• Title/Summary/Keyword: Discharge Test

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Treatment and Prognosis according to Causative Organisms in Neonatal Bacterial Meningitis (신생아 세균성 뇌막염의 원인균에 따른 치료와 예후)

  • Kim, Dong Joon;Lee, Gwang Hoon;Lee, Hyung Won;Kim, Gil Hyun;Lee, Hak Soo
    • Pediatric Infection and Vaccine
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    • v.4 no.1
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    • pp.79-89
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    • 1997
  • Purpose : Neonatal bacterial meningitis is the disease which clinical manifestations are nonspecific and several neurologic complications may occur. We studied neonatal bacterial meningitis, particularly in treatment and prognosis according to causative organisms -gram positive and gram negative bacteria- to assist in treatment of neonatal bacterial meningitis. Methods : We analysed twenty-four cases retrospectively who had been admitted in NICU or pediatric ward in Chung-ang Gil hospital from Jan. 1991 to Jun. 1996, and who had proven causative organisms in culture or latex agglutination[n test in CSF. Results : 1) The ratio of male to female was 2.4: 1. The mean birth weight and gestational age in cases with gram positive bacterial meningitis were $2.91{\pm}0.79kg$ and $38.4{\pm}2.74$ weeks and those in cases with yam negative bacterial meningitis were $3.30{\pm}0.90kg$ and $37.7{\pm}3.33$weeks respectively. There was no significant difference between the two groups. 2) The perinatal predisposing factors were pematurity, mecoinium staining amnionic fluid, matemal diabetes and pregnancy-induced hypertension, etc. The clinical manifestations Were fever, seizure, poor oral intake and fontanel bulging, etc. There were eleven cases with early onset bacterial meningitis(four cases by gram positive bacteria, seven cases by gram negative bacteria), and thirteen cases with late onset bacterial meningitis(seven cases by gram positive bacteria, six cases by gram negative bacteria). There was no significant difference between the two groups in terms of onset. 3) There were eleven cases with yam positive bacterial meningitis and they were coagulase-negative staphylococci(three cases), group B streptococci(three cases), Staphylococcus aureus(two cases), Streptococcus viridans(two cases), and enterococci(one case). And there were thirteen cases with gram negative bacterial menir gitis and they were Escherichia coli(seven cases), Klevsiella pneumoniae(three cases), Pseudomonas aeruginosa(one case), Acinetobactor(one case) and Enterobacter(one case). 4) The initial CSF WBC counts in cases with yam negative bacterial meningitis were significantly higher than those in cases with gram positive bacterial meningitis but the CSF protein and glucose levels were no significant difference in the two groups statistically. 5) The number of cases with abnormal findings in brain ultrasonography was seven in gram positive bacterial meningitis and ten in gram negative bacterial meningitis. 6) There were relatively high sensitivity to penicillin derivatives, the first generation cephalosporin and vancomycin in gram positive bacteria and to the third generation cephalosporin and amikacin in gram negative bacteria. 7) The mortality rate was 20.8%(5 cases were expired or discharged hopelessly). There was no significant difference between the two groups in prognosis. Conclusions : We recommend active treatment in noenatal bacterial meningitis to improve prognosis because the prognosis is poor.

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Assessment of 1,4-Dioxane Removal in Polyester Wastewater by Activated Sludge and Its Microbial Property by 16S rDNA (폴리에스테르 중합폐수의 활성슬러지 공정에서의 1,4-다이옥산 제거 및 16S rDNA에 의한 미생물 군집특성 평가)

  • Han, Ji-Sun;So, Myung-Ho;Kim, Chang-Gyun
    • Journal of Korean Society of Environmental Engineers
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    • v.30 no.4
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    • pp.393-400
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    • 2008
  • 1,4-Dioxane($C_4H_8O_2$), which is used as a solvent stabilizer, could make harmful effects on ecosystem because of its higher solubility, toxicity and carcinogenic by US EPA. From 2011, its discharge limit to waterbody will be regulated at 5 mg/L by Ministry of Environment Republic of Korea. It was thus to investigate that the currently operating activated sludge in polyester manufacturing processes in Gumi can properly treat it to meet with the regulation standard. For that purpose, the removal rate of 1,4-dioxane and its microbial properties were assessed for a few companies(i.e. K, H and T). Its removal efficiency was the most highly recorded in H as 98% and then 77% for K, which met with the regulation standard. However, concentration of 1,4-dioxane of T was 23 mg/L in the effluent, which is more than the regulation standard. Aside from, microbial degradation test was done for 100 ppm of 1,4-dioxane in BSM (Basal salt medium) inoculated with each of activated sludge. After 7 days, 1,4-dioxane was completely removed in the test bottle inoculated with H sludge, 67% in T and 52% in K, which could confirm that the given activated sludge might have different biodegradability against the amount of 1,4-dioxane. Therefore, microbial diversity in each company was investigated by 16s rDNA cloning methods where a species, e.g. Methylibium petroleiphilum PM1, was the greatest observed from H and in lesser from K, but it was not detected from T. Methylibium petroleiphilum PM1 is known to efficiently degrade ether like methyl tertiary-butyl ether(MTBE). It is concluded that the activated sludge in H can be most effectively adopted for a biodegradation of 1,4-dioxane in the concern of industrial sector.

Sleep Quality and Sleep Patterns of Patients Treated by the Hemopoietic Stem Cell Transplantation (조혈모세포 이식환자의 입원 후 수면의 질과 수면양상의 변화)

  • Choi, So-Eun;Park, Hae-Ryung;Park, Ho-Ran
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.37-44
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    • 2005
  • Purpose: To provide the basic data in developing the nursing intervention for patients who have symptoms of insomnia after undergoing hemopoietic stem cell transplantation (HSCT). This was achieved through investigating sleep quality and sleep patterns according to admission time, and discharge time. Methods: Data was put together by studying 52 HSCT patients who have been admitted to the department of HSCT from August 2002 to August 2003, in a university hospital. Research instruments used were, PSQI for sleep quality and a specified questionnaire for sleep patterns. Results: The PSQI regarding the past mono which was measured at the last day of hospitalization, was 11.8. This was significantly higher than 5.3, which was a measurement for the past month before the hospitalization (t=11.41, P=0.000). Looking at it with 7 categories-quality of sleep, consistency of sleep, sleep period, effectiveness of sleep, sleeping disorder, usage of sleeping pills, impediment of daily life- the PSQI for a month after admission increased significantly compared to the rate measured for a month before admission. Comparing the subjects sleep pattern before and after admission, it showed a significant difference regarding time attending sleep, time it takes to sleep, wake-up time, total time of sleep, day time sleep, number of times waking up during sleep, number of usage of sleeping pills, actions that are taken during sleep disorder, reasons for insomnia. Conclusion: The PSQI score of patients who undergo hemopoietic stem cell transplantation have increased significantly after hospitalization. Compared to the change of sleep patterns when hospitalized, significant changes were observed. Therefore nursing interventions addressing sleep are needed.

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Stabilization of Heavy Metal Contaminated Paddy Soils near Abandoned Mine with Steel Slag and CaO (제강슬래그와 CaO를 이용한 폐광산 주변 중금속 오염 농경지 토양의 안정화 처리 연구)

  • Son, Jung-Ho;Roh, Hoon;Lee, Sun-Young;Kim, Sung-Kyu;Kim, Gil-Hong;Park, Joong-Kyu;Yang, Jae-Kyu;Chang, Yoon-Young
    • Journal of Soil and Groundwater Environment
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    • v.14 no.6
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    • pp.78-86
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    • 2009
  • Applicability of CaO and steel slag as stabilizers in the treatment of field and paddy soils near Pungjeong mine contaminated with arsenic and cationic heavy metals was investigated from batch and column experiments. Immobilization of heavy metals was evaluated by TCLP dissolution test. Immobility of heavy metal ions was less than 15% when steel slag alone was used. This result suggests that $Fe_2O_3$ and $SiO_2$, known as the major component of steel slag, have little effect for the immobilization of heavy metal ions due to acidity of TCLP solution. Immobilization of cationic heavy metals was little affected by the ratio of CaO and steel slag while arsenic removal was increased as the ratio of steel slag to CaO increased. In the column test, concentrations of both arsenic and cationic heavy metals in effluents were below the water discharge guideline over the entire reaction period. This result can be explained by the immobilization of cationic heavy metals from the increased pH in soil solution as well as by the formation of insoluble $Ca_3(AsO_4)_2$. From this work, it is possible to suggest that arsenic and cationic heavy metals can be concurrently stabilized by application of both CaO and steel slag.

Clustering according to Inpatients' Opinion on Hospital Foodservice and Analyzing Inpatient Response to Foodservice Qualify and Revisit Intention by the Cluster: In Case of S Hospital (입원환자의 급식서비스 인식에 따른 고객 군집화 및 군집별 급식서비스 질 평가, 재이용 의도 분석: S병원을 대상으로)

  • Lee, Hae-Young;Chang, Seung-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.35 no.10
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    • pp.1491-1497
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    • 2006
  • The purpose of this study was to analyze the relationship among inpatients' perceptions of foodservice quality, satisfaction and revisit intention. Questionnaires were hand-delivered to 350 inpatients and a total of 230 questionnaires were usable (response rate 65.7%), Statistical data analysis was completed using the SPSS Win 11.0 for descriptive analysis, independent t-test, $x^2$ test and k-means cluster analysis. The results of this study can be summarized as follows: The average score of overall importance of meal service in medical service was 4.25 out of 5.0, yet the score of overall quality of meal service and value had lower than importance score. A helpfulness to medical treatment (3.48), bringing customer happiness (3.18), overall satisfaction for foodservice (3.66), satisfaction based on expectation before discharge (3.53) and offering foodservice apt to hospital reputation (3.40) were measured as expressions of satisfaction. As a result of clustering analysis, two clusters were classified and named as affirmative opinion group and negative one. Expectation for four factors of foodservice quality between two groups had no significance. But affirmative opinion group had significantly higher score than negative one in perception and satisfaction. Affirmative customers' intention to revisit in the near future was evaluated as high in both considering general medical service (4.04) and reflecting meal service level (3.84).

Consideration on Shielding Effect Based on Apron Wearing During Low-dose I-131 Administration (저용량 I-131 투여시 Apron 착용여부에 따른 차폐효과에 대한 고찰)

  • Kim, Ilsu;Kim, Hosin;Ryu, Hyeonggi;Kang, Yeongjik;Park, Suyoung;Kim, Seungchan;Lee, Guiwon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.1
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    • pp.32-36
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    • 2016
  • Purpose In nuclear medicine examination, $^{131}I$ is widely used in nuclear medicine examination such as diagnosis, treatment, and others of thyroid cancer and other diseases. $^{131}I$ conducts examination and treatment through emission of ${\gamma}$ ray and ${\beta}^-$ ray. Since $^{131}I$ (364 keV) contains more energy compared to $^{99m}Tc$ (140 keV) although it displays high integrated rate and enables quick discharge through kidney, the objective of this study lies in comparing the difference in exposure dose of $^{131}I$ before and after wearing apron when handling $^{131}I$ with focus on 3 elements of external exposure protection that are distance, time, and shield in order to reduce the exposure to technicians in comparison with $^{99m}Tc$ during the handling and administration process. When wearing apron (in general, Pb 0.5 mm), $^{99m}Tc$ presents shield of over 90% but shielding effect of $^{131}I$ is relatively low as it is of high energy and there may be even more exposure due to influence of scattered ray (secondary) and bremsstrahlung in case of high dose. However, there is no special report or guideline for low dose (74 MBq) high energy thus quantitative analysis on exposure dose of technicians will be conducted based on apron wearing during the handling of $^{131}I$. Materials and Methods With patients who visited Department of Nuclear Medicine of our hospital for low dose $^{131}I$ administration for thyroid cancer and diagnosis for 7 months from Jun 2014 to Dec 2014 as its subject, total 6 pieces of TLD was attached to interior and exterior of apron placed on thyroid, chest, and testicle from preparation to administration. Then, radiation exposure dose from $^{131}I$ examination to administration was measured. Total procedure time was set as within 5 min per person including 3 min of explanation, 1 min of distribution, and 1 min of administration. In regards to TLD location selection, chest at which exposure dose is generally measured and thyroid and testicle with high sensitivity were selected. For preparation, 74 MBq of $^{131}I$ shall be distributed with the use of $2m{\ell}$ syringe and then it shall be distributed after making it into dose of $2m{\ell}$ though dilution with normal saline. When distributing $^{131}I$ and administering it to the patient, $100m{\ell}$ of water shall be put into a cup, distributed $^{131}I$ shall be diluted, and then oral administration to patients shall be conducted with the distance of 1m from the patient. The process of withdrawing $2m{\ell}$ syringe and cup used for oral administration was conducted while wearing apron and TLD. Apron and TLD were stored at storage room without influence of radiation exposure and the exposure dose was measured with request to Seoul Radiology Services. Results With the result of monthly accumulated exposure dose of TLD worn inside and outside of apron placed on thyroid, chest, and testicle during low dose $^{131}I$ examination during the research period divided by number of people, statistics processing was conducted with Wilcoxon Signed Rank Test using SPSS Version. 12.0K. As a result, it was revealed that there was no significant difference since all of thyroid (p = 0.345), chest (p = 0.686), and testicle (p = 0.715) were presented to be p > 0.05. Also, when converting the change in total exposure dose during research period into percentage, it was revealed to be -23.5%, -8.3%, and 19.0% for thyroid, chest, and testicle respectively. Conclusion As a result of conducting Wilcoxon Signed Rank Test, it was revealed that there is no statistically significant difference (p > 0.05). Also, in case of calculating shielding rate with accumulate exposure dose during 7 months, it was revealed that there is irregular change in exposure dose for inside and outside of apron. Although the degree of change seems to be high when it is expressed in percentage, it cannot be considered a big change since the unit of accumulated exposure dose is in decimal points. Therefore, regardless of wearing apron during high energy low dose $^{131}I$ administration, placing certain distance and terminating the administration as soon as possible would be of great assistance in reducing the exposure dose. Although this study restricted $^{131}I$ administration time to be within 5 min per person and distance for oral administration to be 1m, there was a shortcoming to acquire accurate result as there was insufficient number of N for statistics and it could be processed only through non-parametric method. Also, exposure dose per person during lose dose $^{131}I$ administration was measured with accumulated exposure dose using TLD rather than through direct-reading exposure dose thus more accurate result could be acquired when measurement is conducted using electronic dosimeter and pocket dosimeter.

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A Study for The Prognostic Indicators of Korean Alcoholics in Psychological, Social and Biological Aspects (한국인 알코올중독 환자의 예후인자에 관한 연구 : 심리적, 사회적, 생물학적 요인을 중심으로)

  • Sung, Sang-Kyung;Chang, Hwan-Il
    • Korean Journal of Biological Psychiatry
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    • v.2 no.2
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    • pp.218-236
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    • 1995
  • The author studied prognostic indicators of sixty Korean male alcoholics in psychological, social and biological aspects who were divided into abstinent and drinking groups. Thirty patients were assigned to each group. They were controlled in age and sex. Both groups were compared in terms of the demographic characteristics, past drinking history, treatment history, famaily history, ego strength and personality factors differences and distribution of dopamine $D_2$ receptor gene Al allele. Also the author studied relation of clinical course, alcoholic family history and dopamine $D_2$ receptor gene Al allele in both groups. The results were as follows; 1) The abstinent group had higher rate of married state, higher economic status, longer education years and maintained more stable job than the drinking group. But made no differences in occupation and religion. 2) The abstinent group showed higher rate of living with family members than the drinking group, and wives and fellows of the alcoholics anonymous were important factors for maintenance of abstinence. Family loading and parent's characters were not different. 3) The abstinent group had longer maximal length of abstinence but mean amount of alcohol consumption per day were larger than the drinking group. But there were no differences in duration of past drinking, drinking pattern, main drinking time, first drinking age and preference of the kind of alcoholic beverage in the past drinking history. 4) The abstinent group showed stronger treatment motivation, absolute abstinence in treatment goal, more voluntary adimission and maintained longer therapeutic relationship otter discharge than the drinking group. But both groups showed negative attitude toward antabuse therapy. 5) The abstinent group had higher mean score in ego strength scale than the drinking group. 6) In the personality factor questionnaire, the abstinent group showed strong laugh poise and the trait of praxernia, conservatism personality but the drinking group showed tough poise, the trait of weak ego strength(unstableness) and tough mindedness personality. 7) In comparision of dopamine $D_2$ receptor gene A1 allele, the prevalence of A1 allele was seventy percent and the frequency was 0.38 in the abstinent group. The prevalence of A1 allele was sixty percent and the frequency was 0.42 in the drinking group. Both groups were not significantly different in A1 allele prevalence and frequency. 8) In comparision of dopamine $D_2$ receptor gene A1 allele according to alcoholic family history, the prevalence of A1 allele was seventy percent and the frequency was 0.43 in the family history positive group. The prevalence of A1 allele was sixty-one percent and the frequency was 0.38 in the family history negative group. Both groups were not significantly different in A1 allele prevalence and frequency. In comparision of past drinking history according to alcoholic family history, the family history positive group showed earlier first drinking and problem drinking, but the family history negative group hod longer duration of past drinking. The mean amount of alcohol consumption per day, the longest duration of abstinence and Alcoholism Screening Test of Seoul Natoinal Mental Hospital(NAST) results were not significant. In conclusion, the results suggest that successful prognostic indicators of Korean alcoholics are married state, higher economic status, longer education years, stable job, living with family members, longer abstinence during past drinking history, strong treatment motivation, absolute abstinence in treatment goal, voluntary adimission, maintained therapeufic relationship, strong ego strength and the trait of praxernia, conservatism personality. But occupation, religion, alcoholic family history, parent's characters, duration of past drinking, drinking pattern, main drinking time, first drinking age, preference of the kind of alcoholic beverage, attitude to antabuse therapy and distribution of dopamine $D_2$ receptor A1 allele were not significantly related to the prognostic indicators of Korean alcoholics.

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Analyses of Synchronous Fluorescence Spectra of Dissolved Organic Matter for Tracing Upstream Pollution Sources in Rivers (상류 오염원 추적을 위한 용존 유기물질 Synchronous 형광스펙트럼 분석 연구)

  • Hur, Jin;Kim, Mi-Kyoung;Park, Sung-Won
    • Journal of Korean Society of Environmental Engineers
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    • v.29 no.3
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    • pp.317-324
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    • 2007
  • Fluorescence measurements of dissolved organic matter(DOM) have the superior advantages over other analysis tools for applying to water quality management. A preliminary study was conducted to test the feasibility of applying synchronous fluorescence measurements for tracing and monitoring pollution sources in a small stream located in an upstream area of the Sooyoung watershed in Busan. The water quality of the small stream is affected by leachate from sawdust pile and discharge of untreated sewage. The sampling sites included an upstream site, two pipes discharging untreated sewage, leachate from sawdust, and a downstream site. Of the five field samples, the leachate was distinguished from the other samples by a high peak at a lower wavelength range and a blunt peak at 350nm, suggesting that synchronous fluorescence can be used as a discrimination tool for monitoring the pollution. The efficacy of various indices derived from the spectral features to discriminate the pollution source was tested for well-defined mixture of the sawdust leachate and the upstream stream by comparing (1)the difference between measured values and those predicted based on mass balance and the characteristics of the two samples and (2)the linear correlations between index values and mass ratios of the sample mixtures. Of various discrimination indices selected, fluorescence intensities at 276 nm$({\Delta}\lambda=30nm)$and 347 nm$({\Delta}\lambda=60nm)$ were suggested as promising potential discrimination indices for the sawdust pollution source. Despite the limited number of samples and the study area, this study illustrates the evaluation process that should be followed to develop rapid, low-cost discrimination indices to monitor pollution sources based on end member mixing analyses.

A Study on the recognition and Attitude of Home Health Nursing System (가정간호사 제도에 대한 인식 및 태도 조사연구)

  • Lee Sung Ja
    • Journal of Korean Public Health Nursing
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    • v.12 no.1
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    • pp.132-146
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    • 1998
  • This Study was attempted to provide the basic data necessary in the development and introduction of Home Health Nursing System by investigating the recognition and attitude level of Home Health Nursing System. The data were collected by means of questionaires presented to 74 patients who had been admitted in C general hospital in Chon Ju, from June 30, 1997. As the tool for this study, the questionares developed by Kim Yong. Soon, et al (1990) and Han Bok Hee(1993) were modified and supplemented for the aim of this study. The computer was used for data analysis. The items about the charateristics of the subjects and the attitude to the management plan of Home Health Nursing System were represented as the frequency and percentage. The standard deviation and calculation average were produced on the items related to definition, recognition, necessity, expected effect of the attitude of Home Health Nursing System and the items related to admission. The ANOVA test was .used according to the characteristics of variables to analyze the necessity and difference of Home Health Nursing System. The results of this study were as follows 1) The general characteristics of the subjects were as follows ; for sex, man, $58.1\%$ ; for age, 50-59 years, $29.7\%$ ; for the level of education, high school, $51.4\%$ ; $79.7\%$ of them were married; for the family forms, small family, $73.0\%$ ; and $68.9\%$ of them take the monthly income over 100 million won. 2) The characteristics related to admissions of the subjects were as follows ; for clinic, surgical department, $78.4\%$ ; addmission not more then 7days, $47.3\%$ ; for the operation-performance $71.6\%$ of them were experienced; for the admission route, via outpatients clinic, $54.1\%$ ; for waiting period to the admission day, 1-2 days, $71.6\%$. 3) The difficulties comming from the hospitalization were related mostly to the factor that they felt hospital life more inconvenient than home.(3.66) The reasons for the difficulties in the admission which was due to insufficient beds in the hospital was related to the concentration to the general hospital because of 'The Whole National Medical Insurance System'(4.05). 4) On the previous informations about the Home Health Nursing System, those who have heard of only the name were 42 $(56.8\%)$, and on the recognition of it, they thought that it is periodic treatment by the licenced nurses for the recovering pateints after early discharge(3.73). On the attitude about the necessity of Home Health Nursing System, they thought that it is necessary because of the increasing trend of a psychological disease by the change of environment and complexity of the social structure(4.24). On the expected effect of Home Health Nursing System, they answered that it is convinient for the family of the patient to take care of them(4.l8). 5) On the attitude to the management plan of the Home Health Nursing System, those who had intention to participate in the system in the case of systemic support were 42(56.8). In the visiting time, 'visit periodically' and 'visit when the patient needs' were $28(37.8\%)$ respectively. For the application of medical insurance, if possoble, they will use $(91.9\%)$; for the method of payment for the treatment, 'pay by the time required' was $23(31.1\%)$, for the subject of management, 'National public institute must operate' was $33(44.6\%)$. 6) The relationship between the general characteristics of the subjects and the necessity of Home Health Nursing System showed the notable difference in the age (F=3.508, P<0.05) and marrage state (F=5.402, P<.023).

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Cost Analysis of Home Nursing Care Patients in Rural Hospital (농촌 지역 중소병원의 가정간호사업소 등록환자의 방문비용분석)

  • Kim, Jin-Soon;Kum, Ran;HwangBo, Soo-Ja
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.91-101
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    • 1999
  • The home nursing care system is an integral part of the health care delivery system in order to meet the various needs of consummer, in particular, early discharge patient from the hospital, patient with long term care needed and the elderly. To find out the cost of home nursing care services, the home nursing care records of patients registered by home nursing care units established in public hospital with 150beds during the period of 1996 - 1997 were analyzed. The subjects were 102patients, 45 of male patients and 57 of female patients, those who live in a rural area in Kymiggi - Do The results obtained are as follows : 1. The male patients accounted for 44.1% of the total, with 45cases : group aged 60 years and more was the largest group, accounting for 79.5%. 2. The most frequent disease revealed was the osteoporosis which constitute 35.3% of the total registered patients, followed, in order, by malignant tumor, cerebrovascular disease. 3. It revealed that the cost per visit for the male was 47,764won ; the female, 46,078 won per visit. Noteworthy the cost per visit was high in the older patient. It was clearly that the gender, years of age and the cost per visit were statistically significant at 0.01 level and 0.05 level. 4. The cost per visit for the non complicated disease was slightly higher than the complicated disease, but it is not statistically significant, the cost per visit by type of disease varied, the cost per visit for COPD was the highest, followed, in order, by in malignant tumor, cancer, diabetes, osteoporosis etc. 5. It revealed that home nursing care cost for a eligible disease for home nursing care was less than the cost for hospitalization of the same disease, therefore, we expect that the home nursing care is cost efficiency. In conclusion, the home nursing care costs are needed to analyze further in comparison with the hospitalization costs for a certain disease.

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