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Determination of Short Term Prognosis Among Chronic Obstructive Lung Disease with Acute Respiratory Failure According to Simplified Acute Physiology Score (만성 폐쇄성 폐질환에서 급성 호흡부전 발생시 Simplifed Acute Physiology Score에 따른 단기예후의 평가)

  • Lee, Sang-Pyo;Sung, Yun-Up;Kim, Sang-Hoon;Kim, Bong-Sik;Kim, Young-Jun;Park, In-Won;Choi, Byung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.532-539
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    • 1993
  • Background: Physician's estimates of patient survival often influence clinical decisions, especially those near the end of life. In addition. clinical decisions frequently reflect trade-offs between morbidity and length of survival. As a result, accurate estimates of survival can be extremely useful in clinical decision. When the episode of acute respiratory failure in chronic obstructive lung disease, evaluation of the severity of the condition and short term prognosis is difficulit based on the available clinical or paraclinical data at the time of admission. Method: In this study, we performed a retrospective study in Chung Ang University Hospital, 74 patients (51 males, 23 females), who were hospitalized with chronic obstructive lung disease with acute respiratory failure from 1980 to 1992. We evaluated these patients to determine lung prognostic factors at time of admission in the Intensive Care Unit (ICU) that predict short term survival, and to determine the possible application of the Simplified Acute Phsiology Score (SAPS) to this population, All patients were treated with similar regimen during the hospitalization. Results: The results were as follows: 1) Hospital mortality was 34%(25/74 patients) and surival rate was 66%(49/74 patients) in COPD with acute respiratory failure. The prognosis of the older age was much poorer than those of the young age. 2) There was no difference in mortality according to the results of basal pulmonary test and arterial blood gas analysis. 3) The SAPS at admission was higher in those patients who expired(10.8) than the survived(6.5), and there was positive correlation between SAPS and mortality (r=0.91, p<0.05). 4) Prognostic factors in acute respiratory failure complicating COPD which were identifiable at time of admission to the ICU were as follows: cachexia, encephalopathy, serum creatinine and phosphate. Conclusion: In conclusion, the SAPS might have a good prognostic value for determination of short term survival among chronic obstructive lung disease with acute respiratory failure.

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Diagnosis of Malignant Pleural Effusion by using Aberrant Methylation of p16 and RARB2 (p16과 RARB2 유전자의 비정상적인 메틸화 검사를 이용한 악성 흉수의 진단)

  • Rha, Seo Hee;Lee, Su Mi;Koo, Tae Hyoung;Shin,, Bong Chul;Huh, Jung Hun;Um, Soo Jung;Yang, Doo Kyung;Lee, Soo-Keol;Son, Choonhee;Roh, Mee Sook;Bae, Ho-Jeong;Kim, Ki Nam;Lee, Ki Nam;Choi, Pil Jo
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.4
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    • pp.285-292
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    • 2008
  • Background: A diagnosis of malignant pleural effusion is clinically important, as the prognosis of lung cancer patients with malignant pleural effusion is poor. The diagnosis will be difficult if a cytological test is negative. This study was performed to investigate whether the detection of hypermethylation of the p16 (CDKN2A) and retinoic acid receptor b2 (RARB2) genes in pleural fluid is useful for a diagnosis of malignant pleural effusion. Methods: Pleural effusion was collected from 43 patients and was investigated for the aberrant promoter methylation of the RARB2 and CDKN2A genes by use of methylation-specific PCR. Results were compared with findings from a pleural biopsy and from pleural fluid cytology. Results: Of 43 cases, 17 cases of pleural effusion were due to benign diseases, and 26 cases were from lung cancer patients with malignant pleural effusion. Hypermethylation of the RARB2 and CDKN2A genes was not detected in the case of benign diseases, independent of whether or not the patients had ever smoked. In 26 cases of malignant pleural effusion, hypermethylation of RARB2, CDKN2A or either of these genes was detected in 14, 5 and 15 cases, respectively. The sensitivities of a pleural biopsy, pleural fluid cytology, hypermethylation of RARB2, hypermethylation of CDKN2A, or hypermethylation of either of the genes were 73.1%, 53.8%, 53.8%, 19.2%, and 57.7%, respectively; negative predictive values were 70.8%, 58.6%, 58.6%, 44.7%, and 60.7%, respectively. If both genes are considered together, the sensitivity and negative predictive value was lower than that for a pleural biopsy, but higher than that for pleural fluid cytology. The sensitivity of hypermethylation of the RARB2 gene for malignant pleural effusion was lower in small cell lung cancers than in non-small cell lung cancers. Conclusion: These results demonstrate that detection of hypermethylation of the RARB2 and CDKN2A genes showed a high specificity, and sensitivity was higher than for pleural fluid cytology. With a better understanding of the pathogenesis of lung cancer according to histological types at the molecular level, and if appropriate genes are selected for hypermethylation testing, more precise results may be obtained.

A Study of Job Satisfaction and Related Factors of the National Hospital Nurses (국립병원 간호사의 직무만족과 관련요인 연구)

  • Suh Gil-Hee;Kim Ok-Hee
    • Journal of Korean Public Health Nursing
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    • v.7 no.2
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    • pp.53-66
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    • 1993
  • By this time, a few of previous studies of factors related to separation from their jobs and job satisfaction only have dealt with the separation rate. the cause of separation and related factors that induce job satisfaction and incentive factors, the actualities of morale some suggestions for reduction of the separation rate. This study is attempted to determine factors that have effect on job satisfaction of national hospital nurses. and to proide information and materials for the development of the administration of nursing through the appreciation of factors influencing on job satisfaction between isolated ward nurses and general ward nurses working at national hospitals. 185 nurses of national hospitals responsed th this study, and were divided into two groups. Group 1: 57 nurses working at isolated wards for tuberculosis patients and Group 2 : 128 nurses at general wards. Relevant data were collected from August, 5, 1992 through August 20, 1992. The questionnaire consisted of 8 genalized items and 4 items concerning job satisfaction. The collected data were processed with SPSS, and the relationship among vaviables was analyzed by means of $X^2-test$, Pearson Correlation, Multiple Regression. The results of this study are as follows: 1. There is no significant difference between two groups in terms of generalized items. Age distributions show $44.3\%$ under the category of less than 34. and $55.7\%$ under the category more than 35, $19.3%$ was single and $74.6\%$ was married respectively. 2. $79.4\%$ of the nurses have the desire to have in-service education under the satisfactory physical environments such as welfare system, accommodating structures and facilities, instruments or management systems of the hospital, but under the category of unsatisfactory circumstances, $60.3\%$ have the intention of having in- service education. The concern in terms of in-service education shows statistically significant difference between two groups $(X^2=8.85,\;p<0. 05)$. This result accepts the hypothesis that good physical environments could intensify interests in service education. 3. The extent of satisfaction related to psychological environments is heightend according to good physical environments. In result, the hypothesis that the extent of satisfaction in terms of physical environments could raise satisfaction about psychological environment is accepted. 4. In the light of the extent of satisfaction about physical environments, $33.3\%$ of isolated ward nurses are satisfied with physical environments, but only $11.7\%$ of general ward nurses are satisfied. $(X^2=10.88,\; p<0.01)$. This result shows that the satisfaction degree about phusicalenvironments of isolated war nurses was higher than that of general ward nurses in spite of high physical and psychological risks due to exposure to infection. Consequently. the hypothesis was rejected that the satisfaction degree about physical environments would be lower in isolated ward nurses than in general ward nurses. 5. The fact that $87.7%$ of isolated ward nurses took interest in service education and $53.19\%$ of general ward nurses took interest in service education demonstrats that isolated ward nurse have more interest in service education than gerneral ward nurses. The result shows that the hypothesis is accepted that isolated ward nurses would have mor interests in service education than general ward nurses. 6. In the extent of satisfaction about physical environments such as morale human relationship promotion, there is no significant difference between two groups in terms of statistics. The hypothesis is rejected that satisfaction about psychologic environments would be high in isolated ward nurses than in general ward nurses. In conclusion. factors influencing on job satisfaction are considered to have effect on. another, and also interdisciplinary amelioration of factors accompanied with systematic inter cooperative investigation is necessary.

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Nursing Professor's inspection and Status of Patient's Records and Informed Consent for Clinical Practice of Nursing Student in Korea and Japan (한·일 간호대학생의 임상실습 시 환자의 설명동의 및 기록관리와 지도실태)

  • Cho, Yooh-Yang;Kim, In-Hong;Yamamoto, Fujie;Yamasaki, Fujiko
    • Journal of agricultural medicine and community health
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    • v.31 no.1
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    • pp.35-46
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    • 2006
  • Objectives: In recently. the management and protection on individual information in patient's medical & nursing records have been very important, and that need a guideline. The purpose of this study was to investigate the status of using the patient's nursing records of nursing students in clinical practice, to find and discuss the patient's informed consent, and status of education and management concerned to patient's nursing records. Methods: This study used a mailing survey. data collected from September 24th to October 31th in 2002. The subject were 333 professors who are major in adult nursing, pediatric nursing, psychological nursing of 111 university of nursing department and nursing college. And then we received the survey mail from 103 professors that respondent rate was 30.9%. Results: The characteristics of study subjects showed 49.0% of university. 51.0% of college of nursing. 50.0% of the subjects practiced point the patient by oral approval in clinical practice. But when the decision of the patient was very difficult, 21.6% of the subjects take to informed consent from his or her families. During the clinical practice, 49.0% of the subjects were explain to patient about clinical practice and contents of the nursing student, only 7.8% of the subjects were explain to patient with nursing records. 52.0% of the subjects were took out records from the hospital, only 17.6% of the subjects had standard of the patient's informed consent and standard of handling practice records. 17.6%-92.2% of the subjects that educate and manage concern to patient's nursing records.

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Compact Orthomode Transducer for Field Experiments of Radar Backscatter at L-band (L-밴드 대역 레이더 후방 산란 측정용 소형 직교 모드 변환기)

  • Hwang, Ji-Hwan;Kwon, Soon-Gu;Joo, Jeong-Myeong;Oh, Yi-Sok
    • The Journal of Korean Institute of Electromagnetic Engineering and Science
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    • v.22 no.7
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    • pp.711-719
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    • 2011
  • A study of miniaturization of an L-band orthomode transducer(OMT) for field experiments of radar backscatter is presented in this paper. The proposed OMT is not required the additional waveguide taper structures to connect with a standard adaptor by the newly designed junction structure which bases on a waveguide taper. Total length of the OMT for L-band is about 1.2 ${\lambda}_o$(310 mm) and it's a size of 60 % of the existing OMTs. And, to increase the matching and isolation performances of each polarization, two conducting posts are inserted. The bandwidth of 420 MHz and the isolation level of about 40 dB are measured in the operating frequency. The L-band scatterometer consisting of the manufactured OMT, a horn-antenna and network analyzer(Agilent 8753E) was used STCT and 2DTST to analysis the measurement accuracy of radar backscatter. The full-polarimetric RCSs of test-target, 55 cm trihedral corner reflector, measured by the calibrated scatterometer have errors of -0.2 dB and 0.25 dB for vv-/hh-polarization, respectively. The effective isolation level is about 35.8 dB in the operating frequency. Then, the horn-antenna used to measure has the length of 300 mm, the aperture size of $450{\times}450\;mm^2$, and HPBWs of $29.5^{\circ}$ and $36.5^{\circ}$ on the principle E-/H-planes.

A Review on Ultimate Lateral Capacity Prediction of Rigid Drilled Shafts Installed in Sand (사질토에 설치된 강성현장타설말뚝의 극한수평지지력 예측에 관한 재고)

  • Cho Nam Jun;Kulhawy F.H
    • Journal of the Korean Geotechnical Society
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    • v.21 no.2
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    • pp.113-120
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    • 2005
  • An understanding of soil-structure interaction is the key to rational and economical design for laterally loaded drilled shafts. It is very difficult to formulate the ultimate lateral capacity into a general equation because of the inherent soil nonlincarity, nonhomogeneity, and complexity enhanced by the three dimensional and asymmetric nature of the problem though extensive research works on the behavior of deep foundations subjected to lateral loads have been conducted for several decades. This study reviews the four most well known methods (i.e., Reese, Broms, Hansen, and Davidson) among many design methods according to the specific site conditions, the drilled shaft geometric characteristics (D/B ratios), and the loading conditions. And the hyperbolic lateral capacities (H$_h$) interpreted by the hyperbolic transformation of the load-displacement curves obtained from model tests carried out as a part of this research have been compared with the ultimate lateral capacities (Hu) predicted by the four methods. The H$_u$ / H$_h$ ratios from Reese's and Hansen's methods are 0.966 and 1.015, respectively, which shows both the two methods yield results very close to the test results. Whereas the H$_u$ predicted by Davidson's method is larger than H$_h$ by about $30\%$, the C.0.V. of the predicted lateral capacities by Davidson is the smallest among the four. Broms' method, the simplest among the few methods, gives H$_u$ / H$_h$ : 0.896, which estimates the ultimate lateral capacity smaller than the others because some other resisting sources against lateral loading are neglected in this method. But it results in one of the most reliable methods with the smallest S.D. in predicting the ultimate lateral capacity. Conclusively, none of the four can be superior to the others in a sense of the accuracy of predicting the ultimate lateral capacity. Also, regardless of how sophisticated or complicated the calculating procedures are, the reliability in the lateral capacity predictions seems to be a different issue.

A Study of Family Caregiver's Burden for the Terminally III Patients (지역사회 말기질환자 가족 부담감에 관한 연구)

  • Han, Sung-Suk;Ro, You-Ja;Yang, Soo;Yoo, Yang-Sook;Kim, Sek-Il;Hwang, Hee-Hyung
    • Journal of Home Health Care Nursing
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    • v.10 no.1
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    • pp.58-72
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    • 2003
  • The purpose of this study was to describe the perceived burden of the terminally III patients's caregiver and to analyze relationship between the perceived burden and the various demographics, illness characteristics, family relationships, and economic factor of the family & patients. The sample of 132 caregivers who care for the terminally III patients Kyung-Gi province, Seoul, Korea. The period of this study was from August to September, 2002. The perceived burden of the family caregiver was measured by the burden scale(20 items, 4 point scale) developed by Montgomery et al. (1985). The Data was analyzed using SAS-program by t-test and ANOVA. The results were as follows; 1. The mean of the family caregiver's burden score was 3.02. The score showed that caregivers perceive severe the level of burden. The hight items of the family caregiver's burden were' I feel it is painful to watch patient's diseases'(3.77). 'I feel afraid for what the future holds for my patients'(3.66), 'I feel it reduced to amount of privacy time'(3.64). 2. The caregiver's burden was significantly related to patient's gender(F=3.17, p= 0.0020), patient's job(F=2.49, p=0.0476), caregiver's age(F=4.29, p=0.0030), and caregiver's job(F=2.49, p=0.0476). 3. The caregiver's burden according to illness characteristics showed no significant difference. 4. The caregiver's burden was significantly associated with patient's family relationship (F=4.05, p=0.0041), patient's care mean period in a day(F=47.18,

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Effects of activators contained in adhesives on dentin bond strengths (상아질 접착제에 포함된 활성제의 사용 유무가 자가중합 복합레진의 상아질에 대한 전단결합강도에 미치는 영향)

  • Kang, Hye-Kyung;Shin, Joo-Hee;Suh, Kyu-Won;Ryu, Jae-Jun
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.5
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    • pp.511-519
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    • 2008
  • Statement of problem: An incompatibility between the initiator systems of self-curing composite resins and light-curing adhesives was supposed recently. Purpose: The purpose of the study was to evaluate the influence of activators for self/dual bonding on dentin shear bonding strengths. Material and methods: Fifty human molars were divided into 5 groups. A flat dentin surface was created for each tooth. A self-curing composite resin (Luxacore) was bonded with the following adhesives (n = 10); One-Step, Prime&Bond NT, AdheSE, Prime&Bond NT and AdheSE were also used in combination with activators. Shear bond strengths were measured after 24 hours of water storage. The specimens were loaded in shear in the Instron until failure at a 1 mm/min crosshead speed. Data were compared using one-way ANOVA and Tukey HSD test (${\alpha}$= 0.05). Results: The dentin adhesive systems in order of decreasing median bond strength were One-Step > Prime&Bond NT with activator, AdheSE with activator > Prime&Bond NT, AdheSE. Among adhesives, One-Step had the highest bond strength. Prime&Bond NT with activator had higher bond strengths than Prime&Bond NT that was used alone, and so was AdheSE. Conclusion: Shear bond strengths were increased in Prime&Bond NT and AdheSE when these were used with activators comparing used without activators. But using activators was not effective clinically comparing One-Step.

AN EXPERIMENTAL STUDY ON THE TENSILE STRENGTH OF POSTERIOR RESIN-BASED COMPOSITES (구치부 복합레진의 인장강도에 관한 실험적 연구)

  • Kim, Jae-Gon;Lee, Yong-Hee;Yang, Cheol-Hee;Baik, Byeong-Ju
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.3
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    • pp.464-470
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    • 2001
  • The purpose of this study was to evaluate the tensile strength of light-cured restorative posterior resin-based composites. Five commercially available light-cured composites(Denfil : DF, P60 : PS, Unifil S : US, Z100 : ZH, Z250 : ZT) were used. Rectangular tension test specimens were fabricated in a teflon mold giving 5mm in gauge length and 2mm in thickness. Specimens were subjected to the 5,000 thermal cycles between $5^{\circ}C$ and $55^{\circ}C$ and the immersion time in each bath was 15 second per cycle. Tensile testing was carried out with Instron at a crosshead speed of 0.5mm/min and fractured surface were observed with scanning electron microscope. The obtained results were summarized as follows; 1. The tensile strength of PS was highest. PS was significantly higher than DF, US and ZH(p<0.05) but in the case of ZT was similar to PS(p>0.05). 2. The tensile strength DF was lowest. DF was significantly lower than PS, US, ZH and ZT(p<0.05). 3. The tensile strength of US and ZH were significantly lower than PS and ZT(p<0.05). but were significantly higher than DF(p<0.05). The tensile strength of US and ZH were similar(p>0.05).

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Density Dependent Growth of Scapharca satowi in the West Coast of Korea (큰이랑피조개 Scapharca satowi의 양성 밀도별 성장)

  • 송홍인;박광재;조영록;박영제
    • Journal of Aquaculture
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    • v.15 no.3
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    • pp.145-155
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    • 2002
  • Effect of density (30, 40, 65, 90 or 120/cage) of lantern and bottom cages on growth of the ark shell, Scapharca satowi was studied in the Korean west coast from April 2000 to October 2001, when the following range of environmental conditions prevailed : temperature : 4.2 -25.5 $^{\circ}C, salinity : 30.23-32.$15\textperthousand, dissolved oxygen : 5.12-7.16 $ml$/l, pH : 7.84-8.17, phosphate : 0.22-0.56 $\mu $M, dissolved inorganic nitrogen : 3.16-9.10 $\mu $M, suspended solid : 7.6-17.9 mg/l, chemical oxygen demand: 0.46-1.61 mg/l and chlorophyll-a : 0.92-5.93 $\mug/l. Daily growth rate of shell length ranged from 0.066 to 0.071 mm/day for the lantern net cages, and from 0.079 to 0.082 mm/day for the bottom cages. Total weight also ranged from 0.067 to 0.082 g/day in the lantern net cages, as against 0.099 to 0.114 g/day in the bottom cages. Hemoglobin content of S. satowi (55 mm shell length), which was about 3.9 g/dl during february, 2001, increased to 6.0 and 7.0 g/dl during October, 2001 in animals culture in the lantern and bottom cages, respectively. ANOVA test of the growth rate showed that the growth rate of S. satowi, was significantly dependent on rearing density and the tested culture methods (P < 0.0001). The daily growth rate of the shell length was more significantly correlated with water temperature; the growth rate of shell length and total weight showed a tendency decrease with decreasing temperature. In cages suspended at the bottom, not only the increase shell weight but also the meat obtainable from comparable sized S. satowi was greater. Survival decreased with increasing density and was optimal at the density of 30 individual/cage.