• Title/Summary/Keyword: Frequent disease

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Studies on the Seasonal Increase of the Population of the Smallerbrown Planthopper, Laodelphax striatellus(Fallen) (애멸구의 세대별 증식동태에 관한 연구 -기주식물의 종류와 생육단계와 증식과의 관계-)

  • Hyun Jai Sun;Woo Kun Suk;Ryoo Mun Il
    • Korean journal of applied entomology
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    • v.16 no.1 s.30
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    • pp.13-19
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    • 1977
  • The smaller brown planthopper overwinters mostly as the fourth instar nymph. The emerged adult disperses to winter barley or wheat plants. The adult of the first generation disperses into the rice field, and spends three generations in the rice field. The population densities of the adults of the first generation and the overall density of the second generations are the most important in relation to the incidents of the rice stripe disease which is transmitted by this insects. This study was intended to analyse the population increases in these important generations in relation to the kind and the different growing stage of the host plants. The insects were reared on potted host plants of different growing stage in the insect cages. The population increases of the insects in the cages were compared with those on the rice seedlings in the laboratory. The results are as follows: 1. The average longevities of the adults of the generations were 13.4 days for the overwintered, 12.9 days for the first, and 10.2 days for the second generation, and showed no significant differences between the generations even they seemed to be shorter than normal condition probably caused by the frequent disturbance at the time of food renewal in 2 or 3 days. 2. When they were reared on the rice seedling, the average numbers of the eggs per female were 131.2 for the overwintered generation, 124.9 for the first generation grown on the barley, and 142.3 for the second generation grown on rice, and shelved no significant differences between the generations. More than $90\%$ of the eggs were laid within 3 weeks. 3. The hatchabilities of the eggs laid on the rice seedling in laboratory were $77.4\%$ for the first generation, $93.1\%$ for the second generation and $62.1\%$ for the third generation. The estimated hatchabilities of the eggs were $67.5\%$ for the first generation, $84.1\%$for the second generation, and $21.9\%$ for the third generation with the growing plants on the plots. The hatchability on the eggs laid by the adults infested on the barley on May 17 was $13.5\%$ compared with $67.5\%$ for the eggs laid by those infested on barley in late April. 4. The average total nymphal periods were 19.4 days for the first generation, and 13.3 days for the second generation in the laboratory and the mortalities of the nymphs seemed to related with the growing stages of the host plants. 5. With the pot experiments, the average per cents of the emerged adults were $37.2\%$ for the first generation, $55.3\%$ for the second generation, and $11.6\%$, for the third generation. The average numbers of the emerged adults were $7.4\%$ for the pots infested on the barley on May 17, instead of $37.2\%$ adults for those infested in late April. 6. From above results, it may suggest that the innate qualities of the insect are not significantly different between generations, and the differences in the increase of the population for the generations might effected considerably by the differences in the physiological conditions of tile host plant, besides the differences in physical and other biological factors.

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An Operations Study on a Home Health Nursing Demonstration Program for the Patients Discharged with Chronic Residual Health Care Problems (추후관리가 필요한 만성질환 퇴원환자 가정간호 시범사업 운영 연구)

  • 홍여신;이은옥;이소우;김매자;홍경자;서문자;이영자;박정호;송미순
    • Journal of Korean Academy of Nursing
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    • v.20 no.2
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    • pp.227-248
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    • 1990
  • The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

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A Clinical Review of Primary Tracheal Carcinoma (원발성 악성기관종양의 임상적 고찰)

  • Ryu, Jeong-Seon;Cho, Hyun-Myung;Yang, Dong-Gyoo;Lee, Hong-Lyeol;Kim, Se-Kyu;Chang, Joon;Ahn, Chul-Min;Shin, Kye-Chul;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.766-775
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    • 1997
  • Background : Primary malignant tumors of the trachea are extremely rare entities and account for a mere 0.1 per cent of all malignancies of the respiratory tract. Because of vague localizing signs, symptoms and a usually negative routine chest film, the patients with tracheal tumors are often treated for asthma or chronic obstructive pulmonary disease for considerable period of time before correct diagnosis. Method : We have made a review of the 17 cases of primary tracheal tumors in recent 15 years. We reviewed the clinical features including history of smoking and respiratory symptoms, the official readings of initial routine chest film, the cytologic examination of sputum, the time of delay in diagnosis, and the response according to the therapeutic modalities. Results : Eight out of 9 patients with squamous cell carcinoma(SCC) were above 50 years old, five out of 6 patients with adenoid cystic carcinoma(ACC) were below 50 years old. The most common location of primary tracheal tumors was the upper one-third of trachea in 8 cases(47%). The most frequent symptoms were dyspnea in 13/17 cases(76%) and then stridor or wheezing, cough. and sputum in order. The routine chest roentgenographic examinations were not helpful to diagnose tracheal carcinoma and the cytologic examinations of sputums were helpful to diagnose tracheal carcinoma in only one case with adenocarcinoma. The mean times of delay in diagnosis of patients with sec and ACC were 5 months and 24.9 months respectively. We had bronchial asthma in 8 cases(47%) and tracheal tumors in 4 cases(23%) as initial clinical impression. Conclusion : We would like to perform more comprehensive diagnostic tools(high KVP technique, the fibroptic bronchoscopic examination, chest CT scan etc.) in patients who had the suggestive points for the tracheal tumorse(1. unexplained hemoptysis or hoarsness, 2. inspiratory wheezing or stridor, 3. wax and waning of dyspnea according to changes of position, 4. progressive asthmatics unresponsive to antiasthmatic therapy) and radical resection of tumor or external radiation therapy with curative aim as possible.

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Risk Factors of Catheter-related Bloodstream Infection Due to Methicillin-resistant Staphylococcus aureus in Very Low Birth Weight Infants (극소저체중 출생아에서 메티실린 내성 포도상구균으로 인한 카테터 연관 혈류감염의 위험인자)

  • Cho, Il-Hyun;Jung, Tae-Woong;Lee, Ju-Young;Moon, Se-Na;Bin, Joong-Hyun;Lee, Hyun-Seung;Lee, Jung-Hyun;Kim, So-Young;Sung, In-Kyung
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.288-292
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    • 2011
  • Purpose: The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection has increased in children and in neonates, and is particularly associated with frequent use of central venous catheter in very low birth weight (VLBW) infants. It is known that the morbidity and mortality of MRSA infection are low in neonates, as compared with adults. The objective of this study was to examine the difference in clinical characteristics between VLBW infants that survived and those that did not, a catheter-related bloodstream infection (CRBSI) of MRSA. Methods: Thirty-four VLBW infants had laboratory-confirmed bloodstream infection with S. aureus. We examined the incidence, mortality and morbidity of CRBSI, and predictive factors associated with mortality. Results: Twenty-six infants had same pathogen (24 MRSA, 2 Methicillin-sensitive Staphylococcus aureus) in the blood and in the catheter tip. Eight infants (25.8%) died in the CRBSI and they all had MRSA blood infections. Sex ratio, gestational age, duration between blood collection and identification of pathogens, and WBC and platelet count were not significantly different between patients that died from and patients that survived CRBSI of MRSA. C-reactive protein (CRP) was significantly higher in VLBW infants that died. Mean age of onset and hospital day was earlier (9.1${\pm}$6.6 vs. 26.9${\pm}$20.2; P=0.005) and shorter for patients that died (10.1${\pm}$7.0 vs. 73.0${\pm}$32.4; P=0.000). Two survivors had complications of pyogenic arthritis of the lower extremities and soft tissue infection, respectively. Conclusion: Mortality of CRBSI was likely to be high in VLBW infants and might be anticipated by CRP and early onset of disease.

The Effect of Adjuvant Chemotherapy in Locally Advanced Head and Neck Squamous Cell Carcinoma after Induction Chemotherapy (국소진행 두경부 상피세포암에서 선행유도약물요법 후 보조약물요법의 효과)

  • Kim Cheol-Woo;Roh Jae-Kyung;Ahn Joong-Bae;Park Joon-Oh;Chung So-Young;Lee Seok;Lee Hey-Ran;Lee Kyung-Hee;Chung Hyun-Cheol;Kim Joo-Hang;Kim Byung-Soo;Suh Chang-Ok;Kim Gwi-Eon
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.1
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    • pp.13-24
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    • 1994
  • Despite optimal local therapy such as surgery and/or radiotherapy, the long term outcome is poor for patients with advanced squamous cell carcinomma of head and neck, due to frequent loco-regional recurrence and distant metastases. We studied to determine whether the combination chemotherapy, especially as an adjuvant chemotherapy, would improve the survival of these patients. Between January, 1986 and December, 1992, 57 patients with previously untreated, locally advanced squamous cell arcinoma of head and neck were assigned to receive 2-3 cycles of induction chemotherapy consisting of 5-fluorouracil(F) and cisplatin(P) every 3 weeks and standard local therapy such as surgery and/or radiotherapy followed by adjuvant chemotherapy with the same FP regimens. Of the 57 enroled patients, 45 patients were evaluable. The obtained results were as following: 1) Among 45 evaluable patients, 18 patients finished all treatment protocol including adjuvant chemotherapy and 27 patients had no adjuvant chemotherapy. The difference of age, sex, performance status, disease stage, and tumor differentiation was not significant statistically between adjuvant chemotherapy group and no-adjuvant chemotherapy group. 2) After induction chemotherapy, 7/45(15.4%), 30/45(67%) achieved complete remission and partial remission respectively with 82.4% overall response rates in entire patients. 3) The 4year progression free survival was 43.3% in adjuvant chemotherapy group and 24.1% in no-adjuvant chemotherapy group(p>0.05). The 4year overall survival was 56.9% and 25.5% respectively(p>0.05). There was no significant different in the patterns of local recurrence and distant metastasis between the two groups. 4) Adverse reactions from combination chemotherapy included nausea, vomiting, mucositis, diarrhea and hematologic bone marrow depression. These were mild and tolerated by patients, and these was no episode of any life threatening toxicities. In conclusion, adjuvant chemotherapy after induction chemotherapy and local therapy did not show statistically significant survival improvement, but there was trend of prolongation of survival when compared to no adjuvant chemotherapy. Thus, large scale phase III randomized controlled studies are strongly recommended.

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A Study of Genetic Polymonhisms of HLA-class I and II Genes Using Polymerase Chain Reaction (중합효소연쇄반응을 이용한 HLA-class I, II 유전자군의 유전적 다형성에 관한 연구)

  • Kyung-Ok Lee
    • Biomedical Science Letters
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    • v.4 no.1
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    • pp.11-25
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    • 1998
  • The HLA genes located in the short arm of chromosome 6 specify heterodimeric glycoproteins involved in the regulation of the immune response. Recently, in the elucidation of HLA polymorphism, serological and cellular typing methods have been replaced by DNA typing using polymerase chain reaction (PCR). The purpose of this study was to establish the HLA DNA typing methods and determine gene frequencies of HLA molecules in Koreans. PCR-SSP (sequence specific primers) and PCR-RFLP (restriction fragment length polymorphism) techniques were used for the analysis of HLA-A, -B, -C, DRBl genes and HLA-DQAl, DQBl, DPBl genes, respectively. The results of B-lymphoblastoid cells used for control experiment were consistent with the previous data identified in the 11th International Histocompatibility Workshop. Seventeen, 23, 16, 8, 16, 13 and 37 types of HLA-A, B, C, DQAl, DQBl, DPBl and DRBl alleles were found, respectively, in a total of unrelated 120 Korean individuals. The most frequent HLA alleles were $A^*$02 (27.0%), B$^*$40 (17.6%), Cw$^*$01 (19.2%), DQAl$^*$0301 (32.1%), DQBl$^*$0303 (12.9%), DPBl$^*$0501 (31.3%) and DRBl$^*$1501 (9.2%) among Koreans. This study shows that DNA typing method using PCR technique is a relatively simple, fast and practical tool for the determination of the HLA-class I and II genes. Moreover, the data of HLA gene frequencies could be useful for the Korean database before clinical applications, including organ and unrelated bone marrow transplantation, anthropological study, disease association and individual identification.

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Twice Daily Radiation Therapy Plus Concurrent Chemotherapy for Limited-Stage Small Cell Lung Cancer (국한성병기 소세포폐암에서 하루 두 번 분할조사와 동시 화학방사선치료)

  • Yeo Seung-Gu;Cho Moon-June;Kim Sun-Young;Kim Ki-Whan;Kim Jun-Sang
    • Radiation Oncology Journal
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    • v.24 no.2
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    • pp.96-102
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    • 2006
  • Purpose: A retrospective study was performed to evaluate the efficiency and feasibility of twice daily radiation therapy plus concurrent chemotherapy for limited-stage small cell lung cancer in terms of treatment response, survival, patterns of failure, and acute toxicities. Materials and Methods: Between February 1993 and October 2002, 76 patients of histologically proven limited-stage small cell lung cancer (LS-SCLC) were treated with twice daily radiation therapy and concurrent chemotherapy. Male was in 84% (64/76), and median age was 57 years (range, 32-75 years). Thoracic radiation therapy consisted of 120 or 150 cGy per fraction, twice a day at least 6 hours apart, 5 days a week. Median total dose was 50.4 Gy (range, 45-51 Gy). Concurrent chemotherapy consisted of CAV ($cytoxan\;1000mg/m^2,\;adriamycin\;40mg/m^2,\;vincristine\;1mg/m^2$) alternating with PE ($cisplatin\;60mg/m^2,\;etoposide\;100mg/m^2$) or PE alone, every 3 weeks. The median cycle of chemotherapy was six (range, 1-9 cycle). Prophylactic cranial irradiation (PCI) was recommended to the patients who achieved a complete response (CR). PCI scheme was 25 Gy/10 fractions. Median follow up was 18 months (range, 1-136 months). Results: Overall response rate was 86%; complete response in 39 (52%) and partial response in 26 (34%) patients. The median overall survival was 23 months. One, two, and three year overall survival rate was 72%, 50% and 30%, respectively. In univariate analysis, the treatment response was revealed as a significant favorable prognostic factor for survival (p<0.001). Grade 3 or worse acute toxicities were leukopenia in 46 (61%), anemia in 5 (6%), thrombocytopenia in 10 (13%), esophagitis in 5 (6%), and pulmonary toxicity in 2 (2%) patients. Of 73 evaluable patients, 40 (55%) patients subsequently had disease progression. The most frequent first site of distant metastasis was brain. Conclusion: Twice daily radiation therapy plus concurrent chemotherapy produced favorable response and survival for LS-SCLC patients with tolerable toxicities. To improve the treatment response, which proved as a significant prognostic factor for survival, there should be further investigations about fractionation scheme, chemotherapy regimens and compatible chemoradiotherapy schedule.

The Comparison of Clinical Outcomes of Off-Pump versus On-Pump Coronary Artery Bypass Grafting in High Risk Patients (고위험군 환자에서 시행한 On-Pump CABG와 Off-Pump CABG의 비교연구)

  • 윤영남;이교준;김치영;안지영;오영준;유경종
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.749-754
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    • 2004
  • Off-pump coronary artery bypass grafting (Off-Pump CABG) has been proven to have less morbidity and to facilitate early recovery. High-risk surgical patients may have benefitted by avoiding the adverse effects of the cardiopulmonary bypass. We compared the effectiveness of Off-Pump CABG with that of coronary artery bypass using cardiopulmonary bypass (On-Pump CABG) in high-risk patients. Material and Method: 682 patients (424 Off-Pump CABG and 258 On-Pump CABG) underwent isolated coronary artery bypass grafting between January 2001 and June 2003. Patients who were considered high risk were selected High risk is defined as the presence of one or more of nine adverse prognostic factors. Data were collected from 492 patients in Off-Pump CABG and 100 in On-Pump CABG for risk factors, extent of coronary disease, and in-hospital outcomes. Result: Off-Pump CABG group and On-Pump CABG group did not show differences in their preoperative risk factors. We used more arterial grafts in Off-Pump CABG group (p < 0.05). Postoperative results showed that operative mortality (0.5% in Off-Pump CABG versus 2.0% in On-Pump CABG), renal failure (2.6% in Off-Pump CABG versus 7.0% in On-Pump CABG), and perioperative myocardial infarction (1.5% in Off-Pump CABG versus 1.0% in On-Pump CABG) did not differ significantly. However, Off-Pump CABG had shorter mean operation time (p<0.05), lower mean CK-MB level (p <0.05), lower rate of usage of inotropics (p < 0.05), shorter mean ventilation time (p <0.05), lower perioperative stroke (0% versus 2.0%), and shorter length of stay (p < 0.05) than On-Pump CABG. On-Pump CABG had more distal grafts (p<0.05) than Off-Pump CABG. Although Off-Pump CABG and On-Pump CABG did not show statistical differences in mortality and morbidity was more frequent in CABG. Conclusion: Off-Pump CABG reduces morbidity and favors hospital outcomes. Therefore, Off-Pump CABG is safe, reasonable and may be a preferable operative strategy for high-risk patients.

The Difference between Clinical Manifestations and Feeding or Delivery Methods in Healthy Full-term Neonates and Those with Nosocomial Rotaviral Infection (수유 및 분만방법에 따른 신생아실 로타바이러스 원내감염의 증상 차이)

  • Lee, So Young;Kim, Hyun Ji;Kim, Mi Young;Kim, Won Duck;Lee, Dong Seok;Kim, Doo Kwun;Choi, Sung Min
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.454-458
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    • 2003
  • Purpose : Rotavirus is the main cause of infantile diarrheal disease worldwide. The purpose of this study is to assess the difference between clinical manifestations and feeding or delivery methods in healthy full-term neonates and those with nosocomially-acquired rotaviral infection. Methods : The study was conducted on 348 babies who were delivered in Dongguk University Kyongju Hospital from Jan 1 to June 30 in 2001. Stool specimens were collected from clinically symptomatic neonates. We studied the rate of positive stool rotazyme ELISA tests and positive symptoms. We compared the frequency of clinical manifestations according to the feeding methods [breast feeding(BF) or formula feeding(FF)] and the delivery methods[normal vaginal delivery(NVD) or Cesarean section(C/sec)]. Results : Rotavirus was detected in 152 of 348 babies. The rate of positive rotazyme ELISA test was 43.7% in healthy full-term symptomatic neonates. The most common symptom of rotaviral enteritis was mild fever; the others were watery diarrhea, abdominal distension, vomiting, delayed weight gain, irritability, poor oral intake and dehydration. Compared with FF neonates, BF neonates have lower frequency of symptoms, especially watery diarrhea, delayed weight gain and poor oral intake. The symptomatic frequency was higher in FF and NVD neonates than BF and C/sec. Conclusion : The symptoms of rotaviral enteritis were less frequent in BF or C/sec delivered neonates. BF appeared to alleviate the rotaviral enteritis but further studies are needed. The cause of the lower frequency of symptoms in C/sec delivered neonates was unknown.

Clinical Use and Complications of Percutaneous Central Venous Catheterization in Very Low Birth Weight Infants (극소 저출생 체중아에서 경피 중심정맥 도관의 유용성과 합병증)

  • Kim, Hyang;Kim, Sun Hui;Byun, Hyung Suck;Choi, Young Youn
    • Clinical and Experimental Pediatrics
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    • v.48 no.9
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    • pp.953-959
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    • 2005
  • Purpose : The administration of total parenteral nutrition(TPN) has become a standard procedure in the management of nutritionally deprived and critically low birth weight neonates. Sepsis remains the most frequent serious complication during TPN, resulting in increased morbidity, mortality and health care costs. This study was performed to evaluate the clinical efficacy and complications of percutaneous central venous catheterization(PCVC) in very low birth weight infants. Methods : A total of 56 very low birth weight infants below 1,500 g during the period from January 1998 to December 2003 were enrolled and their medical records reviewed. Study group(n=32) included the babies who had undergone PCVC and a control group(n=24) included babies who had not undergone PCVC. We compared the study group with the control group for factors such as subject characteristics and catheter-related complications. Results : There was no difference in subject characteristics, such as birth weight, gestational week, respiratory distress syndrome, duration of ventilator therapy, duration from tube to complete oral feeding, days at TPN and its total duration, body weight at discontinuation of TPN and the days taken to reach to 2,000 g. However, the morbidity rate due to patent ductus arterious, chronic lung disease, necrotizing enterocolitis, osteopenia, cholestasis, and sepsis showed no difference. The study group with infants below 1,000 g showed a higher incidence of sepsis compared to the control group of the same weight group. The study group with infants between 1,000 to 1,500 g showed significantly higher incidences of intraventricular hemorrhage and took longer reach the a body weight of 2,000 g. Conclusion : Considering the high incidence of sepsis in the PCVC group, every attempt should be made to minimize the length of TPN therapy and encourage early enteral feeding. We also recommend the use of PCVC carefully in patients requiring prolonged nutritional support.