• Title/Summary/Keyword: Interval Ratio

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Factors Associated with a Prolonged Length of Hospital Stay in Patients with Diabetic Foot: A Single-Center Retrospective Study

  • Choi, Sang Kyu;Kim, Cheol Keun;Jo, Dong In;Lee, Myung Chul;Kim, Jee Nam;Choi, Hyun Gon;Shin, Dong Hyeok;Kim, Soon Heum
    • Archives of Plastic Surgery
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    • v.44 no.6
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    • pp.539-544
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    • 2017
  • Background We conducted this study to identify factors that may prolong the length of the hospital stay (LHS) in patients with diabetic foot (DF) in a single-institution setting. Methods In this single-center retrospective study, we evaluated a total of 164 patients with DF, and conducted an intergroup comparison of their baseline demographic and clinical characteristics, including sex, age, duration of diabetes, smoking status, body mass index, underlying comorbidities (e.g., hypertension or diabetic nephropathy), wound characteristics, type of surgery, the total medical cost, white blood cell (WBC) count, C-reactive protein (CRP) levels, erythrocyte sedimentation rate, and albumin, protein, glycated hemoglobin, and 7-day mean blood glucose (BG) levels. Results Pearson correlation analysis showed that an LHS of >5 weeks had a significant positive correlation with the severity of the wound (r=0.647), WBC count (r=0.571), CRP levels (r=0.390), DN (r=0.020), and 7-day mean BG levels (r=0.120) (P<0.05). In multiple regression analysis, an LHS of >5 weeks had a significant positive correlation with the severity of the wound (odds ratio [OR]=3.297; 95% confidence interval [CI], 1.324-10.483; P=0.020), WBC count (OR=1.423; 95% CI, 0.046.0-356; P=0.000), CRP levels (OR=1.079; 95% CI, 1.015-1.147; P=0.014), albumin levels (OR=0.263; 95% CI, 0.113.3-673; P=0.007), and 7-day mean BG levels (OR=1.018; 95% CI, 1.001-1.035; P=0.020). Conclusions Surgeons should consider the factors associated with a prolonged LHS in the early management of patients with DF. Moreover, this should also be accompanied by a multidisciplinary approach to reducing the LHS.

Usefulness of End-tidal Carbon Dioxide as a Predictor of Emergency Intervention in Major Trauma Patients (중증 외상 환자에서의 응급중재술 시행 예측 인자로서의 호기말 이산화탄소 분압의 유용성)

  • Kim, Sung Ho;Kim, Seunghwan;Lee, Jae Gil;Chung, Sung Phil;Kim, Seung Ho
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.133-138
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    • 2014
  • Purpose: If the survival of patients suffering from severe blunt trauma is to be improved, appropriate interventions should be taken immediately. The purpose of this study is to evaluate the clinical utility of end-tidal carbon dioxide ($ETCO_2$) as a surrogate marker for predicting both the need for intervention and the prognosis. Methods: This is a prospective observational study. Nasal cannula was applied to measure $ETCO_2$, and the following parameters, which are known to be related to the prognosis for a patient, were recorded: injury severity score (ISS), revised trauma score (RTS), arterial blood gas (ABG), lactate, and hemoglobin (Hb). To evaluate the outcome, we investigated the details of emergent interventions and expired patients. Results: A total of 93 patients were enrolled in this study. Emergent intervention was significantly associated with systolic blood pressure (sBP, p-value=0.001), $ETCO_2$ (p-value<0.001), serum lactate level (p-value<0.001), pH (p-value< 0.003), $HCO_3$ (p-value=0.004), base excess (p-value<0.002), ISS (p-value<0.001) and RTS (p-value=0.005). In the multivariate logistic regression, only $ETCO_2$ (odds ratio (OR): 0.897, 95% confidence interval (CI): 0.792-0.975, p-value= 0.048) and ISS (OR: 1.132, 95% CI: 1.053-1.233, p-value=0.002) were associated with emergent intervention whereas $ETCO_2$ (p-value=0.973) and ISS (p-value=0.511) were not statistically significant in predicting the survival of patients in the univariate analysis. An optimal ETCO cut-off of 29 mmHg on the ROC curve was determined, with the area under the ROC curve (AUC) being 0.824 (0.732-0.917)]. Conclusion: This study has revealed that $ETCO_2$, which can be rapid and easily measured through a nasal cannula, and the ISS may be prognostic indicators of emergent interventions in Emergency Departments.

Changes of RuBisCO Content and Protease Activity during the Life Span of Tobacco Leaf (담배잎의 일생에 있어서 RuBisCO 함량과 Protease활성의 변동)

  • 이학수
    • Journal of the Korean Society of Tobacco Science
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    • v.15 no.1
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    • pp.63-74
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    • 1993
  • Changes in the amount of ribulose 1, 5-bisphosphate carboxylase/oygenase(=RuBisCO) protein, namely fraction I protein, and the protease activity were determined in the 10th leaf of tobacco(Nicotiana tabacum, var. Ky-57) from 10 days after emergence through senescence at 5 days interval. The amount of RuBisCO per deveined leaf rapidly increased during the early growing season, reached a maximal quantity at the around 20 days after leaf emergence, when the leaf has gone through its most rapid expansion, and began gradually to decrease till 30 days after leaf emergence, thereafter significantly declined to 45 days that the leaf has been dried up partly. The pattern of the ratio of RuBisCO protein to soluble protein in quantity changed similar to that of RuBisCO contents in a leaf, that was 43%, 60%, and 21% at the around 10 days, 20 days, and 45 days, respectively. And RuBisCO contents was linearly correlated with the concentration of chlorophyll(r=0.98) throughout the life span of the leaf. So, it was assumed that the leaf color can be a useful indicator for judging whether RuBisCO contents higher or not in tobacco leaves without homogenization. On the other hand, the protease activities for degradation of casein were assayed at pH 5.5. 7.0. and 8.5 with crude extracts desalted on Sephadex G-25. The highest caseolytic activity was found at pH 5.5 throughout the life sawn of the leaf. Also, the activity at 5.5 became gradually to increase from 30 days after leaf emergence, when RuBisCO protein had became to disappear and remarkably increased in the last stage of senescence, although nitrogen contents of the leaf had reached low levels. The caseolytic activity at pH 5.5 was in negative correlation with RuBisCO contents throughout the life span of the leaf, but not in lineality between them. In other words, the caseolytic activity increased in a rapid exponential manner when RuBisCO contents had reached some low levels. These results showed that the leaf age, namely harvesting time, is a very important factor for the production of the tobacco leaf containing higher RuBisCO protein. It was concluded that the practical harvesting time is between 20 days and 30 days after the leaf emergence from the present results.

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Herbal Medicine for Tension-type Headache: Systematic Review and Meta Analysis of Randomized Controlled Trials (긴장성두통에 대한 한약치료: 체계적 문헌고찰 및 메타분석)

  • Choi, Eun-Ji;Kwon, Chan-Young;Han, Kyung-Hun;Kim, Jong-Woo;Chung, Sun-Young
    • Journal of Oriental Neuropsychiatry
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    • v.26 no.4
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    • pp.383-406
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    • 2015
  • Objectives: People with tension-type headache generally take pain relievers, but long term dependency causes problems as well as side effects. The present study aimed to provide clinical evidence of herbal medicine for tension-type headache by systematic review of randomized controlled trials on the effect of herbal medicine for tension-type headache. Methods: Randomized or quasi-randomized controlled trials that verified effects of herbal medicine intervention on patients with tension-type headache were included in the study. A literature search of English, Japanese, Chinese, Korean databases was performed. The selected literature were assessed by Jadad scale and Risk of Bias. Results: Herein, 40 reports were selected from a total of 157. Meta-analyses of 2 trials indicated that the effective rate was significantly higher in the herbal medicine treatment group, as compared to the placebo control (risk ratio: 1.49, 95% confidence interval (CI): 1.23 to 1.80, p<0.0001, I2=0%). Four trials that compared herbal medicine with routine care with routine care only group showed a significantly higher effective rate of benefits for herbal medicine with routine care, as compared to routine care only (RR: 1.57, 95% CI: 1.18 to 2.10, p=0.002, I2=0%). Conclusions: The effective rate was significantly higher than control and adverse events were less in the treatment group. Pattern analysis (辨證) indicated that the studies on wind-fire pattern (風火證) were highest. Yougeun-bang (柔筋方) in prescription and Paeoniae Radix Alba (白芍藥) in medicinal herbs were most used. This finding could be widely utilized in future clinical practice and form the basis for the development of clinical practice guidelines in advance.

Integrative Study on PPARGC1A: Hypothalamic Expression of Ppargc1a in ob/ob Mice and Association between PPARGC1A and Obesity in Korean Population

  • Hong, Mee-Suk;Kim, Hye-Kyung;Shin, Dong-Hoon;Song, Dae-Kyu;Ban, Ju Yeon;Kim, Bum Shik;Chung, Joo-Ho
    • Molecular & Cellular Toxicology
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    • v.4 no.4
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    • pp.318-322
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    • 2008
  • Obesity is an increasing worldwide health problem that is strongly related to the imbalance of food intake and energy metabolism. It was well-known that several substances in the hypothalamus regulate food intake and energy metabolism. We planned an integrative study to elucidate the mechanism of the development of obesity. Firstly, to find candidate genes with the marvelous effect, the different expression in the hypothalamus between ob/ob and 48-h fasting mice was investigated by using DNA microarray technology. As a result, we found 3 genes [peroxisome proliferator activated receptor, gamma, coactivator 1 alpha (Ppargc1a), calmodulin 1 (Calm1), and complexin 2 (Cplx2)] showing the different hypothalamic expression between ob/ob and 48-h fasting mice. Secondly, a genetic approach on PPARGC1A gene was performed, because PPARGC1A acts as a transcriptional coactivator and a metabolic regulator. Two hundred forty three obese female patients with body mass index (BMI)${\geq}$25 and 285 control female subjects with BMI 18 to<23 were recruited according to the Classification of Korean Society for the Study of Obesity. Among the coding single nucleotide polymorphisms (cSNPs) of PPARGC1A, 2 missense SNPs (rs8192678, Gly482Ser; rs3736265, Thr612Met) and 1 synonymous SNP (rs3755863, Thr528Thr) were selected, and analyzed by PCR-RFLP and pyrosequencing. For the analysis of genetic data, chi-square ($X^2$) test and EH program were used. The rs8192678 was significantly associated with obese women (P<0.0006; odds ratio, 1.5327; 95% confidence interval, 1.2006-1.9568). Haplotypes also showed significant association with obese women ($X^2$=33.28, P<0.0008). These results suggest that PPARGC1A might be related to the development of obesity.

Influence of Radiologically Evident Residual Intimal Tear on Expansion of Descending Aorta Following Surgery for Acute Type I Aortic Dissection

  • Kim, Yun Seok;Kim, Jeong Heon;Kim, Joon Bum;Yang, Dong Hyun;Kang, Joon-Won;Hwang, Su Kyung;Choo, Suk Jung;Chung, Cheol Hyun
    • Journal of Chest Surgery
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    • v.47 no.1
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    • pp.6-12
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    • 2014
  • Background: Although a residual intimal tear may contribute to the dilatation of the descending aorta following surgical repair of acute type I aortic dissection (AD), its causal relationship has not been elucidated by clinical data due to the limited resolution of imaging modalities. Methods: This study enrolled 41 patients (age, $55.2{\pm}11.9$ years) who were evaluated with dual-source computed tomography (CT) imaging of the whole aorta in the setting of the surgical repair of acute type I AD. Logistic regression models were used to determine the predictors of a composite of the aortic aneurysm formation (diameter >55 mm) and rapid aortic expansion (>5 mm/yr). Results: On initial CT, a distal re-entry tear was identified in 9 patients. Two patients failed to achieve proximal tear exclusion by the surgery. Serial follow-up CT evaluations (median, 24.6 months; range, 6.0 to 67.2 months) revealed that 14 patients showed rapid expansion of the descending aorta or aortic aneurysm formation. A multivariate analysis revealed that the residual intimal tear (odds ratio [OR], 4.31; 95% confidence interval [CI], 1.02 to 19.31) and the patent false lumen in the early postoperative setting (OR, 4.64; 95% CI, 0.99 to 43.61) were predictive of the composite endpoint. Conclusion: The presence of a residual intimal tear following surgery for acute type I AD adversely influenced the expansion of the descending aorta.

Analytical Studies on the Rice Yield Component and Yield in South Region of Korea I. Variation in the Rice Yield Component and Yield under the Different Transplanting Dates. (남부지방에 있어서 수도수량구성요소 및 수량해석I. 재배시기에 따른 주요형질 및 수량의 변이)

  • 김용재;김규진
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.29 no.3
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    • pp.209-217
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    • 1984
  • This study was conducted to establish fundamental of rice cultivation system in the southern warm region of Korea by investigation of variation of yield component factor and yield under the different transplanting dates which was at interval of 15 days, from May 20 to July 5. In the variation of leaf age, the leaf of July 5 transplanting was less 1.1 leaves than that of May 20 transplanting in Seokwang. However in Dongjin, the leaf of May 20 transplanting was more 1.7 leaves than that of July 5. According to transplanting date delay, the shorten ratio of flag leaf was showed an increasing tendency. Period from transplanting to heading under the different transplanting in Seokwang, required about 75 days in May 20 transplanting and 68 days in June 5, 67 days in June 20, but 71 days in July 5, it was a cause of decrease in grain yield, because of increase in the period from transplanting to heading date. The maximum yield under the different transplanting gathered on May 20 transplanting in Seokwang variety, and on June 20 transplanting in Dongjin variety, and then, on the accumulated temperature 1017$\pm$24$^{\circ}C$ in Seokwang, 952$\pm$15$^{\circ}C$ in Dongjin, from 10 days before heading to 30 days after heading, it was appeared the high yield. It was showed linearly negative correlation between the No. of panicles per unit area and transplanting date (Seokwang; r=-0.6768$^{**}$, Dongjin: r=-0.5182$^{**}$). There were more differentiation of spikelets per panicle in the late transplanting in Seokwang, however in Dongjin, it was decreased in differentiation of spikelets per panicle in the early and the late transplanting.ing.

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Studies on the Growth and Change of Mineral Nutrient Contents in Ginseng (Panax ginseng) Plant During the Growing Process (인삼의 생육과 무기양분의 계절적 변화)

  • 이종철;안대진;변정수
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.32 no.4
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    • pp.471-475
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    • 1987
  • Some physiological analysis and the trend of a change in mineral nutrient contents in 2 years old ginseng plants were investigated for 10 times at 15 to 25 days interval from April 25th to October 10. The growth of leaf in size was completed by the beginning of June and that of stem in height by the late of June. The trend of a seasonal change in root weight showed a form of V letter, that is, the weight was de-creased until late of May and increased continuously thereafter up to September. However, the duration of root growth might be dependent on the defoliation. The growth of root in length begins from the beginning of June and stops in the beginning of August. Relative growth rate, net assimilation rate and crop growth rate were all negative values in just after shoot-emergence. The values showed a peak in May and decreased gradually thereafter. The leaf area ratio showed a peak of 76$\textrm{cm}^2$/g in May, and down to 30$\textrm{cm}^2$ /g in the beginning of October. The contents of nitrogen and potassium in aerial part of ginseng plants decreased at the late growing season, but increased on lime. No seasonal changes on phosphate and magnesium were observed. The contents of nitrogen, phosphate and potassium in root decreased rapidly at the maximum growing season for the aerial part and increased gradually thereafter. Whereas no changes on lime and magesium were observed during the growing season.

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Relationship between Physical Function Factors and Discrimination Experiences of the Elderly in Korea: The 2014 and 2017 National Survey on Living Conditions and Welfare Needs of Korean Older Persons (우리나라 노인의 신체기능 요인과 차별경험의 관련성 연구: 노인실태조사(2014, 2017) 자료 분석)

  • Lee, Kyuhee;Yong, Wangshik;You, Changhoon;Lee, Yongjae;Chung, Woojin
    • Health Policy and Management
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    • v.29 no.4
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    • pp.454-468
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    • 2019
  • Background: Supporting the elderly population is presented as a social issue, and it affects age discrimination, which forms a negative perception and avoids the elderly. Since age discrimination lowers the quality of life of the elderly and hinders social unity, it may be important to research related factors. This study examined the physical function as a factor that influences discrimination experiences and aimed to identify the relationship between physical function factors and discrimination experiences. Methods: In this study, we analyzed 20,225 elderly from the 2014 and 2017 survey of living conditions and welfare needs of Korean older persons, conducted nationwide among older than 65 years. Physical function factors are activities of daily living, instrumental activities of daily living, sight discomfort, hearing discomfort, chewing discomfort, and leg strength as factors of interest. We performed multivariable logistic regression that reflected survey characteristics, adjusting for socio-demographic factors, health related factors, and social-support factors. Results: The number of elderly who faced discrimination experiences was 1,175 (5.8%). The results showed that the odds ratio of facing a discrimination experience in the dependent group was significantly higher compared to the independent group when being transferring out of the room (4.05; 95% confidence interval [CI], 1.50-10.88) and difficulty in hearing (1.25; 95% CI, 1.05-1.49). Even with respect to chewing ability, which was significant in models 1 and 2, they face more discrimination experiences (1.30; 95% CI, 1.11-1.53). Conclusion: These research results indicate that an important strategy for preventing age discrimination is to understand the physical function conditions of the elderly and promote the physical functions of the elderly related to transferring, hearing, and chewing; it is necessary to develop a practical intervention plan that considers these aspects.

Association between Arthritis and Socio-Demographic Factors in Korean Elderlies: The National Survey of Korean Elderly (2014, 2017) Dataset Analysis (우리나라 노인의 관절염 유병과 인구사회적 요인의 관련성: 노인실태조사(2014, 2017) 자료 분석)

  • Ha, Woonkyung;Park, Kwankyu;Kim, Taehyun;Lee, Kyuhee;Lee, Yongjae;Chung, Woojin
    • Health Policy and Management
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    • v.29 no.4
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    • pp.469-481
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    • 2019
  • Background: As South Korea is becoming an aged society very rapidly, the increase in osteoarthritis prevalence raises various public health issues in this country. This study aimed to explore the socio-demographic factors associated with osteoarthritis in the current Korean elderlies. Methods: Using the National Survey of Korean Elderly data (2014, 2017), we analyzed 20,326 elderlies (males, 8,248; females, 12,078) and conducted multivariate logistic regression analyses by sex. The dependent variable is whether a participant was diagnosed with osteoarthritis or not. Independent variables of interest is socio-demographic factors such as age, marital status, household type, residential area, household income, religion, the longest job, the number of close relatives, the number of close friends, and survey year. Control variables are various health behavioral factors and disease-related factors. Results: Prevalence of osteoarthritis was 19.2% in male elderlies and 47.0% in female elderlies. According to the results of the multivariate logistic regression adjusted for all studied control variables, the odds ratio (OR) for having osteoarthritis of under-elementary school graduates (their counterpart was college graduate group) was 1.81 (95% confidence interval [CI], 1.29-2.52) in males and 1.67 (95% CI, 1.12-2.47) in females. The OR of those having a job in agriculture & forestry fishery as their longest job (their counterpart was those who had never participated in labor force during their lifetime) was 5.07 (95% CI, 1.46-17.58) in males and 1.49 (95% CI, 1.27-1.74) in females. In males, the second-low quartile group in household yearly income (their counterpart was the highest quartile group) had the OR of 1.22 (95% CI, 0.98-1.53). In females, the OR of those having a religion of Buddhism (their counterpart was those having no religion) was 1.20 (95% CI, 1.07-1.35) and the OR of those who had no relatives (their counterpart was those having more than 3 close relatives) was 1.31 (95% CI, 1.10-1.56). Conclusion: This study found that in Korean elderlies, education, the longest job, household income, religion, and the number of close relatives are associated with their suffering from osteoarthritis. Further study and designing appropriate interventions are needed to alleviate current and future individual and socioeconomic burdens of osteoarthritis in an aged society like South Korea.