• Title/Summary/Keyword: Risk Weight

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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 Significance of Maturation Score of Brain Magnetic Resonance Imaging in Extremely Low Birth Weight Infant (초극소 저체중 출생아의 뇌 MRI 상 Maturation Score의 의의)

  • Song, In-Gu;Kim, Su-Yeong;Kim, Cur-Rie;Kim, Yoon-Joo;Shin, Seung-Han;Lee, Seung-Hyun;Lee, Jae-Myoung;Lee, Ju-Young;Kim, Ji-Young;Sohn, Jin-A;Lee, Jin-A;Choi, Chang-Won;Kim, Ee-Kyung;Cheon, Jung-Eun;Kim, Woo-Sun;Kim, Han-Suk;Kim, Byeong-II;Kim, In-One;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.310-319
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    • 2011
  • Purpose: The aim of this study was to investigate the effect of perinatal risk factors on brain maturation and the relationship of brain maturation and neurodevelopmental outcomes with brain maturation scoring system in brain MRI. Methods: ELBWI infants born at the Seoul National University Children's Hospital from January 2006 to December 2010 were included. A retrospective analysis was performed with their medical record and brain MR images acquired at near full term. We read brain MRI and measured maturity with total maturation score (TMS). TMS is a previously developed anatomic scoring system to assess brain maturity. The total maturation score was used to evaluate the four parameters of maturity: (1) myelination, (2) cortical infolding, (3) involution of glial cell migration bands, and (4) presence of germinal matrix tissue. Results: Images from 124 infants were evaluated. Their mean gestational age at birth was 27.1${\pm}$2.1 weeks, and mean birth weight was 781.5${\pm}$143.9 g. The mean TMS was 10.8${\pm}$2.0. TMS was significantly related to the postmenstrual age (PMA) of the infant, increasing with advancing postmenstrual age (P<0.001). TMS showed no significance with neurodevelopmental delay, and with brain injury, respectively. Conclusion: TMS was developed for evaluating brain maturation in conventional brain MRI. The results of this study suggest that TMS was not useful for predicting neurodevelopmental delay, but further studies are needed to make standard score for each PMA and to re-evaluate the relationship between brain maturation and neurodevelopmental delay.

A Study on Sexual Function of Women with Coronary Artery Disease (관상동맥질환 여성의 성기능에 관한 연구)

  • Kim, Choon Shim;So, Hyang Sook
    • Korean Journal of Adult Nursing
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    • v.12 no.1
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    • pp.99-111
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    • 2000
  • The purpose of this study was to identify risk factors related to sexual function of women with coronary artery disease, and to determine the predictors of sexual function. The study design, a descriptive correlational study, was done through structural questionnaire and interview. A total of 50 subjects from C University Hospital at Kwang-ju city who have undergone coronary angiography at department of cardiology were observed and interviewed from Feb. 22, 1999 to March. 23, 1999. The number of affected vessels, the level of total serum cholesterol, and the ejection fraction of 2-D echo cardiography were analyzed to evaluate the severity of coronary artery disease. And also type A behavior pattern, health behavior, Brief Index of Sexual Functioning for Women (BISF-W) were measured. The data obtained were analyzed using percentage, mean and standard deviation, t-test, ANOVA, Pearson's correlation coefficient, and stepwise multiple regression analysis via SPSS PC+. The results of this study were as follows: 1. The mean age of the subjects were 58.1 and 72.0% of those have been married over 30 years. Seventy two percentage were unemployed and monthly family income of 56.6% was less than 1,000,000 won (approximately $ 840). Eighty percent were in their postmenopausal state, and the frequency of sexual intercourse of 84.0% were two to three times per month. 2. The scores of type A behavior pattern were from 16 to 38(mean 24.94) and health behavior ranged from 21 to 43(mean 31.2). Abstinence from smoking, alcohol, and caffeine were best compliant factors and weight control and exercise were least abided ones. The result of 2D-ECHO EF showed that the half of the subjects were abnormal, and 24% had more than 240mg/dl of total serum cholesterol. The coronary angiography showed that 64% of the subjects had more than one affected vessels. 3. The predictors to explain the factor score of 'orgasm' were number of health examination, the pre- or post-menopausal state, protestant, number of coronary vessel affected, level of serum total cholesterol, and comorbid group of hypertension and diabetes, and it's total variance accounted for 52.4%. The predictors to explain the factor score of 'sexual activity' were comorbid group of hypertension and diabetes and type A behavior pattern, which accounted for 22.4% of total variance. The predictors to explain the factor score of 'sexual satisfaction' were type A behavior pattern, no religion, exercise, level of serum total cholesterol, and pre or post menopausal state, which accounted for 52.1%. The predictors to explain the factor score of 'sexual desire' were the period of marriage, type A behavior, employment or unemployment, and weight control, which accounted for 43.2%. The predictors to explain the factor score of 'external force of sexual functioning' were physical overload and exercise, which accounted for 41.1%. The predictors to explain the factor score of 'sexual activity' were family monthly income, catholics, and exercise, and which accounted for 35.4%. Above results lead us to some consensus that sexual function of women with coronary artery disease is related to various factors including vasogenic factors such as total serum cholesterol level, number of coronary vessel affected, an endocrinal factor such as menopausal state, and type A behavior pattern as a sociopshychological factor. And also health behaviors such as fitness care, overwork, weight control, and emotional tension are contributed to sexual function.

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Anti-Obesity Effect of Red Garlic Composites in Rats Fed a High Fat-Cholesterol Diet (고지방-콜레스테롤 식이성 흰쥐에서 홍마늘 복합물의 항비만 효과)

  • Lee, Soo-Jung;Hwang, Cho-Rong;Kang, Jae-Ran;Shin, Jung-Hye;Kang, Min-Jung;Sung, Nak-Ju
    • Journal of Life Science
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    • v.22 no.5
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    • pp.671-680
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    • 2012
  • Three kinds of dietary composites-R+T, R+F, and R+TF-were combined in green tea (T), dietary fiber (F), and green tea dietary fiber mixture (TF) to red garlic extract (RG), respectively. The effects of their diets on anti-obesity were investigated $in$ $vitro$ and $in$ $vitro$ in obese rats induced high fat-cholesterol. In $in$ $vivo$ rats, the total phenolic content of the R+T and R+TF was 1.9~2.0 times higher, and their total cholesterol adsorption was 9.5~11.5 times higher than that of RG. $In$ $vivo$, male Sprague-Dawley rats were divided into 6 groups (Normal, HFC, HRG, HR+T, HR+F and HR+TF). Afterwards, the diets of the HRG, HR+T, HR+F, and HR+TF groups were supplemented with 1% of RG and its dietary composites (R+T, R+F, and R+TF) for 4 weeks, respectively. The final body weight of the HRG, HR+T, HR+F, and HR+TF groups decreased significantly compared to the group fed high fat-cholesterol (HFC), but the food efficiency ratio was not significantly different from the HFC group. The liver weight of the HFC group doubled compared to the normal group, whereas that of HR+T and HR+TF groups decreased significantly. The weight of visceral and epididymal fat decreased significantly in the groups fed the composites compared to the HFC group. The obesity index of HR+TF group decreased significantly only when compared to the HFC group. The serum lipid profile such as total lipids, cholesterol, triglyceride, LDL- and VLDL-cholesterol, as well as the atherogenic index and cardiac risk factors decreased drastically in all experimental groups compared to the HFC group, and the levels of HR+T, HR+F and HR+TF groups were a similar trend. GPT activity was not significantly different among the groups fed the composites, and it decreased significantly in the HRG group. The content of the lipid peroxide level decreased significantly in the HRG group and in the groups fed the composites, compared to the HFC group. Serum antioxidant activity was the highest in the HR+T group. We suggest that the hypolipidemic and anti-obesity effect of the RG composites, achieved by mixing green tea extract and/or dietary fiber, was due to their total phenolic content and total cholesterol adsorption effect.

Regional Analysis on the Incidence of Preterm and Low Birth Weight Infant and the Current Situation on the Neonatal Intensive Care Units in Korea, 2009 (2009년 한국 시도별 미숙아, 저체중출생아의 빈도 및 신생아중환자실의 현황)

  • Kang, Byung-Ho;Jung, Kyung-A;Hahn, Won-Ho;Shim, Kye-Shik;Chang, Ji-Young;Bae, Chong-Woo
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.70-75
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    • 2011
  • Purpose: Recently, the incidence of preterm and low birth weight infants (LBWI) is increasing, even though the birth rate is continuously low in Korea. Despite that change, there continues to be a deficit of beds in the neonatal intensive care unit (NICU). This study is based on the 2009 Korean Statistical Information Service that examined the development of a Korean NICU service and the survival rate of preterm infants by regionally analyzing the rate of total live births, preterm infants, LBWI, and NICU beds in Korea. Methods: Data were obtained from the Korean Health Insurance Review and Assessment Service and Korean Statistical Information Service. We confirmed the regional total live birth rate, number of LBWI, and preterm infants and NICU numbers, and all of the results were compared to the average value to determine deficient areas of NICU beds. Results: There were 25,374 (5.7%) preterm infants and 21,954 (4.9%) LBWI in the total number of live births (444,849) in 2009, and regions of high proportion compared to the mean value were Busan, Daegu, and Ulsan. Total NICU beds totaled 1,284, and regions of high rates preterm infants and LBWI per 1 NICU bed compared to the mean value were Incheon, Daegu, Ulsan, etc. The NICU holding rate was 87.5% (1,284/1,468), which was increased from 2005. However, there were still shortages of 184 NICU beds (12.5%), especially in Gyeonggi-do, which lacked 157 beds. Conclusion: High risk neonates difficult to transfer, and they need immediate and continuous treatment. As a result, a foundation of well-balanced, national NICU regionalization is necessary. This study suggested that more NICU facilities must be implemented, and clinicians should realize the continuing deficiency of NICU beds in cities and provinces.

Analysis of prognostic factors of laparotomy for necrotizing enterocolitis in extremely low birth weight infants (괴사성 장염으로 수술한 초극소저체중출생아(<1,000 g)의 예후인자 분석)

  • Kim, Jin Kyu;Kim, Yi Sun;Yoo, Hye Soo;Ahn, So Yoon;Seo, Hyun Ju;Choi, Seo Heui;Park, Soo Kyung;Jung, Yu Jin;Kim, Myo Jing;Jeon, Ga Won;Koo, Soo Hyun;Lee, Kyung-Hoon;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.167-172
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    • 2010
  • Purpose : With improved survival of extremely low birth weight infants (ELBWI), there is an increase in the incidence of necrotizing enterocolitis (NEC) requiring laparotomy, and the risk of morbidity and mortality in these ELBWI is increased. Thus, we determined the prognostic factors in ELBWI who underwent laparotomy for NEC. Methods : We retrospectively reviewed the medical records of 35 ELBWI who underwent laparotomy for NEC from January 2001 to December 2008 at Samsung Medical Center. Results : Of 480 ELBWI, 35 required laparotomy for NEC; the mortality rate was 20% (Alive group n=28, Dead group n=7). The values of preoperative score for neonatal acute physiology-II (P =0.022) and fraction of inspired oxygen (P <0.001) were significantly higher in the dead group and values of base excess (P =0.004) were significantly lower in the dead group. Values of preoperative heart rate, respiration rate, mean blood pressure, pH, $CO_2$, and potassium ion were not significantly different between the study groups. Intraoperative fluid volume was significantly higher in the alive group than in the dead group (P =0.045). Postoperative infusion rate was significantly lower in the alive group than in the dead group (P =0.022). Conclusion : Good preoperative condition, more intraoperative fluid infusion, and stable postoperative hemodynamic condition were factors associated with favorable prognosis of laparotomy for NEC in ELBWI.

Plasma Levels of High Molecular Weight Adiponectin are Associated with Cardiometabolic Risks in Patients with Hypertension (고혈압 환자에서 혈장 고분자량 아디포넥틴 농도와 심장-대사위험인자와의 관련성 연구)

  • Chung, Hye-Kyung;Shin, Min-Jeong
    • Journal of Nutrition and Health
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    • v.41 no.8
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    • pp.733-741
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    • 2008
  • In the present study, we comprehensively examined the associations of plasma levels of total adiponectin and high molecular weight (HMW) adiponectin with the features of cardiometabolic risks including body fat distribution, dyslipidemia, insulin resistance and inflammatory markers in a cross-sectional study of 110 treated hypertensive patients. Blood lipid profiles, high sensitivity C-reactive protein (hsCRP) and homeostasis model assessment of insulin resistance (HOMA- IR) derived from fasting glucose and insulin concentrations were determined. Plasma levels of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), interleukin-6 (IL-6) and intercellular adhesion molecule-1 (ICAM-1) were analyzed using ELISA. The results showed that plasma levels of HMW-adiponectin were negatively associated with body mass index (BMI, r = - 0.203, p < 0.05) and waist circumference (r = -0.307, p < 0.01), which was not shown in total adiponectin. Plasma levels of HMW-adiponectin were negatively associated with triglyceride (r = -0.223, p < 0.05) and positively associated with HDL-cholesterol (r = 0.228, p < 0.05). Plasma levels of adiponectin were positively associated with HDL-cholesterol (r = 0.224, p < 0.05). Plasma levels of HMW-adiponectin were negatively associated with hsCRP (r = -0.276, p < 0.01) and IL-6 (r = -0.272, p < 0.01). In addition, there were weak associations between plasma levels of HMWadiponectin and TNF-${\alpha}$ (r = -0.163, p = 0.07) and ICAM-1 (r = -0.158, p = 0.09). However, there were no significant associations of total adiponectin with inflammatory markers except hsCRP (r = -0.203, p < 0.05). Stepwise multiple linear regression analysis showed that only plasma levels of HMW-adiponectin was an independent factor influencing serum levels of hsCRP, a marker of systemic low grade inflammation, after adjusting for age, gender, BMI, waist circumference, alcohol intake, smoking status, blood lipids, total adiponectin and drug use (p < 0.01). These results suggest that HMW-adiponectin, rather than total adiponectin, is likely to be closely associated with the features of cardiometabolic risks in treated hypertensive patients and might be effective biomarker for the prediction of cardiovascular disease.

The Relationship of the Severity of Sleep Apnea Syndrome to the Resting Energy Expenditure and Leptin (수면무호흡증의 중증도와 안정시 에너지 대사 및 혈중 Leptin과의 관계)

  • Lee, Kwan-Ho;Shin, Kyeong-Cheol;Ahn, Jae-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.836-845
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    • 1999
  • Background : Obesity is present in the majority of adult patients with obstructive sleep apnea(OSA) and is considered to be a major risk factor for its development. A reduction in body weight has been associated with substantial improvement in the severity of apnea. However, a variety of treatment strategies for obesity have yielded limited sucess. This study was done to determine resting energy expenditure(REE) in patients with obstructive sleep apnea and the correlation between the severity of sleep apnea and REE, and to investigate whether leptin influences REE and correlated with the severity of sleep apnea in 39 patients with OSA and 45 controls matched for obesity. Method : Overnight polysomnography was performed on all subjects using standard techniques. Measurements of REE were made using a Sensormedic Vmax 229 and a canopy system. Serum leptin concentration was measured by human leptin RIA kit of LINCO Research INC. Results : REE was greater in patients with OSA compared with controls, but there was no difference between the two groups on REE%. And also there was no significant correlation between anthropometric data, polysomnographic data and REE%. Serum leptin was linearly related to body mass index(BMI), apnea index, apnea hypopnea index and lowest arterial oxygen saturation($SaO_2$) but not related to REE%. Conclusion : This study suggests the followings. Firstly patients patients with sleep apnea have a pattern of obesity characterized by energy homeostasis at an elevated body weight set-point. In order to achieve a lower body weight in these patients, it may be necessary to increase energy expenditure by increasing physical activity. Secondly leptin level was not correlated with REE, suggesting that leptin may predominantly regulate body fat by altering eating behavior rather than calorigenesis. Lastly leptin level was significantly correlated with the severity of sleep apnea. These elevated level of leptin in patients of sleep apnea may be related to the obesity, however it needs further studies to determine the relationship between the severity of sleep apnea and serum leptin.

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Effects of Cutivation Method and Planting Date in Growth and Yield of Momordica charantia L. in Spring Season (여주 봄 작형의 재배방법과 정식기가 생육과 수량에 미치는 영향)

  • Son, Dong-Mo;Kim, Seong-Jun;Kim, Hyo-Joong;Kim, Hee-Gon;Yun, Bong-Ki;Jung, Jong-Mo;Lee, Jeong-hyun
    • Journal of Bio-Environment Control
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    • v.25 no.3
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    • pp.200-205
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    • 2016
  • This study was conducted in order to investigate the effects that the difference of planting time by a method of cultivation in the non-heated greenhouse and the open field with spring planting had on growth and yield. With regard to the tested variety of Momordica charantia, variety 'Dragon' (Japan Yae 農藝) was selected. And 3 treatments on March 20, April 5 and April 20 for the greenhouse cultivation and 3 treatments on April 20, May 5 and May 20 for the open-field cultivation 1 month later than those for the greenhouse cultivation were planted by the randomized complete block design, and 4 secondary vines were trained. In the results of examining 15-day average atmospheric temperature after planting according to the methods of greenhouse and open-field cultivation and planting time, it was shown that there was a tendency for atmospheric temperature inside the greenhouse to decrease as the planting time was moved up. In particular, the average atmospheric temperature was $16.7^{\circ}C$ when seedling was planted on April 20 in the open-field cultivation, which was approximately equal to $17.0^{\circ}C$ of the average atmospheric temperature when a seedling was planted on March 20 in the greenhouse cultivation. With regard to the date of first harvest by the method of cultivation, it was shown that there was a tendency for the date of first harvest to be earlier in the greenhouse cultivation than in the open-field cultivation, and the date of first harvest was moved up as a seedling was planted earlier for the planting period. The number and weight of harvested fruits per plant showed a tendency which was almost similar to that of total number of harvest days and number of harvests. Thus, the number of fruits was 189 and the weight of fruits was 31,649g in case of the greenhouse cultivation and planting on March 20, which were maximum. In case of planting on the latest planting date : May 20 in the open-field cultivation, the number of fruits was 77 and the weight of fruits was 12,502g, which were at a level of 40% of those of planting on March 20 in the greenhouse cultivation 2 months earlier. The total yield per 10a was 10,228kg in the greenhouse cultivation and was 2.2 times as heavy as 4,607kg in the open-field cultivation with regard to the method of cultivation. For the planting period in the greenhouse cultivation, it was 10,539kg and 10,517kg in planting on March 20 and April 5, which was higher by 9% than 9,629kg in planting on April 20. And in the open-field cultivation, it was 4,785kg in planting on April 20 and 4,872kg in planting on May 5, which was higher by 15~17% than 4,163kg in planting on May 20. Taking the above results into account, it is considered proper to plant Momordica charantia from March 20 to April 5 for the greenhouse cultivation and from April 20 to May 5 or thereabouts when a risk of late frost is gone for the open-field cultivation in southern area.

Effects of Medicinal Enzyme Powder on Intestinal Mobility, Lipid Level, and Blood Parameters of Loperamide-Induced Constipation in Rats (약선효소 분말식이가 Loperamide의 투여로 유발된 변비 쥐의 장 운동과 지질 함량 및 혈액학적 성분 변화에 미치는 영향)

  • Park, Chan Sung;Park, Kyung Soo;Kim, Mi Lim;Kong, Hyun Joo;Yang, Kyung Mi
    • Journal of Life Science
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    • v.23 no.2
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    • pp.228-236
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    • 2013
  • This study was aimed at investigating whether dietary therapy using medicinal enzyme powder is effective in reducing constipation caused by loperamide in rats. Nine-week-old male Sprague Dawley were subdivided into 4 groups: normal diet group (C), loperamide treatment and normal diet (CL), medicinal enzyme powder diet (E), and loperamide treatment and medicinal enzyme powder diet (EL). Constipation was induced by subcutaneous injection of loperamide (1.5 mg/kg) 3 days prior to sacrifice. The treatment with loperamide led to an increase in weight gain, a decrease in the number and wet weight of fecal pellets, and a decrease in intestinal motility. The administration of the medicinal enzyme powder significantly reduced weight gain but increased intestinal mobility compared with the loperamide-treated group. The treatment with loperamide in the normal diet group reduced the activities of both suggesting that constipation may be involved in the low level of glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT). Additionally, the loperamide treatment in the medicinal enzyme powder diet group increased the level of GOT, but reduced the level of GPT. Loperamide treatment also reduced cholesterol and increased the atherogenic index (AI) and cardiac risk factors (CRFs). Interestingly, the treatment with the medicinal enzyme powder effectively attenuated both the increase in AI and the reduction in high density lipopretein (HDL)-cholesterol, caused by the treatment with loperamide. Although there were no significant differences in the blood protein level, including hemoglobin and hematocrit, between the normal diet group and the loperamide-treated group, the administration of the medicinal enzyme powder to the loperamide-treated group effectively increased the levels of both hemoglobin and hematocrit. Collectively, the results demonstrate that the medicinal enzyme powder can help to combat the negative events caused by constipation.