• Title/Summary/Keyword: Daily mortality

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Survey of COPD Management among the Primary Care Physicians in Korea (우리나라 일차 진료의사의 만성폐쇄성폐질환(COPD) 진료실태조사)

  • Park, Myung Jae;Choi, Cheon Woong;Kim, Seung Joon;Kim, Young Kyoon;Lee, Sung Yong;Kang, Kyung Ho;Shin, Kyeong-Cheol;Lee, Kwan Ho;Lee, Jin Hwa;Kim, Yu-Il;Lim, Sung-Chul;Park, Yong Bum;Jung, Ki-Suck;Kim, Tae-Hyung;Shin, Dong Ho;Yoo, Jee-Hong
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.2
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    • pp.109-124
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    • 2008
  • Background: The incidence of chronic obstructive pulmonary disease (COPD) is increasing and the disease is becoming an important cause of morbidity and mortality worldwide. It is important to implement evidence-based guidelines by primary care physicians (PCPs) to establish qualified management of COPD patients. The aim of this survey is to investigate the pattern of COPD management among PCPs and to apply it to the development of Korean COPD guidelines. Methods: A web-based questionnaire was prepared that consisted of 25 questions on the pattern of COPD management. A total of 217 PCPs participated in the survey from June 2006 to May 2007. Results: Many PCPs (61.8%) possessed a spirometer, but the application rate was relatively low (35.8%) and more than half of the COPD patients (57%) did not receive a diagnosis based on spirometry. Administration of oral medication was preferred than the administration of inhaled medication for both stable COPD and acutely exacerbated COPD. More than 90% of the PCPs endorsed educational measures to quit smoking and vaccinate against influenza. It was noted that 56.7% of the PCPs were aware of the GOLD guidelines, but only 7.3% tended to fully implement the recommendations of the guidelines in daily practice. Conclusion: The results of the survey indicate that despite the high awareness rate of the current COPD guidelines, deficits exist among the PCPs with respect to the diagnosis and treatment of COPD. The results of this survey should be applied for the development of new COPD guidelines in order to decrease the discrepancy between the guidelines and the daily practice of the PCPs.

Effect of $\beta$-glucan Extracted from Youngji Mushroom on the Growth Performance of Weaning Pigs (영지버섯에서 추출한 $\beta$-glucan 이 자돈의 생산능력에 미치는 영향)

  • Kim, Jong-Duk;Shim, Keum-Seob;Choi, Nag-Jin;Kim, Ji-Hoon;Kim, Yong-Hyun;Kwon, Hyun-Jung;Kim, Sun-Ki;Han, Man-Deuk
    • Korean Journal of Organic Agriculture
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    • v.18 no.3
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    • pp.401-418
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    • 2010
  • This experiment was selected a $\beta$-glucan producing mushroom strain and developed industrial media, and used to $\beta$-glucan as an alternative for antibiotics in weaned pigs. Yields of mycelial biomass and extracellular $\beta$-glucan from Youngji (Ganoderma lucidum) mushroom was 8.52g/L and 4.49g/L respectively. Also, we prepared optimum formula for mushroom cultivations. A total of 144 pigs ($8.6{\pm}0.9$ kg average body weight, weaned $20{\pm}3$ days of age) were allotted to 4 different treatment groups and replicated 4 times with 8 pigs per replicate in randomized complete block design. Treatments were T1) NC (negative control, basal diet), T2) PC (positive control, basal diet+0.255% antibiotics), T3) NC+0.2% $\beta$-glucan and T4) PC+0.2% $\beta$-glucan. The T2 and T4 treatments were significantly higher in feed efficiency by antibiotics group (p<0.05), however, there was no significant differences in terms of average daily gain (ADG) and average daily feed intake (ADFI) during phase I (0~14 days). In phase II (15~28 days), Pigs fed with antibiotics and $\beta$-glucan (T4) had greater ADG than other treatments (p<0.05), while no differences were observed in ADFI and feed efficiency. During the whole experiment period, the ADG of T4 treatment was higher than other treatments. Pigs fed with $\beta$-glucan (T3 and T4) had greater diarrhea score and moisture content than other treatments (p<0.05). Pigs fed with $\beta$-glucan (T3 and T4) had greater moisture content than other treatments (p<0.05). However, there was no significant differences in diarrhea score and mortality of weaned pigs. There was marginal reductions in feed cost measured feed cost per weight gain used in antibiotics and $\beta$-glucan added diet during phase I. In the second phase, the treatment supplemented with antibiotics had a significantly lower feed cost per weight gain compared to the other treatments. The results from these experiments suggests that $\beta$-glucan is likely able to improve the growth performance, and reduce feed cost although they do not have similar effects like antibiotics in weaning pigs.

Investigations on Daily Life and Consciousness of Longevous People in Korea -IV. On the Familial Organization the Marriage Life of Longevous People in the Past- (우리나라 장수자(長壽者)의 생활(生活) 및 의식조사(意識調査)에 관한 연구(硏究) -IV. 장수자(長壽者)의 과거(過去) 가족상황(家族狀況)과 부부생활(夫婦生活)-)

  • Choi, Jin-Ho;Pyeun, Jae-Hyeung;Rhim, Chae-Hwan;Yang, Jong-Soon;Kim, Soo-Hyun;Kim, Jeung-Han;Lee, Byeong-Ho;Woo, Soon-Im;Choe, Sun-Nam;Byun, Dae-Seok;Kim, Mu-Nam
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.15 no.4
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    • pp.64-71
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    • 1986
  • The present study was conducted as a part of the research on the investigation on daily life and consciousness of the longevous people in Korea. Surveys were carried out on their familial organization and the marriage life of longevous people in order to achieve the purpose of the research. The materials for 121 males and 258 females aged more than 80 were collected and analyzed from June to November 1985. The results are summarized as follows: 1. As for parents' mortality age of longevous people, 49.5% of them showed 'both above 70'(20.3%) and/or 'either father or mother above 70' (29.2%). Consequently, a significant difference was found between tile life span and inherent factor. 2. By the birth order of longevous people, '1st' had the highest figure of 41.2%. and decreased in the order of '2nd'(25.1%) and '3rd'(13.7%). It was observed that the more the birth order of longevous people preceded, the more life span of the aged increased. 3. Three to five persons in the number of brother3 and sisters comprised 57.6% of total longevous people surveyed. while 63.9% of them were revealed to have three to six in the number of offsprings.

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Effects of Aerosol Colistin Treatment of Pneumonia Caused by Multi-drug Resistant Acinetobacter baumannii (다약제 내성 Acinetobacter baumannii 에 의한 폐렴에서 Colistin 분무치료의 효과)

  • Choi, Hye Sook;Hwang, Yeon Hee;Park, Myung Jae;Kang, Hong Mo
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.1
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    • pp.8-14
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    • 2008
  • Background: Acinetobacter infections are difficult to treat as they often exhibit multiple resistance to the antibiotics that are currently available for the treatment of pneumonia. Colistin is active against gram-negative bacteria, including the multiple drug resistant (MDR) Acinetobacter species. However, intravenous administration of colistin was abandoned because of its nephrotoxicity and neurotoxicity. The aims of this study were to examine the efficacy and safety of colistin administered by aerosol in the treatment of pneumonia caused by MDR Acinetobacter baumannii. Methods: We retrospectively reviewed the medical records of patients admitted to the intensive care unit (ICU) from Dec. 2006 to Aug. 2007 who had been diagnosed as suffering from pneumonia due to MDR Acinetobacter baumannii and had been treated with nebulized colistin. Results: 31 patients received aerosolized colistin. The average duration of the treatment was $14{\pm}7$ days and the daily dose of ranged from 225 mg to 300 mg. All patients received concomitant intravenous antimicrobial agents. The average length of the stay in the ICU was $34{\pm}21$ days and in the hospital $58{\pm}52$ days. The overall microbiological eradication was observed in 25 patients (80.6%). 14 of these (56%) were cured, and 11 (44%) were infected with other microorganisms. The overall crude mortality of the ICU was 48%. Nephrotoxicity and significant bronchial constriction did not occur in any patient during neublized colistin treatment. Conclusion: Nebulized colistin may be a safe and effective option in the treatment of pneumonia due to MDR Acinetobacter baumannii. Its role in therapy warrants further investigation in comparative studies.

A study of the development of macrovascular complications and factors related to these complications in young adults with childhood/adolescence-onset type 1 diabetes mellitus (소아청소년기에 1형 당뇨병으로 진단된 젊은 성인에서 대혈관 합병증의 발생과 이에 연관된 인자에 대한 연구)

  • Kang, Min Jae;Kim, Joo Hwa;Chung, Hye Rim;Lee, Young Ah;Shin, Choong Ho;Yang, Sei Won;Kim, You Yeh;Jin, Seon Mi;Noh, Chung Il
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.220-226
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    • 2009
  • Purpose : Macrovascular complications are the main cause of mortality in type 1 diabetes mellitus (T1DM). The purpose of this study was to clarify the presence of early vascular changes and to assess the risk factors of macrovascular complications in young adults with T1DM diagnosed in childhood and adolescence. Methods : Seventy-two patients ($23.9{\pm}2.4$ years) with T1DM diagnosed before 18 years of age and twenty normal controls were included. The incidence of hypertension, dyslipidemia, and other risk factors of macrovascular complication were reviewed. Flow-mediated vasodilation (FMD) and mean intima-media thickness (IMT) measured by ultrasound were compared between patients and control subjects, and their correlations with macrovascular risk factors were analyzed. Results : Of the 72 patients, 32 (44.4%) had hypertension. The proportions of maleness (P=0.03) and mean body mass index (P=0.04) were higher in the hypertensive patients than in normotensive patients. Thirty-one (N=69, 44.9%) patients had dyslipidemia and LDL-cholesterol was positively correlated with mean HbA1c (r=0.32, P=0.008) and total daily insulin dose (r=0.27, P=0.02). The mean IMT was significantly higher in patients than in control subjects ($0.43{\pm}0.06$ mm vs $0.39{\pm}0.06$ mm, P=0.03). There was no difference in the value of FMD between patients and controls, but the duration of the disease after pubertal onset was negatively correlated with FMD (r=-0.34, P=0.01). Conclusion : Hypertension, dyslipidemia and atherosclerotic vascular change were observed in young adults with T1DM diagnosed during childhood and adolescence; this strongly suggests that meticulous screening of macrovascular complications and control of their risk factors should be conducted.

Growth Performance, Humoral Immune Response and Carcass Characteristics of Broiler Chickens Fed Alkali Processed Karanj Cake Incorporated Diet Supplemented with Methionine

  • Panda, K.;Sastry, V.R.B.;Mandal, A.B.
    • Asian-Australasian Journal of Animal Sciences
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    • v.18 no.5
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    • pp.677-681
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    • 2005
  • A study was conducted to see the effect of dietary incorporation of alkali (1.5% NaOH, w/w) processed solvent extracted karanj cake (SKC) supplemented with methionine on growth performance, humoral immune response and carcass characteristics of broiler chickens from 0 to 8 weeks of age. One hundred and twenty, day- old broiler chicks were wing banded, vaccinated against Marek' disease and distributed in a completely randomized design (CRD) into 3 groups of 40 chicks each, which was further replicated to 4 and fed on diet containing soybean meal and those of test groups were fed diets containing alkali (1.5% NaOH) treated SKC partially replacing soybean meal nitrogen of reference diet (12.5%) without or with supplementation of methionine (0.2%). Individual body weight of chicks and replicate-wise feed intakes were recorded at weekly intervals throughout the experimental period. Feed consumption from 1 to 14, 28, 42 and 56 d of age was recorded for each replicate and feed conversion efficiency (weight gain/feed intake) for the respective period was calculated. Mortality was monitored on daily basis. On 28$^{th}$ day of experimental feeding, two birds of each replicate in each dietary group (8 birds/diet) were inoculated with 0.1 ml of a 1.0% suspension of sheep red blood cells (SRBC) and the antibody titre (log 2) was measured after 5 days by the microtitre haemmagglutination procedure. After 42 days of experimental feeding, a retention study of 4 days (43-47 d) duration was conducted on all birds to determine the retention of various nutrients such as DM, N, Ca, P and GE. On 43$^{rd}$ day of experimental feeding, one representative bird from each replicate of a dietary treatment (4/dietary group) was sacrificed, after fasting for two hours with free access to water, through cervical dislocation to observe the weight of dressed carcass, primal cuts (breast, thigh, drumstick, back, neck and wing), giblet (liver, heart and gizzard), abdominal fat and digestive organs. The body weight gain of chicks fed reference diet and those fed diet incorporated with NaOH treated SKC (12.5% replacement) with or without methionine supplementation was comparable during 0 to 4 weeks of age. However, dietary incorporation of alkali processed SKC replacing 12.5% nitrogen moiety of soybean meal resulted in growth retardation, subsequently as evidenced by significantly (p<0.05) lowered body weight gain during 0 to 6 weeks of age in birds fed diet incorporated with alkali processed SKC at 6.43% without methionine as compared to those supplemented with methionine or reference diet. Dietary incorporation of alkali (1.5% NaOH) processed SKC replacing 12.5% of soybean meal nitrogen in the diet of broiler chickens had no adverse effect on feed conversion ratio during all the weeks of experimental feeding. The humoral immune response (HIR) as measured by the antibody titre in response to SRBC inoculation was comparable among all the dietary groups. No significant difference in the intake and retention of DM, N, Ca, P or GE was noted among the chicks fed reference and alkali processed SKC incorporated diets with or without methionine supplementation. None of the carcass traits varied significantly due to dietary variations, except the percent weight of liver and giblet. The percent liver weight was significantly (p<0.05) higher in the birds fed diet incorporated with alkali processed SKC as compared to that in other two groups. Thus solvent extracted karanj cake could be incorporated after alkali (1.5% NaOH, w/w) processing at an enhanced level of 6.43%, replacing 12.5% of soybean meal nitrogen, in the broiler diets up to 4 weeks of age, beyond which the observed growth depression on this diet could be alleviated by 0.2% methionine supplementation.

Value of Health, Multidimensonal Health Locus of Control and Level of Self-esteem in Low Income Mothers (도시빈곤여성의 건강가치, 건강통제위성격 및 자아존중감과의 관계)

  • Lee, Kwang-Ok;Yang, Soon-Ok
    • Research in Community and Public Health Nursing
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    • v.7 no.1
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    • pp.52-68
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    • 1996
  • As a product of poverty, health means the physical, mental and social instability caused by poverty. High mortality, high morbidity, and unsatisfied needs for medical care indicate the health condition of poor people. These indicators are related to the social and psychological property. This study is to develop an effective method of nursing in the poor family which is an essential unit in the nursing field of the community and to which a fundamental approach is need as a top priority. We can make such a study, though partially, by revealing the relationship among the Health-value, Health Locus of Contol, and the Level of Self esteem. We randomly sampled 243 women who are participating in the nursing department of the comnnity nursing centers in Seoul. We investigated by using questionaries and made an analysis on the result by SAS program. The result of this investigation can summarized as follows : 1. The average age of the subjects investigated is 43.4 and the participation rate in the economic activity is as high as 49.4%. Most of them are paid daily. The average members of the family are 4.28 persons, and 80.2% of which are nuclear families. The type of housing is as follows:51.4% are monthly-rent houses. Rent houses represent 23.5%. And 43.6% of the subjects graduate the high schools 2. The level of self-esteem possessed by the subjects is 37.17. The quality of task performance(3.46) and the morality(3.53) are low as compared with the other qualities. 3. In relation to the locus of control, internality is 22.39, the influence of powerrful others represents 20.24, and the effect of chance occurance is 16.41. 4. The orderings of value scale are the physical and mental health, comfortable life, happiness, mental peace, and pleasure. The lowest order is social recognition. 5. Considering in relation to the self-esteem and the locus of control, we found out that there is a negative relationship among the self-esteem, the influence of powerful others. The lower the level of self-esteem is, the higher the influence of powerful others is. There is also a negative relationship among the detailed items such as the qualities, and the positive attitude. 6. In a significant test in the general characters of the subjects and in the level of self-esteem, we can obtain the follwing results. The higher the economic level is, the higher the level of self-esteem is. And the higher the level of satisfaction with life is, the higher the level of self-esteem is. 7. In the locus of control, the higher the economic level is, the higher the internality is. 8. In the health-level, 75.72% represent the high health -level. And the group which has the low satisfaction with life represents the high level of health-value(81.6%). With these results, we can conclude that the level of self-esteem possessed by the poor women living in the city is high and that they have the multi-dimemsional health-value even though they are living in the poor condtions. Traditionally, the poverty has been recognized as an unfavorale factor in the health care. But this study shows that the poverty is no longer an unfavorale factor and, on the contrary, it has a potential power with which people can improve their health by possessing the high self-esteem and the high health value. The ultimate purpose which the nursing task of the community has is to make the patients keep and improve their own health. So, when the nurses approach the poor patients, the nurses should put an emphasis on the individual responsibilities of the patients, and respect their own health value.

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Intensive Culture of the Pacific White Shrimp Litopenaeus vannamei, under Limited Water Exchange - II. Indoor Post-Nursery Culture of Juvenile Shrimp - (사육수 비교환 방식에 의한 흰다리새우의 고밀도 사육 - II. 흰다리새우의 실내 중간양성 -)

  • Jang, In-Kwon;Kim, Jong-Sheek;Seo, Hyung-Chul;Cho, Kook-Jin
    • Journal of Aquaculture
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    • v.22 no.1
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    • pp.42-50
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    • 2009
  • Shrimp farming which is entirely conducted in outdoor ponds in the west coast of Korea has been suffered from mass mortality due to viral epizootics. Intensive indoor shrimp culture under limited water exchange can solve these problems of outdoor ponds including viral transmission from environment, pollution due to discharge of rearing water, low productivity and limited culture period. In this study, juvenile L. vannamei (B.W. 0.08-0.09 g) was stocked with $3,000-5,455/m^3$ in density in four raceway tanks (two $12.9\;m^2$, two $18\;m^2$ tanks) and cultured for 42 days with 2.7-3.4% of daily water exchange. Results from four tanks showed FCR of 0.79-1.29, survival of 38.2-48.0%, and yields of $2.49-4.22\;kg/m^3$ which is consistent with 12-20 and 8-14 times higher than those of commercial shrimp hatchery and outdoor pond in Korea, respectively. Concentrations of total ammonia nitrogen in all four tanks were 1.11-1.42 ppm in mean level and did not exceed 6.0 ppm (0.096 ppm of $NH_3$) which is still acceptable levels for shrimp growth. During the culture trial, concentration of $NO_2$-N rapidly increased from stocking, resulting in mean concentration of 18.45-22.07 ppm. It also exceeded 10 ppm over four weeks and maintained at 35-45 ppm for four days in all tanks, accounting for low survival of shrimp due to long-term exposure to high concentration of $NO_2$-N. Nevertheless, the results with survival rate over 38% from raceways which experienced the extreme $NO_2$-N levels suggests that under "biofloc system" white shrimp can acclimate to high $NO_2$-N concentration to some degree.

Talc Pleurodesis via Video-Assisted Thoracoscopic Surgery(VATS) in Malignant Pleural Effusions (악성 흉막삼출 환자에서 비디오 흉강경을 이용한 Talc 흉막유착술)

  • Park, Sang-Joon;Ahn, Seok-Jin;Kang, Kyeong-Woo;Koh, Young-Min;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Kim, Kwhan-Mien;Kim, Jhin-Gook;Shim, Young-Mog;Rhee, Chong-H
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.785-794
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    • 1998
  • Background: Chemical pleurodesis is a widely used method for the control of symptomatic and recurrent malignant pleural effusions. Talc has been accepted to be the most effective sclerosing agent for chemical pleurodesis. This study was undertaken to evaluate the usefulness of talc pleurodesis via video-assisted thoracoscopic surgery (VATS) in treatment of malignant pleural effusions. Methods : A retrospective analysis of the medical records and radiographic findings was performed. The success of the procedure was defined as daily pleural fluid drainage below 100ml within 1 week after pleurodesis and complete expansion of the lung on simple chest radiograph. Recurrence was defined as reaccumulation of pleural fluid on follow-up chest radiographs, and complete response as no fluid accumulation on follow-up chest radiographs. Results: Between October 1994 and August 1996, talc pleurodesis via VATS was performed in 35 patients. Duration of follow-up ranged from 5 days to 828 days(median 79days). The initial success rate of procedure was 88.6%(31 of 35 cases). Complete responses were observed in 92.8% at 30 days, 75.7% at 90 days and 64.9% at 180 days. Postoperative complications were fever (54.3%), subcutaneous emphysema(11.4%), reexpansion pulmonary edema(2.9%) and respiratory failure(5.7%). But procedure related mortality or respiratory failure was not found. Conclusion: Talc pleurodesis via VATS is a safe and effective method for the control of symptomatic malignant pleural effusions.

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Risk Factors of Extubation Failure and Analysis of Cuff Leak Test as a Predictor for Postextubation Stridor (발관 실패의 위험 인자 및 발관 후 천음과 재삽관의 예측에 있어 Cuff Leak Test 의 유용성과 의미 분석)

  • Lim, Seong Yong;Suh, Gee Young;Kyung, Sun Yong;An, Chang Hyeok;Park, Jung Woong;Lee, Sang Pyo;Jeong, Sung Hwan;Ham, Hyoung Suk;Ahn, Young Mee;Lim, Si Young;Koh, Won Jung;Chung, Man Pyo;Kim, Ho Joong;Kwon, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.34-40
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    • 2006
  • Background: Extubation failure was associated with poor prognosis and high hospital mortality. Cuff leak test (CLT) has been proposed as a relatively simple method for detecting laryngeal obstruction that predispose toward postextubation stridor (PES) and reintubation. We examined the risk factors of extubation failure and evaluated the usefulness and limitation of CLT for predicting PES and reintubation. Methods: Thirty-four consecutive patients intubated more than 24 hours were examined. The subjects were evaluated daily for extubation readiness, and CLT was performed prior to extubation. Several parameters in the extubation success and failure group were compared. The accuracy and limitation of CLT were evaluated after choosing the thresholds values of the cuff leak volume (CLV) and percentage (CLP). Results: Of the 34 patients studied, 6 (17.6%) developed extubation failure and 3 (8.8%) were accompanied by PES. The patients who had extubation failure were more likely to have a longer duration of intubation and more severe illness. The patients who developed PES had a smaller cuff leak than the others: according to the CLV ($22.5{\pm}23.8$ vs $233.3{\pm}147.1ml$, p=0.020) or CLP ($6.2{\pm}7.3$ vs $44.3{\pm}24.7%$, p=0.013). The best cut off values for the CLV and CLP were 50ml and 14.7%, respectively. The sensitivity, negative predictive value, and specificity of CLT were relatively high, but the positive predictive value was low. Conclusion: The likelihood of developing extubation failure increases with increasing severity of illness and duration of intubation. A low CLV or CLP (<50ml or 14.7%) is useful in identifying patients at risk of PES, but the CLT is not an absolute predictor and should not be used an indicator for delaying extubation.