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Risk Factors for Nosocomial Pneumonia in Patients at NS ICU (신경외과 중환자실의 병원성 폐렴 발생 위험요인)

  • Kim Nam Cho;Kim So Yeon
    • Journal of Korean Public Health Nursing
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    • v.15 no.2
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    • pp.239-248
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    • 2001
  • The purpose of this study was to analyze risk factors for nosocomial pneumonia in patients admitted to NS ICU, and to provide a basic data to decrease respiratory nosocomial infection rate engendered from medical environments in NS ICU. The study site was the NS ICU at a university hospital located in Seoul, Korea. The subjects were 31 patients diagnosed with nosocomial pneumonia, who were selected from the initial list of 300 potential subjects who had been a) admitted between September 1999 and January 2000, and September 2000 and January 2001, b) resided at the NS ICU over 72 hours. The diagnostic standard of nosocomial pneumonia was based on the nosocomial infection guides of C university hospital. The data were analyzed using frequencies and logistic regression analysis. The sputums obtained from the subjects were cultivated and causal viruses were separated. The results were as follows: 1. The nosocomial pneumonia rate was $10.3\%$. There were 7 types of causal viruses separated from the sputum. and the most prevalent type of virus was MRSA as $62.2\%$. 2. The factors significantly influencing the incidence of nosocomial pneumonia included age, the residential duration at the NS ICU, GCS scores, diabetes mellitus, insertion of tracheal tube and its duration, tracheostomy and its length of insertion, the use of artificial ventilator and the length of its use, and the insertion of naso-gastic tube. The most significant risk factor among these was the insertion of tracheal tube (odds ratio=18.684. $95\%$ CI=6.849-50.974), followed by the use of tracheostomy (odds ratio=15.419, $95\%$ CI=6.615-35.942), the insertion of naso-gastric tube (odds ratio=14.875, $95\%$ CI=6.396-34.595), and the use of artificial ventilator (odds ratio=13.000. $95\%$ CI=5.633­30.001). 3. Regarding the use of the mechanical aids, the insertion of tracheal tube resulted in 12.968 times increase of the nosocomial pneumonia rate, and the use of artificial ventilator lead 6.714 times increase of the nosocomial pneumonia rate. One point increase of the GCS score resulted in the 1.210 times increase of the nosocomial pneumonia rate. For patients who had tracheal tube, tracheostomy, and artificial ventilator, one day increase of their residential duration at NS ICU lead 1.073 times increase of the nosocomial pneumonia rate. 4. In terms of duration of the mechanical aid usage, one day increase in the use of artificial ventilator engendered 1.080 times increase in the nosocomial pneumonia rate. One day increase of the residential duration at the NS ICU lead 1.604 times increase in the nosocomial pneumonia rate. As one point of the GCS score increased, 0.876 times decrease of the nosocomial pneumonia rate was reported. These study findings show that the risk factors significantly influencing the incidence of nosocomial pneumonia include the use of tracheal tube, tracheostomy, naso-gastic tube, and artificial ventilator. It is recommended that nurses working at NS ICU should pay more attention to the patients with these factors as the risky group for the nosocomial pneumonia, and thus make more active efforts to provide nosocomial pneumonia prevention strategies for them. In further studies patients admitted to the different types of ICUs such as internal medicine or surgery unit ICU will be also included, and more wide investigation of nosocomial pneumonia risk factors will be conducted through one-year longitudinal follow up.

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Labor market characteristics of US metropolitan areas and individual earnings attainment : Whites, Blacks, Asians, and Hispanics (미국 대도시지역 노동시장의 특성과 취업 노동자의 개인소득 : 백인, 흑인, 동양인과 남미인)

  • ;Kwon, Sangcheol
    • Journal of the Korean Geographical Society
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    • v.30 no.2
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    • pp.169-187
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    • 1995
  • Contemporary US metropolitan areas have undergone divergent economic transformation, and as a result labor markets have become the focus of concern in their role as determinants of earnings attainment. Explanations of individual earnings attainmnent as a lobor market outcome have been established in two diafferent stances one who emphasizes personal or group attributes in the human capital perspective and the other who emphasizes economic structure in the labor market segmentation perspective. While remaining at the conceptual level and yet relatively unexplored, the importance of place in labormarket operation is a significant advancement as it appears in labor market areas and local labor markets considering that labor market areas represent the intersection of labor market structure and individual labor market experiences at specific geographic places. The substantive inquiry of this study was to explore labor market characteristics and their differentiation across large metropolitan areas, and assess their effects on the individual earnings attainment. Integating individual attributes and labor market characteristics as major factors of labor market operation, this study intended to contextualize individual earnings attainment with geographic labor market areas. Using 1990 US population census 5% "Public-Use Microdata Samples, " the largest 65 metropolitan areas were first selected and employed male workers who are aged between 25 and 50 for whites, blacks, asians, and hispanics. As an initial step earnings differentials between racial/ethnic groups and selected 65 metropolitan areas were examined using analysis of variance, and then earnings differentials were attributed to the individual attributes such as education, age, and immigration status, and four dimensions of metropolitan labor market differentiation devised by principal component analysis of industrial and occupational segments: Public versus Blue Collar Core(CS1), Finance-Core Utility versus Blue Collar Local Monopoly (CS2), Oligopoly versus Blue Collar Periphery(CS3), and Self Employed-White Collar Periphery versus Low-Skill Core(CS4). As a final analysis, individual earnings were related to each individual attribute and its interaction with metropolitan labor market characteristics to examine how the differentiated metropolitan labor market characteristics alter the role of individual attributes on earnings attainment. The findings indicated that individual attributes, education in particular exert significant effects on earnings attainment, but their effects were significantly altered by metropolitan labor market characterristics. Particularly important dimensions were: Oligopoly differentiated from Blue Colla Periphery metropolitan areas enhancing earnings returns to individual attributes for all groups but minority groups (black, asians, hispanics) rely more on this, and Finance-Core Utility differentiated from Blue Collar Local Monopoly metropolitan areas provide higher earnings returns to whites exclusively. These findings suggest that individuals with identical individual attributes involving racial/ethnic categories would have different earnings atteinments depending on the metropolitan labor market characteristics where they reside. Referring back to the major traditions of the human capital and the labor market segmentation in labor market research, the interaction between individual attributes and metropolitan labor market haracteristics on earnings attainment highlights the complimentary nature of the two on earnings determination in particular geographic places, Hence, labor market characteristics differentiatcd across metropolitan areas are an integral part of labor market operation which should be considered for the explanation of individual earnings attainment and racial/ethnic group earnings differentials. Gcographic places are the important contexts for labor market segmentation and individual labor market experiences. In conclusion, this study brings geographic labor markets to the forefront in the examination of individuals' earnings attainments. The empirical vaidation of the role of metropolitan labor market charecteristics on earnings attainment, while exploratory contributes towards a broader perspective of geographic labor market research that recognizes that individuals' labor market experiences are intertwined with geographic contexts of labor market operatin. operatin.

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Sprout Growth and Its Effects on Vegetation after Lumbering of Populus albaglandulosa (은수원사시나무 벌목 후 맹아의 생장과 맹아가 주변 식생에 미치는 효과)

  • Min, Byeong-Mee;Choi, Sun-Hee
    • The Korean Journal of Ecology
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    • v.23 no.3
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    • pp.223-229
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    • 2000
  • To develop the restoration technique from urban planted forest to natural forest, sprout growth and its effects on vegetation composition in the early stage after lumbering, were studied, using only Populus albaglandulosa of the tree layer in Chungdam Park Chungdam-dong, Kangnam-gu, Seoul during the two years from 1997 to 1998. The results were as follow. After lumbering, the more basal areas of the parent stump, the more sprouts were generated. The basal area of parent stump was related more to biomass than to the number of sprouts. In the cutting area, biomasses of sprouts were 552.7 g?DW/㎡ in first year and 8.7 g?DW/㎡ in second year after lumbering. Therefore, cutting of sprouts in first year resulted in decrease of sprout production in second year. In the non-cutting area, biomass of sprouts was 657.4 g?DW/㎡ and more than that of the experiment. Especially, 2-year sprouts grew to a 304 cm height by the end of the growing season in the second year. The growing season of sprouts was from early April to early September and almost all the leaves of the sprouts remained at the end of the growing season. Specific leaf area decreased along with time elapse and plant height but the differences were not conspicuous. Therefore, it is thought that the reason why p. albaglandulosa sprouts grew fast was due to a long growing period and lower layer leaves which remained at the end of the growing season. In the cutting area of the P. albaglandulosa sprouts, there were no changes in the number of species in the shrub layer but an conspicuous increase in the herb layer. Coverage was no changes in the shrub layer but an increase in the herb layer. In the non-cutting area of P albaglandulosa sprouts, the number of species and the coverage changed a little, and the main species of the herb layer were Phytolacca americana, Eupatorium rugosum and Panicum dichotomiflorum, which are tall plant species.

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The Responses of Antioxidative Enzymes and Salt Tolerance of Atriplex gmelini (Atriplex gmelini(가는갯능쟁이)의 내염성과 항산화 효소 반응)

  • 배정진;윤호성;추연식;송승달
    • The Korean Journal of Ecology
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    • v.26 no.5
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    • pp.273-280
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    • 2003
  • Saline conditions invoke oxidative stress attributed to the overproduction of reactive oxygen species (ROS). Changes in quantum efficiency and antioxidative enzyme activity upon salt treatment were examined in a salt-tolerant plant, Atriplex gmelini, to test the hypothesis that salt tolerance of A. gmelini is due to the increased activity of antioxidative enzymes. A. gmelini showed optimum growth at 100 mM NaCl producing 116% of the shoot dry weight over control plants in 0 mM NaCl treatment. Healthy growth persisted up to 300 mM NaCl treatment maintaining normal internal water content and dry weight. No photochemical stress or damages on antioxidative defense system was obvious in plants of 2 and 4 day salt treatment which was indicated by increased quantum efficiency (Fv/Fm value), decreased stress index (Fo/Fm value), and increased activity of antioxidative enzymes such as SOD, APX, GR. However, the plants treated with 400 mM NaCl showed decrease in growth and in antioxidative enzyme activity although the enzyme activity was still higher than that of the 0 mM NaCl treated plants (l31%, 114%, and 134% of the SOD, APX, and GR activity, respectively). Interestingly, another important antioridative enzyme that scavenges H₂O₂ in plant cells, CAT, showed rapid decrease in its activity as salt concentration increased; 38%, 22%, 15% of the 0 mM NaCl treated plants at 200, 300, 400 mM NaCl treatments, respectively. It appears that the enzymes in ascorbate-glutathione cycle such as APX and GR play the major roles in scavenging ROS produced by salt stress in A. gmelini. After 6 days of salt treatment, the damage in photochemical and antioxidative defense system was indicated by decreased Fv/Fm value and increased Fo/Fm value. A. gmelini appears to cope with short term salt treatment by enhanced activity of the antioxidative defense system, whereas long term stress invoke oxidative stress by increased ROS due to the damages in photochemical and antioxidative system.

Studies of Long-term Variability of Methane in the Moo-Ahn Observatory Site in Korea (무안지역을 중심으로 한 메탄의 장주기적 농도변화 특성 연구)

  • Choi, Gyoo-Hoon;Youn, Yong-Hoon;Kang, Chang-Hee;Jo, Young-Min;Ko, Eui-Jang;Kim, Ki-Hyun
    • Journal of the Korean earth science society
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    • v.23 no.3
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    • pp.280-293
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    • 2002
  • In this study, we analyzed the long-term distribution patterns of $CH_4$ determined from the Moo-Ahn (MAN) observatory in relation with those derived from the world major background monitoring sites. Comparison of the data were made using those data sets collected for the period between Aug. 1995 to Dec. 1991. The mean $CH_4$ concentration of MAN observatory was measured to be 1898${\pm}$85.3 ppb, recording the highest concentration of all the monitoring sites. When the concentration of $CH_4$ for different stations was compared over latitudinal scale, its concentration appeared to increase systematically as a function of latitude with an exception of MAN (and the other Korean monitoring site at Tae Ahn). Moreover, such phenomenon was more distinctive in Northern than Southern Hemisphere. According to the analysis of the monthly distribution patterns of $CH_4$ at MAN observatory, its concentration level began to increase from the months of February/March and peaked during August. In addition, when the level of oscillation in monthly concentrations (between the maximum and minimum values) was checked, differences were significant between MAN and other monitoring stations. If the rate of concentration change was checked using the data sets collected for this limited time period in terms of linear regression analysis, results for MAN showed the highest annual increasing rate of 16.5 ppb. It is hence suggested that the largest variability in the $CH_4$ distribution patterns at MAN observatory may be reflected by the high irregularity in its source/sink processes.

Effect of Academic Examination Stress on Taste Perception and Nutrient Intake in University Students (대학생의 시험 스트레스가 미각과 영양소 섭취에 미치는 영향)

  • 전예숙;최미경
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.2
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    • pp.349-355
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    • 2004
  • The purpose of this study was to estimate effect of academic examination stress on taste perception and nutrient intakes in university students. Physical status, blood pressure, stress score using stress test of 2 types, recognition threshold and preference for taste, nutrient intakes using diet record method were measured before and after examination in 20 subjects. Mean age, height, weight, and BMI of the subjects were 23.39$\pm$1.20 years, 164.56$\pm$7.99 cm, 60.66$\pm$13.23 kg, 22.28$\pm$4.56 kg/$m^2$, respectively. Stress scores before examination of the subjects were significantly higher than those after examination. There were no significant differences in blood pressure, pulse rate, recognition threshold and just right concentration for sweetness and saltness, and food and nutrient intakes between pre- and post-examination. There were significantly positive correlation between stress score and diastolic blood pressure. And threshold concentration for saltness was positively correlated with threshold concentration for sweetness and animal protein intake. These results show no effect of examination stress on taste perception and nutrient intakes in university students. This may be due to low level of stress. Therefore, it is needed to study about effect of more higher level of stress on taste perception and nutrient intakes.

A Study on the Current Status of Calcium fortification in the Processed Foods in Korea (우리나라 가공식품의 칼슘강화 현황에 관한 조사 연구)

  • 김욱희;김을상;유인실
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.31 no.1
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    • pp.170-176
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    • 2002
  • The objective of this study was to investigate the current status of calcium fortification in processed foods for obtaining basic data on nutrition fortification policy and nutrition labeling, Surveyed samples were the products fortified wish calcium among processed products sold in department store and large mart in Seoul from Aug. 1998 to Aug. 1999. But supplementary health food or special nutritious food and weaning food and infant formula were excluded from them. We examined the kinds and numbers of added nutrients except calcium and the amounts of calcium per 100 g product and nutrient labeling of calcium-fortified foods. Surveyed products were 81 foods and they were grouped in grain products, milk and milk products, processed meat and fishes, ramyuns, retort pouch foods, fruit juice and drinks. and others. Calcium fortification was found in wide food groups, especially in snack foods and carbonated beverages. In relation to surveyed products, most of them were fortified with only calcium. The number of added nutrients in the product were relatively various in comparison with each food groups. In addition to calcium, the most frequently added nutrient was DHA, and were followed vitamin, mineral, oligosacchride, fiber, etc. This result showed that the kind(s) and the number(s) of nutrient added to product did not consider nutrition balance of calcium-fortified foods. Units of calcium content were decided by companies, therefore consumers confused labelled content with mouth dose of calcium and the comparison of the amounts added calcium among products was difficult. The amounts of calcium in products were from 16.4 to 1226 mg Per 100 and from 2.5 to 27.6% RDA (recommended daily allowance) per serving size. The amounts of calcium in many products were less than 10% RDA per serving size, whole appraisal about fortified content was needed. And for nutrient labeling on calcium, they used various term whether it is approved by law or not.

A Study on Using of Materials and Compliance of Diet Therapy by Distribution of Body Weight in Diabetic Patients (당뇨병 환자의 체중분포별 식사요법 실행 및 자료의 활용 실태)

  • 한지숙;정지혜
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.3
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    • pp.533-541
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    • 2004
  • The purpose of this study was to investigate using of diet therapy materials and the compliance of diet therapy by distribution of body weight in diabetic patients. The percentage of diabetic patients who was distributed by BMI was 18.5% in under weight group, 51.5% in normal weight group, 16.9% in over weight group and 13.1% in obesity group. Of 130 diabetic patients, 62.3% experienced weight loss after the diagnosis. 35.4% of the diabetic patients had ever been in the hospital. 38.5% of the diabetic patients had prevalence of the complications. Knowledge for diet therapy showed low score in over weight and obesity group, specially in the items on the amount of food that I have to consume or the method selecting foods using the food exchange list. Diet therapy practice was also lower in obesity group than the other groups. Most of diabetic patients thought the diet therapy was important and got diet therapy materials through dietitian or doctor. But using of diet therapy materials was 50.0% in under weight group, 41.8% in normal weight group. 22.7% in over weight group and 35.3% in obesity group. Food exchange list was diet therapy item considered as the most difficult for diabetic patients to understand. Diet therapy items considered as the most necessary by diabetic patients were to be attended to choose foods and how to make out menu. This study showed that the diabetic patients were different in using of diet therapy materials or diet therapy practice by distribution of body weight. Therefore it is suggested that the program composed of necessary contents by body weight distribution of diabetic patients need to be developed.

Anticarcinogenic Effects of Sargassum fulvellum Fractions on Several Human Cancer Cell Lines in vitro (모자반 분획물의 in vitro에서의 항발암효과)

  • 배송자
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.3
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    • pp.480-486
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    • 2004
  • Despite many therapeutic advances in the understanding of the processes in carcinogenesis, overall mortality statistics are unlikely to change until there is reorientation of the concepts for the use of natural products as new anticarcinogenic agents. In this study, we investigated the anticarcinogenic activity, antioxidant and DPPH scavenging activity of Sargassum fulvellum (SF). SF was extracted with methanol, which was further fractionated into five different types: hexane (SFMH), ethylether (SFMEE), ethyl acetate (SFMEA), butanol (SFMB) and aqueous (SFMA) partition layers. We determined the cytotoxic effect of these layers on human cancer cells by MTT assay. Among various partition layers of SF, at starting concentration of 100 $\mu\textrm{g}$/mL, SFMEE showed very high cytotoxicity which were 92, 90 and 84% and kept high throughout 5 concentration levels sparsed by 100 $\mu\textrm{g}$/mL against all three human cancer cell lines: HepG2, HT-29 and HeLa. SFMEA showed a low cytotoxicity at the beginning concentration level, but as the concentration became denser, growth inhibition effect of cancer cell lines started to increase and at 500 $\mu\textrm{g}$/mL, it hit the highest, which were 91, 96 and 98% against the same three cell lines as above. We observed QR induced effect in all fraction layers of SF. SFMEE showed similar tendensy of QR induced effect as did against cytotoxicity. The QR induced effect of SFMEE on HepG2 cells at 25 $\mu\textrm{g}$/mL concentration indicated 3 times higher than the control value of 1.0 and SFMH tended to be concentration-dependent on HepG2 cells. At 100 $\mu\textrm{g}$/mL, the QR induced effects resulted a ratio, which was 2.5 times higher than the control value. In search for antioxidation effects of SF extract and partition layer, the reducing activity on the 1, 1-diphenyl-2-picryl hydrazyl (DPPH) radical scavenging potential was sequentially screened. The SFM has similar antioxidant activity as to BHT and vitamin C groups.

Biological Activity of Ixeris dentata Nakai juice Extracts (씀바귀(Ixeris dentata Nakai) 생즙 추출물의 생리활성)

  • 김명조;김주성;강원희;조미애;함승시;정동명
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.31 no.5
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    • pp.924-930
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    • 2002
  • Ixeris dentata extracts exllibited antimicrobial activity against some bacteria and fungi. Also EtOH extracts showed strong antioxidant activity and RC$_{50}$ value was 28 $\mu\textrm{g}$/mL. The inhibitory effect of Ixeris dentata on the mutagenicity in Salmonella and cytotoxicity on cancer cell were studied. Ixeris dentata extracts showed anti-mutagenic effects of 78.83 and 75.96% on B(a)P in S. typhimurium TA98 and Th100, respectively. These extracts showed 78.72% antimutagenicity on TA100 against MNNG. The Ixeris dentata extract with strong antimutagenic activities was further fractionated by hexane, ethyl acetate, butanol and water. Butanol fraction was found to be highest in antimutagenic activity against MNNG than the other fractions. Butanol fraction of Ixreis dentate revealed the highest cytotoxicity against AS49 human lung carcinoma cells in which cell growth was inhibited by 93.75% at 375 $\mu\textrm{g}$/mL. Hexane fraction of ixeris dentate exhibited 68.56% inhibition against MCF-7 human breast adenocarcinoma cells at 500 $\mu\textrm{g}$/mL. Hexane fraction of Ixeris dentata exhibited 84.91% inhibition against Hep 3B human hepatocellular carcinoma cells at 500 $\mu\textrm{g}$/mL. From these results, it is considered that Ixeris dentata has strong antimutagenic and anticancer effects in vitro. However, these extracts and fractions did not show any cytotoxic effect against 293 cells.