Objective: Infection is very common in the elderly, so there is a high prevalence of antibiotics use among this population. Especially, due to the emergence of resistant bacteria, the use of vancomycin is growing. The purpose of this study was to evaluate risk factors associated with vancomycin-induced nephrotoxicity in elderly patients. Methods: The subjects of this study were patients over 18 years old who received intravenous vancomycin in a general hospital located in Gangneung-si, Korea between August 1, 2013 and July 31, 2015. Data collection regarding vancomycin use and baseline characteristics was conducted using computerized hospital database. Logistic regression analysis was used to identify risk factors associated with vancomycin-induced nephrotoxicity. Results: A total of 290 patients were finally included, and 191(66%) out of these patients were age 65 or older. The incidence of vancomycin-induced nephrotoxicity was 11.0%, 12.6%, and 7.0% in the all adult patients, the elderly patients, and the non-elderly patients, respectively. There were significant differences in comorbidities between patients with nephrotoxicity and patients without nephrotoxicity in the all adult patients, and there were significant differences in vancomycin duration, comorbidities, and number of nephrotoxic agents between patients with nephrotoxicity and patients without nephrotoxicity in the elderly patients. However, according to the logistic regression analysis, there was no significant risk factor that increases the incidence of vancomycin-induced nephrotoxicity in all three age groups. Conclusion: There were no differences in risk factors that increase the incidence of vancomycin-induced nephrotoxicity between all adult patients, elderly patients, and non-elderly patients. Further studies with larger sample sizes to identify risk factors associated with vancomycin-induced nephrotoxicity in the elderly to improve the outcome of pharmacotherapy are required.
Objectives: This study was conducted to investigate the effects of the sources of vitamin D (duration of exposure to sunlight, intake of major food sources for vitamin D or vitamin D supplements) on the serum 25-(OH) $D_3$ levels, and the physical growth of a child. Methods: Subjects were 296 children aged 1 to 5 years who visited S hospital located in Changwon City. Survey data collection was carried out by direct interview method, and the biochemical data were collected using hospital records. Results: The study subjects were divided into three groups according to their levels of serum 25-(OH) $D_3$ (deficient, relatively insufficient, sufficient) and their percentage were 48.3%, 44.3% and 7.4% respectively. The average concentration of serum 25-(OH) $D_3$ was $20.41{\pm}6.55ng/mL$, which was relatively insufficient. The average duration of exposure to sunlight was $58.86{\pm}49.18minutes/day$. A total score of vitamin D major food sources was 46.71 points (full marks 153), and the most frequently consumed food items were milk, eggs, and cheese. Thirty-four percent of the subjects took vitamin D supplements and their dose were $11.96{\mu}g/day$. Three vitamin D sources in sufficient group were higher than deficient or relatively insufficient group significantly. Intake of vitamin D supplements showed positive relation (+) and high explanation power ($R^2=0.288$) on serum 25-(OH) $D_3$ concentration, but intake of vitamin D major food sources (+) and the duration of exposure to sunlight (+) had a low explanation power ($R^2=0.068$). The relations between serum 25-(OH) $D_3$ concentration and physical growth (height and weight) were shown as negative (-), and their explanation powers were low as 7.3% and 5.9% respectively. Conclusions: This study results can be useful when discussing the intake standard of vitamin D and the effective intake method for children. In addition, it will be helpful to build the children's nutrition policy and to plan the nutrition education program to improve the vitamin D status in children.
It was a pilot study for developing an algorithm to determine the presence or absence of cervical spine injury by analyzing the severity factor of the patients in motor vehicle occupant accidents. From August 2012 to October 2016, we used the KIDAS database, called as Korean In-Depth Accident Study database, collected from three regional emergency centers. We analyzed the general characteristics with several factors. Moreover, cervical spine injury patients were divided into two groups: Group 1 for from Quebec Task Force (hereinafter 'QTF') grade 0 to 1, and group 2 for from QTF grade 2 to 4. The score was assigned according to the distribution ratio of cervical spine injured patients compared to the total injured patients, and the cut-off value was derived from the total score by summation of the assigned score of each factors. 987 patients (53.0%) had no cervical spine injuries and 874 patients (47.0%) had cervical spine injuries. QTF grade 2 was found in 171 patients (9.2%) with musculoskeletal pain, QTF grade 3 was found in 38 patients (2.0%) with spinal cord injuries, and QTF grade 4 was found in 119 patients (6.4%) with dislocation or fracture, respectively. We selected the statistically significant factors, which could be affected the cervical spine injury, like the collision direction, the seating position, the deformation extent, the vehicle type and the frontal airbag deployment. Total score, summation of the assigned each factors, 10 was presented as a cut-off value to determine the cervical spine injury. In this study, it was meaningful as a pilot study to develop algorithms by selecting limited influence factors and proposing cut-off value to determine cervical spine injury. However, since the number of data samples was too small, additional data collection and influencing factor analysis should be performed to develop a more delicate algorithm.
Objectives: The 2007 Korea National Survey for Environmental Pollutants in the Human Body found the highest blood mercury levels nationwide among residents in Seoksan-ri, Goro-myeon, Gunwi-gun, Gyeonsangbuk-do. With the aim to reduce the blood mercury levels of residents in this region, we conducted this study to identify the association between mercury exposure levels and shark meat consumption. Methods: This survey was conducted with 118 participants in Seoksan-ri before the Chuseok festival and 113 residents were added afterwards. Information on participants was collected via questionnaires. Total mercury concentrations in biological samples were measured using a mercury analyzer with the gold-amalgam collection method. Results: To identify this, we conducted mercury exposure level analysis before and after the Chuseok festival and found that blood and urinary mercury levels after Chuseok (GM of $6.9{\mu}g/L$ in blood and $1.68{\mu}g/g$_cr in urine) were higher than those before (GM of $5.29{\mu}g/L$ in blood and $1.44{\mu}g/g$_cr in urine). This area maintains a custom of using shark meat as one of the ancestral rite foods, and the performance of such rites and shark meat consumption have been identified as main sources of mercury exposure. Other than this, smoking, dental amalgam treatment and residential period in the area also contributed to an increase in mercury exposure levels. On the other hand, recent consumption of oriental medicine and vaccination did not have a significant influence on mercury levels. Conclusion: The results were attributed to the local custom of consuming shark meat with high mercury concentrations during rituals taking place during the festival and ancestral rites. Given that the blood mercury levels in 23.2% of the residents exceeded the HBM II values recommended by the German Commission on Human Biological Monitoring, it is suggested that further appropriate actions and follow-up measures be taken to reduce the mercury exposure levels of the residents that exceeded the reference values.
공동주택환경과 기간통신사업자의 서비스 제공 방식에 따라 광단국 및 광분배장비를 집중구내통신실과 동 지하에 설치하여 여러 서비스를 제공하지만 장비설치를 위한 공간확보와 케이블을 추가 포설하기 위한 예비배관확보를 위하여 서비스 제공 사업자사이에 분쟁이 심화되고 있다. 이러한 사항은 사업자들이 가입자 확보에만 치우치고 유지관리에는 소홀하며 또한 공동주택이 사유지임에도 불구하고 각 사업자들이 투자한 설비는 사업자의 자산임을 내세워 타인이 건드릴 수 없도록 하고 있기 때문이다. 따라서 본 연구에서는 공동주택을 대상으로 여러 통신사업자와 방송사업자가 서비스하는 종류와 방법, 유지관리 실태, 문제점 등을 현장 실태조사를 통해 살펴보고 정보통신부에서 관리하는 정보통신공사업법과 전기통신기본법, 홈네트워크 등 기술기준, 건설교통부에서 관리하고 있는 주택법, 건축법, 주택건설기준등에 관한규정 등 여러 법령과의 관계를 분석하여 일정규모의 공동주택환경에서는 정보통신설비의 유지관리 제도가 의무화되어, 이용자가 안전하게 서비스를 이용할 수 있도록 개선 필요성을 제시하고자 한다.
The purpose of this study was to examine the stressors and coping strategies of school -age children and to explore the relationship between stressful life events and health symptoms and the effects of coping and trait anxiety which is theoretically considered to mediate the relationship between stress and health symptom. The study subjects consisted of 639 elementary school children in the fourth to sixth grade living in Seoul. Of the 639 subjects, 348 were boys and 291 were girls. The mean age was 11.35 (SD=.86). The Feel Bad Scale(FBS), Schoolager's Coping Strategy Inventory(SCSI), Spielberger's Trait Anxiety Scale for Children(STAIC), and Health Symptom Questionnaire (HSQ) were adapted for this study. A pilot study was undertaken to ascertain the reliability and validity of the instruments. The Cronbach alphas of FBS, SCSI, STAIC and HSQ were from .81 to .92. The Researcher and a research assistant visited the school and data were collected in the class using the questionnaire method after an explanation of the purpose and procedures was given to the children. Data collection was done during the period between Nov.25 to Dec.19, 1995. Using the SAS statistical program, percentages, t-test, ANOVA, correlation analysis, and multiple regression were used for data analysis. The result are as follows : 1. The mean score for the FBS was 204.79(range : 48-472) and there was a significant difference according to grade. The most severe stressors perceived by children were parental divorce and death or illness of family members. The most frequently experienced stressful life events were conflict with siblings and being home alone. 2. The mean score for the SCSI was 57.36(range : 9-118) and there was a significant difference according to grade. The most frequently used, and perceived as helpful, coping strategies were distraction and cognitive activities. 3. The mean score for the HSQ were 20.7(range : 0-81) and there were significant differences according to grade and sex. The percentage of the children answering that they perceived their health state as not good was 3.9%. 4. The mean score for the STAIC was 33.76 and there were significant differences according to grade and sex. 5. There was a significant relationship between stressful life events and health symptoms ( r=.53, p<.01). Also, Stressful life events were postively related with coping strategies(r=.39, p<.01). Trait anxiety was highly correlated with health symptoms(r=.72, p<.01). 6. To examine the multivariate effects of the variables to health symptoms, multiple regression was performed. Stressful life events, coping, trait anxiety, and health concerns were identified as significant variables. Explanation of the health symptoms by these variables was 56.78%. The study revealed that stressful life events correlated with health symptoms in school-age children and coping and trait anxiety had mediating effects on this relationship. The implication for nursing is that there is a need to develop supportive interventions for high risk population to decrease health problems due to stress. Also, it is recommended that a study be conducted to explore protective factors for the prevention of health problems in children.
The intent of this longitudinal descriptive correlational study is to investigate the change of the mother - infant interactions over the periods of one month, three months and six months of the infant's age. This study is also intended to explore the interrelationships among three major factors- the perception of pregnancy, the mother -infant inter-action and the maternal attitude. The samples participated are 36 pairs of mother and infant from two university hospitals in Seoul. A data collection was made, from October in 1988 to September in 1989, for each subject at five periods of time ; prenatal period (after 36 weeks in pregnancy), postpartum two or three days, one month, three months and six months of infant's age. The research tools used in this investigation are Mother - Infant Play Interaction Scale (MIPIS), Prenatal Self- Evaluation Questionnaire and Cohler's Maternal Attitude Scale. Some of the findings are as follows ; 1. There is a significant increase in the mother - infant interaction from one month to three months and six months of infant's age. The highest score of the mother - infant interaction during three periods is at the time of three months. 2. The primipara's mother -infant interaction is not affected by the demographic characteristics, such as age, education and vocation of mother, types of delivery, or sex of infant. 3. Among seven categories of the perception of pregnancy, the most positively perceived categories by primiparas are acceptance of pregnancy and identification of. a motherhood role : whereas the negative ones are preparation for labor, concern for well -being of self and baby, md fear of pain, helplessness and loss of control in order of negativity. 4. There is no significant relationship between the perception of pregnancy and the mother - infant interactions. 5. There is no significant change in the maternal attitude over the period of one month, three months, and six months of infant's age. 6. There is no significant relationship between the maternal attitude and the mother - infant interactions. 7, The significant relationships are (end between the perception of pregnancy and maternal attitude, especially in the categories of concern for well -being of self and baby, accetance of pregnancy, identification of a motherhood role, fear of pain, helplessness and loss of control, and relationship with husband. In conclusion, it is confirmed that primipara's mother-infant interactions change over time period, and that perception of pregnancy and the maternal attitude do not affect the mother-infant interactions despite a significat relationship between those two variables. The implications of this investigation include a suggestion that nurses need to teach and demonstrate to mothers how to care for and interact with their infants, with a view to improving the mother-infant interactions which can be obtained through the improvement of maternal sensitivity to their infants.
Objectives : Peripheral blood-buffy coat fractions (N=14,956) have been stored at $-70^{\circ}C$ in the headquarter of the Korean Multicenter Cancer Cohort (KMCC), since 1993. To study the future molecular etiology of cancers using specimens of the cohort, properly stored specimens are necessary, Therefore, the DNA-viability of the bully coat samples was investigated. Methods : Buffy coat fraction samples were randomly selected from various collection areas and years (N=100). The DNA viability was evaluate from the UV-absorbent ratios at 260/280nm and the PCH for $\beta$-globin was performed with genomic DNA isolated from the buffy coat. Results : PCR products were obtained from 85 and 98% of the C and H area-samples, respectively, using 50 or $100{\mu}l$ of the buffy coat. There were significant differences in the yields of the PCR-amplifications from the C and H areas (p<0.05), which was due to differences in the homogenization of the buffy coat fractions available as aliquots. The PCR-products were obtained from all of the samples (N=7) stored at the C area-local confer, but the other aliquots stored at the headquarter were not PCR-amplified, Therefore, the PCR products in almost all the samples, even including the DNA-degraded samples, were obtained. In addition, an improvement in the DNA isolation, i,e. approx. 1.6 fold, was found after using extra RBC lysis buffer. Conclusions : PCR products for $\beta$-globin were obtained from nearly all of the samples. The regional differences in the PCR amplifications were thought to have originated from the different sample-preparation and homogenization performance. Therefore, the long term-stored buffy coat species at the KMCC can be used for future molecular studies.
Osteoporosis has been known as a common complication of rheumatoid arthritis and a major preventable health problem. Lots of studios have demonstrated that changes in life style can help delay or prevent osteoporosis. Therefore nursing intervention related osteoporosis prevention have consisted of education programs aimed at changing dietary and exercise habit. However knowledge gained from education haven't always leaded to behavior change. Therefore it is important to consider other psychological variables in effecting behavior change. Numerous research have found self efficacy and health belief to be an important factor in individual decision making behavior. The purpose of the study was to develop health belief and efficacy expectation promoting program based on Health Belief Model & Self Efficacy Model and to investigate its effects in women with rheumatoid arthritis. For this purpose, one group pretest-post design was used. The subject of the study were 16 women with rheumatoid arthritis in Pusan city and data collection was carried out from April, 1997 to May, 1998. The intervention program was consisted of educating on osteoporosis and enhancing and reinforcing self efficacy by verbal persuasion during the period of 4 weeks. The instruments were used to collect data in this study were Osteoporosis Health Belief Scale, Osteoporosis Self Efficacy Scale, and Osteoporosis Preventive Behavior Scale. Data was analyzed by Wilcoxon signed rank test using SPSS $PC^+$ program. The results are as follows : 1) The behavior should be increased after intervention was supported(Z=-3.5162, p=.0004, diet : Z=-3.2942, p=.0010, exercise). 2) The sub-hypothesis that perceived sensitivity should be increased after intervention was supported (Z=-2.3854, p=.0171). 3) The sub-hypothesis that perceived severity should be increased after intervention was rejected(Z=-1.4327, p=.1520). 4) The sub-hypothesis that perceived benefit should be increased after intervention was supported(Z=-2.6410, p=.0083). 5) The sub-hypothesis that perceived barrier should be decreased after intervention was supported (Z=-2.4138, p=.0158). 6) The sub-hypothesis that efficacy expectation should be increased after intervention was supported(Z=-3.5162, p=.0004). As a conclusion, it was found that health belief and self efficacy promoting program was an effective nursing intervention for preventing osteoporosis of rheumatoid arthritis.
본 시험은 2000년 4월부터 8월까지 충남대학교 생명과학대학내 부속 실험축사에서 수행하였다. 시험에 공시된 목초는 1999년에 경운초지 조성방법으로 조성된 상번초형 혼파초지(tall type mixtures, 파종비율: orchardgrass, Potomac 40+ tall fescue, Fawn 20+ Festulolium braunii, Paulita 10 + perennial ryegrass, Reveille 10+timothy Climax 10+red clover, Kenblue 5+alfalfa, Vernal 5%)와 상ㆍ하번초형 혼파초지{tall+short type mixtures, 파종비율: orchardgrass, Potomac 40+tall fescue, Fawn 20+Kentucky bluegrass, New port(turf type) 10+ redtop, Barricuda(turf type) 10+perennial ryegrass, Palmer III (turf type) 10+red fescue, Flyer II(turf type) 5+white clover, Regal 5%}에서 수확된 1번초(2000년 4월 22일)로 한국재래산양을 이용하여 초지 혼파유형에 따른 목초의 이용성을 비교분석하기 위하여 시험을 실시하였고 얻어진 결과는 다음과 같다. 1) 1일 체중 kg당 건물섭취량은 상ㆍ하번초형 혼파초지가 28.6g으로 상번초형 혼파초지의 27.9g에 비하여 다소 높았으나 유의적인 차이는 없었다. 건물, cellular constituent, NDF 및 ADF 소화을은 상ㆍ하번초형 혼파초지가 상번 초형 혼파초지에 비하여 역시 높은 편이었으나 유의적인 차이는 나타나지 않았다. 2) 체내에 축적된 질소율(외관상의 생물가)은 상ㆍ하번초형 혼과초지가 54.5%으로 상번초형 혼파초지의 53.7%보다 높았으나 유의적인 차이는 인정되지 않았다. 3) 외관상 대사에너지의 축적률은 상ㆍ하번 초형 혼파초지가 59.4%으로 상번초형 혼파초지의 58.2%보다 약간 높은 편이었으나 유의적인 차이는 인정되지 않았다. 따라서, 산양에 의한 목초의 이용성은 두 혼파 초지간에 큰 차이가 없는 것으로 나타나, 혼파초지내 turf type 초류도 사초자원으로써 이용가치가 있다고 하겠다.
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