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A Study on Acute Kidney Injury Caused by Intravenous Colistimethate in Critically Ill Patients (중환자에서 Colistimethate 정맥내 투여와 관련된 급성 신손상에 대한 연구)

  • Oh, Myunghyun;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.4
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    • pp.307-315
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    • 2013
  • Objective: Colistimethate was first became available in 1950s and used until the early 1980s to treat infections caused by gram-negative bacteria and was abandoned due to its nephrotoxicity and neurotoxicity. However, it was recently reintroduced into the clinical practices due to emergence of multidrug-resistance gram-negative bacteria, particularly Pseudomonas aeruginosa and Acinetobacter baumanii. Therefore, it is increasingly used in the intensive care unit settings as a salvage therapy. This study was designed to investigate the incidence rates and risk factors of acute kidney injury associated with colistimethate by using the standardized definition in critically ill patients. Methods: This study retrospectively reviewed the electronic medical records of 71 adult patients above 18 years old receiving intravenous colistimethate at least 48 hours at intensive care unit, university-affiliated hospital from Nov 2012 to Aug 2013 and excluded patients with end-stage renal disease (ESRD) and required renal replacement therapy before initiation of the colistimethate therapy. Acute kidney injury (AKI) was determined by using the standardized RIFLE criteria, classified with risk, injury, failure, loss and ESRD according to serum creatinine (Scr) levels. Results: Among the 71 patients included in the analysis, AKI developed in 40 patients (56.3%) and 6 patients (8.4%) had irreversible kidney injury. AKI occurred within 5 days in 20 patients (50.0%). Maximum Scr level showed a significant increase in the patients with AKI ($1.92{\pm}0.86mg/dL$ vs. $1.12{\pm}0.46mg/dL$ p=0.001), maximum BUN also increased ($64.2{\pm}28.7mg/dL$ vs. $48.4{\pm}24.9mg/dL$ p=0.017) and minimum creatinine clearance (CLcr) was significantly decreased in the patients with AKI than non-AKI ($34.5{\pm}18.6ml/min$ vs. $64.4{\pm}33.7ml/min$ p=0.185). The patients with AKI had significantly longer duration of colistimethate therapy ($21.1{\pm}17.0$ days vs. $13.0{\pm}11.5$ days, p=0.020) and larger cumulative doses of colistimethate ($6465.9{\pm}4717.0mg$ vs. $4438.1{\pm}3426.7mg$, p=0.040). Conclusion: The incidence and severity of AKI associated with colistimethate in critically ill patients was high and serious. Drug monitoring program should be performed to shorten duration of therapy and reduce cumulative dose from initiation of colistimethate therapy for minimizing AKI of colistimethate.

Estimation of Total Cloud Amount from Skyviewer Image Data (Skyviewer 영상 자료를 이용한 전운량 산출)

  • Kim, Bu-Yo;Jee, Joon-Bum;Jeong, Myeong-Jae;Zo, Il-Sung;Lee, Kyu-Tae
    • Journal of the Korean earth science society
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    • v.36 no.4
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    • pp.330-340
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    • 2015
  • For this study, we developed an algorithm to estimate the total amount of clouds using sky image data from the Skyviewer equipped with CCD camera. Total cloud amount is estimated by removing mask areas of RGB (Red Green Blue) images, classifying images according to frequency distribution of GBR (Green Blue Ratio), and extracting cloud pixels from them by deciding RBR (Red Blue Ratio) threshold. Total cloud amount is also estimated by validity checks after removing sunlight area from those classified cloud pixels. In order to verify the accuracy of the algorithm that estimates total cloud amount, the research analyzed Bias, RMSE, and correlation coefficient compared to records of total cloud amount earned by human observation from the Gangwon Regional Meteorological Administration, which is in the closest vicinity of the observation site. The cases are selected four daily data from 0800 LST to 1700 LST for each season. The results of analysis showed that the Bias in total cloud amount estimated by the Skyviewer was an average of -0.8 tenth, and the RMSE was 1.6 tenths, indicating the difference in total cloud amount within 2 tenths. Also, correlation coefficient was very high, marking an average of over 0.91 in all cases, despite the distance between the two observation sites (about 4 km).

Study on Genetic Evaluation for Linear Type Traits in Holstein Cows

  • Lee, Deukhwan;Oh, Sang;Whitley, Niki C.
    • Asian-Australasian Journal of Animal Sciences
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    • v.23 no.1
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    • pp.1-6
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    • 2010
  • The objectives of this study were to i) investigate genetic performance for linear type traits of individual Holstein dairy cows, especially focusing on comparative traits, and to estimate genetic variances for these traits using actual data, and ii) compare genetic performance and improvement of progeny by birth country of the cows. Linear type traits defined with five comparative traits on this study were general stature composite (GSC), dairy capacity composite (DCC), body size composite (BSC), foot and leg composite (FLC), and udder composite (UDC). These traits were scored from 1 to 6 with 1 = poor, 2 = fair, 3 = good, 4 = good plus, 5 = very good and 6 = excellent. Final scores (FS) were also included in this study. Data used was collected from the years 2000 to 2004 by the Korea Animal Improvement Association (KAIA). Only data of more than five tested cows by herd appraisal date and by sires having more than ten daughters were included to increase the reliability of the data analyses. A total of 30,204 records of the selected traits, which was collected from 26,701 individuals having pedigree information were used. Herd appraisal date, year of age, lactation stage (grouped by month), and time lagged for milking (in hours) were assumed as fixed effects on the model. Animal additive genetic effects considering pedigree relationship and residual errors were assumed with random effects. Year of age at appraisal date was classified from one to nine years of age, assigning the value of nine years of age for animals that were greater than or equal to nine years of age. From our results, the estimate for heritability was 0.463, 0.346, 0.473, 0.290, and 0.430 on GSC, DCC, BSC, FLC and UDC, respectively. The estimate for FS heritability was 0.539. The greatest breeding values for GSC were estimated for Canada, with the breeding values for American lines increasing for 10 years starting in 1989 but tending to decrease after that until 2004. For DCC, the breeding values for American and Canadian lines showed similar patterns until 1999, after which the breeding values for the American lines declined sharply. For BSC, data from Korea, Canada and the USA followed similar trends overall except when the breeding values of the American lines decreased starting in 1999. Overall, the methods used to evaluate genetic performance in this study were acceptable and allowed for the discovery of differences by country of genetic origin, likely due in part to the American use of selection indexes based primarily on milk yield traits until methods for evaluating other traits began to emerge.

A Study on Ancient Korean Clothing and Ornaments Through Official Chinese History - focusing on hat and hair style - (중국정사(中國正史) 조선전(朝鮮傳)의 한국(韓國) 고대복식(古代服飾) - 관(冠)과 수발(修髮)을 중심으로 -)

  • Kim, Jin Seon;Koh, Bou Ja
    • Journal of the Korean Society of Costume
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    • v.64 no.1
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    • pp.106-122
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    • 2014
  • This study is based on the official Chinese history of the ancient Korean(中國正史朝鮮傳) clothing and ornaments, and also tries to discover, study, and adjust the system of the ancient Korean clothing and ornaments. Ancient Korea has very poor official records of its clothing and ornaments. Therefore, this study had no choice but to rely on the official Chinese history to cover for the lack of resources. The official Chinese history documents are not only important for studying ancient Korean history, but also important for studying about the ancient Korean clothing and ornaments. This research selected historical documents about the ancient Korean clothing and ornaments from fifteen different Chinese dynasties' official documents, and then systematically classified the documents in order to compare them. All these processes confirmed the following subjects. In regards to the Kwan(冠: general hat), the hat types included Check, Byun(弁), Jeol-poong(折風), Jowoo-Kwan(鳥羽冠), So-gol(蘇骨), and Na-kwan(羅冠). These Kwan(冠) were influenced from Chinese clothing and ornaments. Gold and silver decorations on the Kwan(冠) were influenced from the Scythai culture. The feather decorations on the hat were residual of the bird worshiping culture or the hunting lifestyle. These things show that the ancient Korean clothing and ornaments originated the clothing and ornaments from the North. But the use of Jo-woo(bird feather) was common around the globe in many ways during the ancient times, regardless of area and period. The official Chinese history describes men's hair style as Choo-gyul (椎結) or sometimes pronounced, Choo-gyul(椎結). These seem to describe the topknot. Women had various types of hair styles such as Yu-byun-bal-su-hu (wear women's hair in a braid). The official Chinese history show that the ancient Korean clothing and ornaments originated the clothing and ornaments from the north. The ancient Korean clothing and ornaments influenced and were influenced by its neighboring countries.

The Relationship between Carotid Intima-Media Thickness and 24-hour Ambulatory ECG in Ischemic Stroke Patients (뇌경색 환자의 경동맥 초음파 검사와 24시간 홀터 검사와의 연관성 연구)

  • Kang, Ji-Suck;Park, Sung-Hwan;Song, Moon-Koo;Ahn, Young-Min;Ahn, Se-Young;Lee, Byung-Cheol
    • The Journal of Internal Korean Medicine
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    • v.30 no.2
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    • pp.422-430
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    • 2009
  • Background : Stroke is the second leading cause of death in Korea, following cancer. Stroke consists of ischemic and hemorrhagic stroke, and ischemic stroke can be largely classified as atherothrombotic stroke or embolic stroke. Carotid intima-media thickness (IMT) is an indicator of atherosclerosis used commonly as a screening test for abnormalities of the coronary artery. 24-hour ambulatory ECG is widely used to screen for underlying diseases that causes syncope, palpitation, arrhythmia, etc. Objectives : Since both carotid IMT and 24-hour ambulatory ECG are used to screen for cardiac problems, we endeavored to explore the correlation between carotid IMT and 24-hour ambulatory ECG of stroke patients. Methods : The records of ischemic stroke patients who were admitted to Kyunghee Medical Center Oriental Hospital ward from March 2006 to May 2009 were reviewed. 28 patients who had both carotid Doppler US and 24-hour ambulatory ECG test undertaken during their admission were analyzed. The relationship of abnormal ambulatory results and common carotid artery(CCA) IMT were statistically analyzed using Fisher's exact test and t-test. Results : The mean age of the abnormal ambulatory group was older than the normal group (74${\pm}$ 8.0 vs. 61${\pm}$12.1, p=0.0098). Although insignificant, the abnormal ambulatory group showed much thicker CCA-IMT than normal ambulatory group (2.l7${\pm}$ 1.16 vs. 1.51${\pm}$0.97. p=0.l389). Conclusion: No significant correlation was observed between abnormal ambulatory results and CCA-IMT. However, the difference in CCA-IMT between the two groups was too big to be ignored and further investigation with larger and better controlled trials are warranted.

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Comparison of the Clinical Characteristics of Patients with Burning Mouth Syndrome due to Hyposalivation (타액분비저하에 따른 구강작열감증후군 환자의 임상적 특징 비교)

  • Lee, Ha-nul;Kim, Dong-yoon;Baek, So-young;Jeong, Hae In;Lee, Hyun-Jin;Cho, Yunjae;Ha, Na-yeon;Kim, Jinsung
    • The Journal of Internal Korean Medicine
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    • v.41 no.5
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    • pp.838-847
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    • 2020
  • Objectives: The aim of this study was to investigate the clinical characteristics of patients with Burning Mouth Syndrome (BMS) due to hyposalivation (HS). Methods: We reviewed the clinical records of 39 BMS patients who visited the Department of Digestive Diseases of Kyunghee Korean Medicine Hospital from March 1st, 2020 to July 31st, 2020. The subjects were classified according to the presence or absence of hyposalivation and both groups were compared for the proportion of coated tongue, heart rate variability (HRV), Ryodoraku, and the numeral rating scale (NRS) score of tongue pain results. Results: The BMS with Hyposalivation (HS group) and the BMS without Hyposalivation (Non-HS group) showed a significant difference in the proportion of coated tongue and the NRS score for tongue pain. The NRS score was significantly higher in the Non-HS group and the proportion of coated tongue was lower. However, no significant differences were noted in several HRV parameters between the two groups. The most frequent accompanying symptoms were xerostomia and dyspepsia. Conclusions: The results of this study suggest that hyposalivation might be one of the main causes of tongue pain, the key complaint in BMS patients. Sympathetic/parasympathetic imbalance might not be a main contribution of hyposalivation in BMS. Instead, factors such as the number of medications taken seem to correlate with hyposalivation in BMS. This results could be useful in the management of BMS patients with hyposalivation in clinical practice.

Study on a Methodology for Developing Shanghanlun Ontology (상한론(傷寒論)온톨로지 구축 방법론 연구)

  • Jung, Tae-Young;Kim, Hee-Yeol;Park, Jong-Hyun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.5
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    • pp.765-772
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    • 2011
  • Knowledge which is represented by formal logic are widely used in many domains such like artificial intelligence, information retrieval, e-commerce and so on. And for medical field, medical documentary records retrieval, information systems in hospitals, medical data sharing, remote treatment and expert systems need knowledge representation technology. To retrieve information intellectually and provide advanced information services, systematically controlled mechanism is needed to represent and share knowledge. Importantly, medical expert's knowledge should be represented in a form that is understandable to computers and also to humans to be applied to the medical information system supporting decision making. And it should have a suitable and efficient structure for its own purposes including reasoning, extendability of knowledge, management of data, accuracy of expressions, diversity, and so on. we call it ontology which can be processed with machines. We can use the ontology to represent traditional medicine knowledge in structured and systematic way with visualization, then also it can also be used education materials. Hence, the authors developed an Shanghanlun ontology by way of showing an example, so that we suggested a methodology for ontology development and also a model to structure the traditional medical knowledge. And this result can be used for student to learn Shanghanlun by graphical representation of it's knowledge. We analyzed the text of Shanghanlun to construct relational database including it's original text, symptoms and herb formulars. And then we classified the terms following some criterion, confirmed the structure of the ontology to describe semantic relations between the terms, especially we developed the ontology considering visual representation. The ontology developed in this study provides database showing fomulas, herbs, symptoms, the name of diseases and the text written in Shanghanlun. It's easy to retrieve contents by their semantic relations so that it is convenient to search knowledge of Shanghanlun and to learn it. It can display the related concepts by searching terms and provides expanded information with a simple click. It has some limitations such as standardization problems, short coverage of pattern(證), and error in chinese characters input. But we believe this research can be used for basic foundation to make traditional medicine more structural and systematic, to develop application softwares, and also to applied it in Shanghanlun educations.

Effects of Herbal and Western Medicines on Liver Functions (한.양약 복용이 간기능이상에 미치는 영향에 대한 연구)

  • Park, Hae-Mo;Shin, Heon-Tae;Lee, Sun-Dong
    • Journal of Society of Preventive Korean Medicine
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    • v.11 no.2
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    • pp.23-39
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    • 2007
  • Objectives : The aim of this study was to evaluate effects of herbal medicine and other associated factors for abnormal liver function tests(especially total bilirubin, AST, ALT, and ${\gamma}GT$) levels in outpatients at an oriental medical clinic. Methods : A cross-sectional study based on clinical records was conducted on 1,871 patients at one Oriental medical clinic in Seoul, Korea. 504 patients received a liver function tests for screening and 497 patients ranging from the age of 4 to 74 were chosen for the study. Patients with basal liver disease or DM were excluded during the screening process. Patients were classified into case(abnormal) and control(normal) groups by normal liver function test references. Results and Conclusions : In this study, 33.0% of the patients were females, and 67.0% were males. The mean age was $34.7{\pm}11.9$ years old. The mean total protein value was $6.78{\pm}0.66g/dL$(male $6.79{\pm}0.61$, female $6.76{\pm}0.76$), albumin $3.89{\pm}0.50g/dL$(male $3.94{\pm}0.47$, female $3.81{\pm}0.54$), total bilirubin $0.51{\pm}0.35mg/dL$(male $0.54{\pm}0.39$, female $0.45{\pm}0.23$), AST $23.31{\pm}18.22U/L$(male $26.37{\pm}20.73$, female $17.09{\pm}8.72$), ALT $33.49{\pm}36.36U/L$(male $40.56{\pm}41.77$, female $19.13{\pm}12.64$), LDH $258.07{\pm}74.84mg/dL$(male $263.68{\pm}73.77$, female $246.70{\pm}75.92$), and ${\gamma}GT$ $39.64{\pm}59.16U/L$(male $50.15{\pm}69.43$, female $17.83{\pm}8.36$). The percentage of abnormal total bilirubin levels(>1.0) in these patients was 2.6%, abnormal AST levels(>39m, >29f) 8.5%, ALT levels(>47m, >32f) 18.8%, and ${\gamma}GT$ (>50m, >40f) 19.9%.

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Colonization Rate of Methicillin-resistant Staphylococcus aureus in Neonates: A Single Center Experience (단일병원 신생아 환자의 메티실린내성 황색포도알균 보균율)

  • Choi, Soo Young;Han, Sang Woo;Yoon, Hye Sun;Ki, Moran
    • Pediatric Infection and Vaccine
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    • v.19 no.3
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    • pp.111-120
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    • 2012
  • Purpose: The aim of this study is to investigate the colonization rate of Methicillin-resistant Staphylococcus aureus (MRSA) in neonates by different clinical characteristics, to presume the origin of MRSA acquisition, and to identify the risk factors associated with MRSA colonization. Methods: We retrospectively reviewed the medical records of 1,733 neonates admitted to Seoul Eulji hospital Neonatal Intensive Care Unit between January 2008 and December 2011. Nasal, inguinal and rectal swab specimens were obtained upon admission and each week until discharge. We classified the route of MRSA acquisition as; hospital associated (HA-MRSA) and community associated (CA-MRSA) according to the case definition. Results: Among 1,733 neonates, 415 (23.9%) were colonized with MRSA. Gestational age, birth weight, delivery type, maternal antibiotics usage before delivery, birth place and care place before admission were influencing factors in colonization of MRSA. The colonization rate was significantly high in neonates without maternal prophylactic antibiotics use before delivery than in the other group (relative risk 2.77, 95% CI 1.88-4.07; P<0.01), and outborns showed higher MRSA colonization rate compared to inborns (relative risk 2.28, 95% CI 1.17-4.42; P=0.015). Conclusion: We identified the neonatal MRSA colonization rate to be 23.9%. We estimated HA-MRSA colonization rate to be 10% (51/511) and CA-MRSA colonization rate to be 36% (309/858). We ascertained that risk factors in MRSA colonization in neonates were prophylactic use of antibiotics in mothers and the birth place.

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A Study on the Policy Improvement by Means of a Historical Review of School Health Programs (학교보건사업의 역사적 고찰을 통한 정책 방향에 관한 연구)

  • Kim, Sang-Wook;Kim, Yoon-Shin;Chang, Chang-Gok
    • Journal of the Korean Society of School Health
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    • v.17 no.2
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    • pp.127-150
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    • 2004
  • Objectives: The purpose of this study is to provide a basic structure for the establishment of the direction of school health programs, an overview of the historical changes of school health programs and their results, and a conceptual framework on school health programs. Methods: The data analysis has been done using a statistical almanac, relevant laws and regulations, operation handbook of the program, theses, reports, records of public hearings, and other reports as a technical research primarily based on evidence. The methodology of this research classifies the development and growth transition of school health programs during a historical period through the investigation of regulations, organization, manpower, and its program via its development process and to provide a basic tool to design a solid school health policy. Results: A The growth and development of school health programs The development of school health programs was classified into three different periods including the forthcoming period (1945~1967), the completion period (1967~1993), and the actualization period based on the establishment of legislation for School Health Law, other relevant legislation, and the contents of school health programs (1993~present). B. Policy direction of school health programs School health programs have reestablished their goals and range based on basic direction, and developed the W1it model of information structure for school health program management and its basic structure. Finally, the stepwise support system through the building of the school health support center is recommended. (1) The basic direction of school health programs has proposed 7 basic goals to reestablish the policy direction of health improvement based on total health. (2) The W1it model of information system and the school health information system for school health program management has been developed to utilize positive management. (3) School health policy through the study of the health laws and systems has been developed. The necessity of school health support center for the policy support, functional support and operation support has also been proposed. Conclusions: It is necessary to build a school health support center that consists of health professionals in charge of policy support, functional support, and program support of school health programs in order to realize and develop new policy.