorporated as a component model to simulate the rice growth as they are based on relationships averaged over the entire growth period before heading.

Changes in isoflavone content and quality characteristics of Cheonggukjang prepared with Bacillus subtilis HJ18-3 and KACC 15935 (Bacillus subtilis HJ18-3과 KACC 15935를 이용하여 제조한 청국장의 품질특성과 isoflavone 함량의 변화)

  • Lee, Kyung Ha;Choi, Hye Sun;Choi, Yoon Hee;Park, Shin Young;Song, Jin
    • Food Science and Preservation
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    • v.21 no.1
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    • pp.121-128
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    • 2014
  • This study was conducted in order to investigate the change of isoflavone composition (glycoside and bio-active aglycone), and to evaluate the quality characteristics of Cheonggukjang, which was prepared by different bacillus strains. After the 48-hour fermentation, the contents of daidzein, genistein, and glycitein in the Bacillus subtilis HJ18-3 have significantly increased up to approximately $89.06{\pm}3.59$, $10.36{\pm}0.28$, and $101.37{\pm}3.67ug/g$, respectively. The contents of daidzein, genistein, and glycitein in the Bacillus subtilis KACC 15935 were $38.88{\pm}5.39$, $12.58{\pm}2.14$, and $80.13{\pm}0.71ug/g$, respectively. The original content of daidzein was 3.96 ug/g, while genistein and glycitein were not measured. However, the contents of daidzen and genistein in HJ18-3 and in KACC 15935 were decreased. The ${\alpha}$-Amylase and cellulase activities of Chungkookjang in HJ18-3 were higher than in the KACC 15935. The contents of Chungkookjang in HJ18-3 were $29.70{\pm}11.66$ and $4861.3{\pm}388.07unit/g$, respectively. The amino type nitrogen contents and ammonia type nitrogen contents of Chungkookjang in KACC 15935 were higher than in the HJ18-3. These results suggested that it could be used to increase the bioactivity via fermentation with the Bacillus subtilis possessing a ${\beta}$-glucosidase activity with a view towards the development of functional foods.