• Title/Summary/Keyword: Group management

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Significance of Serum Ferritin in Multiple Trauma Patients with Acute Respiratory Distress Syndrome (다발성 외상 환자에서 발생되는 급성 호흡 곤란 증후군의 예측 인자로서 혈청 페리틴의 의의)

  • Ji, Yae-Sub;Kim, Nak-Hee;Jung, Ho-Geun;Ha, Dong-Yeup;Jung, Ki-Hoon
    • Journal of Trauma and Injury
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    • v.20 no.2
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    • pp.57-64
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    • 2007
  • Purpose: Clinically, acute respiratory distress syndrome (ARDS) occurs within 72 hours after acute exposure of risk factors. Because of its high fatality rate once ARDS progresses, early detection and management are essential to reduce the mortality rate. Accordingly, studies on early changes of ARDS were started, and serum ferritin, as well the as injury severity score (ISS), which has been addressed in previous studies, thought to be an early predictive indicator for ARDSMethods: From March 2003 to March 2005, we investigated 50 trauma patients who were admitted to the intensive care unit in Dongguk University Medical Center, Gyeongju. The patients were characterized according to age, sex, ISS, onset of ARDS, time onset of ARDS, serum ferritin level (posttraumatic $1^{st}\;&\;2^{nd}$ day), amount of transfused blood, and death. Abdominal computed topography was performed as an early diagnostic tool to evaluate the onset of ARDS according to its diagnostic criteria. The serum ferritin was measured by using a $VIDAS^{(R)}$ Ferritin (bioMeriux, Marcy-1' Etoile, France) kit with an enzyme-linked fluorescent assay method. For statistical analysis, Windows SPSS 13.0 and MedCalc were used to confirm the probability of obtaining a predictive measure from the receiver operating characteristics (ROC) curve. Results: The ISS varied from 14 to 66 (mean: 33.8) whereas the onset of ARDS could be predicted with the score above 30 (sensitivity: 90.0%, specificity: 60.0%, p<0.05). On the posttraumatic $1^{st}$ day, the serum ferritin levels were measured to be from 31 mg/dL to 1,200 mg/dL (mean: 456 mg/dL), and the onset of ARDS could be predicted when the value was over 340 mg/dL (sensitivity: 80.0%, specificity: 65.0%, p<0.05). On the posttraumatic $2^{nd}$ day, the serum ferritin levels were measured to be from 73 mg/dL to 1,200 mg/dL (mean: 404 mg/dL), and the onset of ARDS could be predicted when the value was over 627 mg/dL (sensitivity: 60.0%, specificity: 92.5%, p<0.05). The serum ferritin levels and the ISS were significantly higher on the posttraumatic $1^{st}$ and $2^{nd}$ day in the ARDS group, suggesting that they are suitable indices predicting the onset of ARDS, however relationship between the serum ferritin levels and the ISS was not statistically significant. Conclusion: In this study, we discovered increasing serum ferritin levels in multiple- trauma patients on the posttraumatic $1^{st}$ & $2^{nd}$ day and concluded that both the serum ferritin level and the ISS were good predictors of ARDS. Although they do not show statistically significant relationship to each other, they can be used as independent predictive measures for ARDS. Since ARDS causes high mortality, further studies, including the types of surgery and the methods of anesthesia on a large number of patients are essential to predict the chance of ARDS earlier and to reduce the incidence of death.

Efficacy of Neoadjuvant Chemotherapy and Radiotherapy for the Histology-confirmed Intracranial Germinoma - Preliminary Report (조직학적으로 확진된 두개내 배아종의 전보조화학요법 후 방사선치료의 성적 - 예비적 결과)

  • Noh, Young-Ju;Kim, Hak-Jae;Heo, Dae-Seog;Shin, Hee-Yung;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.93-99
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    • 2002
  • Purpose : We intended to decrease late CNS reaction after radical radiotherapy for an intracranial germinoma by using combined neoadjuvant chemotherapy and involved-field radiotherapy. The efficacy in terms of its acute toxicity and short-term relapse patterns was analyzed. Materials and Methods : Eighteen patients were treated with combined neoadjuvant chemotherapy and radiotherapy between 1995 and 2001. The chemotherapy regimen used was the Children's Cancer Group (CCG) 9921A (cisplatin, cyclophosphamide, VP-16, vincristine) for 5 patients younger than 16 years, BEP (bleomycin, VP-16, cisplatin) for 12 patients, and EP (VP-16, cisplatin) for 1 patient. The radiotherapy covered the whole craniospinal axis for 5 patients, the whole brain for 1, and the partial brain (involved field) for 12. the primary lesion received tumour doses between 3,960 and 5,400 cGy. Results : The male to female ratio was 16:2 and the median age was 16 years old. The tumors were located in the pineal gland in 12 patients, in the suprasellar region in 1, in the basal ganglia In 1, in the thalamus in 1. Three patients had multiple lesions and ventricular seedings were shown at MRI. In 3 patients, tumor cells were detected in the cerebrospinal fluid and MRI detected a spinal seeding in 2 patients. The response to neoadjuvant chemotherapy was complete remission in 5 patients, partial remission in 12, and no response in 1. However, after radiotherapy, all except 1 patient experienced complete remission. The toxicity during or after chemotherapy greater than or equal to grade III was remarkable; hematologic toxicity was observed in 11 patients, liver toxicity in none, kidney toxicity in none, and gastrointestinal toxicity in one. One patient suffered from bleomycin-induced pneumonitis. Radiotherapy was therefore stopped and the patient eventually died of respiratory failure. The other 17 are alive without any evidence of disease or relapse during an average of 20 months follow-up. Conclusion : A high response rate and disease control was experienced, which was the same as observed other studies and the morbidity from chemotherapy-induced toxicity was similar. With these results, the results from adjuvant chemotherapy and involved-field radiotherapy cannot be concluded to be equal to those from extended-field radiotherapy. The long term follow-up study on later complications are required in order to draw definite conclusions on the optimal management with minimum side effects.

Prevalence of Feline Leukemia Virus Infection in Cats in Bangladesh (방글라데시의 고양이 백혈병 바이러스의 감염율 조사)

  • Rahman, Siddiqur;Bhuiyan, Salauddin;Islam, Taohidul;Nahar, Azimun;Sarker, Roma Rani;Alam, Emtiaj;Chakrabarty, Amitavo;Sarker, Abu Sayed;Akhter, Laila;Chae, Joon-Seok
    • Journal of Veterinary Clinics
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    • v.31 no.1
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    • pp.1-5
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    • 2014
  • Feline leukemia virus (FeLV) is a retrovirus that represents one of the most common and important infectious diseases of cats worldwide and it is responsible for more deaths among cats than any other infectious diseases. Prevalence data are necessary to define prophylactic, management and therapeutic measures for stray, feral and owned cats which are lacking in Bangladesh. The study was carried out to determine the prevalence of FeLV infection in Mymensingh district of Bangladesh using RapiGEN$^{(R)}$ FeLV Ag Test Kit (RapiGEN$^{(R)}$ Inc., Republic of Korea), a rapid one-step immunochromatographic assay. Blood samples from total 130 cats (23 owned cats and 107 unowned cats) were collected and tested following the manufacturer's instruction. An overall prevalence of FeLV infection was 1.54% (2/130). Prevalence was found 1.79% (2/112) on Day 0-up to one year aged cats (young) but no positive case was found in above 1 year (Adult) aged group. In male and female cats, the prevalence was 1.72% (1/58) and 1.39% (1/72), respectively. In un-owned cats the prevalence was 1.87%. Positive cases to FeLV were found only in clinically sick cats. No significant relationship was found according to age, sex, ownership status and health status. To the best of our knowledge this is the first report of the prevalence of FeLV infection in Bangladesh using RapiGEN$^{(R)}$ FeLV test kits which is very much effective because it is easy to apply, less expensive and quick screening of such type of infection.

Comparisons of 12-Hour and 24-Hour Sustained-Release Theophyllines in the Management of Asthma (천식치료에서 서방형 Theophylline의 1일 1회 제형과 1일 2회 제형의 비교)

  • Lee, Yang-Deok;Park, Seoung-Ju;Lee, Heung-Bum;Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.3
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    • pp.293-299
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    • 2001
  • Background : Sustained-release theophylline, which is generally prescribed as a twice-daily equal-dose regimen, is one of the more common asthma treatments. The development of a sustained-release drug delivery technology that enables improved control of the theophylline blood levels represents a significant advancement in both the efficacy and safety of dosing. Method : A crossover study was conducted with 25 adult chronic asthmatic patients requiring daily bronchodilator therapy. The study group included thirteen males and twelve females with ages ranging from 19 to 71 years. The overall approach was to place the patients first on the twice-daily preparation($Etheophyl^{(R)}$) for 28 days at 8 AM and 8 PM, and measure the pulmonary function and theophylline level on the 28th day. The patients were subsequently switched to the once-daily preparation($Uniphyl^{(R)}$) in the same daily dose at 8 PM on the 29th day and the same parameters were measured on the 56th day. Results : The mean serum levels of theophylline were $8.18{\pm}1.66\;{\mu}g/ml$ in the $Etheophyl^{(R)}$-treated period and $8.00{\pm}1.75\;{\mu}g/ml$ in the $Uniphyl^{(R)}$-treated period. ln addition, the $FEV_1$ showed $71.40{\pm}7.48$ percent in the $Etheophyl^{(R)}$-treated and $69.18{\pm}9.00$ percent in the $Uniphyl^{(R)}$-treated period. Thus there were no significant differences between the once-daily and twice-daily preparation. Conclusion : The results indicated little clinical differences between the two medications. The two drugs are equally effective in controlling asthma over the four weeks of treatment.

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An Analysis of the National Suicide Rate in Korea during 2005 (2005년 전국 자살실태 분석)

  • Kim, Gi-Jeong;Kwak, Jyung-Sik
    • Journal of forensic and investigative science
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    • v.2 no.1
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    • pp.5-22
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    • 2007
  • From the numerous social problems generated by the unbalanced social development and the social trend of belittling life overall, we found the causes of suicide getting worse in its seriousness day by day. In reality, the problem has been approached in a collateral level in contrast with other social problems. There have been an active involvement in studying the definition, causes and ways of prevention of suicide theoretically until now. However, different from other social problems, it is almost impossible to treat or fix the problem of suicide. Only ways to treat or fix the problem is when the suicide has ended in failure. Thus, this study intends to examine the suicide rate among the total accidents during the year 2005, perform the analyses on the actual causes according to the relations such as the means of suicide, occupation, age group, educational background, etc. In order to present a solution to the issue of suicide becoming serious each day. Among the total accidents in 2005, the suicide rate came out to be approximately 52.4%. Among the result, 52.4%, male with 69% resulted higher than female with 31%, which appears to be related to the social functions. While men tends to take more active(80%) means of suicide like jumping off, poison, hanging, etc., women tends to take more passive(60%) means of suicide like sleeping pills, slitting wrist, etc. In terms of the cause, pessimism, illness, denial, mental disorder, etc resulted more than 75%, and there were many cases of suicide after exhibiting the signs of depression. Also there were higher suicide rate of the unemployed engaged in direct labor with educational background lower than college level related to the pessimism regarding the family living cost. We were able to determine the recent increase in the suicidal tendency of the educated people higher than the college level and the retired people with depression caused by the sudden change in social status. Overall there are several reasons for suicide, however, in most cases the signs of depression were exhibited until the final suicide, which tells us the serious psychological problem of suicide. Assuming that the current development of suicide will continue in future, the result of this study will guide the corresponding social policies, be utilized in preparing the insurance or management at the national level dealing with the real social problems that are not just a conflict of an individual, but could spread like a fad and become much bigger than the present by the continuous support at the environmental, social and political levels, and be utilized as the basic data to establish the research plan.

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Efficient Treatment Methods for Reducing Escherichia coli Populations in Commercially-Available Red Pepper Powder in Korea (국내 유통 고춧가루의 병원성 대장균 오염 및 대장균 저감화 방법)

  • Song, Young-Jin;Park, Se-Won;Chun, Se-Chul;Choi, Mi-Jung;Chung, Koo-Chun;Lee, Si-Kyung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.6
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    • pp.875-880
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    • 2012
  • This study was conducted to investigate the level of contamination of pathogenic Escherichia (E.) coli in 50 types of red pepper powders collected domestically. Pathogenic E. coli was confirmed using real-time PCR to confirm the 4 types of EAEC, EPEC, EHEC and ETEC. One sample out of 50 was contaminated with pathogenic E. coli. The type of pathogenic E. coli detected in the sample was EAEC. This study was also conducted to determine the effect of alcohol treatment on the reduction of E. coli populations in red pepper powder. The amount of E. coli in the control was $1.2{\times}10^6$ cfu/mL. The amount of E. coli in 10 minutes immersion treatment with 10% alcohol was $1.1{\times}10^6$ cfu/mL. In samples treated with over 20% alcohol, E. coli was not detected. This showed that 10 minutes of immersion in over 20% alcohol might be effective to reduce E. coli. This study was also conducted to determine the effect of UV irradiation on E. coli reduction. The number of E. coli in the control group was $5.0{\times}10^5$ cfu/mL. However, the number of E. coli in 45 min of the UV irradiated sample decreased to $1.0{\times}10^3$ cfu/mL, by $10^2$ cfu/mL. In contrast, E. coli was not detected in an over 60 min UV irradiated sample in $10^{-2}dilution$. This study showed that over 20% alcohol treatment and UV irradiation for 60 min was effective to control E. coli in red pepper powder.

A Study on the Current Status of Health Screening and the Health Type(Physical Activity, and etc) of the Disabled by Using the Statistics of Health Insurance Corporation (건강보험공단 통계를 이용한 장애인의 건강검진 현황 및 건강형태(신체활동 등)에 대한 소고)

  • Kim, Seck-Jin;Jung, Jin-Sung
    • Journal of the Korean Applied Science and Technology
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    • v.35 no.2
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    • pp.433-444
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    • 2018
  • This study aims to examine the screening rate of health screening of the disabled by screening the data of disability and health statistics of the National Health Insurance Corporation, to suggest the problems of health examination and the future improvement measures, and also to review the type of health management of the disabled based on the results of health examination interview. As people with limited daily life or social life for a long time because of their physical/psychological disabilities in accordance with the Article2 of , out of 2,479,080 registered people with disabilities on the basis of December 31st 2015, the research subjects were limited to people with disabilities who participated in the health screening and health type for presenting the opinions about policies. In conclusion, regarding the health screening for the disabled, first, it would be necessary to collect the opinions from people with disabilities in order to prepare the health screening service suitable for them. Second, it would be needed to develop the health screening items for each type of disability and severity. Third, it would be necessary to consider the medical equipments and amenities of health examination for the disabled. Fourth, there should be the securement of manpower and education for service providers. Fifth, the mobility right of the disabled should be secured. Regarding the health type of the disabled, first, the expert consultative group in each area should be composed for the health enhancement of the disabled. Second, it would be necessary to screening the current status of health enhancement programs for the disabled and operating facilities. Third, the Central Health Medical Center for the Disabled, shown in the law on the securement of health rights & medical accessibility of the disabled should develop the standardized health enhancement programs for each disability type and severity. After examining the contents of health examination and health type of the disabled, the opinions about policies were suggested. Thus, in the future, there should be more detailed researches based on the tasks suggested by this study, and also the causal relations between health of the disabled and relevant programs should be continuously revealed.

The Importance-Performance Analysis of Bakery Cafe Choice Attributes Perceived by Customers in Seoul (베이커리카페 선택속성의 중요도 및 수행도 분석: 서울지역을 중심으로)

  • Choi, Mi-Kyung;Jung, Jae-Chan
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.35 no.4
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    • pp.456-463
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    • 2006
  • The purposes of this study were to extract choice attributes of bakery cafe customers and to conduct important- performance analysis (IPA) of choice attributes perceived by bakery cafe customers. The questionnaire was developed through literature review and focus group interview, and modified after pilot test. The questionnaires for main survey were distributed to 320 males and females aged 20 and over in Seoul. A total of 275 questionnaires were used for analysis (85.9%) and the statistical analyses were conducted using SPSS Win (12.0) for descriptive analyses, exploratory factor analysis, reliability analysis, and correlation analyses. The main results were as follows. 'Products', 'convenience to use', 'services and price', 'interior environments' 'brand' and 'location' dimensions were extracted as choice attributes dimensions of bakery cafe customers and customers of bakery cafe regarded 'sanitation and cleanness', 'kindness of employees', 'quality of products', 'comfortable and pleasant facilities' and 'taste of bakery products' as more important than other attributes. In addition, the results of IPA showed that marketing managers of bakery cafes should focused on the dimension of 'services and price' in the reason that this dimension was low at performance although customers regarded it very important. Overall, researchers and managers of bakery cafes should understand unique choice attributes of bakery cafe customers, and make efforts to establish marketing strategies that meet bakery cafe customers' needs.

Knowledge and Performance of Universal Precautions by Nursing Students (일부 간호대학생의 혈액매개질환 예방 지침에 대한 지식과 실천 정도)

  • 김경미;김민아;정여숙;김남초
    • Journal of Korean Academy of Nursing
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    • v.29 no.4
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    • pp.929-939
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    • 1999
  • The purpose of this study was to identify knowledge of universal precautions and its performance in practice. The research was conducted from November 2 to 30, 1998. A total 515 student nurses ; 249 from a baccalaureate nursing college and 266 from second and third year of a 3-year community nursing college were surveyed. The results are as following : 1. The average score for universal precautions knowledge was 270.41$\pm$19.43/300(range 150-300). The results showed that 99.2% of students avoid injury from used needles, 98.6% answered that they always wash their hands if they had contact with the patient's blood and they always dispose of used needles in special collectors (97.7%) for needles. But, 39.2% responsed that they dispose of used needles after recapping them. 2. The average score for universal precautions knowledge of the senior students in the 4-year college was the highest (277.65$\pm$13.99). 3. The average score for the performance of universal precautions knowledge was 53.18 $\pm$5.91(range 14-70). The items : ‘I cautiously avoid injury from the used needles’(4.92$\pm$0.33), ‘I always wash my hands if there has been contact with the patient's blood’(4.91$\pm$0.34), and ‘I always disposed of used needles in the appropriate collector’(4.89$\pm$0.42) showed the highest performance. However ‘I always dispose of used needles after recapping them’(2.19$\pm$1.39) and ‘I always use protection goggles when in danger of contamination’(2.19$\pm$1.20) showed low performance level. 4. The highest average score for universal precautions performance was shown among the second year students in 3-year nursing college (54.19$\pm$6.92) between the groups. It showed that the level of the universal precautions performance was higher for those who had education on university precautions prior to performance of the universal precautions than for those without any prior education. 5. The percentage of students who reported the experience of direct contact with patients' blood and/or body fluids was 42.30%. The experience of direct contact with blood and/or body fluids of the educational group was significantly higher than those were not educated. 6. The most frequent cause of the direct contact was ‘needle pricking and/or skin cut’(63.04%). The most frequent substance with which the students contact was ‘blood’(59.85%). The majority of the sample had answered that the mode of contamination was ‘unknown’(63.54%). The majority of the sample answered that strategies used after contamination included ‘washing with soap’(33.61%). Reviewing the chart of patients or asking other health professionals(28.85%). 7. The number of students who had the experience of a needle stick and/or skin cut was 145(28.16%). The clinical practice places where the incidents occurred were mainly in the internal medicine unit (45.07%) and the surgical unit (31.92%) followed by the intensive care unit and the emergency unit in order. The experience of a needle stick and/or skin cut happened during on intra-muscular injection 47.34% and intravenous injection 21.81%. The causes of the needle stick and/or skin cut were ‘putting the needle cap back on 77(35.81%)’. The number of students who took an appropriate post management blood test and/or vaccination was 27(18.62%). 8. The Pearson Correlation Coefficient between the knowledge of universal precautions and performance of universal precautions in practice showed a positive correlation.

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A Study on the Children's Eating Habits and Food Preference according to Their Parents' Economic Status (I) - Seoul & Gyeonggi (Incheon) Area - (부모의 경제수준에 따른 자녀의 식습관과 식품기호도에 관한 연구 (I) -서울.경기 (인천)지역을 중심으로-)

  • Chung, Hea-Jung;Eum, Yun-Ho;Kim, Jung-Yoon
    • Journal of Nutrition and Health
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    • v.41 no.1
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    • pp.77-88
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    • 2008
  • This research was carried out a to investigate the food habit and preference of parents' social and economic level with 681 children (145 of Kindergarten, 300 of Children, 236 of Adolescences) in Seoul and Gyeonggi area using question naires. The parents' income level divided into 2 groups, less than 4 million won and equal or greater than 4 million won. Most of the middle years were over-weighing but kindergarten and adolescences had standard weights. The majority of parents had Bachelor degrees, most of father were office workers, majority of mothers of kindergarten with parents' income level less than 4 million won were professional women and mothers of the rest of the groups were mostly house wives. The middle years with parents income level less than 4 million son were skipping meals most frequently, but other groups didn't show much differences in their eating habits. All age groups showed that they like meats the most and dislike vegetables the worst. All age groups also showed that they mostly eat out 1-2 times a week and the next was 3-4 times a week. All age groups preferred ice creams, fruits, juices and snacks for their desserts. The middle years with parents' income equal or greater than 4 million won also showed high preference on strawberry and chocolate flavored milk, burgers and pizzas. The food s that preferred to eat when dining out were Chinese foods (Ja-jang-myeon and sweet and sour pork) for kindergarten group, Korean foods (kalbi and bulgogi) for the middle years with parents' income level less than 4 million won, family restaurant food (steak and rib) for the middle years with parents' income level equal or greater than 4 million won and Korean foods (kalbi and bulgogi) for the adolescences. The preferred cooking methods were roast (fish and sea weeds) for the kindergarten, roasted meat for the middle years, Kimchi and bean paste pot stew for the adolescences with parents' income level less than 4 million won and roasted meats for the adolescences with parents' income level equal or greater than 4 million won. The results showed that the adolescences with higher parental income lever preferred meats.